New Delhi: India is becoming healthier in several traditional indicators, but a far more dangerous epidemic is quietly tightening its grip on the country.
The latest data show that high blood sugar, hypertension, tobacco use and alcohol consumption continue to affect millions of adults, often without symptoms and frequently without diagnosis. The burden is increasingly shifting from infectious diseases to chronic lifestyle-linked illnesses, raising uncomfortable questions about the country’s preparedness for a long-term public health challenge.
The warning emerges from the National Family Health Survey 2023-24, one of the largest health surveys conducted in the world. Covering 679,238 households, 716,397 women and 100,977 men across the country, the survey offers perhaps the clearest picture yet of India’s changing disease profile.
Rising Sugar Burden
The most striking finding of NFHS 2023-24 relates to blood sugar levels among adults aged 15 years and above. According to the report, 17.8% of women now have high or very high blood sugar levels, or are taking medication to control diabetes. Among men, the figure is even higher at 20.9%. In NFHS-5, the corresponding figures stood at 13.5% and 15.6%, respectively.
The increase is not marginal. In just a few years, the prevalence of elevated blood sugar among women has jumped by 4.3 percentage points, while among men it has risen by 5.3 percentage points. Behind these national averages lies a worrying trend: India is steadily becoming a nation of pre-diabetics and diabetics.
The survey also shows that 9.1% of women and 10.9% of men have very high blood sugar levels above 160 mg/dl. Another 7.5% of women and 8.8% of men fall into the high blood sugar category of 141-160 mg/dl.
The urban-rural divide remains visible. Urban residents are considerably more vulnerable than their rural counterparts, reflecting sedentary lifestyles, changing food habits and rising obesity levels. Yet rural India is no longer insulated. The spread of processed foods, declining physical activity and increased household incomes have carried the diabetes risk deep into the countryside.
The findings reinforce a reality that public health experts have warned about for years: economic growth has not necessarily translated into healthier living. India’s development story is increasingly accompanied by an expanding burden of non-communicable diseases.
Pressure Points Rising
Hypertension presents an equally troubling picture. The NHFS-6 estimates that 19.4% of women and 22.1% of men aged 15 years and above have elevated blood pressure or are taking medication to control it. Although these figures are slightly lower than those reported in NFHS-5, they still represent an enormous disease burden in a country with a population exceeding 1.4 billion.
Among women, 9.4% have mildly elevated blood pressure while 4.8% suffer from moderately or severely elevated blood pressure. Among men, 12.4% fall into the mildly elevated category and 3.3% into the more severe category.
Taken together, the diabetes and hypertension data reveal a disturbing overlap. These conditions frequently coexist and are major risk factors for heart disease, stroke, kidney failure and premature death. Yet India’s healthcare system remains heavily geared towards treating illness rather than preventing it.
The survey’s broader findings on adult nutrition offer additional context. Overweight and obesity are rising sharply among adults. More than 30% of women and 27.3% of men aged 15-49 are overweight or obese, up significantly from NFHS-5.
The message is difficult to ignore. India’s public health challenge is no longer confined to malnutrition and infectious diseases. It now includes a rapidly expanding metabolic crisis that demands sustained policy attention.
Habits That Persist
If rising blood sugar and hypertension represent the consequences, tobacco and alcohol consumption remain among the key drivers of future disease.
The NHFS-6 finds that 8.4% of women and 36.3% of men aged 15 years and above use some form of tobacco. While the figures show a modest decline from NFHS-5, the prevalence remains alarmingly high, particularly among men.
Alcohol consumption presents a more mixed picture. About 1.1% of women and 18.9% of men report consuming alcohol. While the national average for women remains low, significant regional variations persist, especially in parts of the Northeast. Among men, nearly one in five continues to consume alcohol.
The numbers expose a contradiction at the heart of India’s health transition. The country has made substantial gains in maternal health, child survival and vaccination coverage. Yet behavioural risk factors that fuel chronic disease continue to remain deeply entrenched.
What makes the NFHS-6 findings particularly significant is that they capture conditions among adults aged 15 years and above, pointing to risk accumulation much earlier in life. The implication is stark: millions of Indians are entering adulthood carrying health risks that will translate into higher healthcare costs, lower productivity and greater pressure on public health systems in the decades ahead.
The report’s data do not merely describe a health landscape; they reveal a warning. India may be winning several old public health battles, but it is simultaneously drifting into a new one. High blood sugar, hypertension, tobacco use and alcohol consumption are no longer isolated health concerns. Together, they constitute a slow-moving national crisis—one that is expanding faster than public awareness and perhaps faster than policy responses themselves.