Choropleth Mapping of Lifestyle Diseases in India

Prevalence and Treatment-Seeking Patterns Using NHFS-5 Data

  • Harsh Kedia The Shriram Millennium School, Noida, India
Keywords: Epidemiological Mapping, NFHS-5, Lifestyle Diseases, Non-Communicable Diseases (NCDs), Healthcare Resource Allocation

Abstract

Lifestyle diseases such as asthma, thyroid diseases, heart diseases, cancer, and kidney diseases are caused due to poor diet, stress, physical inactivity, and environmental factors. These non-communicable diseases (NCDs) pose a significant public health challenge as they account for over 60% of all deaths in India. This study aims to geographically map the prevalence and treatment-seeking behaviour related to major lifestyle diseases in Indian states using data from NFHS-5, which will help healthcare stakeholders to obtain actionable insights for resource allocation and disease management. Raw data from the National Family Health Survey-5 (2019–21) were analysed to extract state-wise and district-wise prevalence of asthma, thyroid disorders, heart disease, cancer, and kidney disease. Variables studied also include the percentage of individuals seeking treatment post-diagnosis. Choropleth maps were created to visualize geographic concentration patterns and regional disparities across the country. The analysis reveals significant geographical disparities in the prevalence of NCDs across India. Mizoram consistently emerges as a multi-disease hotspot, ranking among the top five most affected states across all diseases. Kerala is particularly notable for being the most plagued state for both asthma and thyroid disorders. Regional clustering is also observed, with Ladakh and Jammu & Kashmir leading the nation in prevalence for heart disease and cancer. Treatment-seeking behaviour is inconsistent: while some high-burden states like Kerala and Tamil Nadu have robust healthcare engagement, others like Mizoram and Ladakh lag significantly despite severe disease prevalence. This study identifies high burden and low treatment-seeking areas for key lifestyle diseases. Geographically tailored and targeted interventions by policymakers, healthcare companies, and social impact startups could be developed using the study, which are essential for ensuring equitable healthcare and mitigating the growing burden of non-communicable diseases across India.

References

A Study of salt and fat Consumption pattern in Regional Indian diet among hypertensive and dyslipidemic PaTients - SCRIPT study. (2016, December 1). PubMed. https://pubmed.ncbi.nlm.nih.gov/28405988/

American Lung Association. (n.d.). What causes asthma? https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/learn-about-asthma/what-causes-asthma

Anjana, R. M., Unnikrishnan, R., Deepa, M., Pradeepa, R., Tandon, N., Das, A. K., Joshi, S., Bajaj, S., Jabbar, P. K., Das, H. K., Kumar, A., Dhandhania, V. K., Bhansali, A., Rao, P. V., Desai, A., Kalra, S., Gupta, A., Lakshmy, R., Madhu, S. V., . . . Ghosh, S. (2023). Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17). The Lancet Diabetes & Endocrinology, 11(7), 474–489. https://doi.org/10.1016/s2213-8587(23)00119-5

Banerjee, B., & Banerjee, B. (2024, December 2). Heavy metal contamination in Leh’s groundwater linked to rising cancer cases, reveals BSIP study. Free Press Journal. https://www.freepressjournal.in/india/heavy-metal-contamination-in-lehs-groundwater-linked-to-rising-cancer-cases-reveals-bsip-study

Biswal, S. K., Mohanta, V. L., Verma, P., Singh, P. K., & Department of Environmental Science and Engineering, Indian School of mines, Dhanbad-826004, Jharkhand, India. (2016). Evaluation of Water Quality Pollution Indices for part of Bokaro District, Jharkhand. In International Journal of Engineering Research & Technology (IJERT): Vol. Vol. 5 Issue 02, February-2016 [Journal-article]. https://www.ijert.org/research/evaluation-of-water-quality-pollution-indices-for-part-of-bokaro-district-jharkhand-IJERTV5IS020629.pdf

Bloom, D. E., Jr., Cafiero, E. T., Jané-Llopis, E., Abrahams-Gessel, S., Bloom, L. R., Fathima, S., Feigl, A. B., Gaziano, T., Mowafi, M., Pandya, A., Prettner, K., Rosenberg, L., Seligman, B., Stein, A. Z., Weinstein, C., World Economic Forum, & Harvard School of Public Health. (2011). The global economic burden of noncommunicable diseases. World Economic Forum. https://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf

