Lok Sabha MP KC Venugopal-led Public Accounts Committee submitted a report in the Lower House on Wednesday (April 1), detailing health-related issues prevalent among the Indian Armed Forces.

The report deals with government action on the committee’s earlier observations in their report titled ‘Disability Pension in Indian Army’, which was based on a 2023 CAG report concerning the Ministry of Defence.

Hypertension and Diabetes Mellitus Type-II are prevalent among Junior Commissioned Officers (JCOs) and Other Ranks (OR), based on data received from Record Offices of Arms and Services of the Indian Army up to December 31, 2023.

Per the report, the rate of prevalence of hypertension was 9.61% and that of Diabetes Mellitus Type-II, 2.78%. The prevalence of these diseases among India’s general population, as per the National Family Health Survey-5 (NFHS-5), was 18.3% and 4.9%. The lower rates among the Army are attributed to constant health promotion and activity, as well as advisories and policies focusing on the prevention of lifestyle diseases.

What about the prevalence in the Indian Navy and Air Force?

The Low Medical Category (LMC) applies to people with disabilities affecting their full combat fitness and necessitates mandatory medical and fitness tests for promotions.

For the Navy, the number of personnel in the LMC was 384, or a 3.25% prevalence rate per 100 officers, for hypertension. It was detected in 999 personnel serving as Sailors. For diabetes, this figure was 252, or a 2.14% prevalence rate, and detected among 466 Sailors.

In the Air Force, the prevalence was 4.05% for hypertension and 2.85% for diabetes. As per the report, the number of officers in the IAF with disability, as on September 13, 2023, was 635 with diabetes mellitus, 718 for hypertension, 244 for obesity and 170 for IHD or Ischemic Heart Disease.

What about lifestyle diseases among officers’ ranks in the Army?

The top 10 disabilities for which officers in the Army were in LMC constituted 71% of the total count of disabilities. These include hypertension, with a prevalence rate of 2.66% and accounting for 19.04% of all disabilities.

In terms of prevalence and share of all disabilities, fractures accounted for 1.78% and 12.67%, pregnancy and its related conditions were at 1.68% and 11.90%, and obesity at 1.62% and 11.54%.

Diabetes was prevalent among 1.15% (8.32% share of the total officers), sprains among 1.07% (7.63% of total), disease of the spine for 1.01% (7.19% of total), cardiovascular disease for 0.74% (6.68% of total) and disease of the thyroid among 0.86 (6.12% of total).

What about the prevalence among the Navy and Air Force, leading to LMC?

For the Navy, lifestyle diseases led to 636 out of 11,476, or 5.6% of the total personnel, being categorised under the LMC. The highest incidence of lifestyle diseases was recorded among Commodore ranks, with 77 out of 410, or 18.8%, personnel under LMC.

Among Captains, 228 of 1,232, or 18.5%, were placed in the category due to lifestyle diseases. Sub Lieutenants, numbering 883, accounted for zero personnel being placed under the LMC.

Lifestyle-related disease with specific prevalence rates, per thousand, for all officers in IAF were highest for hypertension, followed by diabetes mellitus, obesity and IHD.

Hypertension accounted for a total of 5.53% — 3.30% among flying, 7.28% among ground and 2.70% among medical staff. When it came to obesity, the prevalence rate was 1.93% — 0.79%, 2.80% and 0.68% among these categories. For Ischemic Heart Disease, the prevalence rate across these categories of personnel was 1.05%, 1.60% and 0.79%, respectively (1.36% of total).

The Flying Branch includes Flying (Pilot) and Flying (Navigator) streams. Ground Duty branches include Aeronautical Engineering (mechanical), Aeronautical Engineering (Electronics), Adm/ Air Traffic Control, Adm/ Fighter Control, Adm, Accounts, Metrology, Education, and Logistics.

What is the root cause?

According to the report, officers superannuate at a comparatively much higher age (56 years) than PBORs or Personnel Below Officer Ranks (34-37 years). The prevalence among officers thus links to how lifestyle diseases are known to increase with age.

Further, the report also said, Officers and PBORs, who continue to serve for a longer duration, are also exposed to “unique stressors of the Military Services for a much longer duration.” Lifestyle diseases, the report stated, have “multifactorial causation thus, to give a root cause analysis with limited accessible data will not be possible.”

However, the report noted, “the decadal trend in Indian Air Force (IAF), Indian Army (IA) and Indian Navy (IN) is showing increasing trends similar to national data. The lower rates in Armed Forces as compared to national data is suggestive of better work and life style environment focusing on preservation of quality of life.”

What has the committee noted?

The committee was of the view that “40% officers retiring with disability” and about 20% of those on the ground having lifestyle diseases “does not speak well for the armed forces where physical fitness is a mandatory requirement.”

The committee asked to be apprised of the prevalence of hypertension and diabetes in Indian Army personnel and the remedial measures suggested by the Army Medical Corps “for checking these life style diseases in order to bring them to the minimum” and that “a root cause analysis be undertaken to remedy this situation.”

How are the forces dealing with the situation?

The Army submitted that health days are observed to raise awareness and understanding about lifestyle diseases amongst serving personnel. Regular information campaigns and activities are also conducted by Medical officers & Specialist Officers from Field Hospitals and Military Hospitals.

The IAF submitted that a detailed “Lifestyle Modification and Intervention Programme” has been implemented to facilitate a multi-sectoral approach. Regular PT with additional customised physical fitness and exercise regimen based on individual health and health corners at every unit/establishment have been created to develop “Work place health Corners” with basic minimum facilities.

Other steps include rationing of liquor “for overweight/ obese and for individuals suffering from lifestyle disease” and psychological counselling to address underlying stress and promote motivation to resolve latent factors that contribute to lifestyle disease.