186478 Comparative health outcomes of Paniya tribes (Wayanad, Kerala): The need to address their differential vulnerability

Tuesday, October 28, 2008: 12:35 PM

Slim Haddad, MD, PhD , Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, QC, Canada
Marta Feletto, PhD , Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
K.S. Mohindra, PhD , Department of Health Care and Epidemiology, University of British Columbia, Vancouver, BC, Canada
Gisèle Contreras, MSc , Department of social and preventive medicine, Université de Montréal, Montreal, QC, Canada
Delampady Narayana, PhD , Centre for Development Studies, Thiruvananthapuram, India

Although the state of Kerala is considered to be one of the most egalitarian states in India, large inequalities persist among castes and social groups. The Paniya indigenous group is consistently at the bottom of the social hierarchy. Paniyas are significantly disadvantaged as compared to other social groups; they suffer from social exclusion, are typically landless, and live in severely deprived conditions. Although their social and economic vulnerability is documented, there is little evidence regarding their health needs and differential vulnerability.


To assess the health needs and differential vulnerability of Paniyas.


A health survey was conducted in 2006 among a random sample of 543 households (2418 individuals) in a rural district with a high proportion of tribal populations (36%). Paniyas were oversampled (one third of the sample).


56.9% of Paniyas are underweight, 12.2% are severely so and 18.1% show symptoms of anaemia (joint pallor in conjunctive, tongue and nail). Paniyas are almost twice as likely to be underweight as other social groups (OR=1.86 95% CI:1.3-2.6), and have a comparatively higher likelihood of presenting symptoms of anaemia (OR=4.7 95% CI:3.2-6.7). Paniyas are not more likely to have thyroid dysfunction (visual detection of goiter), hypertension or tuberculosis (coughing and fever, or tuberculosis test). A considerably higher likelihood of thyroid dysfunction is nonetheless observed among Paniya women (OR: 5.1 95% CI:1.0-24.5).


The plight of Paniyas translates into comparably lower health outcomes. This equity-gap needs to be addressed by designing interventions targeting this especially highly vulnerable population.

Learning Objectives:
- to illustrate how Paniyas are different from the other social groups with regard to their vulnerability - to discuss the need for public health interventions specifically targeting this group

Keywords: Health Needs, Indigenous Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I hold a PhD in public health and am currently a CIHR global health post-doctoral fellow with 10 years experience working in interantional health. I am a co-researcher on the project in which the presentation is based and have been working with the project in Kerala since 2001.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.