Maharashtra: Disease Burden Profile, 1990 to 2016

1990 life expectancy 2016 life expectancy

Females: 55.9 years Males: 55.6 years Females: 69.3 years Males: 65.3 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-5 mortality
Under-5 mortality rate, bothrate, both sexes
sexes combined, combined, 1990-2016
1990-2016

Maharashtra under-5 rate India under-5 rate Comparative average rate globally for similar
Socio-demographic Index as Maharashtra

150
Deaths per 1,000 live births

100

50
39.2
The shaded
27.5 bands indicate
21.6
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?
Whatcontribution
Percent causedofthe most
top 10 causesdeaths
of death byin
agedifferent
in 2016?age 2016
group, both sexes, groups
Percent contribution of top 10 causes of death by age group, both sexes, 2016

0−14 years [6% of total deaths] 15−39 years [10.7% of total deaths]

HIV/AIDS & tuberculosis

4.2% 1.5%
5.8% Diarrhoea/LRI*/other
10.7% 11%
26.1% NTDs† & malaria
8.8% 7.6%
0.8% Maternal disorders
16.2%
1.4% 5.5%
1.3% Neonatal disorders
1.8%
Nutritional deficiencies
2.9%
13.9% Other communicable diseases
10.2%
Cancers

12.3% Cardiovascular diseases

45.4% 6.1%
2.1% 4.5% Chronic respiratory diseases

Cirrhosis

Digestive diseases

Neurological disorders

40−69 years [40.7% of total deaths] 70+ years [42.5% of total deaths]
Diabetes/urog‡/blood/endo§
2.2% 2.6% Other non-communicable
2.4%
Transport injuries
5.4% 5.8% 2.9% 4.6%
6.7% 4.3% Unintentional injuries
14.8% 7.9%
Suicide & violence
11.5% 4.3% 1.5%
7.5% 5.6% 1.5% Other causes of death

5.7% *LRI is lower respiratory infections.

†
NTDs are neglected tropical diseases.
15.4% ‡
Urog is urogenital diseases.
§
Endo is endocrine diseases.
10%

37.8% 39.7%

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
Proportion of total disease burden from:
Premature death: 63.7% | Disability or morbidity: 36.3%

What caused the most years of life lost, by sex, in 2016?

Top 15 causes of YLLs, ranked by percent for both sexes combined, 2016

Females Males

Ischaemic heart disease

Stroke
COPD*
Lower respiratory infections
Suicide
Diarrhoeal diseases
Preterm birth complications
Road injuries
Tuberculosis
Chronic kidney disease
Falls
Diabetes
Other neonatal disorders
HIV/AIDS
Neonatal encephalopathy

20 15 10 5 0 0 5 10 15 20
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 Non-communicable diseases Injuries

*COPD is chronic obstructive pulmonary disease.

What caused the most years lived with disability, by sex, in 2016?
Top 15 causes of YLDs, ranked by percent for both sexes combined, 2016

Females Males

Iron-deficiency anaemia
Sense organ diseases*
Low back & neck pain
Migraine
Depressive disorders
Other musculoskeletal
Skin diseases
COPD*
Diabetes
Anxiety disorders
Oral disorders
Preterm birth complications
Falls
Osteoarthritis
Haemoglobinopathies

15 10 5 0 0 5 10 15
Percent of total years lived with disability Percent of total years lived with disability
Communicable, maternal, neonatal, and nutritional diseases Non-communicable diseases Injuries

*COPD is chronic obstructive pulmonary disease.

*Sense organ diseases includes mainly hearing and vision loss.

2 Maharashtra
 Proportion of total disease burden from:
CMNNDs: 24.6% | NCDs: 63.1% | Injuries: 12.3%
How have
How have the
the leading
leading causes
causesofofdeath
deathand
anddisability combined
disability changed
combined from
changed 1990
from to 2016?
1990 to 2016?
Change in top 15 causes of DALYs, both sexes, ranked by number of DALYs, 1990–2016
Change in top 15 causes of DALYs, both sexes, ranked by number of DALYs, 1990–2016
Communicable, maternal, Non-communicable diseases Injuries same or increase decrease
neonatal, and nutritional diseases

Leading causes of DALYs 1990 Leading causes of DALYs 2016

Diarrhoeal diseases [8.9%] 1 1 Ischaemic heart disease [11.2%]

Preterm birth complications [7.3%] 2 2 COPD† [5.0%]*
Lower respiratory infections [7.2%] 3 3 Stroke [4.1%]
Tuberculosis [6.4%] 4 4 Iron-deficiency anaemia [3.3%]
Ischaemic heart disease [5.2%] 5 5 Sense organ diseases‡ [3.3%]
COPD† [4.1%] 6 6 Preterm birth complications [3.2%]
Other neonatal disorders [3.4%] 7 7 Lower respiratory infections [2.9%]
Neonatal encephalopathy [2.6%] 8 8 Diarrhoeal diseases [2.8%]
Measles [2.6%] 9 9 Self-harm§ [2.8%]
Stroke [2.6%] 10 10 Road injuries [2.8%]
Iron-deficiency anaemia [2.3%] 11 11 Low back & neck pain [2.7%]
Congenital birth defects [2.1%] 12 12 Tuberculosis [2.5%]
Road injuries [2.0%] 13 13 Diabetes [2.4%]
Self-harm§ [2.0%] 14 14 Migraine [2.3%]
Asthma [1.6%] 15 15 Depressive disorders [2.2%]
Sense organ diseases‡ [1.6%] 16 20 Congenital birth defects [1.4%]
Low back & neck pain [1.4%] 17 21 Other neonatal disorders [1.3%]
Migraine [1.3%] 19 23 Asthma [1.2%]
Depressive disorders [1.2%] 23 24 Neonatal encephalopathy [1.1%]
Diabetes [0.9%] 29 104 Measles [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. §
Self-harm refers to suicide and the nonfatal outcomes of self-harm.

