Since the 1990s, India has experienced a profound epidemiological transition, marked by a shift from communicable to non-communicable diseases (NCDs) as the leading causes of mortality. This shift has disproportionately impacted individuals aged 46 years and above, making them particularly susceptible to adverse health outcomes. The present study examines the influence of socioeconomic inequality on both individual and simultaneous health conditions among elderly residents of the Islampur Community Development Block, Uttar Dinajpur District, West Bengal. This research is based on primary data collected through extensive field investigations between November 2022 and June 2023, employing stratified sampling techniques to survey 1137 respondents. The study utilizes a combination of statistical and geospatial methodologies, including descriptive statistics, the Wealth Index, the Concentration Index (CI), decomposition of CI, and Hot Spot Analysis. Findings indicate that Body Mass Index (BMI) is a key determinant of single morbidity, while wealth status is the primary factor influencing multi-morbidity. Spatial autocorrelation analysis yields a maximum Moran’s I value of 0.101, confirming a 99% probability of clustered morbidity occurrences. Hot Spot Analysis highlights Chaprajhar (Islampur Gram Panchayat) and Purbba Gomaidighi (Kamalagaon Sujali Gram Panchayat) as high-risk villages, whereas Uttar Khojagaon (Ramganj-I Gram Panchayat) is the least populated yet significantly affected. By identifying NCD morbidity hotspots at the micro-geographical level, this study provides critical insights for targeted health interventions, facilitating timely and effective strategies to address health disparities and enhance public health outcomes in vulnerable rural communities.