India is host to huge numbers of tropical diseases, predispositions to genetic disease, as well as many rare conditions that as of yet remain largely unstudied. With endless reports of outbreaks of infectious disease as well as fears of vector borne conditions such as the Zika virus arriving in the country it is understandable to be concerned. However, are these concerns misplaced? What are the most common causes of premature death in the country?
These questions were answered in the Global Burden of Disease Report 2016 published in The Lancet. This data was then analysed by The Institute for Health Metric and Evaluation at the University of Washington to project the top ten causes of death within India. The findings indicate non-communicable diseases (NCDs) are by far the most common causes of death. The list (in reverse order of prevalence) is as follows:
- Heart disease – Heart disease is now the number one cause of death within India. The condition is often entirely preventable, and is commonly caused by poor lifestyle habits. Rising obesity rates within urban areas have added to the prevalence of the condition, with high blood pressure also rising in the population. Sedentary lifestyles with low levels of exercise also contribute.
- Chronic obstructive pulmonary disease – This disease classification encompasses a number of lung conditions such as pulmonary hypertension, occupational lung disease, and interstitial lung disease. Each of these conditions causes permanent damage to the airways and lungs, resulting in a reduction of breathing capacity. Smoking, air pollution, and occupations such as mining aggrevate these conditions.
- Diarrhoea – Diarrhoea is one of the most common causes of death of children in India. Diseases such as the rotavirus are responsible for the high prevalence of diarrhoea. Between 800,000 and one million children are killed each year as a result.
- Stroke – Many of the risk factors associated with a stroke are similar to those of heart disease. Obesity, lack of exercise and smoking are all well established risk factors. While a stroke may not always be lethal, it can cause severe disability. In poor families who cannot afford care or treatment, this can later result in the individual passing away.
- Lower respiratory infections – These infections have slipped down a position on the list, though this is primarily due to the heightened prevalence of conditions such as heart disease and strokes. Lower respiratory infections include diseases such as pneumonia, and typically are a common cause of death amongst the elderly.
- Tuberculosis – India accounts for 2.8 million of the 10.4 million new cases of tuberculosis that occur globally. Though the government provides free access to tuberculosis medication the course lasts between six to eight months. Many people in rural areas do not have close access to healthcare facilities and will often not complete the full course.
- Neonatal preterm birth – Infant mortality has been reduced considerably over the past decade. In 2005 neonatal preterm births were fourth on the list of most common causes of death. Despite the reduction, India still faces high numbers of infant mortality, particularly in rural areas.
- Self harm – Mental health is still a taboo topic in India. Due to this, diseases such as depression are often undiagnosed and poorly handled. Self harm and suicide have rapidly entered the top ten list of most common causes of death. Programmes are being rolled out to curb this increase, though this process is long overdue.
- Road injuries – With rapid urbanisation and increasing numbers of people living in sprawling cities, road accidents have increased dramatically. This is an inevitable consequence of having more people in close proximity, with more and more individuals driving every year.
- Other neonatal conditions – Septicaemia, birth asphyxia and birth trauma all add to the last position on the list. Neonatal care has been a fixture in the news recently resulting from the publicity generated from the Gorakhpur tragedy.
The list is now dominated in its highest positions by non-communicable diseases. These conditions are avoidable through alterations to lifestyle choices. Healthy diets and exercise would easily cut down a number of these deaths. Many of the entries on the list are conditions which, while treatable, are often prevalent through the lack of access to healthcare in rural environments. Improvements to healthcare infrastructure and provision of information could be crucial factors in reducing some of India’s most deadly conditions.