The Lancet has published the first comprehensive analysis of the health of India’s 1,34 billion citizens, which reveals vast inequalities between the states…

Key-points of the analysis published on 14 November 2017 are as follows:

  • Life expectancy rises but six out of 10 deaths are now due to non-communicable diseases
  • Under-five mortality rate is improving nationwide, but there is a four-fold difference between states
  • Even in states of similar development levels, there are major differences in the burden of leading diseases, highlighting vast health inequalities
  • The rate of premature death and disability for ischaemic heart disease is nine times higher in some states compared to others; and six times higher for stroke
  • Overall burden of tuberculosis in India is highest in the world and its rate varies nine-fold between states
  • Child and maternal malnutrition is still the leading risk factor for premature death and poor health, and is highest in the poorer states of north India
  • Air pollution, diet and obesity are increasing threats to health across many states

“This has major policy implications for national and local governments,” explains Professor Lalit Dandona, Public Health Foundation of India, Gurugram, India, who led the study. Rather than taking a more generic approach, these new estimates will be crucial to steering health policy to take account of specific health problems and risks in each state, and ultimately achieving the government’s vision of assuring health for all.”

Child and maternal malnutrition still leading risk factor, while diet, obesity and air pollution an increasing threat

Highly preventable risks such as maternal malnutrition, poor diet (e.g., diets high in salt and low in vegetables and fruit), high blood pressure, high cholesterol, and obesity are contributing to the growing burden of Non-Communicable Diseases (NCDs). One area that needs special attention is exposure to air pollution which is among the highest in the world.

“India has come a long way. But these individual state estimates reveal major health inequalities between the ‘nations’ within this nation. …With the availability of state-specific findings now identifying the diseases and risk factors that need most attention in each state, we can act more effectively to improve health in every state of the country,” concludes Professor Dandona.


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