Rahul Gandhi at the rally in Chandigarh on Thursday
where he made the comment. (PTI)
New Delhi, Oct. 13: Rahul Gandhi and Punjab state authorities could do with lessons in the science of estimating the prevalence of health problems, experts say.
Rahul, guided by the contents of a three-year-old court affidavit filed by the Punjab government, said on Thursday that seven in 10 youths in Punjab have drug abuse problems, triggering angry reactions from the state’s Akali Dal government.
“What is happening to human resources in Punjab?” the Congress general secretary asked at a rally on a university campus. “Seven out of 10 youths in Punjab have the problem of drugs.”
The Akali Dal on Friday called Rahul a “joke” and deputy chief minister Sukhbir Singh Badal sought an apology from him. Congress sources pointed out that Rahul’s observations were entirely based on the Punjab government’s own submission in court.
Health experts say a 70 per cent prevalence rate of drug abuse would be unimaginably high, putting in shade even the alarming “current-use” prevalence rate of 22 per cent among young people in Imphal, as documented last year by the Indian Council of Medical Research (ICMR).
Rahul had blindly repeated the contents of a court affidavit pencilled by Punjab’s secretary of social security and women and child development, which carelessly misinterpreted a study that had analysed the background of 600 drug users.
“The Punjab government itself made this submission. They should crosscheck what they told the court. We have lost one generation to terrorism. Now we are losing another generation to drugs,” Congress spokesperson Manish Tewari said on Friday.
Despite repeated attempts, Tewari could not be reached for comment on Saturday when it emerged the affidavit he had cited had got the study wrong.
Ranvinder Singh Sandhu at the Guru Nanak Dev University, Amritsar, had analysed the age and socio-economic profiles of 600 patients in what medical experts call a “cohort” study that examines a group of people with some similarities — in this case, drug abuse.
“A cohort study can never represent the prevalence of a health problem in the community,” said Alben Sigamani, assistant professor at the St John’s Medical College, Bangalore. “A cohort study is biased as it’s only looking at people who already have a health problem.”
Sandhu says his age profile analysis has shown that 73.5 per cent of the 600 users were aged between 16 and 35. This result, he concedes, cannot be used to extrapolate prevalence in a community.
In any case, the study was highlighting what proportion of (these 600) drug users were young rather than what proportion of the young were drug users.
The study was published by Sandhu’s university in a book in 2009. “It seems they (the Punjab government) didn’t understand what we had done,” Sandhu told The Telegraph today.
The 2009 affidavit filed by the state in Punjab and Haryana High Court says Sandhu’s survey has found that “drug addiction in Punjab is 70 per cent”. At another point, it says: “Approximately seven out of 10 college-going students (in Punjab) abuse one or other drug.”
Sigamani said: “A more reliable method to assess drug-abuse prevalence in a community would be direct door-to-door surveys. If that’s impractical, then you take all patients visiting a large hospital as the denominator, and find out how many have drug abuse problems and put that figure in the numerator. In prevalence studies, the denominator is crucial.”
The affidavit also contained a line that health experts say may be closer to reality. It said: “Every third male and every tenth female student has (taken) a drug on the pretext of one or other occasion in Punjab.”
This figure reflects what substance abuse epidemiologists call “prevalence of ever use” — the proportion of people who have used the substance at least once — and this is always higher than community prevalence, because many don’t continue.
The ICMR study, published in the National Medical Journal of India, had shown a 54 per cent “ever use” prevalence of substance abuse among young people in Imphal.
“It’s misleading to discuss nationwide or statewide prevalence rates,” said a scientist at the National Drug Dependence Treatment Centre, Delhi, who asked not to be named. “The rates can vary dramatically from locality to locality.”