Background In India, the usage of modern contraception methods among women is relatively lower in comparison to other developed economies. Even within India, there is a state-wise variation in family planning use that leads to unintended pregnancies. Significantly less evidence is available regarding the determinants of modern contraception use and the level of inequalities associated with this. Therefore, the present study has examined the level of inequalities in modern contraception use among currently married women in India. Methods This study used the fourth round of National Family Health Survey (NFHS-4) conducted in 2015-16. Our analysis has divided the uses of contraception into three modern methods of family planning such as Short-Acting Reversible Contraception (SARC), Long-Acting Reversible Contraception (LARC) and permanent contraception methods. SARC includes pills, injectable, and condoms, while LARC includes intrauterine devices, implants, and permanent contraception methods (i.e., male and female sterilization). We have employed a concentration index to examine the level of socioeconomic inequalities in utilizing modern contraception methods. Results Our results show that utilization of permanent methods of contraception is more among the currently married women in the higher age group (40-49) as compared to the lower age group (25-29). Women aged 25-29 years are 3.41 times (OR: 3.41; 95% CI: 3.30-3.54) more likely to use SARC methods in India. Similarly, women with 15 + years of education and rich are more likely to use the LARC methods. At the regional level, we have found that southern region states are three times more likely to use permanent methods of contraception. Our decomposition results show that women age group (40-49), women having 2-3 children and richer wealth quintiles are more contributed for the inequality in modern contraceptive use among women. Conclusions The use of SARC and LARC methods by women who are marginalized and of lower socioeconomic status is remarkably low. Universal free access to family planning methods among marginalized women and awareness campaigns in the rural areas could be a potential policy prescription to reduce the inequalities of contraceptive use among currently married women in India.

Despite the global disease burden associated with the co-occurrence of cardiovascular diseases (CVDs) and depression, depression remains underdiagnosed and undertreated in the CVD population, especially among older adults in India. As such, this study examines (1) the association between single and multiple CVDs and major depressive disorder among older Indians; (2) whether this association is mediated by older adults' self-rated health and functional limitations; and (3) whether these associations vary for older men and women. Data come from the 2017–18 wave 1 of the Longitudinal Ageing Study in India. Multivariable logistic regression is used to explore the association between CVDs and major depressive disorder among older men and women. The Karlson–Holm–Breen (KHB) method is used to examine the mediation effects of self-rated health and functional difficulties in the observed associations. Overall, 5.08% of the older adults had multiple CVDs. Older women (9.71%) had a higher prevalence of major depressive disorder compared to men (7.50%). Multiple CVDs were associated with greater odds of major depressive disorder after adjusting the potential covariates (adjusted odds ratio [AOR]: 1.49; 95% confidence interval [CI]: 1.10–2.00). Older men with multiple CVDs had a greater risk of major depressive disorder (AOR: 1.64; 95% CI: 1.05–2.57) relative to women with CVDs (AOR: 1.39; 95% CI: 0.93–2.08). The association between multiple CVDs and depression was mediated by self-rated health (34.03% for men vs. 34.55% for women), ADL difficulty (22.25% vs. 15.42%), and IADL difficulty (22.90% vs. 19.10%). One in five older Indians with multiple CVDs reports major depressive disorder, which is three times more common than the prevalence of depressive disorder in older adults without CVDs. This association is attenuated by self-rated health and functional limitations. Moreover, these associations are more pronounced in older men relative to older women. These findings depart from prior inferences that men with CVDs are less psychologically distressed than their female counterparts. Moreover, the findings underscore the importance of gender-specific approaches to interventions and therapeutics for CVD-related mental health.