11 Chapter5 PDF
11 Chapter5 PDF
and working culture of the people. Industrialization, urbanization and modernization have
changed the life style of Indian families. The transition from traditional to modern
lifestyle, consumption of rich fat content food and high calorie food has been contributing
much to the health problem. Coupled with high level of mental stress compounded the
problem further. The way we eat, perform exercise, take rest, play, behave with others,
think, plan, drive a vehicle, sleep, carry out our routine work and live others are included
in the term ‘lifestyle’. It is true that our routine work and day-to-day life depend on
various environmental factors such as social, economical, political, ecological and family
background. When the basic necessities are not easily fulfilled, it is but natural that the
man would try different strategies to achieve them. Our time schedule for working,
resting, eating, entertainment and interacting with people around us would change the
mode of our life pattern. A shift in eating habits, smoking, drinking and a host of other
such unhealthy practices would result in health problems. Thus the life style of people
the sample villages. The profile comprising of age, sex, educational qualification,
community, marital status, occupation, income and family size of the respondents will
help to know their socio-demographic status. The health status of respondents varies with
their age, sex, occupation, income and family size. It is therefore understood that there is
relationship between the health status of the respondents and their socio-demographic
95
composition. Hence an attempt has been made in the study to find out the level of
significance in the relationship between their health status and their socio-demographic
variables.
SAMPLE VILLAGES
Two coastal villages and two inland villages were selected for this study. The
settlement.
TABLE 5.1
Close to one-third of the respondents (32.7 per cent) belong to the coastal villages
and over two-thirds of them (67.3 per cent) belong to inland villages. An attempt has
been made to compare the sample population of these two types of settlements with
96
SEX
The participation of more females in the medical camps than their male
counterparts is the reason for the selection of more female respondents for this study. The
following table shows the sex-wise distribution of the respondents in the sample villages.
TABLE-5.2
RESPONDENTS BY SEX
A sizeable proportion of the respondents (40) are males and a majority of them
(60 per cent) are females. Thus, in the sample population, the male respondents out
number their female counterparts, because the people who attended the medical camps
were mostly females. This variation mainly owes to the difference in the participation of
men and women in the medical camps. In other words, the participation of women in
medical camps is one and a half time higher than the participation of their men
counterparts. This shows that more women than men were interested in attending the
medical camps in order to consult the doctors and take treatment for their diseases.
97
AGE
Age is an important independent variable in the demographic profile of any
following table.
TABLE 5.3
RESPONDENTS BY AGE
A significant proportion of the respondents (43) belong to the age group of 0-14.
One-fifth of them (20.1 per cent) are in 41-60 age groups, close to one-fifth of them (18.8
per cent) are in 26-40 age group. Close to one-tenth of them (9.2 per cent) in the age
group of 15-25, and a similar proportion (9 per cent) of them are above 60 years. It is
inferred from this that the sample population is characterized by adulthood. This is
98
FIGURE 1
50
45
40
35
30
Per
25cent Age
20
15
10
0
0-14 15-25 26-40 41-60 Above 60
Age
99
EDUCATION
This trend mainly owes to their economic backwardness and poor condition of schools in
rural areas in terms of lack of infrastructural facilities. Moreover, the rural parents have
no value for education. The following table presents the educational status of the
respondents.
TABLE 5.4
Educational No. of
Per cent
Qualification Respondents
Others* 22 1.8
Over one-fifth of them (22 per cent) studied upto middle school level; 8.6 per cent of
them studied upto SSLC and 3.2 per cent of them studied upto HSC, and a negligible
100
proportion of them (1.8) completed technical education, under graduate and post-graduate
degrees. This analysis of data shows that close to two-thirds of them (62.7 per cent) are
literates and rest of them (27.3 per cent) are educated. It is important to mention that
COMMUNITY
The coastal villages consist of fisher folk who have been identified as Most
Backward Class by the Government of Tamilnadu. In a similar way, the inland villages
have more Backward Class people than those from other communities. The following
TABLE 5.5
RESPONDENTS BY COMMUNITY
No. of
Community Per cent
Respondents
Forward Class
2 0.2
(FC)
Backward Class
788 66.2
(BC)
Most Backward
387 32.5
Class (MBC)
Scheduled Caste
14 1.2
(SC)
It is understood from the table that two-thirds of the respondents (66.2 per
cent) belong to BC. Close to one-third of them (32.5 per cent) belong to MBC. However,
101
a negligible proportion of them belong to SC and FC. This community-wise distribution
of the respondents discloses that the sample population is mostly represented by the
MARITAL STATUS
Marital status is one of the criteria to evaluate the health status of the respondents.
