Diseases Burden and epidemiological transition status at the national and sub-national level in India: a contemporary perspective
Abstract The present study aims to assess age and gender-specific disease burden variations in India in 2020 and evaluate the epidemiological transition status nationwide and across selected states. Utilising data from vital statistics, census, and cause of death reports and applying innovative meth...
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| Format: | Article |
| Language: | English |
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Springer
2025-02-01
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| Series: | Discover Public Health |
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| Online Access: | https://doi.org/10.1186/s12982-025-00453-5 |
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| author | Mahadev Bramhankar Murali Dhar |
| author_facet | Mahadev Bramhankar Murali Dhar |
| author_sort | Mahadev Bramhankar |
| collection | DOAJ |
| description | Abstract The present study aims to assess age and gender-specific disease burden variations in India in 2020 and evaluate the epidemiological transition status nationwide and across selected states. Utilising data from vital statistics, census, and cause of death reports and applying innovative methods, the present study estimated cause-specific mortality patterns, Years of Life Lost (YLL), Years Lived with Disability (YLD), and Disability-adjusted Life Years (DALYs). The study categorised over two hundred diseases into five groups: Infectious, Nutritional, Maternal, and Perinatal Diseases (INMPDs), NCDs, Injuries, Ill-defined, and COVID-19. Further, to determine the epidemiological transition status, the Epidemiological Transition Ratio (ETR) calculates the ratio of DALYs from INMPDs to NCDs. A lower ETR value indicates a higher epidemiological transition state and vice-versa. Among all causes, NCDs were predominant, causing 60% of deaths, YLLs (51%, 98.7 million), YLDs (71%, 79 million), and DALYs (58%, 177 million). INMPDs, Injuries, COVID-19, and other diseases contributed 5%-20% to these measures. This trend was consistent at the sub-national level. Age-wise DALY distribution showed an inverse relationship between INMPDs and NCDs, with younger populations being more affected by INMPDs and older populations being affected by NCDs. Gender analysis revealed higher YLLs and DALYs in males, while females had higher YLDs. Leading causes included CVDs, maternal-neonatal disorders, chronic respiratory diseases, and infectious diseases, with top individual causes being diabetes, COVID-19, Ischemic-heart Disease, Hypertension, and Tuberculosis. The ETR revealed 36 DALYs of INMPD per 100 DALYs of NCDs. It revealed that India is in a high-middle epidemiological transition state with a growing NCD burden. ETR varied eloquently by state, from Kerala's lowest ratio (7) to Uttar Pradesh's highest (90). The present study highlights a significant burden towards chronic diseases, with variations across states and pronounced age and gender disparities. The epidemiological transition status across Indian states spans from developing to developed, with at least a decade of lag between them, emphasising the need for tailored health strategies. Enhancing the health system with a focus on prevention and early detection of chronic illnesses is essential, without neglecting communicable diseases, to improve health outcomes, particularly in underserved regions and vulnerable populations. Our findings underscore the importance of region-specific policies and interventions to effectively address the diverse health challenges across India. |
| first_indexed | 2025-03-14T16:07:24Z |
| format | Article |
| id | doaj.art-c45c52d65fe144a7a9f0f7f8a14d9682 |
| institution | Directory Open Access Journal |
| issn | 3005-0774 |
| language | English |
| last_indexed | 2025-03-14T16:07:24Z |
| publishDate | 2025-02-01 |
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| series | Discover Public Health |
