West Bengal: Disease Burden Profile, 1990 to 2016 1990 life epectancy 2016 life epectancy emales 596 years ales 5 years emales 1 years ales 61 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

West Bengal nde- ate India nde- ate Caatie aeage ate glall siila Si-degahi Inde as West Bengal

150

100

Deaths per 1,000 lie births 50 9.2 4.2 The shaded 0.4 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? PercentWhat contribution caused of the top 10 most causes deaths of death by in age different group, both sexes,age 2016groups in 2016? Percent contribution of top 10 causes of death by age group, both sexes, 2016

0−14 years [6.4% of total deaths] 15−39 years [11.4% of total deaths]

1 HIIDS telsis 46 1 DiaheaRIthe 5 9 9 3 NDs alaia 306 1 23 Matenal disdes 15 206 19 65 Nenatal disdes 1 Nutritional deficiencies

the niale diseases 3 15 9 Canes

102 Cadiasla diseases 36 43 4 Chni esiat diseases

Cihsis

Digestie diseases

Nelgial disdes 40−69 years [42% of total deaths] 70+ years [40.1% of total deaths] Diaetesgldend

1 2 the nn-niale 2 1 anst inies 45 55 26 33 61 14 3 nintentinal inies 1 3 Siide ilene 1 129 65 59 the ases death 34 121 RI is lwe esiat inetins. NDs ae negleted tial diseases. g is genital diseases. End is endine diseases.

446 42

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 6 Disability or morbidity 5

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

Ischaemic heart disease Stroke Suicide Lower respiratory infections Diarrhoeal diseases COPD* Road injuries Preterm birth complications Tuberculosis Chronic kidney disease HIV/AIDS Other neonatal disorders Diabetes Drowning Neonatal encephalopathy

15 10 5 0 0 5 10 15 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 nuries

*COPD is chronic obstructive pulmonary disease. What caused the most years lived with disability by se in 2016? op 15 causes of YLDs, ranked by percent for both sexes combined, 2016

emales ales

Iron-deficiency anaemia Sense organ diseases* Low back & neck pain Migraine Skin diseases Other musculoskeletal Depressive disorders COPD* Anxiety disorders Diabetes Oral disorders Preterm birth complications Falls Osteoarthritis Schizophrenia

15 10 5 0 0 5 10 15 Percent of total years lied ith disability Percent of total years lied ith disability Communicable, maternal, neonatal, and nutritional diseases on-communicable diseases nuries

*COPD is chronic obstructive pulmonary disease. *Sense organ diseases includes mainly hearing and vision loss.

2 West Bengal roportion of total disease burden from CDs 2 CDs 62 nuries 126 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

Cniale, atenal, Nn-niale diseases Inies sae inease deease nenatal, and ntitinal diseases

Leading causes of DALYs 1990 Leading causes of DALYs 2016

Lower respiratory infections [9.8%] 1 1 Ischaemic heart disease [9.7%] Diarrhoeal diseases [7.7%] 2 2 Stroke [8.5%] Preterm birth complications [6.2%] COPD† [4.2%] Measles [5.9%] 4 4 Self-harm§ [3.7%]* Tuberculosis [4.4%] Iron-deficiency anaemia [3.5%] Ischaemic heart disease [4.2%] 6 6 Lower respiratory infections [3.3%] Stroke [4.0%] 7 7 Sense organ diseases‡ [3.2%] Other neonatal disorders [3.7%] 8 8 Diarrhoeal diseases [3.0%] Self-harm§ [2.8%] 9 9 Preterm birth complications [2.7%] COPD† [2.5%] 10 10 Low back & neck pain [2.6%] Neonatal encephalopathy [2.5%] 11 11 Road injuries [2.6%] Iron-deficiency anaemia [2.2%] 12 12 Migraine [2.3%] Congenital birth defects [1.6%] 1 1 Chronic kidney disease [2.2%] Road injuries [1.5%] 14 14 Skin diseases [2.1%] Tetanus [1.5%] 1 1 Tuberculosis [2.0%] Sense organ diseases‡ [1.4%] 18 21 Other neonatal disorders [1.3%] Low back & neck pain [1.3%] 21 22 Congenital birth defects [1.2%] Chronic kidney disease [1.2%] 22 2 Neonatal encephalopathy [0.9%] Skin diseases [1.2%] 2 86 Measles [0.2%] Migraine [1.1%] 24 11 Tetanus [0.0%]

*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 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 12.5

[1.75]

10.0

[1.74] [1.39] 7.5 [1.12] [2.16] [0.93] [0.8] [2.73] [0.61] [0.69] [0.56] [3.29] Percent of total DALYs Percent 2.5 [0.46] [3.76]

[0.32] [0.32] [4.31] 2.5 [4.81]

0.0

5 to 9 (8%) Under 5 (6%) 10 to 14 (9%) 15 to 19 (9%) 20 to 24 (9%) 25 to 29 (9%) 30 to 34 (8%) 35 to 39 (8%) 40 to 44 (7%) 45 to 49 (6%) 50 to 54 (6%) 55 to 59 (5%) 60 to 64 (3%) 65 to 69 (2%) 70 to 74 (2%) 75 to 79 (1%) 80 to 84 (1%) 85+ (<1%) Age Communicable, maternal, neonatal, and nutritional diseases on-communicable diseases nuries

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. West Bengal 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 What riskrisk factors factors are are driving driving the the most most death death and and disability disability combined? combined? ContributionBehavioural of of 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%] [32.9%]1 1 1 Malnutrition* [14.8%] 1 Dietary risks [13.1%] AirWaSH pollution [15.2%] [12.0%]2 2 2 Air pollution [5.1%] 2 High blood pressure [12.9%] Air pollutionWaSH [7.7%] [8.5%] High blood pressure [5.0%] Air pollution [11.4%] Tobacco use [3.6%] 4 4 Tobacco use [4.9%] Dietary risks [6.2%] 4 4 Malnutrition* [10.4%] Dietary risks [2.3%] Dietary risks [4.7%] HighHigh blood blood pressure pressure [2.2%] [5.7%]6 6 High fasting plasma glucose [4.0%]Tobacco use [8.6%] OccupationalTobacco risks [1.9%] use [5.5%]7 6 7 WaSH [3.9%] 6 High fasting plasma glucose [5.9%] HighAlcohol total & drug cholesterol use [1.6%] [2.3%]8 7 8 Alcohol & drug use [3.9%]7 High total cholesterol [5.2%] High fasting plasma glucose [1.4%] 9 9 Occupational risks [2.6%] HighImpaired fasting kidney plasma function glucose [0.9%] [2.1%]10 8 10 Impaired kidney function8 [2.0%]Impaired kidney function [4.0%] Impaired kidney function [2.0%] 9 9 Alcohol & drug use [3.8%] The percent figure in bracket next to each risk is DALYs from that risk out of total DALYs. *Malnutrition is child and maternal malnutrition. Occupational risks [2.0%] 10 WaSH is unsafe water, sanitation,10 Occupational and handwashing. risks [3.3%] Alcohol & drug use [1.9%] 11 12 WaSH [3.1%]

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

Dietary risks High blood pressure Air pollution Malnutrition* Tobacco use High fasting plasma glucose High total cholesterol Impaired kidney function Alcohol & drug use Occupational risks

16 12 0 0 12 16 Percent of years of life lost and years lied ith disability Percent of years of life lost and years lied ith disability

ehaioural nironmentaloccupational etabolic

*Malnutrition is child and maternal malnutrition.

4 West Bengal