The following table shows the distribution of respondents according to their marital
status.
TABLE 5.6
Widowed 83 12.1
Separated 3 0.4
It is clear from the table that a great majority of the respondents (71.6 per cent)
are married, 15.8 per cent of them are unmarried, 12.1 per cent of them are in widowhood
and a few of them are separated. Thus the sample population is represented by married
respondents.
102
OCCUPATION
There is no job opportunity in the sample inland settlements other than petty
business, casual work (coolie) in agriculture and allied activities. Moreover, agriculture is
not at present a progressive occupation due to lack of irrigation in those settlements. The
beedi rolling is an important secondary occupation for over one-fourth (26.0 per cent) of
the total employed people in the settlements. The following table shows the distribution
TABLE 5.7
Primary occupation
No. of Respondents Per cent
Unemployed 52 12.4
Fishing 21 5.1
103
It is evident from the table that a significant proportion of the respondents (37.0)
are coolies, i.e. the coolies are those who are unskilled labourers usually hired for low or
subsistence wages. Over one-fourth of the respondents (26 per cent) are beedi rollers, 8.8
per cent of them are employed in private sector, 6.9 per cent of them are agricultural
workers, 5.1 per cent are fishermen and 2.6 per cent of them are petty businessmen. The
remaining (12.4 per cent) respondents are unemployed. It is evident from the table that
more respondents (coolies: 37.0 per cent and beedi workers: 26 per cent) are employed in
irregular monsoon and poor irrigation facilities in the sample villages agriculture remains
to be an unprofitable work. Men from this region prefer any type of work based on daily
wage, especially construction, brick work and the like. Particularly women prefer beedi
work because it is like a domestic work and fetching moderate income through out the
year. Since Tirunelveli District in which the sample villages are located, is industrially
backward region, the people have to resort to whatever jobs available from time to time.
INCOME
Income of the population is mostly depends on their occupation. As most of those
from the population are casual workers or daily wage earners, their income is rather low.
They get work for 2-3 days a week. Most of the households have one or two bread-
winners or potential earners. The following table exhibits the distribution of the
104
TABLE 5.8
2001-3000 11 3.0
3001-4000 30 8.2
Rs. 1001-2000 and very close to one-third of them (29.7 per cent) earn below
Rs.1000. The rest of them (14.4 per cent) earn above Rs.2000. This shows that an
overwhelming majority of the respondents (85.6 per cent) are living below
105
FIGURE 2
60
50
40
Per
30cent Income
20
10
0
Below 1000 1001-2000 2001-3000 3001-4000 Above 4000
Income
FAMILY INCOME
There is a variation between the individual income and family income of the
earners. So the family income of the respondents in the sample villages mainly depends
106
on the earning of one potential earner and supported by one supplementary earner. The
following table shows the distribution of monthly family income of the respondents.
TABLE 5.9
3001-4000 36 12.0
There is a similar proportion between the respondents’ family (41.9 per cent)
earning a monthly income of below Rs. 2000 and the respondents’ family (40.9 per cent)
earn a monthly income of Rs. 2001- 3000. The rest of their families (12.0 per cent) earn
Rs.3001- 4000 and 5.2 per cent of them earn above Rs.4000 per month as family income.
This shows that an overwhelming majority of the respondents’ family (82.8 per cent) are
earning below Rs.3000 per month. The average monthly family income is Rs.2200.80
and it is higher than the average individual income. So, it clearly indicates that the
107
FAMILY SIZE
The family size of coastal village is relatively bigger than the family size of inland
villages. Especially in the fisher households, the children are considered assets, because
they help their parents in fishing and allied activities. The following table shows the
TABLE 5.10
1 38 38 3.2
2 38 76 6.4
3 33 99 8.3
4 67 267 22.4
5 73 364 30.6
6 32 190 16.0
7 14 100 8.4
Above 8 6 57 3.9
followed by 22.4 per cent of them whose family size is 4 and 16 per cent of them have 6
members family. The proportions of other respondents having different the family size
are rather insignificant. Collectively a majority (53 per cent) of them have the family size
108
of 4-5 members. This is confirmed by the average family size (4.25) of the sample
population. The average family size is close to both state level (4.3) and national level
(5.3) family size. However the average family size is a little higher than the state level
family size and a little lower than the national level family size.
