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Indian Journal of Community Medicine

Morbidity profile of ex-servicemen residing in Sangli-Miraj-Kupwad municipal corporation area and its relationship with certain clinico-epidemiological factors

Author(s): Kumbhar SK, Joshi JK, Tapare VS, Yadav JU

Vol. 32, No. 2 (2007-04 - 2007-06)

ORIGINAL ARTICLE

Year : 2007 | Volume : 32 | Issue : 2 | Page : 111-114

Morbidity profile of ex-servicemen residing in Sangli-Miraj-Kupwad municipal corporation area and its relationship with certain clinico-epidemiological factors

Kumbhar SK, Joshi JK, Tapare VS, Yadav JU
Department of Preventive and Social Medicine, Government Medical College, Miraj, India
Date of Submission 09-Jun-2005

Correspondence Address:
Kumbhar S K
C/O K. B. Kumbhar, 775, 'Panchsheel', Sangliwadi, Miraj, Sangli - 416 416, Maharashtra
India

Source of Support: None, Conflict of Interest: None
How to cite this article:
Kumbhar SK, Joshi JK, Tapare VS, Yadav JU. Morbidity profile of ex-servicemen residing in Sangli-Miraj-Kupwad municipal corporation area and its relationship with certain clinico-epidemiological factors. Indian J Community Med 2007;32:111-4
How to cite this URL:
Kumbhar SK, Joshi JK, Tapare VS, Yadav JU. Morbidity profile of ex-servicemen residing in Sangli-Miraj-Kupwad municipal corporation area and its relationship with certain clinico-epidemiological factors. Indian J Community Med [serial online] 2007 [cited 2007 Nov 30];32:111-4. Available from: http://www.ijcm.org.in/text.asp?2007/32/2/111/35647

Abstract

Research Question: What is the morbidity profile of ex-servicemen residing at Sangli-Miraj-Kupwad corporation area. Objectives: 1) To determine types and extent of prevalent morbidities among ex-servicemen. 2) To ascertain the association between prevalent morbidities and selected predictor variables Study Design: Cross-sectional study. Setting: Ex-servicemen's canteen, Vishrambag, Sangli. Participants: 416 ex-servicemen, registered under ex-servicemen's canteen, Vishrambag. Statistical Analysis: Percentage, Chi-square test, and odds ratio. Results: 217 (52.2%) subjects had one or more diseases/conditions. Commonest diseases detected were hypertension (26.20%), musculoskeletal problems (23.55%), and mental health problems (12.98%). Increase in the post-retirement period of ex-servicemen was significantly associated with increase in prevalence of hypertension, OR = 8.75 (3.73-20.52) and musculoskeletal disorders, OR = 10.88 (4.54-26.52). Prevalence of hypertension was significantly more for those who served less than 10 years in the military job, OR = 1.90 (1.04-3.8). In the upper socio-economic class, the risk of hypertension was significantly more, OR = 6.08 (1.78-20.17); in the upper lower class, the risk of musculoskeletal disorders was significantly more, OR = 4.15 (1.88-9.16). Considering the importance of health of ex-servicemen and existence of high morbidity pattern, periodical screening was needed for every ex-serviceman who belonged to the high-risk group.

Keywords: Ex-servicemen, post-retirement period, prevalence rate

Ex-servicemen belong to a special group, unlike any other occupationally-retired groups. The ex-servicemen population is mainly concentrated in the states of Utter Pradesh, Punjab, Haryana, Maharashtra, Kerala, Tamil Nadu, Rajasthan, and Himachal Pradesh. The population of ex-servicemen in Maharashtra state is 1,39,223 and in Sangli district is about 22,000. 1

It is commonly believed that all military personnel are physically and mentally fit during their service and after retirement. On the other hand, they may be more prone to psychosomatic problems as well as various other health problems. However, the literature shows the scarcity of such accounts.

Therefore, this study was an attempt to study the status of ex-servicemen, particularly, with regard to their health and the health-related factors

Materials and Methods

Descriptive cross-sectional study was designed and performed in a representative sample of ex-servicemen, registered under ex-servicemen's canteen, Vishrambag in Sangli city.

Totally, 4217 ex-servicemen of all ranks and cadres residing in Sangli-Miraj-Kupwad Municipal Corporation area and registered under ex-servicemen's canteen, Vishrambag Sangli comprised the reference population of the present study.

Due to the lack of previous similar studies in this area, a pilot survey was conducted on a small sample (N = 100) chosen with simple random sampling method; with the help of this pilot survey, the sample size (416) for this study was determined.2 Thus, a total of 416 ex- servicemen were selected with the help of proportional stratified random sampling method proportional to the size of the strata with respect to the post-retirement period [Table 1]. 3 Association of mental disorder with selected variable is shown in [Table 2].

Primary data was obtained through a specially designed questionnaire schedule and physical examination of ex-servicemen. Mental health pertaining to anxiety disorders and depression was assessed with the help of the questionnaire as per Diagnostic criteria DSM IV.4 To measure relative frequency of the diseases and other qualitative attributes, prevalence rate (%) was calculated. The association between the selected variables and commonest diseases were tested using c2 test and odds ratio (OR).5

Results

Among the study population, 217 subjects were suffering from at least one disease, out of which 69 (16.6%) subjects had one disease/condition. Two diseases/conditions were detected in 91 (21.9%) subjects, while three or more diseases/conditions were observed in 57 (13.7%) subjects. Of all, 199 (47.8%) subjects had no clinically detectable diseases/condition at the time of examination. Hence, the overall morbidity rate was 52.16%.

