Fellowship Site: Public Health Research Institute, Mysore, India
U.S. Institution: Florida International University
Project Title: Knowledge, Health Beliefs, Cardiovascular Risk Factors and Burden of Coronary Heart Disease Among Slum Dwellers in Mysore India: The Mera Dil (My Heart) Study.
Coronary Heart Disease (CHD) accounts for almost a third of all deaths in India. The prevalence of CHD, which is characterized by a narrowing of the coronary arteries leading to the heart, has more than quadrupled in the last 45 years. Studies largely from northern India have found a CHD prevalence of up to 7.4% in rural areas and 13.5% in urban centers. There are no studies of CHD prevalence among urban populations in Karnataka where the study will be conducted. The reasons for the high and increasing burden of disease appear multifactorial and include a growing prevalence of traditional risk factors, and low population knowledge about ways to prevent cardiovascular disease. The proposed study will carry out a cross-sectional survey among a sample of 400 slum dwelling men and women, 40 – 64 years of age, living in five wards identified as having the largest number of slums in Mysore, the second largest city in Karnataka. Studies from around the world suggest that slum dwellers are at elevated risk for developing non-communicable diseases like CHD resulting of higher tobacco and alcohol use, stress and crowding, low health literacy and poor access to healthcare. Slum dwellers in Mysore are predominantly migrants from rural areas so it is unknown whether CHD prevalence will reflect their rural roots or mirror the higher levels found in other slum populations. This study will measure knowledge and beliefs about CHD; prevalence eight modifiable risk factors (smoking, use of alcohol, weight, physical activity, healthy diet, blood pressure, serum cholesterol, and blood glucose), and prevalence and correlates of CHD (defined as previously diagnosed CHD disease, symptoms on the Rose angina questionnaire, or ischemic abnormalities detected by electrocardiography). Studies from Europe and the United States suggest that reducing these factors through lifestyle changes can significantly lower disease burden and mortality from CHD. The results of this study will inform the design of interventions for health promotion and disease prevention in this vulnerable population.