Bowe, B., Xie, Y., Li, T., Yan, Y., Xian, H., & Al-Aly, Z. (2017). Particulate matter air pollution and the risk of incident CKD and progression to ESRD. Journal of the American Society of Nephrology, 29(1), 218–230. https://doi.org/10.1681/asn.2017030253

Causes and Triggers | NHLBI, NIH. (2024, April 17). NHLBI, NIH. https://www.nhlbi.nih.gov/health/asthma/causes

Causes of cancer and reducing your risk. (2025, January 24). Cancer Research UK. https://www.cancerresearchuk.org/about-cancer/causes-of-cancer

Causes of chronic kidney disease in adults. (2025, August 12). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/causes

CEICdata.com. (2023, October 11). India Government Hospital: GoA: Average population served per hospital bed. https://www.ceicdata.com/en/india/health-infrastructure-government-hospital-beds/government-hospital-goa-average-population-served-per-hospital-bed

CEICdata.com. (2024, August 12). India Government Hospital: Kerala: Number of hospital beds. https://www.ceicdata.com/en/india/health-infrastructure-government-hospital-beds/government-hospital-kerala-number-of-hospital-beds

Chitnis, P. (2017, December 5). Why Kanpur’s tanneries are at the centre of a fight to save the Ganga. NDTV Profit. https://www.ndtvprofit.com/business/why-kanpurs-tanneries-are-at-the-centre-of-a-fight-to-save-the-ganga

Comptroller and Auditor General of India. (2022). Performance Audit of Air Pollution Control by Government of Gujarat. In Report. https://cag.gov.in/uploads/icisa_it_reports/Performance-Audit-of-Air-Pollution-Control-by-GoG-Report-No-02-of-2022-0632d8a52067c30-27727299-0664c5ed2d6bbf5-43951617.pdf

Darshan, A. J. (2020, March 6). India’s health care delivery and the burden of lifestyle diseases. Primedeq-Blog. https://www.primedeq.com/blog/indias-health-care-delivery-and-the-burden-of-lifestyle-diseases/

Dileep V Kumar. (2020, August 20). Thyroid cancer cases on the rise in Kerala. The New Indian Express. https://www.newindianexpress.com/states/kerala/2020/Aug/20/thyroid-cancer-cases-on-the-rise-in-kerala-2185746.html

Economics of NCDs. (2024, October 30). PAHO/WHO | Pan American Health Organization. https://www.paho.org/en/topics/economics-ncds

Eilat-Adar, S., Mete, M., Fretts, A., Fabsitz, R., Handeland, V., Lee, E., Loria, C., Xu, J., Yeh, J., & Howard, B. (2012). Dietary patterns and their association with cardiovascular risk factors in a population undergoing lifestyle changes: The Strong Heart Study. Nutrition Metabolism and Cardiovascular Diseases, 23(6), 528–535. https://doi.org/10.1016/j.numecd.2011.12.005

Environmental pollution and kidney disease. (n.d.). National Kidney Foundation. https://www.kidney.org/news-stories/environmental-pollution-and-kidney-disease?utm_source=chatgpt.com

Facts about chronic kidney Disease. (n.d.). National Kidney Foundation. https://www.kidney.org/kidney-topics/chronic-kidney-disease-ckd

FaST FaCTs: Health and economic costs of chronic conditions. (2024, July 12). Chronic Disease. https://www.cdc.gov/chronic-disease/data-research/facts-stats/index.html

Ferranna, M., Cadarette, D., Chen, S., Ghazi, P., Ross, F., Zucker, L., & Bloom, D. E. (2023). The macroeconomic burden of noncommunicable diseases and mental health conditions in South America. PLoS ONE, 18(10), e0293144. https://doi.org/10.1371/journal.pone.0293144

Ferrari, S. M., Fallahi, P., Antonelli, A., & Benvenga, S. (2017). Environmental issues in thyroid diseases. Frontiers in Endocrinology, 8. https://doi.org/10.3389/fendo.2017.00050

