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Target families for screening to check and treat chronic diseases, say experts

November 29,2017 Read time: 4 mins
Illustration : Purabi Deshpande / Research Matters

Families live and eat together, they breathe the same air and they share the same genes. It is time to think about the entire household collectively in relation to health issues, experts say.

“Our findings suggest that families could be targeted for screening to help identify, treat earlier and control chronic conditions”, says Dr. Shivani Patel, Assistant Professor at the School of Public Health in Emory University, Georgia, USA, lead author of the study.

The study, by a consortium of public health professionals in India and the USA concluded that families that live together are also likely to be suffering from or contract the same chronic disease. The researchers believe that this may be a way to address the burgeoning chronic disease burden in India.

A staggering number of people live with chronic conditions like diabetes in India, often undiagnosed. A WHO data suggests that the number of people who live with diabetes in India could double by 2030. Some studies even go as far to suggest that the burden of chronic diseases could undermine the country’s growth potential.

“In India, undiagnosed chronic conditions are common. For example, up to 50% of adults with diabetes do not know that they have this condition. Many chronic conditions are manageable if detected but lead to devastating comorbidities if gone untreated. It is therefore crucial that we identify chronic conditions early in the course of the disease,” says Dr. Patel.

The study took into consideration 7,522 adults from 2,574 households during 2013 and 2014. The participants of the study hailed from diverse geographies in both rural and urban India -- from Dhar district in Madhya Pradesh, home to large number of Adivasis; the rural plains of Junagadh district in Gujarat; sparsely populated hill villages in the Mashobra district of Himachal Pradesh; and coastal urban dwellers in Puducherry with relatively better public health infrastructure.

After analyzing the data, obtained from interviews and health tests conducted on the participants, the study concludes that chronic conditions like diabetes, common mental disorders like depression and anxiety, hypertension, obesity and high cholesterol are likely to be shared by family members, regardless of whether they are related by blood. Adults who resided with another adult with any chronic condition had 29% higher adjusted odds of having one or more chronic conditions themselves, the study found.  The researchers also claim to have, consistently observed that adults tended to have the same chronic condition as a co-residing household member.

According to Dr. Patel, it’s crucial for other family members to undergo tests if one household member gets diagnosed with chronic conditions like high blood pressure. “If a family member newly diagnosed with a condition takes dietary precautions and increases activity, the family should also consider such measures as preventative practices. We believe it is time for a paradigm shift in public health to transition from targeting the individual to targeting the family,” she says.

This study, establishing familial concordance related to chronic conditions in households, is crucial, because it emphasizes the need to restructure India’s healthcare system to tackle the sharp rise of chronic conditions. “We hope that our study is just the beginning; we established that familial concordance exists, and we hope that others will also engage in exploring other facets of the issue in detail,” Dr. Patel says.

Though the study throws some much-needed light on how chronic conditions need to be treated, researchers are well aware of its limiting factors. For instance, the study only considered five major chronic conditions namely diabetes, common mental disorders like depression and anxiety, hypertension, obesity and high cholesterol. There are also other crucial factors to consider. “Due to differing cultural practices and socioeconomic milieu, familial concordance may have varying implications across India,” says Dr. Patel.

Further studies in the area are likely to provide more insights that the researchers hope to pursue. “We plan to continue exploring these issues, and we hope that other researchers will also consider this perspective in their work,” she says.

Editor's Note: The title of the story was corrected to make it appropriate.