JOIN USThe report "India: Health of the Nation's States," which was released last week, gives a better and more detailed perspective of the state of the nation's health than similar reports and surveys done in the past. It is very comprehensive and has much more data than exercises like the National Family Health Survey. It confirms some known facts but also provides new information which will be useful in formulating public health policies for particular regions and states. The report was prepared by the Indian Council of
Medical Research (ICMR) and some other organisations in collaboration with the Union health ministry. It has traced the changes which have taken place in the country's health profile over a period from 1990 to 2016 and mapped the state-wide divergences in disease burden. It is well known that social and economic development improves health outcomes. This has happened in India also and key health indicators like life expectancy have shown great improvement from 1990 to 2016. The report has shown this.
An important finding is that the disease profile has undergone a major change. During the 1990-2016 period, the threat posed by communicable diseases like tuberculosis and malaria and by maternal, neonatal and nutrition-related diseases declined and the burden of non-communicable diseases (NCDs) like heart ailments and diabetes has grown. In 1990, the burden of infectious and associated diseases was 61% and that of others, linked to lifestyles, was 30%. The relative positions reversed in 2016, with infectious diseases accounting for 33% and NCDs accounting for 55%. This trend is going to continue in the years to come and so public health strategies will have to be changed accordingly. Different strategies will be needed, which target sections of people in different socio-economic strata. Health infrastructure, medical education and the training and skills of medical personnel will have to be re-oriented to cater to the new situation.
The report also shows that the health profiles of different states vary widely. While NCDs took more lives in developed states like Tamil Nadu, Kerala and Punjab, infectious and associated diseases were the major threats to health in states like UP, MP and Orissa. The report also compared pairs of states like UP and MP, Punjab and Himachal Pradesh and Maharashtra and Gujarat and showed that national health performance can be vastly improved if the health problems and risks in particular states are targeted separately. The national health policy should be decentralised to address the specific needs of states, and even of regions within states. Collection of more data and better research will also help to fine-tune the policy.