Spatial Association between Air Pollution and Non-communicable Diseases and their Distribution in India

Abstract Background: Non-communicable diseases (NCDs) are the fastest-growing global health burden, and air pollution is a major threat to human health. Growing evidence suggests that air pollution especially PM 2.5 is associated with diabetes mellitus and hypertension, which are currently major public health concerns. There has not yet been any study on the association between air pollution and NCDs at a national level in India. We used the National NCD Monitoring Survey (NNMS) surveyed diabetes and hypertension data (2017–2018) of 9,759 individuals in India and superimposed it on a 20-year average concentration of PM 2.5 in ambient air, measured by satellite-based imagery (2000–2019), to find the association of PM 2.5 with diabetes and hypertension. Methods: Spatial and geostatistical methods were employed to assess the association and examine the distribution of PM2.5, diabetes, and hypertension rates across geographic regions in India. Results: We observed a weak positive correlation between hypertension and PM 2.5 levels, whereas diabetes showed both positive and negative correlations across geographic spaces, albeit with low strength. We did not find any statistically significant results that explain an association, suggesting a lack of association between the two. Conclusions: Since we did not find any significant result of the association, which may be evidence of not having any direct association, conducting prospective cohort studies may help find if there is any association at all.