Ganie, M. A., Charoo, B. A., Sahar, T., Bhat, M. H., Ali, S. A., Niyaz, M., Sidana, S., & Yaseen, A. (2020). Thyroid function, urinary iodine, and thyroid antibody Status among the tribal population of Kashmir Valley: data from endemic zone of a Sub-Himalayan region. Frontiers in Public Health, 8. https://doi.org/10.3389/fpubh.2020.555840

Goa Population 2025 | Sex Ratio & Literacy rate 2025. (n.d.). https://www.census2011.co.in/census/state/goa.html

Gu, W., Xie, D., Li, Q., Feng, H., Xue, Y., Chen, Y., Tang, J., Zhou, Y., Wang, D., Tong, S., & Liu, S. (2024). Association of humidity and precipitation with asthma: a systematic review and meta-analysis. Frontiers in Allergy, 5. https://doi.org/10.3389/falgy.2024.1483430

Home | Pradhan Mantri National Dialysis Programme,. (n.d.). https://pmndp.mohfw.gov.in/en

Ians. (2018, October 13). In Ladakh, sedentary lifestyle and UV rays are giving rise to numerous cases of cancer. Indiatimes. https://www.indiatimes.com/news/india/in-ladakh-sedentary-lifestyle-and-uv-rays-are-giving-rise-to-numerous-cases-of-cancer-354727.html?utm_source=chatgpt.com

IJFANS International Journal of Food and Nutritional Sciences. (n.d.). https://www.ijfans.org/

India Today. (2024, October 29). Medical drone launched at AIIMS Andhra, to transport samples between hospitals. https://www.indiatoday.in/india/andhra-pradesh/story/medical-drone-service-launched-guntur-reduce-travel-time-rural-healthcare-phcs-hospitals-2625274-2024-10-29

India’s govt hospital bed-population ratio dismally low at 0.79:1,000. (2024, December 17). https://medicalbuyer.co.in/indias-govt-hospital-bed-population-ratio-dismally-low-at-0-791000/

Innes, J. K., & Calder, P. C. (2020). Marine omega-3 (N-3) fatty acids for cardiovascular health: An update for 2020. International Journal of Molecular Sciences, 21(4), 1362. https://doi.org/10.3390/ijms21041362

It, N. (n.d.). NFHS. https://www.nfhsiips.in/nfhsuser/nfhs5.php

Kalarani, I. B., & Veerabathiran, R. (2022). Impact of iodine intake on the pathogenesis of autoimmune thyroid disease in children and adults. Annals of Pediatric Endocrinology & Metabolism, 27(4), 256–264. https://doi.org/10.6065/apem.2244186.093

Kalita, K. (2022, June 9). Northeast has highest prevalence of alcohol and tobacco consumption in India: Survey. The Times of India. https://timesofindia.indiatimes.com/city/guwahati/ne-has-highest-prevalence-of-alcohol-and-tobacco-consumption-in-country-survey/articleshow/92092054.cms

Kalita, K. (2023, March 10). Delay in diagnosis leading to rise in kidney failures in NE: Experts. The Times of India. https://timesofindia.indiatimes.com/city/guwahati/delay-in-diagnosis-leading-to-rise-in-kidney-failures-in-ne-experts/articleshow/98531507.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

Khetan, M., & Babu, B. V. (2025). Silicosis prevalence and related issues in India: a scoping review. Journal of Occupational Medicine and Toxicology, 20(1). https://doi.org/10.1186/s12995-024-00445-2

Kidney failure. (2025, June 2). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17689-kidney-failure

KPMG, Pillai, A. M., KPMG Advisory Services Private Limited, Kumar, S., & KPMG Advisory Services Private Limited. (2024). Kerala Medical Value Travel Vision 2030 (By CII, CII, & CII). https://assets.kpmg.com/content/dam/kpmg/in/pdf/2024/08/kerala-medical-value-travel-vision-2030.pdf

Kshirsagar, M. V., & Ashturkar, M. D. (2022). Prevalence of lifestyle diseases in Maharashtra: A comparison between NFHS-5 and NFHS-4 surveys. Journal of Family Medicine and Primary Care, 11(6), 2474–2478. https://doi.org/10.4103/jfmpc.jfmpc_1944_21

