In the same passage, choose the correct word to fill the blank: “We in India may not have been _____ by it to the extent that people in western countries have been.”

Introduction / Context:
The final blank in this passage compares the impact of a metaphorical “disease” on India and western countries. The disease is not necessarily medical; it could be a lifestyle or attitude. However, the grammar “have been _____ by it” points towards a verb that describes being affected by something, similar to being infected by an illness. The correct option must fit both grammatically and metaphorically.

Given Data / Assumptions:
- Sentence fragment: “we in India may not have been _____ by it to the extent that people in western countries have been.”
- Options: infected, inflicted, accompanied, associate, afflicted.
- The word “it” refers to the earlier described “disease” of living an over-scheduled, anxiety-filled life.

Concept / Approach:
When English speakers talk about diseases, they say people are “infected by” or “afflicted by” them. The verb “inflict” generally takes the illness or harm as its subject: someone inflicts pain on another person. “Associate” and “accompanied” do not express the idea of suffering from a condition. Therefore, we must choose a verb that correctly forms a passive construction “have been X by it”. The strongest collocation here is “infected by it”, which connects directly to the disease metaphor.

Step-by-Step Solution:
Step 1: Substitute “infected”: “may not have been infected by it”. This closely matches the disease metaphor and is grammatically sound. Step 2: Consider “afflicted”. “Afflicted by it” is also possible in English, but more commonly we say “afflicted with a disease”. The passage earlier uses the word “disease” figuratively, but the typical collocation with “by it” is “infected by it”. Step 3: Consider “inflicted”. People are not “inflicted by” something; rather, something is inflicted on them, so the structure would be wrong. Step 4: Consider “accompanied”. Being “accompanied by it” would suggest that the country is simply accompanied by the disease, which does not convey the idea of being harmed. Step 5: Consider “associate”. “Have been associate by it” is grammatically incorrect; the correct form would be “associated with”, not “by”. Step 6: Therefore, “infected” is the most natural and accurate choice.

Verification / Alternative check:
Read the completed sentence: “We in India may not have been infected by it to the extent that people in western countries have been.” This successfully conveys the idea that the harmful lifestyle has not taken hold in India as strongly as in the West. “Infected by it” matches both the structure and the metaphor of a spreading disease, confirming our selection.

Why Other Options Are Wrong:
- Inflicted: the pattern is “inflict something on someone”, not “inflicted by it”, so the passive structure is incorrect.
- Accompanied: suggests something neutral that simply occurs together, lacking the idea of harm or ailment.
- Associate: would need “associated with”, which is a different grammatical pattern and less appropriate in the disease metaphor.
- Afflicted: closer in meaning but not as strong a collocation with “by it” in the exact structure given; exam keys typically prefer “infected by”.

Common Pitfalls:
Students sometimes choose “inflicted” or “afflicted” because they look similar to medical terms. The key is to focus on preposition patterns: “infected by”, “afflicted with”, “inflict upon/on”. Misremembering these combinations leads to avoidable mistakes. Always check whether the preposition in the original sentence fits the verb you are considering.

Final Answer:
The correct word to complete the sentence is infected, giving “may not have been infected by it”.