It is more common to find that many of the coastal families are characterized by
fairly large size families, whereas many of them in inland areas are characterized by
TABLE 5.11
The family size is higher in the sample coastal villages than the family size in the
inland villages. The increase in family size in the coastal village results in the increase in
the proportion of families. On the other hand, the increase of family size in the inland
villages leads to the decrease in the proportion of families. The coastal village people
have less aware of the small family norm and they need more men power to do their
109
fishing occupation. That is perhaps the reason why they increase their family size by
DISEASES
the decline due to better living conditions and improved health care delivery system.
communicable, chronic and genetic diseases. Several diseases which could be prevented
by improving the environment, giving timely immunization and taking steps for early
detection and treatment, account for high morbidity among the people. Now almost half
cholera, dysentery, malaria and worms are promoted by the poor environment, i.e. due to
lack of safe drinking water, open drains, stagnant water and crowded unhealthy living
place and working conditions, b) diseases caused by poor nutrition e.g. anemia and c)
pox, measles and poliomyelitis for which effective vaccines are available. Illnesses due to
ageing and degenerative diseases such as cardio vascular diseases are preventable.
However they can be reduced through public education as in the USA where illness due
to cardio vascular diseases was reduced by 50 per cent in 10 years through public
education. This highlights the need for improving public awareness, availability and
quality of health services all over the country. The distribution of the respondents
110
TABLE 5.12
RESPONDENTS BY DISEASES
Diseases No. of Respondents Per cent
Normal * 462 38.9
Fever and Common Cold 184 15.4
Arthritis 259 21.7
Acid Peptic Diseases and Gastritis 62 5.2
Worm Infestation 27 2.3
Lower Respiratory Problem 25 2.1
Skin Diseases 22 1.8
Bronchial Asthma 8 0.7
Cancer 27 2.3
White Discharge 6 0.5
Diabetes 16 1.5
Benign Tumors 6 0.5
Goiter 6 0.5
Old Age Changes 5 0.4
General Infection 3 0.3
Congenital Anomalies 33 2.8
Deaf Mutism 4 0.3
Other Gynecological Diseases 3 0.3
Mental Retardation 12 0.2
Deficiency Status 2 0.2
Hypertension 2 0.2
Osteoporosis 2 0.2
Tuberculosis 17 1.4
Dental Disease 1 0.1
Paralysis 1 0.1
Upper Respiratory Problem 1 0.1
Total 1191 100
* Though the respondents were normal, still they are suffering from the consequences of
chikungunya fever.
The above table clearly indicates that chronic diseases account for a higher
proportion of reported diseases than that of acute diseases. Fever and common cold (15.4
111
per cent), Arthritis (21.7 per cent), Acid peptic diseases and Gastritis (5.2 per cent)
account for close to a majority (42.3 per cent) of all reported diseases. Worm infection
(2.3 per cent), Cancer (2.3 per cent), Lower Respiratory Problem (2.1 per cent) and Skin
diseases (1.8 per cent) constitute negligible proportions of total reported diseases.
Similarly the other diseases, Bronchial Asthma (0.7 per cent), and the like, constitute
Deaf Mutism were the chronic diseases threatening the people in the study area. All the
respondents are still suffering from joint pain in the aftermath of chikungunya fever.
A few cases of Cerebral Palsy were reported, which is one of the painful diseases
permanent brain injury that will occur before, or shortly after birth, leading to lack of
muscle control and movement. It may cause a number of symptoms including seizures,
spasms, visual and hearing problems, hyper activity and learning disorder”.
1
Dean of Government Medical College Hospital, Tirunelveli.
