Title : Spatial modeling of asthma prevalence and contributing factors in high-altitude western Himalayan: A geospatial and epidemiological study
Abstract:
Asthma is a major global health challenge, and its impact is particularly pronounced in high-altitude regions, where environmental and socio-cultural factors may play unique roles. This study investigates the prevalence of asthma and its socio-economic, environmental, and behavioral determinants among the Gujjar Bakarwal tribe in the Himalayan Mountains, focusing on connections to traditional practices and natural environmental influences. A stratified sampling approach included 816 households across 50 villages in the Poonch and Rajouri districts, categorized by elevation and population density. Geographic Information Systems (GIS) mapped asthma prevalence using Inverse Distance Weighting (IDW) and Natural Breaks classification, while a Binary Logistic Regression Model (BLRM) identified key contributing factors. Notably, higher altitude appeared to reduce asthma risk (AOR: 0.10, p = 0.002), while certain socio-cultural conditions, like extended family living (AOR: 8.80, p = 0.008) and adults in prime working years (AOR: 93.36, p = 0.001), were associated with increased prevalence. Protective factors included education, government employment, farming, higher income, and modern housing, possibly indicating the influence of lifestyle shifts away from traditional practices on respiratory health. With strong model fit (Nagelkerke R² = 0.82) and high accuracy (ROC AUC = 0.98), this spatial model underscores the relevance of socio-economic status, environmental conditions, and traditional practices in asthma prevalence in high-altitude regions. Findings suggest that integrating GIS spatial modeling with traditional knowledge could enhance the identification of high-risk areas and foster targeted interventions. Emphasizing traditional ethnomedical knowledge and natural therapies could contribute to sustainable asthma management strategies in similar high-altitude and culturally rich populations.
