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: Disease Burden Profile, 1990 to 2016 1990 life epectancy 2016 life epectancy emales 5. years ales 5.2 years emales 6. years ales 6.0 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

Jharkhand nder- rae nder- rae Caraie aerae rae lall r iilar The state of Jharkhand was carved Si-derahi Inde a Jharkhand out from in 2000. Estimates for Jharkhand prior to 2000 were computed for comparison by disaggregating data from its parent 150 state based on its current district composition.

100

Deaths per 1,000 live births 50 4 4.1 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% of total deaths] 15−39 years [12.3% of total deaths]

1. HIIDS erli 3 1. DiarrheaRIher 62 141 134

59 1 ND alaria 1.6 9 Maernal dirder 2 394 15 Nenaal dirder

Nutritional deficiencies 103 43 her niale dieae 54 Caner 32 11 4 9 Cardialar dieae 41 Chrni reirar dieae

. Cirrhi

Dieie dieae

Nerlial dirder 40−69 years [41.2% of total deaths] 70+ years [33.5% of total deaths] Diaeerldend

2. her nn-niale

2.9 ranr inrie 4 53 41 36 44 65 nineninal inrie 2. 34 Siide ilene 161 66 1.1 her ae deah 41 332

39 101 RI i lwer reirar inein. ND are neleed rial dieae. 11 r i renial dieae. 6 End i endrine dieae.

56 22 29

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 6.9 Disability or morbidity 2.1

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

Diarrhoeal diseases Ischaemic heart disease Lower respiratory infections Tuberculosis Road injuries Preterm birth complications Stroke Other neonatal disorders COPD* Neonatal encephalopathy Suicide Congenital birth defects HIV/AIDS Chronic kidney disease Drowning

16 12 0 0 12 16 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. Top 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 Diabetes Oral disorders Falls Protein-energy malnutrition Diarrhoeal diseases

20 15 10 5 0 0 5 10 15 20 Percent of total years lived with disability Percent of total years lived with 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 Jharkhand roportion of total disease burden from CDs 0. CDs . nuries 10.9 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

Cniale, aernal, Nn-niale dieae Inrie ae r inreae dereae nenaal, and nriinal dieae

Leading causes of DALYs 1990 Leading causes of DALYs 2016

Diarrhoeal diseases [13.5%] 1 1 Diarrhoeal diseases [9.8%] Lower respiratory infections [10.5%] 2 2 Ischaemic heart disease [6.6%] Measles [5.5%] Lower respiratory infections [4.5%]

Tuberculosis [5.2%] 4 4 -deficiency anaemia [4.2%]

Preterm birth complications [4.8%] Tuberculosis [3.8%]

Other neonatal disorders [3.9%] 6 6 Preterm birth complications [3.3%] Tetanus [3.1%] 7 7 COPD† [3.3%] Neonatal encephalopathy [2.9%] 8 8 Road injuries [2.9%] Ischaemic heart disease [2.7%] 9 9 Stroke [2.7%] Iron-deficiency anaemia [2.2%] 10 10 Sense organ diseases‡ [2.6%] Malaria [1.7%] 11 11 Other neonatal disorders [2.3%] Leishmaniasis [1.7%] 12 12 Low back & neck pain [2.0%] Drowning [1.7%] 1 1 Skin diseases [1.9%] Stroke [1.6%] 14 14 Migraine [1.9%] Congenital birth defects [1.6%] 1 1 Diabetes [1.8%] Road injuries [1.5%] 16 16 Neonatal encephalopathy [1.7%] COPD† [1.5%] 17 17 Congenital birth defects [1.6%]* Sense organ diseases‡ [1.2%] 20 24 Drowning [1.1%] Low back & neck pain [1.0%] 24 29 Malaria [0.9%]* Skin diseases [1.0%] 26 44 Measles [0.5%] Migraine [0.9%] 28 7 Leishmaniasis [0.4%] Diabetes [0.6%] 8 99 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. 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 [2.25] 20

15

10 Percent of total DALYs Percent

[2.21]

[1.76] [2.79] [0.71] [0.83] [1.43] [0.64] [0.95] [1.15] [0.35] [0.59] [3.38] 5 [0.34] [0.48]

[3.85] [4.38] [4.77]

0

85+ (<1%) Under 5 (9%) 5 to 9 (14%) 10 to 14 (12%) 15 to 19 (9%) 20 to 24 (8%) 25 to 29 (8%) 30 to 34 (8%) 35 to 39 (7%) 40 to 44 (5%) 45 to 49 (5%) 50 to 54 (4%) 55 to 59 (4%) 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. Jharkhand 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%] [37.7%]1 1 1 Malnutrition* [14.8%] 1 Malnutrition* [17.1%] WaSHWaSH [15.2%] [14.1%]2 2 2 Air pollution [5.1%] 2 WaSH [9.5%] Air Airpollution pollution [7.7%] [10.3%] High blood pressure [5.0%] Air pollution [8.9%] Tobacco use [3.6%] 4 4 Tobacco use [4.9%] Dietary risks [3.5%] 4 4 Dietary risks [6.9%] Dietary risks [2.3%] Dietary risks [4.7%] HighHigh blood blood pressure pressure [2.2%] [3.3%]6 6 High fasting plasma glucose [4.0%]High blood pressure [6.9%] OccupationalTobacco risks [1.9%] use [3.0%]7 6 7 WaSH [3.9%] 6 High fasting plasma glucose [4.5%] High fastingAlcohol plasma & drug use glucose [1.6%] [1.8%]8 7 8 Alcohol & drug use [3.9%]7 Tobacco use [2.9%] High fasting plasma glucose [1.4%] 9 9 Occupational risks [2.6%] Impaired kidneyOccupational function [0.9%] risks [1.6%]10 8 10 Impaired kidney function8 [2.0%]Occupational risks [2.6%] Alcohol & drug use [1.2%] 9 9 Alcohol & drug use [2.6%] The percent figure in bracket next to each risk is DALYs from that risk out of total DALYs. *Malnutrition is child and maternal malnutrition. Impaired kidney function [1.1%] 10 WaSH is unsafe water, sanitation,10 High and body-mass handwashing. index [2.4%] High body-mass index [0.5%] 12 12 Impaired kidney function [2.2%]

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

20 15 10 5 0 0 5 10 15 20 Percent of years of life lost and years lived with disability Percent of years of life lost and years lived with disability

Behavioural Environmentaloccupational etabolic

*Malnutrition is child and maternal malnutrition. WaSH is unsafe water, sanitation, and handwashing.

4 Jharkhand