Gender Differentials in the Impact of Multi-Morbidity on Self Rated Health in Rural West Bengal in India

Objective: Self Rated Health (SRH) has widely been used as an indicator of overall health in a population. Given the rising burden of chronic conditions even in the rural region of India, the present study explores the gender differentials in the impact of multi-morbidity on SRH in the Sundarbans of West Bengal. Methods: A cross sectional study was done in the 19 blocks of the Sundarbans in West Bengal, India. A gender segregated analysis was done to understand the effect of multi-morbidity on SRH while controlling for sociodemographic and lifestyle behaviors. Partial Proportional Odds Regression was used. Results: The odds of a poor rating on SRH was 2.61 (C.I 1.44-4.72) for multi-morbid cases as compared to those who had no disease and the odds increased with age among men. The odds ratio of poor rating among families with income deficits, compared to those without any deficits was 3.04(C.I 1.57-5.89). Age had no association with SRH rating, but, it showed a positive association with multi-morbidity and education among women. Poor rating on SRH was negatively associated with employment status and marital status. Conclusion: SRH is a widely used indicator for mortality. With increasing burden of chronic conditions, specifically multi-morbidities, there is a need for responsive, gender sensitive strategies for healthcare in an ageing, rural population.