Rural-urban differentials in prevalence of non-communicable diseases (NCDs) and its contextual determinants in India: a secondary data analysis of the 75th round of NSSO (2017-18)

Non-communicable diseases (NCDs) have emerged as a leading cause of morbidity and mortality in India, with significant disparities across socioeconomic and geographic groups. This study examines rural-urban differences in the prevalence of NCDs and investigates the key determinants and contextual factors contributing to these disparities. The study analyzed data from 555,352 individuals using the 75th round of the National Sample Survey (2017–2018). Bivariate analysis and binary logistic regression were conducted to examine the prevalence and determinants of NCDs, and Blinder–Oaxaca decomposition method was applied to quantify rural–urban disparities. The findings reveal significant rural-urban disparities in the prevalence of NCDs in India. Cardiovascular and endocrine diseases are more prevalent in urban regions, whereas respiratory, musculoskeletal, gastrointestinal, and psychiatric diseases are more common in rural areas. Regional variations are also evident, with individuals in Southern [OR: 2.14; CI: 1.94–2.37] and Eastern [OR: 1.69; CI: 1.52–1.87] regions more likely to be affected by NCDs. The elderly, females, Christians, other caste groups, and the affluent face a higher risk of NCDs in both settings. The decomposition analysis shows rural–urban differences in NCD prevalence are primarily driven by Southern region (19.5%), highest MPCE tertile (19.0%), other social groups (16.4%), and individuals with higher secondary education and above (7.1%). These findings underscore the need for targeted interventions that focus on vulnerable groups by improving healthcare access, strengthening prevention and treatment efforts, enhancing social support systems, promoting lifestyle modifications, and raising public awareness to address the growing burden of NCDs.