'In­di­ans have gained 10 years of life ex­pectancy since 1990'

Financial Chronicle - - MISCELLANY -

In­dian pop­u­la­tion has gained nearly a decade of life ex­pectancy since 1990, but with vast in­equal­i­ties be­tween states, rang­ing from 66.8 years in Ut­tar Pradesh to 78.7 years in Ker­ala for women, ac­cord­ing to study pub­lished today in The Lancet Jour­nal.

The study is the first com­pre­hen­sive anal­y­sis of the health of In­dia's 1.34 bil­lion cit­i­zens - en­com­pass­ing al­most a fifth of the world's pop­u­la­tion.

It es­ti­mates the key driv­ers of ill health, dis­abil­ity, and pre­ma­ture death in all 29 states, many of which have pop­u­la­tions the size of large coun­tries, and in­clude peo­ple from over 2,000 dif­fer­ent eth­nic groups.

The re­searchers di­vided In­dia's states into four groups ac­cord­ing to their level of de­vel­op­ment or epi­demi­o­log­i­cal tran­si­tion, us­ing the ra­tio of ill­ness and pre­ma­ture death caused by com­mu­ni­ca­ble, ma­ter­nal, neona­tal, and nutri­tional dis­eases (CMNNDs) ver­sus non-com­mu­ni­ca­ble dis­eases (NCDs) and in­juries as an in­di­ca­tor.

"In­di­vid­ual states in In­dia are in dif­fer­ent phases of epi­demi­o­log­i­cal tran­si­tion, and this has re­sulted in wide in­equal­i­ties in the mag­ni­tude and progress against var­i­ous dis­eases and their causes," said Lalit Dan­dona, from the Pub­lic Health Foun­da­tion of In­dia in Gurugram.

"Rather than tak­ing a more generic ap­proach, these new es­ti­mates will be cru­cial to steer­ing health pol­icy to take ac­count of spe­cific health prob­lems and risks in each state, and ul­ti­mately achiev­ing the gov­ern­ment's vi­sion of as­sur­ing health for all," said Dan­dona, who led the study.

The In­dian pop­u­la­tion has gained nearly a decade of life ex­pectancy since 1990, ris­ing to 66.9 years in men and 70.3 years in women.

How­ever, there are wide in­equal­i­ties be­tween states, with life ex­pectancy for women rang­ing from 66.8 years in Ut­tar Pradesh to 78.7 years in Ker­ala.

Since 1990, In­dia has made sub­stan­tial gains in health, with the over­all health loss from all dis­eases and con­di­tions about onethird less per per­son in 2016 than in 1990.

How­ever, progress has been mixed, with greater im­prove­ments in states at the most ad­vanced phases of de­vel­op­ment (eg, Ker­ala and Goa), com­pared to those in the ear­lier stages (eg, As­sam, Ut­tar Pradesh and sev­eral other poorer north In­dian states).

Child health re­mains a par­tic­u­lar con­cern, with high lev­els of neona­tal and un­der-5 dis­ease rel­a­tive to other age groups.

The un­der-5 mor­tal­ity rate has re­duced sub­stan­tially since 1990 in all states, but rates in As­sam and Ut­tar Pradesh are four times higher than in Ker­ala, in­di­cat­ing ma­jor health in­equal­i­ties.

The bur­den from CMNNDs has de­creased. Yet, dis­eases that pri­mar­ily cause ill­ness and death in chil­dren and moth­ers con­tinue to dom­i­nate in the coun­try.

Lower res­pi­ra­tory in­fec­tions and di­ar­rhoeal dis­eases were the third and 4th lead­ing causes of health loss in 2016, ac­count­ing for about 9 per cent of all pre­ma­ture death and ill health. More­over, there are wide dif­fer­ences be­tween states in terms of over­all progress.

De­spite signs of progress, sev­eral CMNNDs in­clud­ing di­ar­rhoeal dis­eases, iron-de­fi­ciency anaemia, and tu­ber­cu­lo­sis still cause a dis­pro­por­tion­ate amount of ill health, and claim more lives, than is ex­pected for In­dia's stage of de­vel­op­ment, par­tic­u­larly in states in the early stages of epi­demi­o­log­i­cal tran­si­tion.

As a re­sult of ur­ban­i­sa­tion and age­ing, the bur­den of NCDs is large and rapidly ris­ing in all states.

The fastest-grow­ing causes of ill-health over the last 26 years were di­a­betes (in­creased by 174 per cent) and is­chaemic heart dis­ease (up 104 per cent).

Rapid ur­ban­i­sa­tion 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, re­searchers said.

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