OBJECTIVES: Non-communicable diseases (NCDs) include cardiovascular, neurological, autoimmune diseases, cancers, etc., which are not transmitted among people. With the combined effect of lifestyle changes, globalization, changing dietary habits, and pollution, the prevalence of NCDs is increasing in India leading to substantial clinical and economic burden. There is a need for systematic understanding of the NCDs’ burden for research and policy purposes. The present study aimed to analyse how the NCDs’ burden has changed among different states/Union Territories (UTs) of India between 1990 and 2017.

METHODS: The NCDs' burden in terms of disability-adjusted life-years (DALYs), and deaths was analysed in different Indian states/UTs from 1990 to 2017 using the Global Burden of Diseases (GBD) Database 2017. To demonstrate the relationship of NCDs’ burden with sociodemographic development levels of the states, the GBD database classified 31 states/UTs into four groups. This classification was based on the epidemiological transition level (ETL) of states/UTs. ETL is defined as the ratio of DALYs due to communicable, maternal, neonatal and nutritional diseases versus NCDs and injuries.

RESULTS: The total NCDs-related deaths across all the states/UT was reported to be 348/100,000 (251-446/100,000) in 1990 and 440/100,000 (265-704/100,000) in 2017. The NCDs-related death rate was high in >40 years age group. Similarly, the NCDs-related DALYs was reported to be 17,862/100,000 (14,534-21,982/100,000) in 1990 and 19,051/100,000 (14,219-23,818/100,000) in 2017. An increase in the overall NCDs’ burden was observed across states from 1990–2017, irrespective of their ETL status; however, it was higher in states with high ETL status. In 2017, the highest burden of NCDs was reported in Kerala, followed by Karnataka, and Tamil Nadu.

CONCLUSIONS: NCDs pose major public health issue with varied burden across different states in India. With increasing NCDs’ burden, the most affected states/UTs need more effective health policy intervention in India.