Uttarakhand: Disease Burden Profile, 1990 to 2016 1990 life e pectancy 2016 life e pectancy emales 60.5 years ales 5 . years emales 1.1 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
Uttarakhand nder- rate India nder- rate C arati e a era e rate l all r i ilar S i -de ra hi Inde a Uttarakhand The state of Uttarakhand was carved out from Uttar Pradesh in 2000. Estimates for Uttarakhand prior to 2000 were computed for comparison 150 by disaggregating data from its parent state based on its current district composition.
100
Deaths per 1,000 live births 50 46.2 9.2 The shaded 24.9 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 [10.3% of total deaths] 15−39 years [10.9% of total deaths]
1.2 HI IDS t er l i 4 3 2. 6 2 12 4 11 6 Diarrh ea RI ther
N D alaria 6 1.1 10 12 6 Maternal di rder 3 9 2 Ne natal di rder 2 3 6 Nutritional deficiencies 9 5 ther ni a le di ea e 10 4 Can er
32 2 1 Cardi a lar di ea e 4 Chr ni re irat r di ea e 2.9 2.6 2.6 Cirrh i
Di e ti e di ea e
Ne r l i al di rder 40−69 years [38.7% of total deaths] 70+ years [40% of total deaths] Dia ete r l d end
2. ther n n- ni a le 1.1 ran rt in rie 1 5 4 3 4 6 4 3 1 Unintenti nal in rie 4 2 15 9 S i ide i len e 6 4 6 ther a e death 2 2 14 2 3 2 5 RI i l wer re irat r in e ti n . N D are ne le ted tr i al di ea e . Ur i r enital di ea e . End i end rine di ea e . 16 6 23 1 2 2 2
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 .0 Disability or morbidity 2.0
What caused the most years of life lost by se in 2016? Top 15 causes of YLLs, ranked by percent for both sexes combined, 2016
emales ales
Ischaemic heart disease Lower respiratory infections COPD* Road injuries Tuberculosis Diarrhoeal diseases Preterm birth complications Stroke Suicide Intestinal infectious diseases Other neonatal disorders Falls Diabetes Neonatal encephalopathy Congenital birth defects
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 byis chronic se obstructive in 2016? pulmonary disease. Top 15 causes of YLDs, ranked by percent for both sexes combined, 2016
emales ales
Iron-deficiency anemia Sense organ diseases* Low back & neck pain Migraine Skin diseases COPD* Other musculoskeletal Depressive disorders Diabetes Anxiety disorders Preterm birth complications Oral disorders Falls Osteoarthritis Schizophrenia
12.5 10.0 .5 5.0 2.5 0 0 2.5 5.0 .5 10.0 12.5 Percent of total years lived with disability Percent of total years lived with 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 Uttarakhand roportion of total disease burden from C Ds 1. CDs 55.5 n uries 12.9 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, aternal, N n- ni a le di ea e In rie a e r in rea e de rea e ne natal, and n triti nal di ea e
Leading causes of DALYs 1990 Leading causes of DALYs 2016
Diarrhoeal diseases [12.7%] 1 1 Ischaemic heart disease [7.8%] Lower respiratory infections [8.3%] 2 2 COPD† [6.8%] Tuberculosis [7.1%] Lower respiratory infections [5.5%] COPD† [4.2%] 4 4 Road injuries [4.2%] Preterm birth complications [3.9%] Tuberculosis [3.6%] Ischaemic heart disease [3.7%] 6 6 Diarrhoeal diseases [3.0%] Tetanus [3.5%] 7 7 Preterm birth complications [3.0%]* Other neonatal disorders [2.8%] 8 8 Iron-deficiency anaemia [2.8%] Intestinal infectious diseases [2.7%] 9 9 Sense organ diseases‡ [2.8%] Road injuries [2.5%] 10 10 Low back & neck pain [2.3%] Neonatal encephalopathy [2.4%] 11 11 Diabetes [2.2%] Measles [2.2%] 12 12 Stroke [2.2%] Iron-deficiency anaemia [2.1%] 1 1 Skin diseases [2.1%] Stroke [1.6%] 14 14 Migraine [2.1%] Asthma [1.5%] 1 1 Falls [2.0%] Sense organ diseases‡ [1.4%] 17 17 Intestinal infectious diseases [1.7%] Skin diseases [1.3%] 19 18 Other neonatal disorders [1.7%] Falls [1.2%] 21 21 Asthma [1.6%]* Low back & neck pain [1.2%] 2 24 Neonatal encephalopathy [1.3%] Migraine [1.1%] 2 7 Tetanus [0.3%] Diabetes [0.7%] 7 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
[2.21]
15
10
[2.08] Percent of total DALYs Percent [1.34] [1.67] [2.6] [1.09] [0.54] [0.66] [0.78] [0.89] [0.45] [0.59] [3.11] 5 [3.53] [0.33] [0.31] [4.02] [4.45]
0
85+ (<1%) Under 5 (8%) 5 to 9 (10%) 10 to 14 (10%)15 to 19 (11%)20 to 24 (10%) 25 to 29 (8%) 30 to 34 (8%) 35 to 39 (7%) 40 to 44 (6%) 45 to 49 (5%) 50 to 54 (5%) 55 to 59 (4%) 60 to 64 (4%) 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 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.
Uttarakhand 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%] [29.2%]1 1 1 Malnutrition* [14.8%] 1 Malnutrition* [13.5%] WaSH WaSH [15.2%] [12.9%]2 2 2 Air pollution [5.1%] 2 Air pollution [9.3%] Air Airpollution pollution [7.7%] [10.8%] High blood pressure [5.0%] Tobacco use [8.8%] Tobacco use [3.6%] 4 4 Tobacco use [4.9%] Tobacco use [6.4%] 4 4 High blood pressure [7.5%] Dietary risks [2.3%] Dietary risks [4.7%] High blood pressureDietary [2.2%] risks [4.4%]6 6 High fasting plasma glucose [4.0%]Dietary risks [7.4%] OccupationalHigh blood risks pressure [1.9%] [4.0%]7 6 7 WaSH [3.9%] 6 High fasting plasma glucose [5.5%] High fastingAlcohol plasma & drug use glucose [1.6%] [2.1%]8 7 8 Alcohol & drug use [3.9%]7 High body-mass index [4.7%] High fasting plasma glucose [1.4%] 9 9 Occupational risks [2.6%] Impaired kidneyOccupational function [0.9%] risks [2.1%]10 8 10 Impaired kidney function8 [2.0%]High total cholesterol [3.9%] Alcohol & drug use [1.8%] 9 9 Alcohol & drug use [3.7%] The percent figure in bracket next to each risk is DALYs from that risk out of total DALYs. *Malnutrition is child and maternal malnutrition. High total cholesterol [1.7%] 10 WaSH is unsafe water, sanitation,10 Occupational and handwashing. risks [3.2%] High body-mass index [1.0%] 12 11 WaSH [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. 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 High blood pressure Dietary risks High fasting plasma glucose High body-mass index High total cholesterol Alcohol & drug use Occupational risks
16 12 0 0 12 16 Percent of years of life lost and years lived with disability Percent of years of life lost and years lived with disability
ehavioural Environmental occupational etabolic
*Malnutrition is child and maternal malnutrition.
4 Uttarakhand