Lifestyle triggers major shift in disease burden across India

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Overall disease burden by diabetes rose the highest in the country, by 174% in the last 26 years, followed by the burden of heart disease which rose by 104%. The Indian Council of Medical Research, the Public Health Foundation of India and the Institute for Health Metrics and Evaluation prepared the report in collaboration with the Ministry of Health.This is a first state-wise report on disease burden and risk factors trends from 1990 to 2016.

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. The report said Kerala had the lowest burden of malnutrition among the Indian states, but even that was 2.7 times higher per person than in China.

"The findings show that the overall disease burden per person in some states of India is nearly twice as much as in some other states, and the burden rate due to the leading diseases ranges five to ten times between the states", said vice president Venkaiah Naidu on the occasion of the report launch.

The contribution of injuries to the total disease burden has increased in most states since 1990, affecting the young adults (15-39 years of age) the maximum. The wide variations between the states in this epidemiological transition are reflected in the range of the contribution of major disease groups to the total disease burden in 2016: 48% to 75% for non-communicable diseases, 14% to 43% for infectious and associated diseases, and 9% to 14% for injuries.

According to the report, titled "India State-level Disease Burden" and released by Vice President M. Venkaiah Naidu here, indoor air pollution also caused five percent of the disease burden a year ago.

Life expectancy at birth improved from 59.7 years in 1990 to 70.3 years in 2016 for women. Again, men in Kerala enjoyed a life expectancy of 73.8 years, but the corresponding figure for men in Assam was 63.6 years.

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. The range of disease burden or Disability Adjusted Life Year (DALY) rate varied 3 fold for road injuries and 6 fold for self-harm among the states of India in 2016.

Exposure to household air pollution from solid fuels has dropped by 52 per cent in India since 1990.

Tobacco also emerged as a significant contributor to cardiovascular diseases, diabetes and certain cancers it was responsible for 6% of the total disease burden in India in 2016. However, there was an nearly two-fold difference in this disease burden rate among the states in 2016, with Assam, Uttar Pradesh, and Chhattisgarh having the highest rates, and Kerala and Goa the lowest rates. These included all available data and inputs from a large network of highly skilled collaborators. "This knowledge has the potential of making fundamental and long-term contributions to improving health in every state", said Dr. Soumya Swaminathan, Director-General of ICMR.

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