Out of the 559 diseases/conditions detected during the study, 134 were detected for the first time, and the subjects were unaware of the existence of these diseases/conditions. These 134 conditions/diseases included 59 cases of hypertension, 50 cases of anemia, 19 cases of mental disorders, and 6 cases of diabetes.[Table - 3] shows that the commonest diseases detected among the ex-servicemen were cardiovascular problems (120 (28.8%)), musculoskeletal problems (98 (23.5%)), mental health problems (54 (13%)), and gastro intestinal problems (53 (12.7%)).

The highest overall morbidity (81.4%) was observed in subjects having a retirement age of <30 years, while lowest (44.6%) was observed in those in the age group of 30-40 years. Overall morbidity was observed to be significantly associated ( P < 0.001) with the retirement age. The percentage of morbidity was significantly ( P < 0.001) high (84%) in subjects having less than 10 years of military service. Highest morbidity was observed in upper- lower class (78.6%) and the lowest morbidity was observed in subjects of lower-middle class (48.8%) without any specific trend.

[Table - 4] shows that the occurrence of hypertension was almost three times more in the subjects completing 10-20 years of post-retirement period, while in the subjects completing 20-30 years and those completing more than 30 years of the post-retirement period, hypertension had increased by almost 5 and 8 times, respectively, compared to the subjects with less than 10 years of the post-retirement period, which was statistically significant. This indicates that the post-retirement period influenced hypertension occurrence in the subjects.

The subjects belonging to the group with less than 10 years of the total service period had almost two times more occurrence of hypertension than those retired after serving for more than 10 years; this was statistically significant. It could be because ex-servicemen face more physical and psychological stress during their initial service period, which is one of the important risk factors for hypertension. It was observed that the occurrence of hypertension was significantly more, i.e., six times more in subjects belonging to the upper socio-economic class than those belonging to the lower-middle class.

The occurrence of musculoskeletal disorders was 3.12 and 3.44 times more in subjects with less than 10 years and 20-30 years of post-retirement period, respectively, than those completing 10-20 years of the post-retirement period. In subjects completing 30 years or more, the occurrence of musculoskeletal disorders was 10.88 times more, which was statistically significant. This indicates that the musculoskeletal disorders were influenced by the post-retirement period. Higher occurrence was observed at early- (<10 years) and (<20 years) post-retirement period due to sudden changes in the occupation during the early period and due to biological aging process during the later period.

In subjects of lower-socio-economic class, the occurrence of musculoskeletal disorders was 4.1 times more than those in the middle-class; this was statistically significant. The probable reason for this was that most of the socio-economically lower class subjects were employed in the field of agriculture, where musculoskeletal disorders appeared to occur often due to the nature of the work.

Discussion

Among the study population, 52.2% subjects reported at least one chief complaint. Among the diseases detected, cardio-vascular problems (28.8%), musculoskeletal problems (23.5%), mental health problems (13%), and gastro-intestinal problems (12.7%) were the commonest. In another study it was found that about 33% veterans were hypertensive, which was slightly more than that observed in the present study.

As the post retirement period of the ex-servicemen increased, the relevance of hypertension and musculoskeletal disorders significantly increased. The occurrence of hypertension was significantly more in the subjects who served less than 10 years in the military job. In the upper socio-economic class, the risk of hypertension was significantly more than those in other classes, while in the upper-lower class, the risk of musculoskeletal disorders was significantly high.

Out of the diseases/conditions detected during the study, 134 were detected for the first time, and the subjects were unaware of the existence of these diseases/conditions. The detection of hypertension, mental disorders, and anemia, anew, clearly indicates the necessity of routine screening of ex-servicemen for these conditions.

Recommendations

It is recommended that every ex-serviceman should be periodically screened for diseases like hypertension, musculoskeletal disorders, and mental disorders, and efforts with regard to health education must be initiated at all levels with special emphasis on the prevalent diseases present in the ex-servicemen.

References

1. Government of India Information, 1991. Ministry of Health and Family Welfare. Nirman Bhawan: New Delhi; 1991. p. 32,55.
2. Lwanga SK, Lemeshow S. Sample size determination in health studies. A practical manual. WHO: Geneva; 1991.
3. Armitage P. Berry G. Statistical methods in medical research. 3rd ed. Blackwell Scientific Publication: London; 1994.
4. Kaplan HI, Sadock BJ. Synopsis of psychiatry behavioural and clinical psychiatry, 8 th ed. Williams and Wilkins: 1996.
5. Holland WE. Oxford text book of Public Health Vol. 3, 1st Indian ed. Bombay Oxford University Press: 1987.

Tables

(Please click on image for larger view)

Table 1: Association of musculoskeletal disorders and the selected variables

Table 1

Table 2: Association of mental disorder and the selected variables

Table 2

Table 3: System wise clinically detected diseases/conditions

Table 3

Table 4: Association of hypertension and the selected variables

Table 4

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