| spelling | doaj.art-c45c52d65fe144a7a9f0f7f8a14d96822025-02-23T12:09:25ZengSpringerDiscover Public Health3005-07742025-02-0122111810.1186/s12982-025-00453-5Diseases Burden and epidemiological transition status at the national and sub-national level in India: a contemporary perspectiveMahadev Bramhankar0Murali Dhar1Department of Bio-Statistics and Epidemiology, International Institute for Population Sciences (IIPS)Department of Bio-Statistics and Epidemiology, International Institute for Population Sciences (IIPS)Abstract The present study aims to assess age and gender-specific disease burden variations in India in 2020 and evaluate the epidemiological transition status nationwide and across selected states. Utilising data from vital statistics, census, and cause of death reports and applying innovative methods, the present study estimated cause-specific mortality patterns, Years of Life Lost (YLL), Years Lived with Disability (YLD), and Disability-adjusted Life Years (DALYs). The study categorised over two hundred diseases into five groups: Infectious, Nutritional, Maternal, and Perinatal Diseases (INMPDs), NCDs, Injuries, Ill-defined, and COVID-19. Further, to determine the epidemiological transition status, the Epidemiological Transition Ratio (ETR) calculates the ratio of DALYs from INMPDs to NCDs. A lower ETR value indicates a higher epidemiological transition state and vice-versa. Among all causes, NCDs were predominant, causing 60% of deaths, YLLs (51%, 98.7 million), YLDs (71%, 79 million), and DALYs (58%, 177 million). INMPDs, Injuries, COVID-19, and other diseases contributed 5%-20% to these measures. This trend was consistent at the sub-national level. Age-wise DALY distribution showed an inverse relationship between INMPDs and NCDs, with younger populations being more affected by INMPDs and older populations being affected by NCDs. Gender analysis revealed higher YLLs and DALYs in males, while females had higher YLDs. Leading causes included CVDs, maternal-neonatal disorders, chronic respiratory diseases, and infectious diseases, with top individual causes being diabetes, COVID-19, Ischemic-heart Disease, Hypertension, and Tuberculosis. The ETR revealed 36 DALYs of INMPD per 100 DALYs of NCDs. It revealed that India is in a high-middle epidemiological transition state with a growing NCD burden. ETR varied eloquently by state, from Kerala's lowest ratio (7) to Uttar Pradesh's highest (90). The present study highlights a significant burden towards chronic diseases, with variations across states and pronounced age and gender disparities. The epidemiological transition status across Indian states spans from developing to developed, with at least a decade of lag between them, emphasising the need for tailored health strategies. Enhancing the health system with a focus on prevention and early detection of chronic illnesses is essential, without neglecting communicable diseases, to improve health outcomes, particularly in underserved regions and vulnerable populations. Our findings underscore the importance of region-specific policies and interventions to effectively address the diverse health challenges across India.https://doi.org/10.1186/s12982-025-00453-5Diseases BurdenEpidemiological transitionMortalityNCDsDALYsIndia |
| spellingShingle | Mahadev Bramhankar Murali Dhar Diseases Burden and epidemiological transition status at the national and sub-national level in India: a contemporary perspective Discover Public Health Diseases Burden Epidemiological transition Mortality NCDs DALYs India |
| title | Diseases Burden and epidemiological transition status at the national and sub-national level in India: a contemporary perspective |
| title_full | Diseases Burden and epidemiological transition status at the national and sub-national level in India: a contemporary perspective |
| title_fullStr | Diseases Burden and epidemiological transition status at the national and sub-national level in India: a contemporary perspective |
| title_full_unstemmed | Diseases Burden and epidemiological transition status at the national and sub-national level in India: a contemporary perspective |
| title_short | Diseases Burden and epidemiological transition status at the national and sub-national level in India: a contemporary perspective |
| title_sort | diseases burden and epidemiological transition status at the national and sub national level in india a contemporary perspective |
| topic | Diseases Burden Epidemiological transition Mortality NCDs DALYs India |
| url | https://doi.org/10.1186/s12982-025-00453-5 |
| work_keys_str_mv | AT mahadevbramhankar diseasesburdenandepidemiologicaltransitionstatusatthenationalandsubnationallevelinindiaacontemporaryperspective AT muralidhar diseasesburdenandepidemiologicaltransitionstatusatthenationalandsubnationallevelinindiaacontemporaryperspective |