Health transition in India: does data on causes of death reveal trends, patterns and determinants?

Purpose - Twenty-first century has dawned with substantial achievements in population health outcome indicators in India. However, very little is known on patterns in causes of death in India. The paper aims to discuss this issue. Design/methodology/approach - In this paper, data was drawn from two sources namely, National Family Health Survey (NFHS-1, 1992-1993 and NFHS-2, 1998-1999) and published reports of Survey of Cause of Death (Rural). Three-years moving average causes-of-death estimates were calculated based on World Health Organization classification of causes of death. Negative binomial regression models were fitted to capture the effect of socio-demographic and behavioural determinants of patterns in causes of death. Findings - The leading causes of death were heart diseases, tuberculosis, asthma, paralysis, prematurity and cancer. Three-fifth of the deaths to children under the age of ten was from communicable, maternal, perinatal and nutritional conditions. On the other hand, about two-third persons aged 45 years and above were dying from non-communicable diseases. Female were at greater risk of dying from non-communicable diseases (IRR: 1.22, 95 per cent CI: 1.11-1.34, p < 0.001). Research limitations/implications - The epidemiologic transition in India has produced a shift in mortality from communicable, maternal, perinatal and nutritional conditions to non-communicable diseases, with little or no role played by injuries regardless of the level of all-cause mortality. Coupled with the effects of population age structures, other factors were also responsible for the bulk of the inter-regional disparities. These factors include differences in the populations' health risks associated with the natural or built environments, prevalence of behavioural risk factors, or gaps in the capacities of health systems to respond to specific disease challenges, social stratification and others. Originality/value - This paper described the trends, patterns and geographic variability in India's causes-of-death profile in terms of communicable diseases, non-communicable diseases and injuries, and socio-economic and demographic determinants of patterns in the profile.