Urban–rural Disparities in Modifiable Behavioral and Metabolic Risk Factors of Noncommunicable Diseases: Insights from a Hilly Region of North India

Summary Non-communicable diseases (NCDs) are an increasing public health concern in India. A cross-sectional study was conducted among NCD patients attending outpatient clinics in two urban and two rural health centers in the Shimla district of Himachal Pradesh to investigate urban-rural differences in the prevalence of modifiable behavioral and metabolic risk factors. Hypercholesterolemia (≥200 mg/dL) and elevated diastolic blood pressure (≥90 mmHg) were significantly more prevalent among urban participants. In contrast, rural participants had greater exposure to second-hand smoke and lower intake of fruits and vegetables. These findings underscore the need for targeted interventions tailored to the place of residence to address risk factors for NCDs.