Nav: Home

Comprehensive health study in India finds rise of non-communicable diseases

November 14, 2017

DELHI - A new state-by-state health analysis in India finds that over two decades heart- and lung-related conditions, as well as other non-communicable diseases (NCDs), have surpassed infectious diseases, such as diarrhea and tuberculosis, as the nation's leading killers. The extent of this difference, however, varies significantly among the nation's 29 states and seven union territories.

The study, which covers 1990 through 2016, also concludes that while child and maternal malnutrition has dropped substantially, this remains the most pernicious risk factor causing loss of healthy life. Moreover, road injuries and suicides are leading contributors to death among young people, with a nearly four-fold difference in suicide rates among different Indian states.

"India has come a long way, but our individual state estimates reveal major health inequalities between the 'nations' within this nation," said Dr. Lalit Dandona, Distinguished Professor at the Public Health Foundation of India in New Delhi and a Professor of Global Health at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. "Over the past two decades the Government of India has launched many initiatives and programs to address a variety of diseases and risk factors. However, these data show that what we have being doing up to now is not enough. With the availability of state-specific findings now identifying the diseases and risk factors that need most attention in each state, we can act more effectively to improve health in every state of the country. This has the potential of reducing the major health inequalities observed currently between the states, and this would also help achieve better health outcomes for India as a whole."

The study, published today in the international medical journal The Lancet, notes that life expectancy at birth improved from about 60 years of age in 1990 to just over 70 years in 2016 for females, and from about 58 years to nearly 67 years for males. However, among states, there are inequalities of up to 10 years.

The overall loss of healthy life from all diseases and conditions together was about one-third less per person in India in 2016 as compared to 1990. However, progress is mixed. The disease burden rate at present is significantly higher in states in a less advanced phase of development, such as Assam, Uttar Pradesh, and other poorer northern states, as compared with those in the nation's most advanced phases of development, such as Kerala and Goa.

In addition, water quality and sanitation conditions have improved over the past 26 years, but they remain major factors in disease transmission and, by comparison, their contribution to disease burden is 40 times more per person in India than in China.

Air pollution also has emerged as a growing health risk in India, which has some of the most polluted air in the world. While indoor air pollution has decreased since 1990, outdoor pollution has increased from power production, industry, vehicles, construction, and waste burning.

The top conditions in India causing health loss are (in order of severity): ischemic heart disease, chronic obstructive pulmonary disease (COPD), diarrhea, lower respiratory infections, stroke, iron-deficiency anemia, preterm birth complications, tuberculosis, sensory organ diseases such as eyesight and hearing impairments, road injuries, suicide, low back and neck pain, and diabetes.

Urbanization and aging have led to increasing poor health conditions related to non-communicable diseases in all states. The fastest-growing causes of disease burden over the last 26 years were diabetes (rate increased by 80%) and ischemic heart disease (up 34%). More than 60% of deaths, about 6.1 million, in 2016 were due to NCDs, up from about 38% in 1990.

Even states with similar levels of development showed striking differences in rates of death and illness from some leading NCDs. For instance, Punjab has much higher rates of premature death and ill health due to diabetes and ischemic heart disease, but lower rates due to COPD compared to neighboring Himachal Pradesh, despite the two states both being at an advanced level.

Similarly, Uttar Pradesh has much higher rates due to COPD and tuberculosis, but lower rates from stroke compared to Madhya Pradesh, despite both states being at a similarly early stage of epidemiological transition. These differences are due to variations in exposures to risk factors as well as other determinants.

Urbanization is responsible for rising deaths and health loss from road injuries in most states since 1990, highlighting the lack of a comprehensive national policy for injury prevention. Road injures were highest in Jammu and Kashmir, with rates of premature death and illness nearly three times higher than that of Meghalaya. The burden of suicide was highest in Tripura, with rates almost six times higher than in Nagaland.

"Larger and more organized efforts, supported by greater financial and human resources, are needed to control the growing burden of NCDs and injuries," said Dr. Dandona.

Other highly preventable risks, such as diets high in salt and low in vegetables and fruit, high blood pressure, high cholesterol, and high body mass index, are contributing to the growing burden of non-communicable diseases. Together, they accounted for almost a quarter of poor health in 2016 - over twice that from 1990.

