Reporting heterogeneity in the measurement of hypertension and diabetes in India

  • Parul PuriEmail author
  • S. K. Singh
  • Swati Srivastava
Original Article



Public health research in India frequently depends on self-reported data, which is usually a compromised method. Policies and programs based upon such data may not be efficient enough to estimate the actual burden of the diseases. Previous studies have looked at the issues of discrepancies between self-reported and measured estimates. However, the majority of them have failed to examine the reasons for such disparities. This pivotal research gap is decoded in this study, which explores the determinants of heterogeneity between self-reported and clinically-diagnosed hypertension and diabetes.

Subject and methods

The study utilizes the data from the fourth round of the District Level Household and Facility Survey, 2012–13, and has considered 860,501 nationally representative samples of respondents aged 18 years and above from 18 demographically developed states of India. Age-adjusted prevalence rates of hypertension/diabetes and a multinomial logistic regression model are utilized to draw inferences from the data.


The findings bring out heterogeneity by comparing respondents’ Clinical, Anthropometric, and Biochemical (CAB) test results with their self-reported data. Heterogeneity included respondents who self-reported themselves as not suffering from hypertension/diabetes while their CAB test indicated otherwise, and those who had self-reported being hypertensive/ diabetic even though their CAB test data information proved otherwise. Additionally, respondent’s age, sex, wealth, and occupation are the major determinants of heterogeneous reporting.


The study suggests that the estimates obtained by self-reporting underrate the actual scenario. Thus, large-scale surveys should focus on collecting data using clinical diagnostic tools to access the actual burden of disease in the community.


Anthropometric Biochemical Clinical Diabetes Hypertension Reporting heterogeneity 



The authors are thankful to all the project coordinators of DLHS-4 for their relentless efforts in producing vital information for the community based upon the estimates of prevalence of diabetes and hypertension. Additionally, the authors would like to thank the two anonymous reviewers for their insightful comments and suggestions on the manuscript.

Compliance with ethical standards

The authors assert that the present study is based on a secondary data set, District Level Household and Facility Survey (DLHS-4), 2012–13, which is easily available online. All the procedures contributing to this work comply with the ethical standards of the Institutional Review Board at the International Institute for Population Sciences, Mumbai, India.

Conflict of interest

The authors have no conflicts of interest to declare.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Mathematical Demography and StatisticsInternational Institute for Population SciencesMumbaiIndia

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