Incidence of non-communicable diseases in India rose by 25 % since 1990

Lalit Dandona

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 Lancet report said that underdeveloped states, including Bihar, Jharkhand, Uttar Pradesh, Rajasthan, Madhya Pradesh and Haryana, have a low epidemiological transition level (ETL).

Another communicable disease, tuberculosis too continues to figure among the top killers in most states barring the southern states, and Goa and Punjab where it is diabetes which has climbed into the list of top killers.

Lifestyle diseases like heart ailments, diabetes and injuries constitute the major disease burden of most Indian states in the last 25 years. Road injuries and self-harm, which includes suicides and non-fatal outcomes of self-harm, are the leading contributors to the injury burden in India.

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It said that the burden of household air pollution decreased between 1990 and 2016 due to decreasing use of solid fuels for cooking, and that of outdoor air pollution increased due to a variety of pollutants from power production, industry, vehicles, construction and waste burning. All states have started seeing the effects of these two factors and many will see an acceleration of these as unplanned urbanisation picks up pace and life expectancy increases coupled with reduced cases of early deaths. Non-communicable diseases contributed a whopping 59.2 percent to the State's overall disease burden. The highest rate was recorded in Assam and Uttar Pradesh compared to the lowest in Kerala a year ago. 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.

Vice Preident Venkaiah Naidu released the study on disease burden in India on Tuesday.

"It causes burden through a mix of non-communicable and infectious diseases, mainly cardiovascular diseases, chronic respiratory diseases, and lower respiratory infections", said the report. But, in the states that recorded the highest number of such mortalities, such as Assam and Uttar Pradesh, the rates were four times that of the states with the lowest incidence, such as the relatively more prosperous Kerala.

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The study conducted by the Indian Council of Medical Research, Public Heath Foundation of India and Institute for Health Metrics and Evaluation is the first comprehensive analysis of the health of India's 1.34 billion citizens.

Calling for immediate measures, the report says that control of air pollution has to be ramped up through inter-sectoral collaborations based on the specific situation of each state. The per person disease burden measured as DALYs rate dropped by 36% from 1990 to 2016 in India, after adjusting for the changes in the population age structure during this period. "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. These findings and the ongoing work of the India State-level Disease Burden Initiative could provide important inputs for the data-driven and decentralised health planning and monitoring recommended by the National Health Policy 2017 and the NITI Aayog Action Agenda 2017-2020.

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