Bihar: Disease Burden Profile, 1990 to 2016 1990 Life E Pectancy 2016 Life E Pectancy Emales 5 9 Years Ales 5 9 Years Emales 6 Years Ales 6 Years
Bihar: Disease Burden Profile, 1990 to 2016 1990 life e pectancy 2016 life e pectancy emales 5 9 years ales 5 9 years emales 6 years ales 6 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
Bihar nder- ra e India nder- ra e C ara i e a era e ra e l all r i ilar S i -de ra hi Inde a Bihar
150
100
66.4
Deaths per 1,000 li e births 50 4 .8 9.2 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? 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 [18.6% of total deaths] 15−39 years [11.6% of total deaths]
0 9 HI IDS er l i 3 1 1 1 5 5 11 13 5 Diarrh ea RI her
9 5 N D alaria 0 9 13 4 2 Ma ernal di rder 39 5 2 4 1 5 Ne na al di rder 10 4 Nutritional deficiencies 2 her ni a le di ea e
5 Can er 9 31 3 9 Cardi a lar di ea e 12 3 9 4 1 Chr ni re ira r di ea e
Cirrh i
Di e i e di ea e
Ne r l i al di rder 40−69 years [38.2% of total deaths] 70+ years [31.6% of total deaths] Dia e e r l d end
2 5 2 her n n- ni a le
ran r in rie 2 5 3 6 6 3 5 5 4 5 6 9 nin en i nal in rie 11 9 23 2 3 6 1 6 S i ide i len e 6 1 her a e dea h 2 4 11 3 9 RI i l wer re ira r in e i n . 16 4 N D are ne le ed r i al di ea e . 5 4 r i r eni al di ea e . 12 1 End i end rine di ea e .
33 3 33 1
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 69 9 Disability or morbidity 0 1
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 Ischaemic heart disease Lower respiratory infections Other neonatal disorders Congenital birth defects COPD* Preterm birth complications Stroke Neonatal encephalopathy Tuberculosis Road injuries HIV/AIDS Intestinal infectious diseases Diabetes Chronic kidney disease
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 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* Low back & neck pain Migraine Skin diseases Other musculoskeletal Depressive disorders COPD* Anxiety disorders Preterm birth complications Oral disorders Falls Diabetes Haemoglobinopathies Diarrhoeal diseases
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 Bihar roportion of total disease burden from C Ds 2 6 CDs 6 n uries 9
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 ni a le, a ernal, N n- ni a le di ea e In rie a e r in rea e de rea e ne na al, and n ri i nal di ea e
Leading causes of DALYs 1990 Leading causes of DALYs 2016
Diarrhoeal diseases [14.1%] 1 1 Diarrhoeal diseases [7.6%] Lower respiratory infections [12.3%] 2 2 Ischaemic heart disease [6.6%] Measles [7.0%] Lower respiratory infections [6.4%] Preterm birth complications [4.2%] 4 4 Iron-deficiency anaemia [4.3%] Tuberculosis [3.8%] COPD† [3.9%] Other neonatal disorders [3.4%] 6 6 Preterm birth complications [3.5%]* Ischaemic heart disease [2.8%] 7 7 Congenital birth defects [3.3%]* COPD† [2.7%] 8 8 Other neonatal disorders [3.1%]* Neonatal encephalopathy [2.6%] 9 9 Stroke [2.8%] Leishmaniasis [2.5%] 10 10 Neonatal encephalopathy [2.6%]* Iron-deficiency anaemia [2.5%] 11 11 Sense organ diseases‡ [2.5%] Congenital birth defects [2.1%] 12 12 Tuberculosis [2.4%] Tetanus [1.8%] 1 1 Road injuries [2.1%] Falls [1.3%] 14 14 Low back & neck pain [1.9%]
Stroke [1.3%] 1 1 Skin diseases [1.8%] Sense organ diseases‡ [1.2%] 17 18 Falls [1.6%]* Low back & neck pain [1.1%] 20 Leishmaniasis [0.7%]
Road injuries [1.1%] 22 41 Measles [0.6%] Skin diseases [1.0%] 2 101 Tetanus [0.1%]
*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.
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 [2.41]
20 Percent of total DALYs Percent
10
[2.03] [1.61] [2.56] [0.35] [0.6] [0.66] [0.76] [0.87] [1.05] [1.3] [0.33] [0.45] [0.54] [3.11] [3.54] [4.05] [4.43]
0
5 to 9 (13%) 85+ (<1%) Under 5 (12%) 10 to 14 (12%) 15 to 19 (9%) 20 to 24 (8%) 25 to 29 (8%) 30 to 34 (8%) 35 to 39 (6%) 40 to 44 (5%) 45 to 49 (4%) 50 to 54 (4%) 55 to 59 (3%) 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. Bihar 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%] [39.7%]1 1 1 Malnutrition* [14.8%] 1 Malnutrition* [21.7%] WaSH WaSH [15.2%] [14.9%]2 2 2 Air pollution [5.1%] 2 Air pollution [11.6%] Air Airpollution pollution [7.7%] [12.7%] High blood pressure [5.0%] WaSH [7.9%] Tobacco use [3.6%] 4 4 Tobacco use [4.9%] Tobacco use [3.8%] 4 4 Dietary risks [7.0%] Dietary risks [2.3%] Dietary risks [4.7%] High blood pressureDietary [2.2%] risks [3.3%]6 6 High fasting plasma glucose [4.0%]High blood pressure [6.4%] OccupationalHigh blood risks pressure [1.9%] [2.8%]7 6 7 WaSH [3.9%] 6 Tobacco use [4.8%] AlcoholOccupational & drug use [1.6%] risks [1.9%]8 7 8 Alcohol & drug use [3.9%]7 High fasting plasma glucose [3.8%] High fasting plasma glucose [1.4%] 9 9 Occupational risks [2.6%] HighImpaired fasting kidney plasma function glucose [0.9%] [1.5%]10 8 10 Impaired kidney function8 [2.0%]High total cholesterol [2.7%] High total cholesterol [1.3%] 9 9 Occupational risks [2.7%] The percent figure in bracket next to each risk is DALYs from that risk out of total DALYs. *Malnutrition is child and maternal malnutrition. Alcohol & drug use [1.2%] 10 WaSH is unsafe water, sanitation,10 Alcohol and handwashing. & drug use [2.3%]
The percent figure in bracket next to each risk is DALYs from that risk out of total DALYs. *Malnutrition is child and maternal malnutrition. 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 WaSH Dietary risks High blood pressure Tobacco use High fasting plasma glucose High total cholesterol Occupational risks Alcohol & drug use
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 Bihar