Decoding the drivers of healthcare utilization: The role of illness burden, lifestyle and household factors in rural North Karnataka, India

<h2>Abstract</h2><h3>Background</h3> Healthcare utilization in rural India remains uneven despite expansion of public health infrastructure. Identifying factors associated with healthcare-seeking is essential to strengthen service delivery. This study assessed the burden of illness and examined household, lifestyle, and health-related factors associated with healthcare utilization in rural North Karnataka. <h3>Methods</h3> A community-based cross-sectional study was conducted among 1400 adults selected through a cluster-stratified sampling design. Healthcare utilization was defined as at least one visit to a formal healthcare facility within the preceding six months. Data were collected using a structured questionnaire. Multivariable logistic regression with cluster-adjusted robust standard errors was used to identify factors associated with healthcare utilization. <h3>Results</h3> Approximately two-thirds of participants reported healthcare utilization within the previous six months. In adjusted analyses, the presence of an elderly household member (AOR: 3.42; 95% CI: 2.15–5.43), hypertension (AOR: 2.18; 95% CI: 1.41–3.36), and diabetes mellitus (AOR: 1.61; 95% CI: 1.10–2.35) were independently associated with higher healthcare utilization. Ever use of tobacco was associated with lower utilization (AOR: 0.69; 95% CI: 0.50–0.96). Disability status was not independently associated after adjustment. <h3>Conclusion</h3> Healthcare utilization in rural North Karnataka was primarily associated with household context and chronic disease burden rather than individual demographic characteristics. These findings highlight population groups that may benefit from targeted health education, chronic disease management, and outreach services. Longitudinal studies are warranted to further examine causal pathways.