Other findings of the paper include:
  • The rate of under-age-5 mortality has dropped substantially since 1990 in all states; however, there was a more than four-fold difference between the top and bottom performing states.
  • Of the total disease burden in 1990, 61% was due to communicable, maternal, neonatal, and nutritional diseases; this dropped to 33% in 2016.
  • There was a corresponding increase in non-communicable diseases to 55% in 2016, as compared to 31% in 1990.
  • Injuries increased from 9% of total burden in 1990 to 12% in 2016.
  • Major non-communicable diseases increased throughout India, including cardiovascular diseases, diabetes, mental health and neurological disorders, cancers, musculoskeletal disorders, and chronic kidney disease.
"The study and our related policy report have significant policy implications for Indian health officials, said Dr. Christopher Murray, IHME's Director. "This research is the culmination of many years of work and it represents a starting point from which, we hope, new initiatives will be developed to improve the lives and livelihoods of many of India's 1.3 billion people."
-end-
More data are available through IHME's data visualization at: https://vizhub.healthdata.org/gbd-compare/india.

The study, "Nations within a nation: variations in epidemiological transition across the states of India, 1990-2016 in the Global Burden of Disease Study," was announced November 14 in Delhi at an event hosted by Indian Council of Medical Research, Public Health Foundation of India, and IHME, in collaboration with the Ministry of Health and Family Welfare, Government of India.

Media contacts:

Kelly Bienhoff
1-206-897-2884 (office)
1-913-302-3817 (cell)
kbien@uw.edu

Rajiv Chhibber
91-98104-26698
rajiv.chhibber@phfi.org

Gina Sharma
91-9811-887088
gina.sharma@phfi.org

About the Institute for Healthcare Metrics and Evaluation

The Institute for Health Metrics and Evaluation (IHME) is an independent global health research organization at the University of Washington that provides rigorous and comparable measurement of the world's most important health problems and evaluates the strategies used to address them. IHME makes this information widely available so that policymakers have the evidence they need to make informed decisions about how to allocate resources to improve population health.

Institute for Health Metrics and Evaluation

Related Risk Factors Articles:

Too little sleep may raise death risk in people with cluster of heart disease risk factors
Sleeping less than six hours was associated with higher risk of death in people with metabolic syndrome, a cluster of several heart disease and diabetes risk factors.
New risk factors for anxiety disorders
Several newly discovered variants of a gene increase the risk of developing anxiety disorders.
Alcohol abuse increases risk of heart conditions as much as other risk factors
Alcohol abuse increases the risk of atrial fibrillation, heart attack and congestive heart failure as much as other well-established risk factors such as high blood pressure, diabetes, smoking and obesity, according to a study published today in the Journal of the American College of Cardiology.
Preventing heart failure risk factors in midlife substantially lowers risk
Preventing the development of hypertension, obesity and diabetes by the age of 45 to 55 years may lead up to an 86 percent lower risk for heart failure through the remainder of life, according to research published today in JACC: Heart Failure.
Knowing risk factors could help catch melanomas
University of Sydney researchers and their collaborators have pinpointed risk factors that could help doctors tailor individuals' skin examinations and catch melanoma at an early stage.
Ranking global risk factors for childhood stunting
The leading risk factor for childhood stunting is being born at term but small for gestational age, according to a 137-country analysis published in PLOS Medicine.
Severe lead poisoning in children: Causes and risk factors
Although national and local policies have reduced the prevalence of lead poisoning in the United States, severe cases still occur.
Perinatal risk factors linked with higher risk of obsessive compulsive disorder
A range of perinatal factors appear to be associated with higher risk for children later developing obsessive compulsive disorder, according to an article published online by JAMA Psychiatry.
Study examines risk, risk factors for depression after stroke
During the first three months after stroke, the risk for depression was eight times higher than in a reference population of people without stroke, according to an article published online by JAMA Psychiatry.

Related Risk Factors Reading:

The Risk Factor: Crossing the Chicken Line Into Your Supernatural Destiny
by Kevin Dedmon (Author), Chad Dedmon (Author), Bill Johnson (Foreword), Heidi Baker (Foreword)

The Risk Factor: Crossing the Chicken Line Into Your Supernatural Destiny was written by a father-son team who discuss the dynamics and importance of risk as a Kingdom lifestyle of faith that rockets believers into the supernatural—and into fulfilling their unique God-given destinies. Through many down-to-earth and inspiring true stories, the Dedmons raise the standard for what is attainable for all believers—including healing. You are challenged to embrace and celebrate risk and encouraged to take steps to cross your own “chicken line” to see what God will do through you as... View Details


The Risk Factor: Why Every Organization Needs Big Bets, Bold Characters, and the Occasional Spectacular Failure
by Deborah Perry Piscione (Author)

