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ORIGINAL ARTICLE Table of Contents   
Year : 2020  |  Volume : 45  |  Issue : 2  |  Page : 139-144
Socioeconomic inequalities in clustering of health-compromising behaviours among Indian adolescents

1 Department of Non-Communicable Diseases and Health Policy, Public Health Foundation of India, Gurgaon, Haryana, India
2 Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Melbourne, Adelaide, Australia
3 Center for Life Course Health Research, University of Oulu, Oulu, Finland
4 Department of Epidemiology and Public Health, University College London, London, United Kingdom

Correspondence Address:
Dr. Manu Raj Mathur
Public Health Foundation of India, Plot No. 47, Institutional Area, Sector 44, Gurgaon - 122 002, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijcm.IJCM_349_19

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Background: The simultaneous occurrence of health-compromising behaviors can accentuate the risk of noncommunicable diseases (NCDs). This study aimed to examine the existence and patterns of clustering of four NCD risk behaviors among adolescents and its association with social position. In addition, socioeconomic inequalities in the occurrence of clustering of NCD risk behaviors were also assessed. Methods: A cross-sectional study was undertaken among 1218 adolescents (14–19 years old) in the city of New Delhi, India. An interviewer-administered questionnaire was used to assess health-compromising behaviors (tobacco and alcohol use, fruit/vegetable intake, and physical inactivity). Clustering was assessed using pairwise correlations, counts of clustering of health-compromising behaviors, comparison of observed/expected ratios, and hierarchical agglomerative cluster analysis. Multivariable logistic regressions were used to test the associations of clustering with social position (education and wealth). The relative and slope indices of inequalities in the presence of clustering of behaviors according to education and wealth were estimated. Results: Three major clusters of health behaviors emerged: (a) physical inactivity + lower fruit and vegetable intake, (b) tobacco + alcohol use, and (c) lower fruit and vegetable intake + tobacco + alcohol use. Pronounced clustering of health-compromising behaviors was observed with lower educational attainment and wealth. Conclusion: The presence of clustering of health-compromising behaviors was considerably higher among adolescents with lower educational attainment and wealth. The area of residence has an important influence on socioeconomic inequalities in clustering of NCD risk factors.

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