Kulothungan, V., Mascarenhas, L., Das, P., & Mathur, P. (2024). District-level epidemiology and sociodemographic determinants of noncommunicable diseases - results the National Family Health Survey −5 (2019–21). Diabetes & Metabolic Syndrome Clinical Research & Reviews, 18(7), 103085. https://doi.org/10.1016/j.dsx.2024.103085

Ladakh, V. O. (2022, February 4). Cancer awareness and Prevalent risk factors in Ladakh. Voice of Ladakh. https://voiceofladakh.in/2022/02/cancer-awareness-prevalent-risk-factors-in-ladakh/?utm_source=chatgpt.com

Mallet, R. T., Burtscher, J., Richalet, J., Millet, G. P., & Burtscher, M. (2021). Impact of high altitude on cardiovascular health: Current perspectives. Vascular Health and Risk Management, Volume 17, 317–335. https://doi.org/10.2147/vhrm.s294121

Manda Ravinder Reddy. (2025, January 1). Fluoride contamination alarmingly high in Telangana: Jal Shakti report. The New Indian Express. https://www.newindianexpress.com/states/telangana/2025/Jan/01/fluoride-contamination-alarmingly-high-in-telangana-jal-shakti-report

Marriott, B. M., & Carlson, S. J. (1996). Physiology of cold exposure. Nutritional Needs in Cold and in High-Altitude Environments - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK232852/

Mathew, I. E., & Mathew, A. (2017). Rising thyroid cancer incidence in Southern India: an epidemic of overdiagnosis? Journal of the Endocrine Society, 1(5), 480–487. https://doi.org/10.1210/js.2017-00097

Ministry of Health & Family Welfare-Government of India. (n.d.). National Programme for prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & stroke (NPCDCS) :: National Health Mission. https://nhm.gov.in/index1.php?lang=1&level=2&sublinkid=1048&lid=604

Nair, R. R. K., Rajan, B., Akiba, S., Jayalekshmi, P., Nair, M. K., Gangadharan, P., Koga, T., Morishima, H., Nakamura, S., & Sugahara, T. (2008). BACKGROUND RADIATION AND CANCER INCIDENCE IN KERALA, INDIA—KARANAGAPPALLY COHORT STUDY. Health Physics, 96(1), 55–66. https://doi.org/10.1097/01.hp.0000327646.54923.11

Ni, R., Su, H., Burnett, R. T., Guo, Y., & Cheng, Y. (2024). Long-term exposure to PM2.5 has significant adverse effects on childhood and adult asthma: A global meta-analysis and health impact assessment. One Earth. https://doi.org/10.1016/j.oneear.2024.09.022

Noncommunicable diseases | Knowledge Action Portal on NCDs. (n.d.). https://knowledge-action-portal.com/en/content/noncommunicable-diseases

Panicker, V. (2011, November 1). Genetics of thyroid function and Disease. https://pmc.ncbi.nlm.nih.gov/articles/PMC3219766/

Pulipaka, B., Pulipaka, B., & Chronicle, D. (2025, January 11). Deccan Chronicle. Deccan Chronicle. https://www.deccanchronicle.com/southern-states/telangana/nitrate-laced-ground-water-everywhere-in-telangana-1853572

Raghuram, S., Ponnada, B., & Keechilat, P. (2019). Rising thyroid cancer incidence in Kerala: Is it real or over diagnosis? Journal of Clinical Oncology, 37(15_suppl), e17589. https://doi.org/10.1200/jco.2019.37.15_suppl.e17589

Rai, B., & Bramhankar, M. (2021). Tobacco use among Indian states: Key findings from the latest demographic health survey 2019–2020. Tobacco Prevention & Cessation, 7(March), 1–2. https://doi.org/10.18332/tpc/132466

Rana, R. K., Jha, R. R., Sinha, R., Kumar, D., Jaiswal, R., Patel, U., Prasad, J. B., Kar, S. S., & Goel, S. (2024). Correlates of diabetes mellitus and hypertension in India: Change as evidenced from NFHS- 4 and 5 during 2015–2021. PLoS ONE, 19(7), e0305223. https://doi.org/10.1371/journal.pone.0305223

Salt Department-HO. (n.d.). https://saltcomindia.gov.in/SIP_IodineDeficiencyDisorders.aspx

