Assam: Disease Burden Profile, 1990 to 2016 1990 life e pectancy 2016 life e pectancy emales 56 6 years ales 55 6 years emales 66 9 years ales 6 5 years
How much did the under-5 mortality rate change from 1990 to 2016? How much did the under-5 mortality rate change from 1990 to 2016? Under-5Under-5 mortality mortality rate, both rate, sexes combined, both sexes 1990-2016 combined, 1990-2016
Assam nde - a e India nde - a e C m a a i e a e a e a e l all simila S i -dem a hi Inde as Assam
150
100
2.2 Deaths per 1,000 li e births 50 9.2 7.8 The shaded bands indicate 95% uncertainty intervals around 0 the estimates 1990 1995 2000 2005 2010 2016 Year What caused the most deaths in different age groups in 2016? WhatPercent contributioncaused theof top most 10 causes deaths of death byin age different group, both age sexes, groups2016 in 2016? Percent contribution of top 10 causes of death by age group, both sexes, 2016
0−14 years [13% of total deaths] 15−39 years [13.6% of total deaths]
1 1
HI AIDS e l sis 3 5 3 12 Dia h ea RI he 1 1 15 5 0 9 N Ds mala ia
2 9 10 3 Ma e nal dis de s 35 1 12 6 Ne na al dis de s 5 6 Nutritional deficiencies
5 1 he mm ni a le diseases 4 5 6 Can e s 4 1 3 1 5 Ca di as la diseases 11 5 2 Ch ni es i a diseases
Ci h sis
Di es i e diseases
Ne l i al dis de s 40−69 years [39.8% of total deaths] 70+ years [33.5% of total deaths] Dia e es l d end
2 2 6 he n n- mm ni a le 1 3 ans in ies 6 nin en i nal in ies 9 2 2 22 6 3 3 S i ide i len e 3 2 4 3 1 6 he a ses dea h
5 4 RI is l we es i a in e i ns. 15 N Ds a e ne le ed i al diseases. 6 9 16 5 is eni al diseases. 10 5 End is end ine diseases.
2 2 9
India: Health of the Nation's States — The India State-Level Disease Burden Initiative. New Delhi: ICMR, PHFI, and IHME; 2017. ISBN 978-0-9976462-1-4. 1 roportion of total disease burden from Premature death 1 Disability or morbidity 2
What caused the most years of life lost by se in 2016? op 15 causes of YLLs, ranked by percent for both sexes combined, 2016
emales ales
Diarrhoeal diseases Stroke Lower respiratory infections Ischaemic heart disease Tuberculosis Preterm birth complications COPD* Other neonatal disorders Suicide Neonatal encephalopathy Hepatitis Road injuries Chronic kidney disease Congenital birth defects Diabetes
9 6 0 0 6 9 Percent of total years of life lost due to premature mortality Percent of total years of life lost due to premature mortality
Communicable, maternal, neonatal, and nutritional diseases on-communicable diseases n uries
What caused the most years lived with disability *COPD isby chronic se obstructive in 2016? pulmonary disease. op 15 causes of YLDs, ranked by percent for both sexes combined, 2016
emales ales
Iron-deficiency anaemia Sense organ diseases* Migraine Low back & neck pain Skin diseases Other musculoskeletal Depressive disorders COPD* Anxiety disorders Diabetes Preterm birth complications Oral disorders Falls Osteoarthritis Schizophrenia
20 15 10 5 0 0 5 10 15 20 Percent of total years li ed ith disability Percent of total years li ed ith disability Communicable, maternal, neonatal, and nutritional diseases on-communicable diseases n uries
*COPD is chronic obstructive pulmonary disease. *Sense organ diseases includes mainly hearing and vision loss.
2 Assam roportion of total disease burden from C Ds 5 CDs 51 2 n uries 10
HowHow havehave the leading causescauses of of death death and and disability disability combined combined changed changed from from 1990 1990 to 2016? to 2016? ChangeChange in top 15 causes of of DALYs, DALYs, both both sexes, sexes, ranked ranked by by number number of ofDALYs, DALYs, 1990 1990–2016–2016
C mm ni a le, ma e nal, N n- mm ni a le diseases In ies same in ease de ease ne na al, and n i i nal diseases
Leading causes of DALYs 1990 Leading causes of DALYs 2016
Diarrhoeal diseases [14.0%] 1 1 Diarrhoeal diseases [5.8%] Lower respiratory infections [7.9%] 2 2 Stroke [5.6%]
Tuberculosis [5.6%] Lower respiratory infections [5.1%] Preterm birth complications [4.9%] 4 4 COPD† [4.1%]* Measles [4.7%] Ischaemic heart disease [4.1%] Other neonatal disorders [4.1%] 6 6 Preterm birth complications [3.8%]*
COPD† [3.4%] 7 7 Tuberculosis [3.8%] Neonatal encephalopathy [3.2%] 8 8 Iron-deficiency anaemia [3.7%] Stroke [3.0%] 9 9 Other neonatal disorders [2.4%] Iron-deficiency anaemia [2.4%] 10 10 Sense organ diseases‡ [2.3%]
Ischaemic heart disease [1.7%] 11 11 Road injuries [2.3%] Self-harm§ [1.6%] 12 12 Self-harm§ [2.2%]*
Asthma [1.5%] 1 1 Hepatitis [2.1%]
Malaria [1.4%] 14 14 Neonatal encephalopathy [2.1%]
Intestinal infectious diseases [1.4%] 1 1 Diabetes [2.0%] Hepatitis [1.3%] 18 2 Asthma [1.2%]* Sense organ diseases‡ [1.1%] 20 26 Malaria [1.2%]*
Road injuries [1.1%] 21 27 Intestinal infectious diseases [0.9%] Diabetes [0.7%] 7 46 Measles [0.6%]
*Change not significant. COPD is chronic obstructive pulmonary disease. The percent figure in brackets next to each cause is Sense organ diseases includes mainly hearing and vision loss. DALYs from that cause out of total DALYs. Sel -ha m refers to suicide and the nonfatal outcomes of self-harm.
