New Delhi: Child and maternal malnutrition posed the most challenging health risk in India in 2016, followed by air pollution, dietary risks, high blood pressure and diabetes, according to the Economic Survey 2017-18, presented in Parliament on Monday.

“In 2016, malnutrition still remains the most important risk factor (14.6%) that results in disease burden in the country. Neonatal disorders and nutritional deficiencies as well as diarrhoea, lower respiratory infections, and other common infections are manifestation of maternal and child malnutrition," said the report.

The survey said the contribution of air pollution to India’s disease burden remained high between 1990 (11.1%) and 2016 (9.8%), with the levels of exposure remaining among the highest in the world. The survey further said air pollution is responsible for a mix of non-communicable and infectious diseases, mainly cardiovascular diseases, chronic respiratory ailments, and lower respiratory tract infections.

According to a government report titled India: Health of the Nation’s States and released last year, 33% of the total disease burden in India was caused by communicable, maternal, neonatal, and nutritional diseases (termed infectious and associated diseases) in 2016. The contribution of non-communicable diseases increased from 30% of the total disease burden in 1990 to 55% in 2016 and that of injuries from 9% to 12%.

Noting that the disease burden has shifted from communicable diseases to non-communicable diseases (NCDs) in the country between 1990 and 2016, the Economic Survey report, “The behavioural and metabolic risk factors associated with the rising burden of NCDs have become quite prominent in India."

It added: “In 2016, the dietary risks, which include diets low in fruit, vegetables, and whole grains, but high in salt and fat, were India’s third leading risk factor, followed closely by high blood pressure and high blood sugar (high fasting plasma glucose)."

Among the leading NCDs, the largest increase in the disease burden rate, or disability adjusted life years (DALYs), was observed for diabetes at 80%, and ischemic heart disease at 34% during the period between 1990 and 2016. DALYs is the sum of years of potential life lost due to premature mortality and the years of productive life lost due to disability.

“In health problems, India is suffering from jeopardy; diseases related to under- and overnutrition. Those states where health transition is rapidly occurring (increase in heart disease, diabetes) are also most urbanised and mechanised. But such changes are dynamic, and will quickly march over to other states. In view of this, several national control programs need not only strengthening but capacity building to tackle deluge of non-communicable diseases," said Anoop Misra, chairman of the Fortis-C-DOC Centre for Diabetes, Metabolic Diseases and Endocrinology and National Diabetes, Obesity and Cholesterol Foundation.

The survey said there has been significant improvement in the health status of individuals in India. Life expectancy at birth has increased by 10 years during the period 1990 to 2015. Despite the improvement, inequalities still persist among states with life expectancy ranging from 64.5 years in Uttar Pradesh to 75.2 years in Kerala in 2015, it said.

The survey said around 5% per cent of health loss in India is attributable to unsafe water, sanitation, and hand-washing practices, which the government is trying to address through the Swachh Bharat Mission (SBM).

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