Aim: This study aims to identify the disaster-related health impact on endemic diseases among middle-aged individuals in India. Data & Methods: This study utilizes data from the first wave of the Longitudinal Ageing Survey of India, 2017-18 with an eligible sample of 66,606 individuals aged 45 years and above. Binary logistic regression analysis and the Fairlie decomposition technique were used to understand the factors affecting endemic disease and to predict the factors contributing to rural-urban inequality in endemic disease prevalence. Results: The prevalence of endemic disease was 48 % among individuals whose health was affected by the disaster and 25 % among those whose health was not affected by the disaster. The Odds Ratio (ORs) of having endemic disease among disaster-affected individuals was found to be uniformly higher in rural areas [OR: 2.6 (95% CI: 2.2,3.0)] than in urban areas [OR: 1.84 (95% CI: 1.4,2.5)]. In the adjusted model, the risk of endemic disease among disaster-affected individuals was 2.17 times and 1.42 times higher in rural and urban areas respectively in comparison to individuals without any health impact from a disaster. Conclusion: Efforts aimed at education on hygiene, and provisions of safe water and sanitation will significantly reduce the burden. Preparedness in disaster-prone areas, training the health and local community, efficient resource allocation, and identifying and managing the particular disease will help to minimize disease transmission.