Madhya Pradesh: Disease Burden Profile, 1990 to 2016 1990 life epectancy 2016 life epectancy emales 559 years ales 556 years emales 69 years ales 65 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

Madhya Pradesh nder- rae India nder- rae Caraie aerae rae lally r siilar Si-derahi Inde as Madhya Pradesh

150

100

Deaths per 1,000 lie births 50 4.2 4.9 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 [13.2% of total deaths] 15−39 years [11.7% of total deaths]

1 1 HIIDS erlsis 54 119 10 DiarrheaRIher

0 NDs alaria 15 Maernal disrders 361 11 156 34 Nenaal disrders

34 Nutritional deficiencies

59 her niale diseases 112 Caners 119 3 3 11 Cardiaslar diseases

3 Chrni resirary diseases

6 Cirrhsis

Diesie diseases

Nerlial disrders 40−69 years [37.7% of total deaths] 70+ years [37.3% of total deaths] Diaeesrldend

2 her nn-niale

36 ransr inries 59 3 44 nineninal inries 3 69 9 2 Siide ilene 5 226 3 0 her ases deah 32 25 132 RI is lwer resirary ineins. 143 NDs are neleed rial diseases. 65 r is renial diseases. 115 End is endrine diseases.

329 329

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 699 Disability or morbidity 01

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 Lower respiratory infections Diarrhoeal diseases Preterm birth complications Stroke Tuberculosis Other neonatal disorders COPD* Suicide Road injuries Intestinal infectious diseases Congenital birth defects Neonatal encephalopathy Falls Diabetes

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

What caused the most years lived with disability*COPD byis 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* Diabetes Anxiety disorders Oral disorders Preterm birth complications Falls Osteoarthritis Haemoglobinopathies

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 Madhya Pradesh roportion of total disease burden from CDs 5 CDs 505 nuries 120 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

Lower respiratory infections [14.2%] 1 1 Ischaemic heart disease [7.7%] Diarrhoeal diseases [11.6%] 2 2 Lower respiratory infections [5.6%] Preterm birth complications [6.1%] Diarrhoeal diseases [4.9%] Other neonatal disorders [5.3%] 4 4 COPD† [4.2%] Tuberculosis [4.9%] Preterm birth complications [4.2%] Measles [4.8%] 6 6 Iron-deficiency anaemia [3.5%] Ischaemic heart disease [2.6%] 7 7 Tuberculosis [3.4%] COPD† [2.6%] 8 8 Stroke [3.4%] Intestinal infectious diseases [2.5%] 9 9 Other neonatal disorders [3.2%] Neonatal encephalopathy [2.1%] 10 10 Road injuries [2.6%] Protein-energy malnutrition [2.1%] 11 11 Sense organ diseases‡ [2.6%] Iron-deficiency anaemia [1.9%] 12 12 Self-harm§ [2.4%] Stroke [1.7%] 1 1 Low back & neck pain [2.0%] Congenital birth defects [1.6%] 14 14 Diabetes [2.0%] Meningitis [1.6%] 1 1 Intestinal infectious diseases [1.9%] Self-harm§ [1.2%] 19 16 Congenital birth defects [1.9%]* Sense organ diseases‡ [1.1%] 20 24 Neonatal encephalopathy [1.1%] Road injuries [1.0%] 22 2 Protein-energy malnutrition [1.1%] Low back & neck pain [1.0%] 24 27 Meningitis [1.0%] Diabetes [0.5%] 7 48 Measles [0.5%]

*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

[2.24]

20

15

10 Percent of total DALYs Percent

[1.68] [2.08] [1.1] [1.36] [0.67] [0.78] [0.9] [2.59] [0.54] [0.6] [3.13] 5 [0.44] [0.32] [0.31] [3.54] [4.03] [4.4]

0

5 to 9 (10%) 85+ (<1%) Under 5 (10%) 10 to 14 (10%)15 to 19 (10%) 20 to 24 (9%) 25 to 29 (8%) 30 to 34 (8%) 35 to 39 (7%) 40 to 44 (6%) 45 to 49 (5%) 50 to 54 (4%) 55 to 59 (4%) 60 to 64 (3%) 65 to 69 (2%) 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. Madhya 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 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%] [42.1%]1 1 1 Malnutrition* [14.8%] 1 Malnutrition* [17.7%] AirWaSH pollution [15.2%] [13.0%]2 2 2 Air pollution [5.1%] 2 Air pollution [10.1%] Air pollutionWaSH [7.7%] [12.7%] High blood pressure [5.0%] Dietary risks [7.7%] Tobacco use [3.6%] 4 4 Tobacco use [4.9%] Tobacco use [4.6%] 4 4 High blood pressure [7.3%] Dietary risks [2.3%] Dietary risks [4.7%] High blood pressureDietary [2.2%] risks [3.3%]6 6 High fasting plasma glucose [4.0%]Tobacco use [5.9%] OccupationalHigh blood risks pressure [1.9%] [3.0%]7 6 7 WaSH [3.9%] 6 High fasting plasma glucose [5.7%] High fastingAlcohol plasma & drug use glucose [1.6%] [1.8%]8 7 8 Alcohol & drug use [3.9%]7 WaSH [5.0%] High fasting plasma glucose [1.4%] 9 9 Occupational risks [2.6%] Impaired kidneyOccupational function [0.9%] risks [1.7%]10 8 10 Impaired kidney function8 [2.0%]High total cholesterol [3.7%] Alcohol & drug use [1.4%] 9 9 Alcohol & drug use [3.4%] 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 total cholesterol [1.2%] 10 WaSH is unsafe water, sanitation,10 Occupational and handwashing. risks [2.8%]

The percent figure in bracket next to each risk is DALYs from that risk out of total DALYs. *Malnutrition is child and maternal malnutrition. 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 Dietary risks High blood pressure Tobacco use High fasting plasma glucose WaSH High total cholesterol Alcohol & drug use Occupational risks

20 15 10 5 0 0 5 10 15 20 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 Madhya Pradesh