Way of life, study of death

India undertakes the world?s biggest health study correlating death and lifestyle, reports Aditya Ghosh.Will this improve understanding of risks factors?

The Central government has, in what is the world’s biggest ever health survey, started mapping death patterns across India to understand major causes of death and how lifestyle affects mortality.

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The study — started in February and to continue till 2014, mapping 10 lakh deaths — has been undertaken by the census commissioner in collaboration with Canada’s Centre for Global Health Research (CGHR) and McLaughlin Centre for Molecular Medicine, University of Toronto. The first phase, covering 35,000 deaths, is complete and the results will be out next week. The findings will throw light on causes of maternal deaths.

Census Commissioner Devender Kumar told HT: “We want to understand how causes of death change along with the changing times, how several new factors are influencing lifestyles.”

Dr Prabhat Jha, who is spearheading the study, said the data has already shown that causes of death can be measured reliably in young and middle age, when most avoidable deaths occur. Jha is the Canada Research Chair at the University of Toronto and director of CGHR, which is part of St. Michael’s Hospital. He added, “Deaths in India need to be classified and the impact of physical factors, like blood pressure and obesity, and lifestyle factors, like smoking, alcohol consumption and HIV risk taking, must be correlated to the causes of death.” There are other factors, like immunisation history, blood lipids and genetic factors that lead to different diseases among people with similar lifestyles and biological factors. These need to be measured, he said.

The study will eventually monitor 14 million people in 2.4 million nationally-representative households. ‘Verbal autopsies’ — trained professionals undertaking expert questioning of the family on the deceased person’s medical history and lifestyle — are being conducted.

“We’ve trained 800 full-time government staffers in verbal autopsy. Family or close associates of the deceased discuss the details of the death and the events which led to it,” Jha said.

India’s Sample Registration System (SRS) is sending two independent surveyors to monitor selected rural and urban households across India.

Medical experts are backing the effort. Dr Neeraj Dhingra, an expert in public health associated with the study, told HT, “It will improve understanding of health risks like tobacco and alcohol, pollution, and other factors like fertility preferences for male children, immunisation and migration. The study could substantially improve our understanding of genetic and environmental factors.”

Added Subrata Lahiri, head of mortality studies at the International Institute of Population Sciences in Mumbai, “Adult mortality in urban areas is rising due to unruly and fast lifestyles. Cardiovascular diseases as well as cancer and other lifestyle ailments are killing more people. The study was much-needed.”