112
PHOTO 1
113
PHOTO 2
Congenital Anomaly
114
PHOTO 3
115
PHOTO 4
116
PHOTO 5
117
FIGURE 3
Normal *
Fever and Common Cold
Arthritis
Acid Peptic Diseases and Gastritis
Worm Infestation
Lower Respiratory Problem
Skin Diseases
Bronchial Asthma
Cancer
White Discharge
Diabetes
Benign Tumors
Goiter
Old Age Changes
General Infection
Congenital Anomalies
Deaf Mutism
Other Gynecological Diseases
Mental Retardation
Deficiency Status
Hypertension
Osteoporosis
Tuberculosis
Dental Disease
Paralysis
Upper Respiratory Problem
TYPES OF DISEASE
The respondents’ diseases are classified into acute diseases and chronic diseases in the
village settlements. The following table shows the distribution of types of disease among the
respondents.
118
TABLE 5.13
health problems, while over one-third of them (35.8 per cent) have chronic diseases and
the rest of them (25.4 per cent) have acute diseases. The chronic types of diseases are
2
World Diabetes Foundation, Copenhagen, Denmark, 14th April 2010
119
AGE AND TYPES OF DISEASE
As regards acute disease, they increase of age leads to the decrease of the
As regards chronic disease, the increase of age leads to the increase of the
known as concomitant variation. The data in the following table show that there is high
level of morbidity among the young and the old age respondents.
The following table depicts the relationship between the age of the respondents
TABLE 5.14
Types of Disease
Age Total
No disease Acute Chronic
255 210 47 512
0-14
(49.8) (41.0) (9.2) (100)
52 21 36 109
15-25
(47.7) (19.3) (33.0) (100)
71 30 123 224
26-40
(31.7) (13.4) (54.9) (100)
58 34 147 239
41-60
(24.3) (14.2) (61.5) (100)
26 8 73 107
Above 60
(24.3) (7.5) (68.2) (100)
462 303 426 1191
Total
(38.8) (25.4) (35.8) (100)
χ 2 = 328.71 Df = 8 P < 0.01
120
Among the respondents in the age group of 0-14 (49.8 per cent) and 15-25 (47.7
per cent) many of them have no health problems. Over a majority of respondents having
chronic diseases are in the age groups of 26-40 (54.9 per cent), 41-60 (61.5 per cent) and
above 60 age (68.2 per cent). On the other hand, the proportion of respondents having
acute diseases are less than the proportion of their counterparts having chronic diseases,
especially in the age group of 15-25, 26-40, 41-60 and above 60.This clearly shows that
the proportion of young respondents having diseases is significantly less than that of their
elder counterparts. The statistical analysis proves that there is a high significant
relationship between the age of the respondents and their types of disease. A similar
Though the nature has set equilibrium between male and female, human
continues to exist in India in all aspects including health care. Women from infant
stage to their old age get an unfair deal in matters of health. They are conditioned
through generations to place themselves last within the family itself. They themselves
bear in silence, pains and discomforts for long periods of time without seeking relief.
They earn for family by toiling themselves. Within or outside their home from dawn
to dusk, they seem to be invisible labour and their substantial contribution to their
family income goes unnoticed. The priority of their health is not given due to
3
National Council of Applied Economic Research) NCAER 1993 survey.
121
importance at their family level. The following table exhibits the relationship between
TABLE 5.15
Types of Disease
Sex Total
No Problem Acute Chronic
A significant proportion of male respondents (47.1 per cent) are free from
diseases. As regards the acute diseases that affect the respondents, the proportion of male
respondents (26.7 per cent) is more or less equal to the proportion of their female
counterparts (24.6 per cent).But, with respect to chronic diseases, the proportion of
female respondents (42.1 per cent) is over one and a half time higher than their male
counterparts (26.2 per cent). However, this has been statistically proved that there is a
high significant relationship between the types of disease affecting the respondents and
their sex. In other words, more female respondents than their male counterparts are
122
This is evident from a study that a high natural resistance of females to
morbidity in their younger age is apparent which gets converted into high level of risks in
The education and health are two sides of the same coin. Education
and Health are inseparable and complementary to each other. Education and health are
the major instruments for the development of a country. The educated and healthy people
of the country will bring about socio-economic changes, which will improve their quality
of life. Particularly the task of educating woman should be the prime focus of the
country.