Our most revered business icons of the last few decades are the bold risktakers, such as Richard Branson, Elon Musk, and Steve Jobs. Yet in today's stock market-driven economy, companies are playing it safe, with too many leaders focused on short-term gains, rather than value creation. The result is a static business culture that generates forgettable results―even as the world demands big solutions. So how do we get back in the risk-taking game? In The Risk Factor, Deborah Perry Piscione takes the most comprehensive look at this crucial, undervalued leadership behavior, and outlines... View Details


Medical, Genetic & Behavioral Risk Factors of Miniature Bull Terriers
by Ross D. Clark DVM (Author)

View Details


Public Health and the Risk Factor (Rochester Studies in Medical History)
by William G. Rothstein (Author)

The greatest revolutions in twentieth-century public health and preventive medicine have been the concepts of risk factors and healthy lifestyles as methods of preventing disease. A risk factor is anything that increases the risk of disease in an individual. Lifestyle refers to the individual's personal behaviors with regard to risk factors. Identifying risk factors and modifying them by changing lifestyles in order to prevent disease has become ubiquitous as a strategy in public health. The book examines the history and evolution of the concepts of risk factors and healthy lifestyles and... View Details


Factor Investing: From Traditional to Alternative Risk Premia (Quantitative Finance)
by Emmanuel Jurczenko (Editor)

This new edited volume consists of a collection of original articles written by leading industry experts in the area of factor investing. The chapters introduce readers to some of the latest research developments in the area of equity and alternative investment strategies.Each chapter deals with new methods for constructing and harvesting traditional and alternative risk premia, building strategic and tactical multifactor portfolios, and assessing related systematic investment performances. This volume will be of help to portfolio managers, asset owners and consultants, as well as... View Details


Risk Factor
by Bold Strokes Books

Myra Owens runs a therapeutic riding program for returning soldiers. She won't risk getting hurt by becoming personally involved with her riders until Ainslee Harriot challenges her to take a chance on love.

Risk Factor was previously published in Sweet Hearts (Bold Strokes Books, 2015). View Details


Glioblastoma: Risk Factors, Diagnosis and Treatment Options (Cancer Etiology, Diagnosis and Treatment)
by Marcelo F. Bezerra (Editor), Claudio R. Alves (Editor)

View Details


Medical, Genetic & Behavioral Risk Factors of Pomeranians
by ROSS D. CLARK DVM (Author)

View Details


Risk-Based and Factor Investing
by Emmanuel Jurczenko (Editor)

This book is a compilation of recent articles written by leading academics and practitioners in the area of risk-based and factor investing (RBFI).

The articles are intended to introduce readers to some of the latest, cutting edge research encountered by academics and professionals dealing with RBFI solutions. Together the authors detail both alternative non-return based portfolio construction techniques and investing style risk premia strategies.

Each chapter deals with new methods of building strategic and tactical risk-based portfolios, constructing and combining... View Details


Global Burden of Disease and Risk Factors
by Alan D. Lopez (Editor), Colin D. Mathers (Editor), Majid Ezzati (Editor), Dean T. Jamison (Editor), Christopher J. L. Murray (Editor)

This volume is a single up-to-date source on the entire global epidemiology of diseases, injuries and risk factors with a comprehensivestatement of methods and a complete presentation of results. It includesrefined methods to assess data, ensure epidemiological consistency, andsummarize the disease burden. 'Global Burden of Disease and Risk Factors' examines the comparative importance of diseases, injuries, and risk factors; it incorporates a range of new data sources to develop consistent estimates of incidence, prevalence, severity and duration, and mortality for 136 major diseases and... View Details

Best Science Podcasts 2017

We have hand picked the best science podcasts for 2017. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Simple Solutions
Sometimes, the best solutions to complex problems are simple. But simple doesn't always mean easy. This hour, TED speakers describe the innovation and hard work that goes into achieving simplicity. Guests include designer Mileha Soneji, chef Sam Kass, sleep researcher Wendy Troxel, public health advocate Myriam Sidibe, and engineer Amos Winter.
Now Playing: Science for the People

#448 Pavlov (Rebroadcast)
This week, we're learning about the life and work of a groundbreaking physiologist whose work on learning and instinct is familiar worldwide, and almost universally misunderstood. We'll spend the hour with Daniel Todes, Ph.D, Professor of History of Medicine at The Johns Hopkins University, discussing his book "Ivan Pavlov: A Russian Life in Science."