An analysis published in The Lancet Global Health, which looked at about 9.7 million deaths in India in 2017, found that every condition that was common in one part of India was uncommon elsewhere.
For example, the Northeastern states, Uttar Pradesh, Rajasthan, West Bengal, Haryana, Gujarat, Kerala, Karnataka and Madhya Pradesh account for 44% of India’s cancer burden (The Indian Express, November 12).
Premature deaths due to various causes, expressed as YLLs, too were unevenly distributed in terms of the burden on the states. By the World Health Organzation definition, YLLs, or years of life lost, are calculated from the number of deaths multiplied by a standard life expectancy at the age of death.
For example, liver and alcohol-related YLL rates were high in the northeastern states, Bihar, Karnataka, and Maharashtra, accounting for 18% of national YLLs. Suicide YLL rates were highest in the southern states, accounting for 15% of national totals. Road traffic injuries were high in the northern states of Uttar Pradesh, Punjab, Uttarakhand, Haryana and Himachal Pradesh, accounting for 33% of national totals.
Drowning YLL rates, meanwhile, were highest in the central states of Madhya Pradesh and Chhattisgarh, and in Assam in the Northeast, accounting for 11% of national totals.
In 2017, India had 486 million DALYs (disability-adjusted life years, a measure of the number of years lost due to ill health or disability). The ratio of DALYs to the 9.7 million deaths was about 50 to 1. More than three quarters of deaths and DALYs occurred in rural areas, and males accounted for 54·3% of all DALYs.
At all ages, the DALY rate per 100 000 population was 36,300, but rates were higher among rural residents and among males. DALY rates in rural areas were at least twice those of urban areas for certain conditions.
The study, funded by the Ministry of Heath and Family Welfare, included authors from the Indian Council of Medical Research, and from the global health research wings of the University of Toronto and University of California, San Francisco.
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