For instance, life expectancy at birth improved significantly during 1990 to 2016 - from 59.7 years and 58.3 years for females and males respectively in 1990 to 70.3 years for females and 66.9 years for males in 2016. And on top of this, vast inequities exist among states. "However, the extent of these risk factors varies considerably across the states of India", said K Srinath Reddy, President of Public Health Foundation of India (PHFI). This is the first time burden of disease has been studied at state-level.
A clear shift is visible in the pattern of the common disease during this period.
The India State-level Disease Burden Initiative is a collaboration between the Indian Council of Medical Research, Public Health Foundation of India, and Institute for Health Metrics and Evaluation at the University of Washington, and experts and stakeholders now from close to 100 institutions across India. "There were, however, continuing inequalities between states, with a range of 66.8 years in Uttar Pradesh to 78.7 years in Kerala for females, and 63.6 years in Assam to 73.8 years in Kerala for males in 2016", the report said.
Since 1990, India has made substantial gains in health, with the overall health loss from all diseases and conditions about one-third less per person in 2016 than in 1990.
The biggest change is seen in the overall disease pattern in the country. But that is a rare bit of good news as India faces a severe lifestyle crisis, with its disease burden from communicable diseases such as diarrhoea and tuberculosis to non-communicable diseases like heart disease and diabetes, the study has found.
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Of the total disease burden, 61% was due to communicable, maternal, neonatal, and nutritional diseases in 1990, which dropped to 33% in 2016.
"Life expectancy in the whole of India has improved over three decades but is still lower by eleven years than in China and Sri Lanka", Lalit Dandona, Director, India State-Level Disease Burden Initiative, was quoted as saying in the report. "Punjab had 157 per cent higher per person burden from diabetes and 134 percent higher burden from ischaemic heart disease", said the report.
The contribution of air pollution to disease burden has remained high in India between 1990 and 2016, with levels of exposure among the highest in the world.
Air pollution is proving to be another significant threat, especially household air pollution, which was responsible for 5% of the total disease burden in India in 2016, and outdoor air pollution for 6%. "On the other hand, the states that have had this transition more recently, such as the EAG states, now have rising risk for non-communicable diseases and also continue to have a high burden of infectious and maternal-child diseases".
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). "The specific disease burden trends for each state in this report provide a reference for planning interventions that are needed to address the major disease problems in each state", he said. He suggested that generation of such comprehensive estimates for each district. In 1990, there were only five noncommunicable diseases that contributed to DALY.