International Institute for Population Sciences, 400088, Mumbai, India.
BMC Public Health. 2023 Mar 23;23(1):547. doi: 10.1186/s12889-023-15454-9.
The present study tries to provide a comprehensive estimate of gender differences in the years of life lost due to CVD across the major states of India during 2017-18.
The information on the CVD related data were collected from medical certification of causes of death (MCCD reports, 2018). Apart from this, information from census of India (2001, 2011), SRS (2018) were also used to estimate YLL. To understand the variation in YLL due to CVD at the state level, nine sets of covariates were chosen: share of elderly population, percentage of urban population, literacy rate, health expenditure, social sector expenditure, labour force participation, HDI Score and co-existence of other NCDs such as diabetes, & obesity. The absolute number of YLL and YLL rates were calculated. Further, Pearson's correlation had been calculated and to understand the effect of explanatory variables on YLL due to CVD, multiple linear regression analysis had been applied.
Men have a higher burden of premature mortality in terms of Years of life lost (YLL) due to CVD than women in India, with pronounced differences at adult ages of 50-54 years and over. The age pattern of YLL rate suggests that the age group 85 + makes the highest contribution to the overall YLL rate due to CVD. YLL rate showed a J-shaped relationship with age, starting high at ages below 1 years, dropping to their lowest among children aged 1-4 years, and rising again to highest levels at 85 + years among both men and women. In all the states except Bihar men had higher estimated YLL due to CVD for all ages than women. Among men the YLL due to CVD was higher in Tamil Nadu followed by Madhya Pradesh and Chhattisgarh. On the other hand, the YLL due to CVD among men was lowest in Jharkhand followed by Assam. Similarly, among women the YLL due to CVD was highest in Tamil Nadu followed by Madhya Pradesh and Chhattisgarh. While, the YLL due to CVD among women was lowest in Jharkhand. Irrespective of gender, all factors except state health expenditure were positively linked with YLL due to CVD, i.e., as state health expenditure increases, the years of life lost (YLL) due to CVDs falls. Among all the covariates, the proportion of a state's elderly population emerges as the most significant predictor variable for YLL for CVDs (r = 0.42 for men and r = 0.50 for women).
YLL due to cardiovascular disease varies among men and women across the states of India. The state-specific findings of gender differences in years of life lost due to CVD may be used to improve policies and programmes in India.
本研究试图全面估计 2017-18 年印度主要邦因心血管疾病导致的寿命损失年数的性别差异。
心血管疾病相关数据的信息来自死因医学证明（2018 年 MCCD 报告）。除此之外，还使用了印度人口普查（2001 年、2011 年）和 SRS（2018 年）的数据来估计 YLL。为了了解州一级因心血管疾病导致的 YLL 的变化，选择了九组协变量：老年人口比例、城市人口比例、识字率、卫生支出、社会部门支出、劳动力参与率、人类发展指数得分以及其他非传染性疾病（如糖尿病和肥胖症）的共存情况。计算了 YLL 的绝对数量和 YLL 率。此外，还计算了 Pearson 相关系数，并应用多元线性回归分析来了解解释变量对因心血管疾病导致的 YLL 的影响。
与女性相比，印度男性因心血管疾病导致的寿命损失年数（YLL）的过早死亡负担更高，在 50-54 岁及以上的成年年龄组差异更为明显。YLL 率的年龄模式表明，85 岁及以上的年龄组对因心血管疾病导致的总体 YLL 率贡献最大。YLL 率与年龄呈 J 形关系，在 1 岁以下的年龄组中最高，在 1-4 岁的儿童中降至最低，然后在男性和女性中再次升至 85 岁及以上的最高水平。除比哈尔邦外，所有州的男性因心血管疾病导致的 YLL 都高于女性。在男性中，泰米尔纳德邦的心血管疾病导致的 YLL 最高，其次是中央邦和恰蒂斯加尔邦。另一方面，男性中因心血管疾病导致的 YLL 最低的是恰尔康得邦，其次是阿萨姆邦。同样，在女性中，泰米尔纳德邦的心血管疾病导致的 YLL 最高，其次是中央邦和恰蒂斯加尔邦。而在女性中，因心血管疾病导致的 YLL 最低的是恰尔康得邦。无论性别如何，除州卫生支出外，所有因素都与因心血管疾病导致的 YLL 呈正相关，即随着州卫生支出的增加，因心血管疾病导致的寿命损失年数（YLL）减少。在所有协变量中，一个州的老年人口比例是心血管疾病 YLL 的最重要预测变量（男性 r=0.42，女性 r=0.50）。
印度各邦男女因心血管疾病导致的 YLL 存在差异。因心血管疾病导致的寿命损失年数的性别差异的州特定发现可用于改善印度的政策和计划。
