There has been an increase in the burden of non-communicable (NCD) diseases over the past two decades, with NCD burden rising from 30% of total disease burden in 1990 to 55% of total disease burden in 2016 (Indian Council of Medical Research, Public Health Foundation of India and Institute of Health Metrics and Evaluation [ICMR, PHFI and IHME], 2017). The most considerable DALY rate increase (from 1990-2016) was observed for diabetes and ischemic heart disease (IHD) (ICMR, PHFI and IHME, 2017). In addition, there has also been a rise in NCD neurological disorders in India, with their contribution to total DALYs increasing from 4% in 1990 to 8.2% in 2019 (India State-Level Disease Burden Initiative Neurological Disorders Collaborators, 2021). Stroke, headache disorders, and epilepsy contributing most significantly to total neurological disorder DALYs in 2019 (India State-Level Disease Burden Initiative Neurological Disorders Collaborators, 2021).

Moreover, NCDs which typically present over the age of 55 in developed countries are presenting almost a decade earlier (≥45 years of age) in the Indian population (Arokiasamy, 2018). In addition, considering that communicable diseases are also highly prevalent in the country as they contribute to 27.5% of all deaths (Mohan et al., 2019), the Indian public health system faces significant challenges with this double burden of disease (Arokiasamy, 2018).

State wise variations in NCDs:

As per GBD 2019 data, the prevalence of NCDs varies across different across states. In 2019, the lowest prevalence rate was in Arunachal Pradesh, which had a prevalence rate of 91,599.98 prevalent cases per 100,000 people (90,577.05 – 92,577.86) (ICMR, PHFI and IHME, 2019). Whereas, the highest prevalence was in Kerala, with 94,140.27 prevalent cases per 100,000 people (93,473.85 – 94,765.24) (ICMR, PHFI and IHME, 2019). With respect to NCD burden, the number of deaths and Disability Adjusted Life Year’s (DALY’s) are also described. The least number of deaths was in the state of Arunachal Pradesh with 262.98 deaths per 100,000 people (214.73 – 318.26) and the highest number of deaths was in the state of Kerala – 596.35 deaths per 100,000 people (503.58 – 697.71) (ICMR, PHFI and IHME, 2019). In terms of DALY’s – the state of Arunachal Pradesh again had the lowest number of 14,675.94 per 100,000 people (12,212.71 – 17,202.98) and Tamil Nadu had the highest number of DALY’s with 23.406.3 per 100,000 people (19,820.32 – 27,314.47) (ICMR,PHFI and IHME, 2019).

References:

Arokiasamy, P. (2018). India’s escalating burden of non-communicable diseases. The Lancet Global Health, 6, e1262–e1263. https://doi.org/10.1016/S2214-109X(18)30448-0

India State-Level Disease Burden Initiative Neurological Disorders Collaborators (2021). The burden of neurological disorders across the states of India: The Global Burden of Disease Study 1990-2019. The Lancet. Global health, 9(8), e1129–e1144.

Indian Council of Medical Research, Public Health Foundation of India and Institute for Health Metrics and Evaluation (ICMR, PHFI, and IHME). (2017). India: Health of the Nation’s States-The India State-level Disease Burden Initiative, New Delhi: ICMR, PHFI and IHME. Available from: https://www.healthdata.org/sites/default/files/files/policy_report/2017/India_Health_of_the_Nation%27s_States_Report_2017.pdf

Indian Council of Medical Research, Public Health Foundation of India, and Institute for Health Metrics and Evaluation (ICMR, PHFI, and IHME). (2019). GBD India Compare Data Visualization. Available from: https://vizhub.healthdata.org/gbd-compare/

Mohan, P., Mohan, S. B., & Dutta, M. (2019). Communicable or noncommunicable diseases? Building strong primary health care systems to address double burden of disease in India. Journal of family medicine and primary care, 8(2), 326–329. https://doi.org/10.4103/jfmpc.jfmpc_67_19