Outdoor pollution behind 6% disease burden

Outdoor pollution behind 6% disease burden”

The study, published today in the worldwide 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 almost 67 years for males. A lot less number of people are burdened with communicable diseases, but the burden of non-communicable diseases is rising. And on top of this, vast inequities exist among states.

In all, scientists have identified 333 disease conditions and 84 risk factors for all the states in India. This is the first time burden of disease has been studied at state-level. Till now only national-level data was available, masking varying disease patterns in states. Over 200 experts from 100 Indian institutions participated in this initiative.

The report used data from censuses, vital registration, sample registration system, large-scale national household surveys, other population-level surveys and cohort studies, disease surveillance data, disease programme-level data, administrative records of health services, disease registries, and a wide range of other studies conducted across India.

It is higher in states of Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Rajasthan and Assam and is higher in females than males.

Releasing the India State-level Disease Burden report and technical papers in New Delhi on Tuesday, Mr Naidu said, high disease burden caused by malnutrition in India must be tackled soon to enable the next generation of Indians to reach their full potential in their personal development as well as the nation's development.

It said that the under-five mortality rate has reduced substantially from 1990 in all states, but there was a four-fold difference in this rate between the highest in Assam and Uttar Pradesh and the lowest in Kerala in 2016.

The biggest change is seen in the overall disease pattern in the country.

"The burden due to NCDs and injuries (from 9% to 12% between 1990 and 2016) has overtaken the burden due to infectious and maternal-child diseases in every state of India, though this happened in some states about 3 decades ago and in other states more recently". This figure has dropped to 33% in 2016.

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.

NCDs dominate infectious and associated diseases in Kerala, Goa, and Tamil Nadu.

According to the first such government data released on Tuesday, the share of non-communicable diseases (NCDs) in the total burden of disease increased to 55% in 2016 from 30% in 1990. "We have four times more Tuberculosis and three times more iron deficiency anaemia than countries which have same socio-demographic factors".

"The range of disease burden among the states of India was nine-fold for diarrhoeal diseases, seven-fold for lower respiratory infections, and nine-fold for tuberculosis in 2016, highlighting the need for efforts based on the specific trends in each state", the report said. 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. The disease burden due to unsafe water and sanitation has also reduced significantly in India, but this burden is still 40 times higher per person in India than in China. "I wish continuing success for further work of the India State-level Disease Burden Initiative in providing the best possible annual disease burden estimates for every state and union territory that could be utilized in many ways for improving the health of Indians in every nook and corner of the country".

While the disease burden due to child and maternal malnutrition has dropped in India substantially since 1990, this is still the single largest risk factor responsible for 15% of the total disease burden in India in 2016.

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.

National-level data can obscure disparities across India's varied landscape, so a detailed understanding of health challenges at the state level is necessary to ensure that policies are responsive to the specific context of each state, it says.

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