Uttar : Disease Burden Profile, 1990 to 2016 1990 life epectancy 2016 life epectancy emales 55 years ales 59 years emales 66 years ales 66 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

Uttar Pradesh nder- rate nder- rate Caratie aerae rate lall r siilar Si-derahi Inde as Uttar Pradesh

150

100

48.7 Deaths per 1,000 lie births 50 48. 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 [14.1% of total deaths] 15−39 years [11.9% of total deaths]

1 12 HIIDS terlsis

114 DiarrheaRIther 5 135 4 0 NDs alaria 15 136 Maternal disrders 125 401 3 Nenatal disrders

Nutritional deficiencies 49 96 ther niale diseases

64 Caners 33 124 3 9 Cardiaslar diseases Chrni resiratr diseases

5 Cirrhsis

Diestie diseases

Nerlial disrders 40−69 years [38.1% of total deaths] 70+ years [35.9% of total deaths] Diaetesrldend

2 ther nn-niale 0 ransrt inries 103 51 51 41 45 Unintentinal inries 32 62 2 105 56 35 Siide ilene 245 35 ther ases death 22 RI is lwer resiratr inetins. 12 NDs are neleted trial diseases. 211 Ur is renital diseases. 62 End is endrine diseases. 1

23 24

India: Health of the Nation's States — The India State-Level Disease Burden Initiative. New : ICMR, PHFI, and IHME; 2017. ISBN 978-0-9976462-1-4. 1 roportion of total disease burden from Premature death 16 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

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

12 9 6 0 0 6 9 12 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 by is 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 COPD* Depressive disorders Anxiety disorders Diabetes Falls Preterm birth complications Oral disorders Protein-energy malnutrition 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 Uttar Pradesh roportion of total disease burden from CDs 05 CDs 9 nuries 116 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, aternal, Nn-niale diseases Inries sae r inrease derease nenatal, and ntritinal diseases

Leading causes of DALYs 1990 Leading causes of DALYs 2016

Diarrhoeal diseases [15.7%] 1 1 COPD† [6.1%] Lower respiratory infections [11.2%] 2 2 Diarrhoeal diseases [6.0%] Tuberculosis [5.5%] Ischaemic heart disease [5.8%] Tetanus [4.6%] 4 4 Lower respiratory infections [5.7%] Measles [4.5%] Tuberculosis [5.0%] Preterm birth complications [3.7%] 6 6 Preterm birth complications [3.7%]* Other neonatal disorders [3.6%] 7 7 Iron-deficiency anaemia [3.3%] COPD† [3.6%] 8 8 Road injuries [3.0%] Neonatal encephalopathy [2.5%] 9 9 Other neonatal disorders [2.9%]* Intestinal infectious diseases [2.3%] 10 10 Sense organ diseases‡ [2.4%] Ischaemic heart disease [2.2%] 11 11 Congenital birth defects [2.1%]* Iron-deficiency anaemia [1.8%] 12 12 Self-harm§ [2.0%] Protein-energy malnutrition [1.7%] 1 1 Stroke [1.9%] Asthma [1.6%] 14 14 Falls [1.8%] Congenital birth defects [1.5%] 1 1 Intestinal infectious diseases [1.8%] Road injuries [1.5%] 16 19 Asthma [1.7%]* Sense organ diseases‡ [1.1%] 18 21 Neonatal encephalopathy [1.5%] Self-harm§ [1.1%] 19 24 Protein-energy malnutrition [1.1%] Falls [1.0%] 21 Measles [0.7%] Stroke [1.0%] 22 68 Tetanus [0.3%]

*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 25 [2.26]

20

15

Percent of total DALYs Percent 10

[2.17] [1.74] [1.41] [2.71] [0.46] [0.79] [1.12] [0.56] [0.6] [0.67] [0.92] 5 [3.28] [0.32] [0.31] [3.71] [4.15] [4.44]

0

5 to 9 (11%) 85+ (<1%) Under 5 (10%) 10 to 14 (11%)15 to 19 (11%) 20 to 24 (9%) 25 to 29 (8%) 30 to 34 (7%) 35 to 39 (6%) 40 to 44 (5%) 45 to 49 (5%) 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 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. Uttar 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%] [38.0%]1 1 1 Malnutrition* [14.8%] 1 Malnutrition* [18.2%] WaSHWaSH [15.2%] [16.2%]2 2 2 Air pollution [5.1%] 2 Air pollution [11.1%] Air Airpollution pollution [7.7%] [12.2%] High blood pressure [5.0%] Tobacco use [6.2%] Tobacco use [3.6%] 4 4 Tobacco use [4.9%] Tobacco use [4.1%] 4 4 WaSH [6.1%] Dietary risks [2.3%] Dietary risks [4.7%] High blood pressureDietary [2.2%] risks [2.8%]6 6 High fasting plasma glucose [4.0%]Dietary risks [5.7%] OccupationalHigh blood risks pressure [1.9%] [2.1%]7 6 7 WaSH [3.9%] 6 High blood pressure [5.1%] AlcoholOccupational & drug use [1.6%] risks [1.8%]8 7 8 Alcohol & drug use [3.9%]7 High fasting plasma glucose [4.1%] High fasting plasma glucose [1.4%] 9 9 Occupational risks [2.6%] Impaired Alcoholkidney function & drug [0.9%] use [1.5%]10 8 10 Impaired kidney function8 [2.0%]Alcohol & drug use [3.3%] High fasting plasma glucose [1.4%] 9 9 Occupational risks [2.9%] 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 [0.9%] 10 WaSH is unsafe water, sanitation,10 High and body-mass handwashing. index [2.5%] High body-mass index [0.7%] 12 11 High total cholesterol [2.4%]

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

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 Uttar Pradesh