Indian Journal of Preventive Medicine

Background: Sleep inequality in college populations is an emerging public health concern, often shaped by both behavioral habits and environmental conditions. Objective: To explore behavioral and environmental determinants contributing to disparities in sleep quality among college students. Methods: Thirty-five participants (18 males, 17 females), aged 18–45 years, from diverse academic backgrounds, participated in in-depth qualitative interviews. Data were analyzed thematically to identify recurrent patterns influencing sleep. Results: Key behavioral factors included excessive screen use before bed (82.9%), academic stress (85.7%), and bedtime procrastination (77.1%). Environmental contributors were noise disturbance (71.4%), inconsistent lighting (62.9%), and poor ventilation or temperature extremes (48.6%). Interaction between behavioral and environmental factors amplified sleep inequality, with noticeable gender variations—female students more frequently cited safety concerns and environmental discomfort. Conclusion: Multifactorial interventions addressing both personal behaviors and environmental conditions are crucial to promoting equitable sleep health in college populations.

India’s maternal mortality and morbidity statistics remain contested due to methodological ambiguities and systemic data gaps. While the Maternal Mortality Ratio (MMR) is internationally standardized as deaths per 100,000 live births, confusion persists with the Maternal Mortality Rate, which uses women of reproductive age as the denominator. In India, estimates are derived largely from the Sample Registration System (SRS), household surveys such as the National Family Health Survey (NFHS), and facility-based reporting under the Health Management Information System (HMIS). These sources, however, are periodic, sample-based, and often modeled, rather than real-time. The PCPNDT Act presumes sex-selective abortion and female infanticide as the primary causes of skewed sex ratios, yet medical realities reveal a broader spectrum of female fetal loss — including spontaneous abortions, stillbirths, and medically indicated terminations — that household surveys cannot capture. Despite extensive digitization of hospitals, the absence of mandatory ICD coding and real-time reporting undermines the reliability of morbidity and mortality data.1 Consequently, policy formulations risk being based on self-supporting guesstimates rather than robust, coded health statistics. This paper argues for a shift from politically framed digitization claims to mandatory ICD-coded, real-time hospital reporting, centrally collated and analyzed state-wise. Only such a system can provide India with reliable health statistics, ensure medico-legal accountability, and support evidence-based policy in maternal and child health.

Climate change has emerged as one of the largest public health challenges of the twenty-first century, with India being particularly vulnerable due to its diverse climatic conditions, high population density, fast urbanization, and socioeconomic inequality. Rising temperatures, irregular rainfall, frequent floods, droughts, cyclones, and decreasing air quality are significantly influencing the prevalence and distribution of climate-sensitive diseases while compounding existing health inequities. This study synthesizes existing information on the relationship between climate change and human health in India, stressing its direct and indirect implications on communicable and non-communicable diseases, nutritional status, mental health, occupational health, and maternity and child health. The review also evaluates the disproportionate burden borne by vulnerable people, including children, older persons, pregnant women, economically disadvantaged communities, and individuals dwelling in climate-sensitive locations. Particular attention is placed on preventative public health interventions that can increase resistance against developing climate-related health concerns. These include climate-informed disease surveillance, early warning systems, climateresilient healthcare infrastructure, health promotion, community engagement, environmental risk communication, multisectoral collaboration, and the integration of digital technologies and the One Health approach into public health practice. The assessment also addresses the existing policy landscape in India, highlights significant implementation obstacles, and outlines future research goals for establishing sustainable and evidence-based solutions. By integrating scientific knowledge with public health views, this review highlights the critical need to incorporate climate adaptation and mitigation into national health strategy. Strengthening preventative public health systems through coordinated policy action, capacity building, and community-centered initiatives will be vital to safeguard population health and promote climate resilience in India.

India is experiencing a rapid rise in young-onset type 2 diabetes mellitus (T2DM), with a growing proportion of new cases occurring below 40 years of age. Compared with later onset disease, young onset T2DM follows a more aggressive course with earlier complications and longer lifetime exposure to hyperglycaemia. This trend is largely driven by rising childhood and adolescent obesity, physical inactivity, unhealthy diets, excessive screen time, and psychosocial stress. A large hidden burden of prediabetes among young adults further reflects missed opportunities for early prevention. Although national programs offer scope for screening and counselling, their reach among adolescents and young working populations remains limited. Strengthening early, life course based prevention is urgently needed.

Chronic kidney disease (CKD) is a surging public health crisis in India, primarily driven by rising rates of diabetes and hypertension. Because early-stage CKD is largely asymptomatic, it frequently remains undetected until advanced stages, causing severe health system strain and catastrophic financial hardship for families. This communication advocates for integrating systematic, targeted CKD screening into India’s primary healthcare infrastructure, specifically utilizing the expanding network of Ayushman Bharat Health and Wellness Centres. Rather than population-wide screening, a feasible, cost-effective strategy focusing on high-risk populations—including individuals with diabetes, hypertension, advanced age, obesity, or cardiovascular disease—is recommended. Screening can be efficiently conducted using simple, low-cost diagnostic tools: serum creatininebased estimated glomerular filtration rate (eGFR) and urine albumin testing. Early detection enables timely, renoprotective clinical interventions that significantly slow disease progression, reduce cardiovascular risk, delay expensive renal replacement therapies, and promote sustainable health financing across India.