Lifestyle triggers major shift in disease burden across India


Indians have gained almost a decade of life expectancy since 1990, women more so than men, a first of its kind study released on Tuesday has revealed.

From diarrhoea being the top killer in a couple of states to Alzheimer, a corollary of higher life expectancy, making it to a state's leading causes of death the variation between states is huge.

Kerala, Goa, and Tamil Nadu-relatively prosperous states-have the largest share of NCDs such as cardiovascular diseases, diabetes, chronic respiratory diseases, mental health and neurological disorders, cancers, musculoskeletal disorders and chronic kidney disease. "Similarly, Ischaemic heart disease that is greatly influenced by air pollution has gone up from rank 5 to number 1, diabetes from rank 22 to rank 5 and stroke from rank 16 to rank 15", he said.

"The contribution of NCDs to health loss, fuelled by unhealthy diets, high blood pressure, blood sugar and overweight, has doubled in India over the past two decades". In 1990, 61% of the total disease burden in India was attributed to communicable, maternal, neonatal, and nutritional diseases. Kerala had the lowest burden due to this risk among the Indian states, but even this was 2.7 times higher per person than in China.

Though life expectancy at birth has improved at the national level, inequalities between states continue - ranging from 66.8 years in Uttar Pradesh to 78.7 years in Kerala for females, and 63.6 years in Assam to 73.8 years in Kerala for males in 2016.

The under-five mortality rate has reduced substantially from 1990 in all states, the report said, adding that there was a four-fold difference in this rate between states. "However, the extent of these risk factors varies considerably across the states of India", said K Srinath Reddy, President of Public Health Foundation of India (PHFI).

Unveiling the study in Gurugram, Vice-President M Venkaiah Naidu said the findings show that the overall disease burden per person in some states of India was nearly twice as much as in some other states, and the burden rate due to the leading diseases ranges from five to ten times between the states.

Outdoor air pollution was responsible for six per cent of the total disease burden in India in 2016, a new study has said at a time when thick smog hung low over Delhi-NCR, leaving residents gasping for breath.

The per person disease burden dropped by 36% from 1990 to 2016.

"The per person burden from numerous leading infectious and non-communicable diseases varies 5-10 times between different States and malnutrition continues to be the single largest risk for health loss in India, which is higher among females and is particularly severe in the empowered action group States and Assam", noted the report.

This knowledge base can be a crucial aid for more informed policy and interventions to improve population health in every state and union territory of India and in reducing health inequalities between the states.

"India is committed to strengthening health data surveillance and health systems in the country".