Andhra Pradesh: Disease Burden Profile, 1990 to 2016 1990 life epectancy 2016 life epectancy emales 5 years ales 5 years emales 19 years ales 6 years

HowHow much much did the did under-5 the mortality under-5 rate change mortality from 1990 rate to 2016? change from 1990 to 2016? Under-5Under-5 mortality mortality rate, both rate,sexes combined, both sexes 1990-2016 combined, 1990-2016

Andhra Pradesh nder- rae India nder- rae Caraie aerae rae lall r siilar Si-derahi Inde as Andhra Pradesh

150

100

50

Deaths per 1,000 lie births 9.2 .7 The shaded .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 [7.6% of total deaths] 15−39 years [11.7% of total deaths]

15

HIAIDS erlsis 12 5 99 11 DiarrheaRIher

5 NDs alaria 291 96 25 1 Maernal disrders 199 21 Nenaal disrders 12 5 Nutritional deficiencies

her niale diseases 25 149 92 Caners

Cardiaslar diseases 421 113 Chrni resirar diseases 2 3.7% Cirrhsis

Diesie diseases

Nerlial disrders 40−69 years [43.7% of total deaths] 70+ years [37% of total deaths] Diaeesrldend

2 2.9% her nn-niale 2 ransr inries 46 5 52 46 nineninal inries 1 29 Siide ilene 11 44 1.4% her ases deah 65 1 31 RI is lwer resirar ineins. NDs are neleed rial diseases. 141 r is renial diseases. 9 End is endrine diseases.

40 36

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 56

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 Suicide Diarrhoeal diseases Stroke COPD* Lower respiratory infections Preterm birth complications Road injuries Tuberculosis Neonatal encephalopathy HIV/AIDS Diabetes Chronic kidney disease Congenital birth defects Falls

20 15 10 5 0 0 5 10 15 20 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

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* Low back & neck pain Depressive disorders Migraine Skin diseases Other musculoskeletal COPD* Diabetes Anxiety disorders Falls Oral disorders Preterm birth complications Osteoarthritis Road injuries

16 12 0 0 12 16 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 Andhra Pradesh roportion of total disease burden from CDs 20 CDs 59 nuries 1 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, aernal, Nn-niale diseases Inries sae r inrease derease nenaal, and nriinal diseases

Leading causes of DALYs 1990 Leading causes of DALYs 2016

Diarrhoeal diseases [16.4%] 1 1 Ischaemic heart disease [11.6%] Lower respiratory infections [8.1%] 2 2 COPD† [4.6%] Preterm birth complications [6.6%] Iron-deficiency anaemia [3.7%] Ischaemic heart disease [4.4%] 4 4 Diarrhoeal diseases [3.7%] Tuberculosis [4.1%] Self-harm§ [3.6%]* Measles [3.8%] 6 6 Stroke [3.5%]* Neonatal encephalopathy [3.7%] 7 7 Preterm birth complications [3.3%] COPD† [2.4%] 8 8 Road injuries [3.1%] Congenital birth defects [2.4%] 9 9 Sense organ diseases ‡ [3.1%] Self-harm§ [2.3%] 10 10 Lower respiratory infections [2.7%] Iron-deficiency anaemia [2.2%] 11 11 Low back & neck pain [2.5%] Other neonatal disorders [2.2%] 12 12 Diabetes [2.4%] Stroke [2.0%] 1 1 Depressive disorders [2.3%] Neonatal haemolytic disease [1.6%] 14 14 Migraine [2.2%] Intestinal infectious diseases [1.5%] 1 1 Falls [2.2%]* Road injuries [1.5%] 16 18 Tuberculosis [1.8%] Sense organ diseases ‡ [1.3%] 18 20 Congenital birth defects [1.6%] Low back & neck pain [1.2%] 19 22 Neonatal encephalopathy [1.6%] Falls [1.2%] 20 24 Intestinal infectious diseases [1.0%] Depressive disorders [1.1%] 22 27 Other neonatal disorders [0.9%] Migraine [1.1%] 2 49 Neonatal haemolytic disease [0.4%] Diabetes [0.7%] 4 82 Measles [0.2%]

*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-har refers to suicide and the nonfatal outcomes of self-harm. What caused the most death and disability combined across age groups in 2016? WhatPercent caused of DALYs the by most age group,death bothand disabilitysexes, 2016 combined across age groups in 2016? Percent of DALYs by age group, both sexes, 2016

[1.75]

10

[2.07]

[1.36] [1.66] [2.59] [1.1] [0.8] [0.92] [0.61] [0.68] Percent of total DALYs Percent [3.11] [0.55] 5 [0.46] [3.55]

[0.31] [0.3] [4.04]

[4.51]

0

5 to 9 (8%) 85+ (<1%) Under 5 (7%) 10 to 14 (8%) 15 to 19 (9%) 20 to 24 (9%) 25 to 29 (9%) 30 to 34 (9%) 35 to 39 (8%) 40 to 44 (7%) 45 to 49 (6%) 50 to 54 (5%) 55 to 59 (4%) 60 to 64 (4%) 65 to 69 (3%) 70 to 74 (2%) 75 to 79 (1%) 80 to 84 (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. Andhra Pradesh 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 risk factors factors are are driving driving the the most most death death and anddisability disability combined? combined? ContributionContributionBehavioural of of top top 10 10 risksEnvironmental/occupational risks to toDALYs 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* [36.9%] [36.9%]1 1 1 Malnutrition* [11.7%] 1 Malnutrition* [11.7%] WaSHWaSH [16.4%] [16.4%]2 2 2 Dietary risks [11.5%] 2 Dietary risks [11.5%] Air pollutionAir pollution [9.5%] [9.5%] High blood pressure [10.5%] High blood pressure [10.5%] Dietary risks [5.1%] 4 4 Air pollution [8.7%] Dietary risks [5.1%] 4 4 Air pollution [8.7%] High blood pressure [4.4%] High fasting plasma glucose [6.4%] HighTobacco blood use pressure [4.2%] [4.4%]6 6 Tobacco use [6.0%] High fasting plasma glucose [6.4%] High total cholesterolTobacco [2.3%] use [4.2%]7 6 7 High total cholesterol [5.9%]6 Tobacco use [6.0%] High fastingHigh plasma total glucose cholesterol [2.2%] [2.3%]8 7 8 High body-mass index [5.4%]7 High total cholesterol [5.9%] Occupational risks [1.9%] 9 9 WaSH [3.6%] High fastingAlcohol plasma & drug use glucose [1.4%] [2.2%]10 8 10 Alcohol & drug use [3.3%]8 High body-mass index [5.4%] High body-massOccupational index [0.6%] risks [1.9%]1 9 11 Occupational risks [3.2%]9 WaSH [3.6%] Alcohol & drug use [1.4%] 10 10 Alcohol & drug use [3.3%] The percent figure in bracket next to each risk is DALYs from that risk out of total DALYs. *Malnutrition is child and maternal malnutrition. High body-mass index [0.6%] 1 WaSH is unsafe water, sanitation,11 Occupational and handwashing. risks [3.2%]

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* Dietary risks High blood pressure Air pollution High fasting plasma glucose Tobacco use High total cholesterol High body-mass index WaSH Alcohol & drug use

12 0 0 12 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. WaSH is unsafe water, sanitation, and handwashing.

4 Andhra Pradesh