Religious disparities in health in Bangladesh–the case of hypertension and diabetes: evidence from two nationally representative cross-sectional surveys

Abstract

ObjectivesReligious affiliation, beliefs, and practices shape lifestyles and disease risks. This study examined Hindu–Muslim differences in the prevalence and management of hypertension and diabetes in Bangladesh, a religiously plural country with 91% Muslims and 8% Hindus.Design, settings and participantsWe used the nationally representative 2011 Bangladesh Demographic and Health Survey (BDHS) and 2017–2018 BDHS data. The 2011 BDHS collected blood pressure (BP) data with an 89% response rate (RR) and fasting blood glucose (FBG) data (RR 85%) from household members aged 35 years and above. The 2017–2018 BDHS collected BP and FBG data from household members aged 18 years and above with 89% and 84% RRs, respectively. We analysed 6628 participants for hypertension and 6370 participants for diabetes from the 2011 BDHS, 11 449 for hypertension and 10 744 for diabetes from the 2017–2018 BDHS.MethodsWe followed the WHO guidelines to define hypertension and diabetes. We used descriptive statistics and multiple logistic regression to examine the Hindu–Muslim differences in hypertension and diabetes, and estimated predicted probabilities to examine the changes in hypertension and diabetes risk over time.ResultsNine in 10 of the sample were Muslims. About 31% of Hindus and 24% of Muslims were hypertensive; 10% of both Hindus and Muslims were diabetic in 2017–2018. The odds of being hypertensive were 45% higher among Hindus than Muslims (adjusted OR: 1.45; 95% CI: 1.23 to 1.71; p<0.001). The levels of awareness, medication and control of hypertension were similar between the religious groups. Between the 2011 and 2017–2018 BDHS, the Hindu–Muslim difference in the prevalence of hypertension increased non-significantly, by 3 percentage points.ConclusionsFurther studies on religious-based lifestyles, Hindu–Muslim differences in diet, physical activity, stress, and other risk factors of hypertension and diabetes are needed to understand Hindus’ higher likelihood of being hypertensive, in contrast, not diabetic compared with Muslims.

Adult mortality trends in Matlab, Bangladesh: an analysis of cause-specific risks

“…Women, in contrast, appear to be more likely to seek healthcare, more likely to adhere to preventive interventions and thus more likely to achieve the associated survival benefits 9. However, women are also more likely to be hypertensive or overweight than men,28 31 and thus are more likely to carry higher risk of dying from NCDs.…”

“… 23 Over the course of this study, we found that higher mortality among non-Muslims was due to higher mortality from stroke and heart disease, but not from other causes. A recent study 31 showed that non-Muslims have a significantly higher risk of elevated BP or hypertension than Muslims. And hypertension is a strong risk factor for stroke and heart disease, thus explaining the higher non-Muslim mortality when compared with Muslims.…”

Religious minority identity associates with stress and psychological health among Muslim and Hindu women in Bangladesh and London

“…Regarding health disparities between religious groups in Bangladesh, higher rates of hypertension have been found among religious minorities (Haider et al, 2023), and psychological distress has been suggested as a potential mechanism for the increased hypertension among religious minority women (Datta & Chowdhury, 2022). Hossain and colleagues (2022) found that religious minorities in Bangladesh have a higher likelihood of chronic disabling illness and higher out-of-pocket expenditure for care.…”