Non-communicable diseases such as hypertensive heart disease and cerebral stroke replaced tuberculosis, which was the top killer in 1990, reflecting changing disease patterns in the country, a study conducted by the Washington-based Global Burden of Disease (GBD) has found.
The study also found that hypertensive heart disease and suicide took more lives in 2013 than in 1990, with deaths increasing 138% and 129%, respectively.
The mortality rate from road injuries also increased 88% between 1990 and 2013.
On an average, the life expectancy for Indian men increased to 64.2 years and women’s average life expectancy increased to 68.5 years in 2013.
The trend is true globally, with a reduction in the rates of cardiovascular disease deaths in high-income countries and child deaths in low-income countries, said a report based on the study, published in medical journal The Lancet.
This is the first journal publication of country-specific cause-of-death data for 188 countries.
Globally, three conditions—ischemic heart disease, stroke and chronic obstructive pulmonary disease (COPD)—claimed the most lives in 2013, accounting for nearly 32% of all deaths.
The study, called Global, regional and national age-sex-specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013, was conducted by an international consortium of more than 700 researchers led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
Given the size of India’s population and the projections that it may soon become the world’s most populous nation, mortality trends in the country have global implications.
In 2013, India accounted for 19%, or 10.2 million, of the world’s deaths.
The country has made great strides in reducing both child and adult mortality since 1990. The average yearly rates of decline in mortality have been 3.7% per year for children and 1.3% per year for adults. Between 1990 and 2013, life expectancy at birth increased from 57.3 years to 64.2 years for males and from 58.2 years to 68.5 years for females.
“It’s very encouraging that adults and children in India are living longer and healthier lives," said Jeemon Panniyammakal, head, clinical trials unit, of the Public Health Foundation of India, a public-private initiative, and a co-author of the study. “But India’s growing influence on global health means we must do more to address the diseases that kill people prematurely." Panniyammakal was part of the IHME researchers’ consortium.
Two diseases, HIV/AIDS and malaria, followed very different mortality trends from other diseases. The global death toll from both diseases peaked around 2005 rather than 1990, with deaths from HIV/AIDS and malaria declining 22% and 30%, respectively, from 2005 to 2013. For India, HIV/AIDS mortality peaked in 2002, claiming 286,602 lives. By 2013, deaths due to HIV/AIDS decreased 73%. Malaria mortality in India peaked in 1983, with 176,970 deaths, and then fell 34% by 2013.
The leading killers in India were ischemic heart disease, chronic obstructive pulmonary disease, and stroke, accounting for 30% of all deaths in 2013. Tuberculosis and ischemic heart disease were the top two causes of deaths of people between the ages of 15 and 49, resulting in the deaths of 408,114 people in 2013. Among individuals aged 70 and above, ischemic heart disease claimed the most lives that year. The top cause of child mortality was neonatal encephalopathy in 2013, killing 212,686 children under the age of 5.
Since 1990, India saw marked declines in mortality from a number of diseases that used to take a large toll. For instance, by 2013, mortality from pneumonia decreased 50%, and diarrheal diseases caused 42% fewer deaths. In 1990, these diseases killed 1,532,459 people. Twenty-three years later, they claimed 715,303 fewer lives.
Ischemic heart disease took a greater toll on men, killing 962,686 males and 623,823 females in 2013. By contrast, diarrheal diseases claimed 232,825 women’s lives and 180,401 men’s lives.