Chikungunya has killed no one in India and dengue doesn’t kill half the people hospital and government records say it does. Delhi government’s investigation into chikungunya- and dengue-related deaths last week threw up startling results: Even when people die of diseases and complications aggravated by infection, their deaths may not be attributed to the infection.
What, then, is killing people in India?
Apart from vaccine-preventable childhood infections such as diarrhoea and pneumonia and treatable adult infections such as tuberculosis, the diseases killing people in India are the same as in the rest of the world, shows Registrar General of India data.
Heart disease and stroke is the biggest killer of men and women in India, killing one in four people, followed by undefined causes. If you live in India, here are the top five diseases that are most likely to kill you and those around you.
Heart disease and stroke
Heart disease and stroke, clubbed together as cardiovascular disease because they involve the heart and blood vessels, account for 31% of all global deaths and one in four deaths in India. Heart disease in India is marked by early age of onset, accelerated buildup and high death rate, with changing diets, obesity and low activity putting an increasing number of young people at risk.
Heart disease can be reversed. A healthy diet, regular physical activity and not using tobacco products, along with controlling risk factors such as high blood pressure, high cholesterol, weight and high blood sugar (diabetes) can prevent 80% of premature heart attacks and strokes, says the World Health Organisation.
All causes of deaths that list symptoms, signs and abnormal clinical and laboratory findings yet fail to certify what the underlying cause is fall into this category, which accounts for one in 10 deaths for men and one in seven for women. With most deaths in India occurring at home without medical attention, death certificates are often issued on the basis of verbal autopsy, where the cause of death is concluded from the family’s description of the symptoms and illness at led to death.
Deaths from infections such as chikungunya, dengue and acute encephalitis syndrome, when not recorded as such, would fall into this category, which accounts for one in 10 deaths in India.
Chronic respiratory diseases such as asthma, chronic obstructive pulmonary disease, pulmonary hypertension, occupational lung disease, and interstitial lung disease damage the airways and other structures of the lungs and lower breathing capacity, causing close to 8% of all deaths in India. Lung diseases are not curable, but can be managed using treatments that dilate major air passages and improve shortness of breath.
In addition to tobacco smoke, factors that aggravate respiratory illnesses are air pollution, occupational chemicals and dusts, and frequent lower respiratory infections during childhood. Pulmonary fibrosis (scar tissue in the lungs) is irreversible, with lung transplantation being the only option.
More people are dying of cancer in India than ever before, with the disease accounting for 15% of all deaths in 2013, up from 12% in 1990. They are projected close to kill 736,000 people in 2016, mostly because only 12.5% people get diagnosed and treated in early stages of the disease.
Breast cancer takes the most lives of women, while lung cancer is the biggest cause of deaths in men in India and among men and women in the world. Lung cancer ranks eighth among cancer deaths in Indian women because they have lower smoking rates.
If treatment is hard, prevention is not. Around one third of cancer deaths are due to the five behavioural and dietary risks that are common to all lifestyle-related diseases: overweight, low fruit and vegetable intake, lack of physical activity, tobacco use, alcohol use.
More babies die in the womb, at birth or in the first week of life in India than anywhere else in the world. Prematurity and low birth-weight, neonatal infections such as septicaemia, birth asphyxia and birth trauma are the leading causes of perinatal deaths, defined as deaths between 22 completed weeks (154 days) of gestation and seven days after birth, kill 27.7 deaths per 1,000 live births in India compared to the world’s average of 19.2 deaths per 1,000 live births.
Monitoring the mother and child’s nutrition and health through all the stages of pregnancy and ensuring the baby is delivered by trained health-workers at a clinic or hospital can help manage complications and bring down perinatal deaths substantially.
Top 10 causes of death in India
1. Heart disease and stroke
2. Ill-defined diseases
3. Respiratory diseases
5. Perinatal conditions
6. Diarrhoeal diseases
7. Digestive diseases
8. Unintentional injuries (falls, drowning) other than road accidents
9. Respiratory infections