What causedthe
What caused themost
most death
death and
and disability
disability combined
combined across
across age groups
age groups in 2016?
in 2016?
Percent
Percent of
of DALYs by age group,
group, both
both sexes,
sexes,2016
2016
12.5

[1.6]

10.0

[2.61]
[1.69] [2.08]
[1.36]
Percent of total DALYs

7.5

[0.92] [1.11]
[0.68] [0.81] [3.14]
[0.6]
[0.54]
5.0 [3.61]
[0.45]

[0.31] [4.15]
[0.29]
2.5
[4.66]

0
%)
%)

%)

%)

%)

%)

%)

%)

%)

%)

%)
)

%)

%)
%)

%)

)
7%

0%

1%
(9

(9

(4

(2

(1

(1
(8

(7

(7

(6

(5

(4

(3
(8

(9
5(

(1

(<
29

34

64

74

79

84
14

39

44

49

54

59

69
o9

19

24
r

+
de

5t

to

to

to

to

to

to
to

to

to

to

to

to

to
to

85
to
Un

25

30

60

70

75

80
10

35

40

45

50

55

65
15

20

Age
Communicable, maternal, neonatal, and nutritional diseases Non-communicable diseases Injuries

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.
Maharashtra 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, 19
What risk factors are driving the most death and disability combined?
What risk factors are driving the most death and disability combined?
Contribution
Contribution
Behaviouralof
oftop
top1010risks toto
risks DALYs number,
DALYs bothboth
number,
Environmental/occupational sexes, ranked
sexes, by number
ranked
Metabolic of DALYs,
by number 1990-2016
of DALYs,
same 1990-2016
or increase decrease
Behavioural Environmental/occupational Metabolic same or increase decrease

Risk factors 1990 Risk factors 2016

Risk factors 1990 Risk factors 2016
Malnutrition* [30.1%]
Malnutrition* [32.2%] 1
1 1 Malnutrition* [14.8%]
1 Dietary risks [11.5%]
Air pollution
WaSH †
[15.2%] [9.8%]
2 2 2 Air pollution [5.1%] 2 High blood pressure [10.4%]
Air pollutionWaSH
[7.7%] † [8.9%]
3 3 3 High blood pressure [5.0%]
3 Malnutrition* [10.3%]
Tobacco use [3.6%] 4 4 Tobacco use [4.9%]
Dietary risks [6.3%] 4 4 Air pollution [8.6%]
Dietary risks [2.3%] 5 5 Dietary risks [4.7%]
High
High blood
blood pressure
pressure [2.2%] [5.1%]
6 5 6 5 [4.0%]
High fasting plasma glucose High fasting plasma glucose [7.1%]
OccupationalTobacco use [4.6%]
risks [1.9%] 7 6 7 WaSH† [3.9%] 6 High total cholesterol [5.3%]
Alcohol & drug use [1.6%] 8 8 Alcohol & drug use [3.9%]
High fasting plasma glucose [3.2%] 7 7 Tobacco use [4.8%]
High fasting plasma glucose [1.4%] 9 9 Occupational risks [2.6%]
Alcohol & drug use [2.7%] 8
Impaired kidney function [0.9%] 10 10 Impaired kidney function8 [2.0%]Alcohol & drug use [4.6%]
High total cholesterol [2.4%] 9 9 High body-mass index [4.5%]
The percent figure in bracket next to each risk is DALYs from that risk out of total DALYs. *Malnutrition is child and maternal malnutrition.
Occupational risks [2.2%] 10 † 10 Impaired
WaSH is unsafe water, sanitation, kidney function
[3.6%]
and handwashing.
Impaired kidney function [1.9%] 11 11 Occupational risks [3.2%]
High body-mass index [0.9%] 12 12 WaSH† [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.
†
WaSH is unsafe water, sanitation, and handwashing.

How did the risk factors differ by sex in 2016?

Percent of total DALYs attributable to top 10 risks, ranked by percent for both sexes combined, 2016

Females Males

Dietary risks
High blood pressure
Malnutrition*
Air pollution
High fasting plasma glucose
High total cholesterol
Tobacco use
Alcohol & drug use
High body-mass index
Impaired kidney function

15 10 5 0 0 5 10 15
Percent of years of life lost and years lived with disability Percent of years of life lost and years lived with disability
Behavioural Environmental/occupational Metabolic

*Malnutrition is child and maternal malnutrition.

4 Maharashtra