Social factors associated with chronic non-communicable disease and comorbidity with mental health problems in India: a scoping review

Abstract

ObjectivesThe purpose of this study is to examine the existing literature of the major social risk factors which are associated with diabetes, hypertension and the comorbid conditions of depression and anxiety in India.DesignScoping review.Data sourcesScopus, Embase, CINAHL Plus, PsycINFO, Web of Science and MEDLINE were searched for through September 2019.Eligibility criteria for selecting studiesStudies reporting data on social risk factors for diabetes or hypertension and depression or anxiety in community-based samples of adults from India, published in English in the 10 years to 2019, were included. Studies that did not disaggregate pooled data from other countries were excluded.Data extraction and synthesisTwo independent reviewers extracted study aims; methods; sample size and description; demographic, social and behavioural risk factors and a summary of findings from each paper. Risk factors were synthesised into six emergent themes.ResultsTen studies were considered eligible and included in this review. Nine presented cross-sectional data and one was a qualitative case study. Six themes emerged, that is, demographic factors, economic aspects, social networks, life events, health barriers and health risk behaviours.ConclusionsLiterature relating to the major social risk factors associated with diabetes, hypertension and comorbid depression and anxiety in India is sparse. More research is required to better understand the interactions of social context and social risk factors with non-communicable diseases and comorbid mental health problems so as to better inform management of these in the Indian subcontinent.

Social and behavioural risk factors in the prevention and management of cardiovascular disease in Kerala, India: a catchment area population survey

“…It is possible that there are social and other risk factors that impact on risk factor management and which we have [15]. In addition, we have used measures which have been widely validated in India.…”

“…The epidemiological transition found in India, characterized by increasing urbanization and increased affluence, is related to the increase in degenerative and lifestyle-related diseases such as hypertension and diabetes [14]. Also, factors such as poverty, poor social networks and adverse life events all act as barriers to the effective management of NCDs such as hypertension and diabetes, as well as the commonly associated co-morbid mental health issues such as depression and anxiety [15].…”

“…These include behavioural risk factors such as alcohol misuse and cigarette smoking [18]. A recent scoping review examining social risk factors as related to NCDs in India found only 10 studies where social factors were documented or considered in the context of NCDs [15]. This review found that factors such as demographics, poverty, social networks, life events, health barriers and health risk behaviours were associated with poor management of diabetes and hypertension, as well as the co-morbidities of depression and anxiety in India [15].…”

“…A recent scoping review examining social risk factors as related to NCDs in India found only 10 studies where social factors were documented or considered in the context of NCDs [15]. This review found that factors such as demographics, poverty, social networks, life events, health barriers and health risk behaviours were associated with poor management of diabetes and hypertension, as well as the co-morbidities of depression and anxiety in India [15]. From this it is clear that there is currently a lack of data about the inter-relationship between social, behavioural and traditional risk factors in India.…”

Swāsthya, an integrated chronic condition management programme for families of patients with hypertension and diabetes mellitus: a study protocol for a randomised controlled trial

“…The absence of evidence highlights the need to develop a contextually relevant and theoretically driven intervention model for a community population. This intervention is modelled on the basis of the results of several phases of intervention development, namely scoping review [11], community survey [9], rapid systematic review, and qualitative interviews with patients with HTN or DM and health professionals in the community health ecosystem. This stakeholder-driven model explores behavioural, social, and cognitive factors clustered within individuals, families, and communities in Kerala.…”