Health-Seeking Behavior for Noncommunicable Diseases in Rural and Urban Areas of Ernakulam District, Kerala: A Cross-Sectional Study

Background: Health-seeking behavior (HSB) is a crucial determinant of population health and reflects how individuals recognize symptoms and utilize healthcare services. Differences between rural and urban populations influence the management of non-communicable diseases (NCDs), particularly in states like Kerala, where health indicators are high, yet inequities persist. Objective: To compare patterns and determinants of health-seeking behavior among adults with NCDs in rural and urban areas of Ernakulam district, Kerala. Methods: A community-based cross-sectional comparative study was conducted in the field practice areas of Amrita Urban Health Centre (Kaloor) and Amrita Community Health Training Centre (Njarackal). Adults aged ≥ 18 years with NCDs such as diabetes, hypertension, thyroid disorders, and cardiovascular diseases were included. Data were collected using a semi-structured questionnaire and analyzed with JAMOVI v2.5.7. Descriptive statistics and chi-square tests were used; p < 0.05 was considered significant. Results: A total of 168 participants (84 rural, 84 urban) were studied. In rural areas, 54.8% preferred government facilities, whereas 75% of urban residents utilized private or tertiary centers (p < 0.001). Rural residents were 3.63 times more likely to seek care from government hospitals (95% CI 1.89-6.99). Allopathy was the predominant system of treatment (96.4% rural, 95.2% urban). Cost, availability, and accessibility were major determinants influencing the choice of facility. Rural participants depended more on public transport (33.3%) than urban residents (14.3%). Both groups showed high satisfaction levels (≥ 80%). Conclusion: Urban residents demonstrated more proactive health-seeking behavior, largely due to better access, literacy, and economic resources. Rural populations continue to rely on public healthcare and face constraints related to transportation, affordability, and awareness. Focused interventions are needed to improve accessibility and continuity of NCD care in rural areas.