Non-communicable diseases emerge as the biggest killer, says new health report

Non-communicable diseases emerge as the biggest killer, says new health report


Although life expectancy at birth for both the sexes has improved over the last quarter of a century, a recent report points out that ‘non-communicable diseases’ (NCDs) now account for a larger proportion of total deaths vis-à-vis ‘communicable, maternal, neonatal and nutritional disease' (CMNNDs).

The report entitled India: Health of the Nation’s States - The India State-Level Disease Burden Initiative, which has been prepared after two years of intense collaborative research work, shows that NCDs including cardiovascular diseases, diabetes, chronic respiratory diseases, 'mental health and neurological disorders', cancers, musculoskeletal disorders, chronic kidney disease etc. accounted for 61.8 percent of total deaths in the country in 2016, which was 37.9 percent in 1990.

On the other hand, the contribution of CMNNDs to total deaths was 53.6 percent in 1990, which almost halved to 27.5 percent in 2016. CMNNDs include ‘HIV/AIDS and tuberculosis’, 'diarrhea, lower respiratory, and other common infectious diseases', 'neglected tropical diseases and malaria', maternal disorders, neonatal disorders, nutritional deficiencies, and 'other communicable, maternal, neonatal, and nutritional diseases'.

Injuries, which include transport injuries, unintentional injuries, 'suicide and interpersonal violence' and others, accounted for 8.5 percent of total deaths almost 25 years back, which increased marginally to 10.7 percent in 2016.

As could be seen from the square pie chart-1 (for accessing the interactive version of the same chart, please go to http://ihmeuw.org/4a86), ischaemic heart disease (17.8 percent of total deaths) accounted for most deaths in 2016, followed by chronic obstructive pulmonary disease (8.66 percent of total deaths), and diarrheal diseases (7.94 percent of total deaths). In 1990, however, diarrheal diseases (14.29 percent of total deaths) accounted for most deaths, followed by ischaemic heart disease (8.37 percent of total deaths) and lower respiratory infections (8.3 percent of total deaths).

Chart 1: Causes of deaths in India in 1990 & 2016 for all ages and both sexes (in %)

 
Chart 1 Major causes of deaths in India

Source: Global Burden of Disease Study 2016 (India), http://ihmeuw.org/4a86

The size of the box in the square pie chart-1 is proportionate to the burden displayed. 
 
Cardiovascular diseases caused most number of deaths per lakh population (also called death rate) in 2016, followed by 'diarrhea, lower respiratory, and other common infectious diseases' and 'chronic respiratory diseases'. In 1990, however, 'diarrhea, lower respiratory, and other common infectious diseases' topped the list of causes in terms of deaths per lakh population, followed by cardiovascular diseases and chronic respiratory diseases. Please check the arrow chart-2 (for accessing the interactive version of the same chart, please go to http://ihmeuw.org/4a87).

Chart 2: Ranking of various causes of death in 1990 & 2016 in terms of deaths per lakh

 
Chart 2 Death rate per lakh in 1990 and 2016

Source: Global Burden of Disease Study 2016 (India), http://ihmeuw.org/4a87

Table-1 shows that that within the various groups of states, NCDs caused 68.5 percent of total deaths in 'Other states group' (which is higher than the contribution of NCDs to total deaths at the national level), 58.8 percent deaths in 'North-East states group' and 55.1 percent deaths in 'Empowered Action Group states'.

On the other hand, CMNNDs caused 34.6 percent of total deaths in 'EAG states' (which is higher than the contribution of CMNNCDs to total deaths at the national level), 32.1 percent deaths in 'North-East states group' and 20.2 percent of deaths in 'Other states group'.

Table 1: Contribution of disease categories to deaths in the state groups in 2016
 
Table 1 Contribution of disease categories to deaths in 2016
 
Source: India State-Level Disease Burden Initiative (2016), please click here to access 

The EAG states are Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttar Pradesh and Uttarakhand. The North-Eastern states considered for the study are Assam, Meghalaya, Arunachal Pradesh, Mizoram, Nagaland, Tripura, Sikkim and Manipur. The 'Other states' are Gujarat, Andhra Pradesh, Delhi, Haryana, Jammu and Kashmir, Karnataka, Maharashtra, Telangana, Union Territories other than Delhi, West Bengal, Goa, Himachal Pradesh, Kerala, Punjab and Tamil Nadu.

It needs to be mentioned that the India State-level Disease Burden Initiative is a collaboration between the Indian Council of Medical Research, Public Health Foundation of India, and Institute for Health Metrics and Evaluation at the University of Washington, and experts and stakeholders from nearly 100 institutions across the country. The Disease Burden India Secretariat also provided crucial support for the work of this Initiative. The study was funded by the Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India, and the Bill & Melinda Gates Foundation.

The estimates were produced as part of the Global Burden of Disease Study 2016, says the study. Please click here to access the key findings of the study.

References:

India: Health of the Nation’s States -The India State-Level Disease Burden Initiative, Disease Burden Trends in the States of India: 1990 to 2016, published on 14 November, 2017, prepared by Indian Council of Medical Research (ICMR), Public Health Foundation of India (PHFI), Institute for Health Metrics and Evaluation (IHME) and Ministry of Health & Family Welfare (MoHFW), please click here to access 

Why are there disparities between States on diseases? -Bindu Shajan Perappadan, The Hindu, 9 December, 2017, please click here to access
 
A toolkit to think local -Soumya Swaminathan & Lalit Dandona, The Hindu, 27 November, 2017, please click here to access 
 
 
Image Courtesy: UNDP India



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