TABLE 5.16
Types of Disease
Educational Qualification Total
No Disease Acute Chronic
Illiterates 110 53 120 283
(38.9) (18.7) (42.4) (100)
Literates 284 217 245 746
(38.1) (29.1) (32.8) (100)
Educated 68 33 61 162
(42.0) (20.4) (37.6) (100)
Total 462 303 426 1191
(38.8) (25.4) (35.8) (100)
χ 2 = 40.61 Df = 4 P < 0.01
Note: Literates refer to those who studied up to middle school and educated refer to those
whose educational qualification ranges from SSLC to Post graduate.
123
A significant proportion of respondents (38.8 per cent) from the educated
category don’t have any health problem. The chronic diseases are higher among the
illiterates (42.4 per cent) than their literate (32.8 per cent) and educated (37.6 per cent)
counterparts. On the other hand, the acute diseases are higher among the literate
This shows that the education makes the respondents aware of the seriousness of
the diseases. The statistical analysis of data proves that there is a high significant
disease.
The respiratory tract and skin are readily accessible to toxic factors in the
environment; not surprisingly they account for a high proportion of all work-related
diseases. Back pain is a common problem among the manual and sedentary workers. But
among heavy manual workers such as miners, dockers and nurses, it is an important
heavy manual workers. Like this the interphalangeal joints are affected among the
workers, especially tailors. Occupational factors are associated with a broad spectrum of
disorders affecting both central nervous system and causing organic and also behavioural
manifestations. Men and women are exposed to a similar range of occupational hazards
but, by virtue of child bearing function, women experience additional occupational risks
mainly affecting the fetus. The following table illustrates the relationship between
occupational status of the respondents and the types of disease affecting them.
124
TABLE 5.17
agriculture and fishing. Petty business, beedi rolling and coolie work are categorized
under the self employed. Over a majority (55 per cent) of the respondents, who are
affected by the chronic diseases, are self employed persons and over two-thirds of them
(68 per cent) having chronic diseases are engaged in traditional occupation. In the same
category, significant proportions of them are unemployed (30.9 per cent) and employed
in private/public sectors (38.1 per cent). As regards to acute disease, over one-fourth of
them (27.4 per cent) are unemployed. The statistical analysis also shows that there is high
significant relationship between the respondents’ occupation and their types of disease.
125
MARITAL STATUS AND TYPES OF DISEASE
The following table presents the relationship between the marital status of the
TABLE 5.18
There is a difference between the married and the unmarried respondents in terms
of acute and chronic diseases affecting them. After marriage, the people seem to have
given less importance to their health. This is the pre-dominant reason for more diseases
among the married respondents. The statistical analysis also shows that there is a high
significant relationship between their marital status and types of disease. This is
126
Case: Saraswathi (29)
127
MONTHLY FAMILY INCOME AND TYPES OF DISEASE
The following table illustrates the relationship between family income of the
TABLE 5.19
OF DISEASE
Types of Disease
Family
Total
Income No
Acute Chronic
Disease
Below 393 271 373 1037
2000 (37.9) (26.1) (36.0) (100)
63 26 44 133
2000-4000
(47.4) (19.5) (33.1) (100)
Above 6 6 9 21
4000 (28.6) (28.6) (42.8) (100)
462 303 426 1191
Total
(38.8) (25.4) (35.8) (100)
Close to two-thirds of the respondents (62.1 per cent) in the income category of
below Rs.2000 have acute as well as chronic diseases. A majority of the respondents
(52.6 per cent) in the income group of Rs.2000-4000 have similar diseases. But a great
majority of them (71.4 per cent) in the income group of above Rs. 4000 have similar
family income and types of disease. The result is supported by NCAER survey 1995.
128
The survey reports:
constitutes the base for studying them in terms of their diseases. Sex, age,
community, education, occupation, income and family size of the respondents are
analyzed with the diseases to find the relationship. From the analysis, there is a
diseases.
129
FIGURE 4
4.0
3.5
3.0
2.5 Sex
Mean
Age
2.0
Educational Qualific
ation
1.5
Primary Occupation
1.0
Marital Status
.5 Family Income
No Problem Acute Chronic
Other Disease
130