Premature adult mortality in India: what is the size of the matter?
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Abstract
Background: Reducing adult mortality by 2030 is a key component of the United Nations Sustainable Development Goals (UNSDGs). Monitoring progress towards these goals requires timely and reliable information on deaths by age, sex and cause. To estimate baseline measures for UNSDGs, this study aimed to use several different data sources to estimate subnational measures of premature adult mortality (between 30 and 70 years) for India in 2017. Methods: Age-specific population and mortality data were accessed for India and its 21 larger states from the Civil Registration System and Sample Registration System for 2017, and the most recent National Family and Health Survey. Similar data on population and deaths were also procured from the Global Burden of Disease Study 2016 and the National Burden of Disease Estimates Study for 2017. Life table methods were used to estimate life expectancy and age-specific mortality at national and state level from each source. An additional set of life tables were estimated using an international two-parameter model life table system. Three indicators of premature adult mortality were derived by sex for each location and from each data source, for comparative analysis Results: Marked variations in mortality estimates from different sources were noted for each state. Assuming the highest mortality level from all sources as the potentially true value, premature adult mortality was estimated to cause a national total of 2.6 million male and 1.8 million female deaths in 2017, with Bihar, Maharashtra, Tamil Nadu, Uttar Pradesh and West Bengal accounting for half of these deaths. There was marked heterogeneity in risk of premature adult mortality, ranging from 351 per 1000 in Kerala to 558 per 1000 in Chhattisgarh among men, and from 198 per 1000 in Himachal Pradesh to 409 per 1000 in Assam among women. Conclusions: Available data and estimates for mortality measurement in India are riddled with uncertainty. While the findings from this analysis may be useful for initial subnational health policy to address UNSDGs, more reliable empirical data is required for monitoring and evaluation. For this, strengthening death registration, improving methods for cause of death ascertainment and establishment of robust mortality statistics programs are a priority.
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Vital registration varies substantially within the states from which all-cause mortality data are available.
“Second, vital registration varies substantially within the states from which all-cause mortality data are available [16–18].”
From Estimates of pandemic excess mortality in India based on civil registration data (2022) · cites this paper as [18]
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- Authors
- Rao, C., Gupta, A., Gupta, M., & Yadav, A. K.
- Affiliations
- Australian National University (AU)
- University of Pennsylvania (US)
- Alchemist Research and Data Analysis, Chandigarh, India
- International Institute for Population Sciences (IN)
- Corresponding author
- Rao, Chalapati
- Venue
- BMJ Global Health
- Publisher
- BMJ
- Published
- 2021-06
- Volume
- 6
- Issue
- 6
- Pages
- e004451
- ISSN
- 2059-7908 (ISSN-L)
- PMC
- PMC8211056
- OpenAlex
- W3166088114
- Cited by
- 13
- References
- 33
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 2 · 2020: 1
- FWCI
- 3.54
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMJ Global Health (publishedVersion, cc-by-nc)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- ANU Open Research (Australian National University) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Institute for Health Metrics and Evaluation
- Topics
- Social Sciences › Demography › Insurance, Mortality, Demography, Risk Management
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- India, Sustainable Development Goals, life tables, sex differences in mortality, death registration, cause of death determination, mortality statistics
- MeSH terms
- Adult, Female, Humans, India, Life Expectancy, Male, Models, Statistical
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