India has witnessed an alarming rise in the occurrence of heart disease, stroke, diabetes and cancers over the past 25 years, a series of studies published on Wednesday in The Lancet and associated journals, revealed.
Detailed estimates of cardiovascular diseases, diabetes, chronic respiratory diseases, cancer, and suicide show that their prevalence has gone up in every Indian state between 1990 and 2016, with vast variation between states.
Heart disease and stroke alone have increased by over 50 percent in the years between 1990 and 2016 in the country.
The contribution of these diseases to total deaths and disease burden has nearly doubled in the 25 years period. Heart disease is now the single leading cause of disease burden in India, and stroke, the fifth leading.
Heart disease and stroke together contributed to 28 percent of total deaths in India in 2016 — compared with 15 percent in 1990. Heart disease contributed 18 percent of total deaths and stroke contributed 7 percent of total deaths.
The proportion of deaths and disability from heart disease was significantly higher in men than in women, but was similar among men and women for stroke.
Deaths due to cardiovascular diseases rose from 13 lakh in 1990 to 28 lakh in 2016. The number of prevalent cases of cardiovascular diseases has increased from 2.57 crore in 1990 to 5.45 crore in 2016.
The prevalence was the highest in Kerala, Punjab and Tamil Nadu, followed by Andhra Pradesh, Himachal Pradesh, Maharashtra, Goa, and West Bengal.
More than half of the total cardiovascular disease deaths in India in 2016 were in people younger than 70 years.
“This proportion was the highest in less developed states, which is a major cause for concern with respect to the challenges posed to the health systems. Reducing premature deaths from cardiovascular diseases in the economically productive age groups requires urgent action across all states of India,” the researchers have observed.
“The study shows that the response has to be appropriate to the context of each state. By shining the torchlight on specific disease burdens that each state must prioritise, this study will help direct health system resources to maximise impact through early prevention and effective treatment,” Professor K Srinath Reddy, President, Public Health Foundation of India, explained.
“While it is known that non-communicable diseases have been increasing in India, a major finding of concern is that the highest rate of increase in heart disease and diabetes is in less developed states," Professor Balram Bhargava, ICMR director general, said.
"These states already have high burden from chronic obstructive lung disease and range of infectious and childhood diseases.”
The increase in poor health from diabetes since 1990 is the highest among major non-communicable diseases. The increase has been observed in every state of the country, and the relative rate of increase is the highest in several less developed states.
“Policy action must take these state-level differences into account to control this potentially explosive public health situation,” the researchers suggest.
The number of diabetic people in India has risen from 2.6 crore in 1990 to 6.5 crore in 2016.
Among the risk factors contributing to diabetes in India in 2016, high body mass index (BMI) had the highest impact. Other risk factors included dietary risks, tobacco use, occupational exposure to second-hand smoke, low physical activity, and alcohol use.
The proportional contribution of cancers to the total health loss in India has also doubled from 1990 to 2016, but the incidence of different types of cancers varies widely between the states, the study says
Over 8 percent of the total deaths in India in 2016 were due to cancer — double the number as in 1990.
The estimated number of cancer cases increased from 5.48 lakh in 1990 to 10.6 lakh in 2016.
The leading types of cancer in 2016 were stomach (9 percent), breast (8·2 percent), lung (7·5 percent), lip and oral cavity (7·2 percent), pharynx cancer other than nasopharynx (6·8 percent), colon and rectum (5·8 percent), leukaemia (5·2 percent), and cervix (5·2 percent).
Another area pf concern is the rise in suicides, which is presently the leading cause of death in the 15-39 year age group in India.
Almost 37 percent of the global suicide deaths among women occur in India, and suicide death rate among the elderly has also increased over the past quarter century.