Sethi, J., Anandh, U., & Jha, V. (2024). Nature’s Cure or kidney curse? The nephrotoxic potential of Indigenous remedies. Indian Journal of Nephrology, 35, 335–342. https://doi.org/10.25259/ijn_321_2024

Sharma, M., Gaidhane, A., & Choudhari, S. G. (2024). A comprehensive review on trends and patterns of non-communicable disease risk factors in India. Cureus. https://doi.org/10.7759/cureus.57027

Sharma, M., & Majumdar, P. (2009). Occupational lifestyle diseases: An emerging issue. Indian Journal of Occupational and Environmental Medicine, 13(3), 109. https://doi.org/10.4103/0019-5278.58912

Shylla, L., Barik, S. K., Behera, M. D., Singh, H., Adhikari, D., Upadhyay, A., Thapa, N., Sarma, K., & Joshi, S. R. (2021). Impact of heavy metals on water quality and indigenous Bacillus spp. prevalent in rat-hole coal mines. 3 Biotech, 11(5). https://doi.org/10.1007/s13205-021-02808-6

Singh, K. (2017, April 17). Is Over Diagnosis Leading To An Increase In Thyroid Cancer Cases In Kerala? NDTV Health Matters. https://sites.ndtv.com/healthmatters/is-over-diagnosis-leading-to-an-increase-in-thyroid-cancer-cases-in-kerala-1667/

Status of Goitre or thyroid disorders in India. (n.d.). https://www.pib.gov.in/PressReleasePage.aspx?PRID=1796440

Takale, G., Handore, A., Jeyakumar, A., & Godbharle, S. (2024). Prevalence and determinants of multiple chronic conditions (MCC) among young adults in Indian households: an analysis of NFHS-5. Journal of Health Population and Nutrition, 43(1). https://doi.org/10.1186/s41043-024-00560-0

Teo, K. K., Ounpuu, S., Hawken, S., Pandey, Valentin, V., Hunt, D., Diaz, R., Rashed, W., Freeman, R., Jiang, L., Zhang, X., & Yusuf, S. (2006). Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: a case-control study. The Lancet, 368(9536), 647–658. https://doi.org/10.1016/s0140-6736(06)69249-0

The economic impact of non-communicable disease in China and India: Estimates, projections, and comparisons (Report No. 7563). (2013). IZA. https://docs.iza.org/dp7563.pdf (Original work published 2013)

The Global Asthma Report 2022. (n.d.). https://globalasthmareport.org/regions/india.php

Varma, P. P. (2015, June 1). Prevalence of chronic kidney disease in India - Where are we heading? https://pmc.ncbi.nlm.nih.gov/articles/PMC4446915/

Veedu, J. S., & Mathew, A. (2018). Are we missing the elephant in the room? A case for thyroid cancer overdiagnosis as the etiology for its increasing incidence in India. Journal of Global Oncology, 4, 1–3. https://doi.org/10.1200/jgo.18.00177

Website, N. (2025a, August 8). Cancer. nhs.uk. https://www.nhs.uk/conditions/cancer/

Website, N. (2025b, August 22). Causes. nhs.uk. https://www.nhs.uk/conditions/coronary-heart-disease/causes/

Wikipedia contributors. (2025a, July 30). Nun kun. Wikipedia. https://en.wikipedia.org/wiki/Nun_Kun

Wikipedia contributors. (2025b, August 19). Demographics of Kerala. Wikipedia. https://en.wikipedia.org/wiki/Demographics_of_Kerala

Wikipedia contributors. (2025c, August 26). Chenab River. Wikipedia. https://en.wikipedia.org/wiki/Chenab_River

World Health Organization: WHO. (2024, December 23). Noncommunicable diseases. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases

World Health Organization: WHO. (2025a, February 3). Cancer. https://www.who.int/news-room/fact-sheets/detail/cancer

World Health Organization: WHO. (2025b, July 31). Cardiovascular diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-%28cvds%29

Published
2025-09-17
How to Cite
Kedia, H. (2025). Choropleth Mapping of Lifestyle Diseases in India. International Journal of Social Science Research and Review, 8(9), 298-320. https://doi.org/10.47814/ijssrr.v8i9.2931