Age and sex patterns of premature mortality in India

OBJECTIVES To estimate premature mortality by age, sex and cause of death in India. BACKGROUND Studies on premature mortality in India are limited. Although evidence suggests recent reductions in infant and child mortality, little is known about the age and sex patterns of premature deaths in India. METHODS Secondary data from the Sample Registration System and, census of India and report on cause of death. A set of indices are used to estimate the premature mortality were analysed. PRIMARY AND SECONDARY OUTCOME MEASURES Standardised years of potential life lost (YPLL), premature years of potential life lost (PYPLL) and working years of potential life lost (WYPLL) for broad age groups and by selected causes of death. RESULTS From 1991 to 2011, the age-standardised rate of YPLL (per 1000 population) declined from 310 to 235 for males and from 307 to 206 for females. The estimated YPLL (in millions) declined from 134 to 147 for males and from 123 to 108 for females, the YPLL for adults (aged 15-65) increased by 32% for males and 28% for females, the standardised PYPLL (per 1000 population) declined from 259 to 137 for males and from 258 to 115 for females, the estimated PYPLL increased by 13% for all adult males and by 32% for 30-45-year-old adult males, and the standardised rate of WYPLL declined from 274 to 131 for males and from 295 to 91 for females. These findings suggest a significant improvement in early childhood mortality and increasing mortality trends in 30-45-year-old adult males. The YPLL and WYPLL standardised rates for males and females were highest for cardiovascular disease. CONCLUSIONS The increasing share of premature deaths among adults and high levels of premature mortality suggest an improvement in child survival increased attention should be given to prevention and treatment of non-communicable diseases in order to avoid premature deaths in India.