India’s health profile: More youngsters killing selves

A snapshot of healthcare

• 938,861 is the total number of allopathic doctors registered up to 2014
• There is an increasing trend in the availability of allopathic medical practitioners, dental surgeons and nurses per lakh population over the years.
• Total number of registered AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) doctors in India as on Jan 1, 2014 was 736,538
• There are 20,306 hospitals having 675,779 beds in the country
• There are 16,816 hospitals in rural areas, with 183,602 beds
• There are 3,490 hospitals in urban areas, with 492,177 beds
• Maternal mortality ratio highest in Assam and lowest in Kerala
• In India, 61 per cent of all women married before 16. The median age at first pregnancy is 19.2 years.
• Cardiovascular diseases (24%), chronic respiratory diseases (11%), cancer (6%) and diabetes (2%) are the leading cause of mortality in India.

The burden of aspirations and expectations seems to be taking a toll on young India, especially males who succumb to suicidal deaths more than their female counterparts,

according to the data published by the Central Bureau of Health Intelligence (CBHI). The data showed that over 67 per cent cases of suicidal deaths in 2013 had male victims.

CBHI is the health intelligence wing of the Director General of Health Services in the Union Ministry of Health and Family Welfare.

"Suicidal rates are increasing significantly for young adults in a wider population. Maximum number of suicide cases – 46,368 – is reported between 15-29 years age group,” the report titled National Health Profile 2015 said.

The National Health Profile covers demographic, socio-economic, health status and health finance indicators, along with information on health infrastructure and human resources in the sector. CBHI has been publishing National Health Profile every year since 2005. This is the 11th edition.

According to the data, there was a 14.3 per cent rise in suicidal deaths among males up to 14 years of age in 2013 over the previous year while similar cases for females in the same bracket fell 2.89 per cent.

“Depression, anxiety, life style disorders and peer pressure are some of the reasons for the increase in suicide rates among youngsters,” said Pankaj Kumar, joint secretary, Delhi Psychiatric Society.

“The nuclear family set-up has replaced the joint-family system that was prevalent earlier and parents, too, do not have time for children, thus leading to lesser personal interactions and stress outlets. There are a lot of online friends for young people but no real friendships. Also, less physical and outdoor activities add to the problem,” he said.

There has been a decrease in suicidal deaths among females across all age groups, the data showed. Although, there has been a marginal 0.5 per cent decline in overall deaths due to suicides in the country but cases have risen significantly among males in the 15-29 and 45-59 years’ age group.

According to Kumar, females are doubly prone to being depressed than males and attempt more suicides but the completion of the same is more among males.He attributes the same to difference in brain make up, hormonal set-up and vigorous planning of suicides by males than females.

There were 134,799 cases of suicidal deaths in 2013, of which 90,543 or 67 per cent were males. There was around 3 per cent rise in similar cases among males in 15-29 and 45-59 years’ age group.

The data also showed the cases have always been on the rise for the male population since 2000 while the same has been erratic for females.

Cancer cases to grow 15 per cent by 2020

The report further added that industrialisation and persistent inequality in health statuses between and within states due to various economic and social causes has made India bear a “triple burden of diseases”. This burden involves communicable diseases, emerging non-communicable diseases due to lifestyles and emerging infectious diseases.

While non-communicable diseases like cancer, diabetes, cardiovascular diseases are on a rise due to urbanisation and life-style change, communicable and water-borne diseases continue to be a major public health problem,

it said.In addition, there is always a threat of new emerging and re-emerging infectious diseases like Ebolavirus, Avian Influenza, SARS, novel H1N1 influenza virus etc,” said the National Health Profile 2015.

The report projected cancer cases to grow about 15 per cent by 2020 to 1,320,928, with females being more prone to the disease. According to the report, currently 548,844 males in the country are projected to suffer from cancer while the number is 599,847 for females.

Shedding light on the inequity in access to health services in the country, the report said that increased use of technology in diagnostics and treatment of diseases, coupled with rising knowledge and expectations of the population regarding therapeutic measures, has caused an increase in cost of treatment.

The increase has, in turn, led to inequity in access to healthcare services, it said, adding that five per cent of India’s gross domestic product (GDP) is spent on health and 80 per cent of that is in the form of out-of-pocket expenditure.

According to World Health Organization (WHO), out-of-pocket expenditure is any direct outlay by households, including gratuities and in-kind payments, to health practitioners and suppliers of pharmaceuticals,

therapeutic appliances, and other goods and services whose primary intent is to contribute to the restoration or enhancement of the health status of individuals or population groups.

Urban India incurred an out-of-pocket expenditure of Rs 146 per capita per month in 2011-12 while rural India’s similar expense was Rs 95, according to the report. “Over 60 per cent of the total out-of-pocket health expenditure is on medicines, both in rural and urban India in 2011-12,” it said.

Centre’s contribution to health expenditure dips

The per capita public expenditure on health in India has gone up in nominal terms to Rs 890 in 2012-13, from Rs 621 in 2009-10. Adding that the share of Centre in total public expenditure on health isdeclining steadily over the years, the report said the centre-to-state ratio was 33:67 in 2012-13.

“The share of the Union Ministry of Health and Family Welfare is 26 per cent of the total health expenditure of the Government whereas the share of other central ministries is seven per cent and state and UTs (union territories) share is 67 per cent,” the report said.

India’s public spending on health, as a percentage of GDP, is one of the lowest among South-East Asian countries and the lowest among Brazil, Russia, India and China (BRIC nations), according to the report. This spending was 1.08 per cent in 2012-13 and there was no significant change in expenditure since 2009-10.

According to the report, the north-eastern states had the highest average per capita public expenditureon health in 2012-13 while empowered action group states and Assam had the lowest expenditure. Among all the states, excluding union territories, Kerala had the highest per capita out-of-pocket medicalexpenditure as well as total consumption expenditure in 2011-12.

By:Karnika Bahuguna

(Courtesy: http://www.downtoearth.org.in/)