Spatial evidence-based study on cardiometabolic risk among Indian adults

Cardiometabolic risk (CMR) is driven by the co-occurrence of hypertension, diabetes, and obesity, which are associated with multiple factors; however, spatial evidence-based studies on CMR remain limited in India. This study examines the socioeconomic and behavioral determinants of CMR and their spatial heterogeneity using the National Family Health Survey-5 (2019–21) of India, comprising 653,610 adults aged 18 to 49 years. The results shows that overall 21.67 percent of Indian adults had CMR, with the highest prevalence among adults aged 40 to 49years, men, individuals from smaller family size, wealthier households, those with only primary education, belong to general caste, Muslims, urban residents, tobacco users and those who consumes alcohol. A global Moran’s I of 0.29 (p < 0.001) indicates a significant clustering of CMR across districts. Further, SaTScan cluster analysis identified four statistically significant high CMR clusters located in northeastern, southern, and northern India, while the bivariate local indicators of spatial association (LISA) map also shows significant spatial correlations between CMR with socioeconomic and behavioral factors. These findings highlight the geographical disparities of CMR and underscore the need for targeted district-level interventions, including early screening for CMR, improvements in socioeconomic conditions, health services, health education, awareness, and sedentary lifestyles.