Morbidity Transitions and Environmental Chemical Health Risks in Haryana, India: Spatial Patterns, Socioeconomic Differentials, and District-Level Analysis Using NSSO Data (2004–2018)

Abstract

Introduction: Haryana, despite having the third-highest per capita income in India, exhibits profound spatial inequalities in disease burden compounded by pervasive environmental chemical exposures—including airborne particulate matter, groundwater fluoride and arsenic contamination, agrochemical residues, and severe WASH deficits.

Objectives: To examine spatial patterns, temporal transitions, and socioeconomic differentials of morbidity across Haryana's 21 districts from 2004 to 2018, and to evaluate the role of environmental chemical exposures in shaping district-level health risk zones.

Methods: Unit-level micro-data from three NSSO rounds (60th/2004, 71st/2014, 75th/2017–18) were analysed using bivariate analysis, prevalence-based odds ratios, coefficients of variation, Pearson correlations, and spatial environmental correlation analysis drawing on CGWB (2020), HPCB (2021), and NFHS-5 (2021) data.

Results: State-level non-chronic morbidity declined 60.6% from 94 to 37 per 1,000 population (2004–2018); total morbidity declined from 94 to 59 per 1,000. Inter-district CV narrowed from 92.8% to 50.2%. A near-zero Pearson correlation (r=0.088) between 2004 and 2018 district rankings indicates fundamental geographic reshuffling. Air pollution correlated positively with morbidity (r=0.62), WASH deprivation with infectious disease (r=0.61), and groundwater fluoride with disability morbidity (r=0.54). Women, elderly, SC/ST communities, and the educationally disadvantaged carried disproportionate burdens.

Conclusions: Environmental chemical exposures constitute active, spatially structured determinants of morbidity in Haryana. Targeted environmental health regulation, district-specific chemical risk mitigation, and equity-sensitive health programming are urgently required.