Each state of India has a different disease burden

Disease Burden Report Shows Health Inequalities Among States​​

Recently, the Union ministry of health and family welfare, in association with the Indian Council of Medical Research (ICMR), Public Health Foundation of India (PHF), and Institute for Health Metric and Evaluation (IHME), released the first ever India state-level disease burden report. The estimates are based on analysis of all identifiable epidemiological data from India from 1990 to 2016.

The comprehensive report has brought out some interesting facts and figures about the disease burden in every state in India. It finds that though the health status in India is improving, there are major inequalities in disease burden between the states. Another important finding in the report is the large differences between states in the changing disease profile.

Significance Of The Report

The report is significant in the fact that it can be a useful guide for each state in the country to plan health and other services that address specific situations in each state. It will provide a valuable resource for policymakers, health managers, academics, health providers, agencies supporting health, other stakeholders and the public at large to understand the heterogeneity of disease burden and risk factors across various states of India, which can be utilised to improve the health of people.

The major areas in which these findings could be useful include planning of state health budgets, prioritisation of interventions relevant to each state, informing the government’s Health Assurance Mission in each state, monitoring health-related sustainable development goals in each state, assessing impact of large-scale interventions based on time trends of disease burden and forecasting population health under various scenarios in each state.

This knowledge base can be a crucial aid for more informed policy and interventions to reduce health inequalities between the states. The report can be an important input 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.

Findings

Life expectancy at birth improved in India from 59.7 years in 1990 to 70.3 years in 2016 for females, and from 58.3 years to 66.9 years for males. However, there were continuing inequalities between states, with a range of 66.8 years in Uttar Pradesh to 78.7 years in Kerala for females, and from 63.6 years in Assam to 73.8 years in Kerala for males in 2016. Kerala has the life expectancy 12 years more than states like UP, Assam.

Every State in India has a higher burden from non-communicable diseases and injuries, than from infectious diseases.

Non-communicable diseases, fuelled by unhealthy diets, high BP, blood sugar, are leading to loss of life, and this trend has doubled in the last two decades. Air pollution and smoking continue to be major contributors to health loss. Significantly, the extent of these risk factors varies considerably across the states

The wide variations between the states in epidemiological transition are reflected in the range of contribution of major disease groups to the total disease burden: 48% to 75% for non-communicable diseases, 14% to 43% for infectious and associated diseases, and 9% to 14% for injuries. (the figures are relating to 2016) Mental diseases like dementia are also on the rise, specially among the elderly.

Kerala, Goa, and Tamil Nadu have the largest dominance of non-communicable diseases and injuries over infectious and associated diseases, whereas this dominance is present but relatively the lowest in Bihar, Jharkhand, Uttar Pradesh, and Rajasthan.

Action Plan

Now, with the much needed data in place, it is the responsibility of the Centre as well as the state governments to take immediate corrective measures on a war footing for the improvement of health in the country and also to reduce health inequalities among states. As health is a State subject, the respective governments should establish a mechanism for sustained monitoring of health-related development goals.

For all this to happen, healthcare facilities should be bolstered in the lakhs of PHCs across the country where basic requirement like presence of doctors is wanting.