WhatWhat caused the the most most death death and and disability disability combined combined across across age groups age groups in 2016? in 2016? PercentPercent ofof DALYs by age group, bothboth sexes,sexes, 2016 2016 [2.4]
20
15
10 Percent of total DALYs Percent
[1.13] [1.41] [1.75] [0.61] [0.68] [0.8] [0.93] [2.16] [0.57] [2.71] [0.46] 5 [3.27] [0.33] [0.32] [3.71] [4.13] [4.41]
0
85+ (<1%) Under 5 (9%) 5 to 9 (10%) 10 to 14 (10%) 15 to 19 (9%) 20 to 24 (9%) 25 to 29 (9%) 30 to 34 (8%) 35 to 39 (7%) 40 to 44 (6%) 45 to 49 (6%) 50 to 54 (5%) 55 to 59 (4%) 60 to 64 (3%) 65 to 69 (2%) 70 to 74 (1%) 75 to 79 (1%) 80 to 84 (1%) Age Communicable, maternal, neonatal, and nutritional diseases on-communicable diseases n uries
The number in the bracket on top of each vertical bar is the ratio of percent DALYs to population for that age group. The number in parentheses after each age group on the x-axis is the percent of population in that age group. Assam 3 What risk factors are driving the most death and disability combined? Contribution of top 10 risks to DALYs number, both sexes, ranked by number of DALYs, 1990-2016 WhatWhat risk factorsfactors are are driving driving the the most most death death and and disability disability combined? combined? ContributionContributionBehavioural ofof top top 10 10 risksEnvironmental/occupational risks to to DALYs DALYs number, number, both both sexes, sexes, rankedMetabolic ranked by number by number of DALYs,same of DALYs, 1990-2016 or increase 1990-2016 decrease
Behavioural Environmental/occupational Metabolic same or increase decrease
Risk factors 1990 Risk factors 2016 Risk factors 1990 Risk factors 2016
Malnutrition*Malnutrition* [32.2%] [35.4%]1 1 1 Malnutrition* [14.8%] 1 Malnutrition* [17.4%] WaSH WaSH [15.2%] [14.1%]2 2 2 Air pollution [5.1%] 2 Air pollution [8.7%] Air pollutionAir pollution [7.7%] [9.3%] High blood pressure [5.0%] High blood pressure [7.6%] Tobacco use [3.6%] 4 4 Tobacco use [4.9%] Tobacco use [4.4%] 4 4 Dietary risks [6.9%] Dietary risks [2.3%] Dietary risks [4.7%] High blood pressureDietary [2.2%] risks [3.7%]6 6 High fasting plasma glucose [4.0%]Tobacco use [5.7%] OccupationalHigh blood risks pressure [1.9%] [3.6%]7 6 7 WaSH [3.9%] 6 WaSH [5.7%] High fastingAlcohol plasma & drug use glucose [1.6%] [2.1%]8 7 8 Alcohol & drug use [3.9%]7 High fasting plasma glucose [4.8%] High fasting plasma glucose [1.4%] 9 9 Occupational risks [2.6%] Impaired Alcoholkidney function & drug [0.9%] use [2.0%]10 8 10 Impaired kidney function8 [2.0%]Alcohol & drug use [3.9%] Occupational risks [1.9%] 9 9 High body-mass index [3.5%] The percent figure in bracket next to each risk is DALYs from that risk out of total DALYs. *Malnutrition is child and maternal malnutrition. Impaired kidney function [1.3%] 10 WaSH is unsafe water, sanitation,10 Occupational and handwashing. risks [2.5%] High body-mass index [1.0%] 11 11 Impaired kidney function [2.5%]
The percent figure in bracket next to each risk is DALYs from that risk out of total DALYs. *Malnutrition is child and maternal malnutrition. WaSH is unsafe water, sanitation, and handwashing.
How did the risk factors differ by se in 2016? Percent of total DALYs attributable to top 10 risks, ranked by percent for both sexes combined, 2016
emales ales
Malnutrition* Air pollution High blood pressure Dietary risks Tobacco use WaSH High fasting plasma glucose Alcohol & drug use High body-mass index Occupational risks
20 15 10 5 0 0 5 10 15 20 Percent of years of life lost and years li ed ith disability Percent of years of life lost and years li ed ith disability
eha ioural n ironmental occupational etabolic
*Malnutrition is child and maternal malnutrition. WaSH is unsafe water, sanitation, and handwashing.
4 Assam