Across the world, India included, even as longevity has increased during the period 1990 to 2013, the number of years both men and women live with disease and disability has shot up. The major causes of disability in men and women in India are depression, anaemia, low back pain, migraine, chronic obstructive pulmonary disease, age-related and other hearing loss, neck pain (spondylitis), diabetes, anxiety disorders, and uncorrected refractive error.

These are the results of a Global Burden of Disease Study 2013 report published on Monday in the journal The Lancet .

Important findings emerge from the study. “Mortality is declining faster than disease prevalence due to treatment and faster than disability, which is also increasing due to ageing.” In an accompanying Comment piece, Rifat Atun from Harvard University said: “[This] combination is driving the increase in the absolute numbers of years lived with disability and in relative terms as a proportion of total burden.”

For both sexes combined in India, the leading causes of years lived with disability have remained largely the same during the period 1990-2013. However, the disability caused by disease has taken an increased toll on health due to population growth and ageing.

“The major causes of death and disability are generally different, which has implications for planning of health services,” said Prof. Lalit Dandona, study co-author who is Professor at the Delhi-based Public Health Foundation of India and the Institute for Health Metrics and Evaluation at the University of Washington. “While ischemic heart disease kills the most number of people in India, it is not a leading cause of disability. On the other hand, major depression is the leading cause of disability in India, but is not a direct cause of death,” he said.

Relative to the 44 per cent growth in India’s population during the period 1990-2013, diabetes has shown the greatest increase in the disability burden. “The number of years lived with disability from diabetes per million people in India is about 55 per cent higher in 2013 compared with 1990,” said Prof. Dandona. The total increase in the number of years lived with disability from diabetes in India during the period 1990 to 2013 is 123 per cent. In contrast, the number of years lived with disability from anaemia per million people in India has gone down by 45 per cent.

The number of years lived with disability per million people in India has gone up for many leading diseases from 1990 to 2013. For instance, it is 16 per cent higher in the case of major depression, 20 per cent higher in the case of low back pain, 26 per cent higher in the case of chronic obstructive pulmonary disease, and 19 per cent higher in the case of neck pain.

Published in The Hindu on June 9, 2015