Socio-economic Disparities and Cardiovascular Disease in India: Impact of Healthcare Access and Policy Interventions

Cardiovascular Diseases, Socioeconomic Factors, Healthcare Disparities, Health Policy,

Socio-economic disparities significantly exacerbate cardiovascular disease (CVD) burden in India, particularly among lower socio-economic status (SES) populations, driven by limited healthcare access and uneven policy interventions. This review examines how income inequality, low health literacy, caste-based exclusion, gender disparities, and urban-rural divides worsen CVD prevalence and mortality. High out-of-pocket expenditure (58% of healthcare costs), consuming 75% of lower SES household income, pushes 40 million Indians into poverty annually. Limited health insurance (20% coverage) and Ayushman Bharat’s restricted reach (30% of CVD patients) hinder affordability, especially for rural and marginalized groups. Inadequate infrastructure, with only 0.1 cardiologists per 100,000 and 40% of rural health centers equipped for diagnostics, restricts timely care. Urban areas, hosting 70% of CVD facilities for 31% of the population, contribute to 15% pre-hospital CVD deaths. Policies like COTPA and NPCDCS curb tobacco and alcohol use but are limited by weak rural enforcement and low reach (10% rural screening). Air pollution, linked to 15% of CVD cases, is inadequately addressed, particularly in rural and slum areas. Gender norms reduce women’s access to care by 20%, and caste-based exclusion disproportionately affects Scheduled Castes/Tribes. Recommendations include expanding rural healthcare infrastructure, increasing insurance coverage to 50%, enhancing health literacy, and strengthening policy enforcement for tobacco, alcohol, and environmental exposures. These findings highlight the need for equitable healthcare access and robust policy interventions to mitigate CVD disparities among lower SES populations.