Religious group differences in non-communicable disease risk factors in India: A cross-sectional study of adults aged 45 and older

This study highlights the underexplored differences in the prevalence and distribution of noncommunicable disease (NCD) risk factors among Hindu, Muslim, Christian, and Sikh Indian adults aged 45 and older. Using nationally representative data from 54,601 participants in the Longitudinal Ageing Study in India (2017–2018), we investigated nine NCD risk factors by sex: hypertension, abdominal adiposity, diabetes, tobacco use, excessive alcohol consumption, physical inactivity, poor sleep hygiene, household air pollution exposure, and elevated C-reactive protein (CRP) levels. The multilevel regression analyses we conducted yielded novel findings (reference: Hindu men and women). Muslim men and women had a higher risk of high abdominal adiposity (adjusted odds ratio (aORmen) = 1.33 [ 95% confidence interval: 1.17–1.52]; aORwomen = 1.60 [1.42–1.81]), diabetes (aORmen = 1.24 [1.08–1.42]; aORwomen = 1.40 [1.24–1.59]), and physical inactivity (aORmen = 1.20 [1.06–1.36]; aORwomen = 1.49 [1.31–1.70]). Additionally, Muslim women were more likely to be hypertensive (aOR = 1.20 [1.09, 1.32]) and have elevated CRP levels (aOR = 1.23 [1.07–1.42]). Sikh men and women had increased odds of abdominal adiposity (aORmen = 2.01 [1.52–2.66]; aORwomen = 2.11 [1.45–3.08]). Sikh men were also more likely to be hypertensive (aOR = 1.31 [1.03–1.68]). Both Christian men and women showed lower odds of poor sleep hygiene (aORmen = 0.72 [0.59, 0.89]; aORwomen = 0.71 [0.61, 0.84]), with Christian men also being less likely to have diabetes (aOR = 0.67 [0.56–0.81]). Hindu adults reported higher exposure to household air pollution. Public health stakeholders in India need to be informed about these disparities to guide prevention efforts, and the factors driving these disparities require further study.