Burden of disease shifts to non-communicable ailments

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There has been a 17 per cent rise in deaths and disabilities due to diseases caused by air pollution across the country, a report titled India: Health of the Nation's States released here on Tuesday revealed.

It found that three of the five leading killers in India in 2016 were NCDs - ischaemic heart disease, chronic obstructive pulmonary disease and stroke.

The study mentioned that the burden due to outdoor air pollution is highest in northern states, including Haryana, Uttar Pradesh, Punjab, Rajasthan, Bihar, and West Bengal.

"However, the extent of these risk factors varies considerably across the States of India", said Dr. K. Srinath Reddy, president of the Public Health Foundation of India (PHFI), one of the partners of the India State-level Disease Burden Initiative (ISDBI).

The study used multiple data sources to map State-level disease burden from 333 disease conditions and injuries, and 83 risk factors for each State from 1990 to 2016.

"Household air pollution was responsible for 5 per cent of the total disease burden in India in 2016, and outdoor air pollution for 6 per cent", the report stated.

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.

Life expectancy at birth improved in India from 59.7 years in 1990 to 70.3 years in 2016 for females, and from 58.3 years to 66.9 years for males.

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On a national scale, the report shows, there are major health inequalities among states irrespective of the improvements in the last 25 years. But here again, state level inequalities are stark, with a range of 66.8 years in Uttar Pradesh to 78.7 years in Kerala for women, and 63.6 years in Assam to 73.8 years in Kerala for men in 2016, the report said.

Of the total disease burden in India measured as disability-adjusted life years (DALYs) DALYs, 61% was due to communicable, maternal, neonatal, and nutritional diseases (termed infectious and associated diseases in this summary for simplicity) in 1990, which dropped to 33% in 2016.

"The highest proportion of disease burden due to injuries is in young adults".

In the worst affected states, over 2,750 cases of deaths or severe illnesses such as non-communicable diseases, chronic respiratory diseases and lower respiratory infections, per lakh pollution were reported a year ago, the study says.

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.

The disease burden and risk factor estimates for every state of India from 1990 to 2016 in this report are the most comprehensive description of disease epidemiology attempted so far in a single standardised framework for every part of the country.

He said, many health indicators in India continue to be poorer than some other countries at a similar level of development. "This means that the more developed states that had this transition a long time ago need to go on a war footing to control the rapidly rising burden of major NCDs and injuries", said J.P. Nadda, union minister of health and family welfare.