Trends in Health-adjusted Life Expectancy Across Indian States and Union Territories, 1990-2021: An Ecological Analysis Using Data from the 2021 Global Burden of Disease Study.

IF 0.9 4区医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Indian journal of public health Pub Date : 2026-07-29 DOI:10.4103/ijph.ijph_607_25

Vishal Vennu

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引用次数: 0

Abstract

Background: India has undergone major demographic and epidemiological transitions over the past three decades. Although life expectancy has improved, conventional mortality indicators do not capture years lived with illness or disability. Health-adjusted life expectancy (HALE) offers a more comprehensive measure of population health by integrating mortality and morbidity.

Objective: The objective of this study was to assess trends in HALE in India from 1990 to 2021 by state, sex, and age group using estimates from the Global Burden of Disease (GBD) Study 2021.

Materials and methods: This ecological analysis used publicly available HALE estimates from the GBD Study 2021 for all 28 states and 8 union territories of India. Percentage changes in HALE between 1990 and 2021 were analyzed by sex, age group, and geography. Estimates are presented with 95% uncertainty intervals (UI).

Results: National HALE increased from 15.20 years (95% UI: 13.95-16.33) in 1990-16.00 years (95% UI: 14.63-17.27) in 2021, representing a 5.25% increase. Female HALE improved slightly more than male HALE (5.36% vs. 5.28%). The largest gains were observed among individuals aged 20-24 years, whereas HALE declined among males aged ≥ 75 years. Goa recorded the highest HALE in 2021 (19.31 years), while Uttarakhand had the lowest (14.78 years). Jharkhand (22.15%), Andhra Pradesh (20.83%), Odisha (18.68%), and Telangana (18.54%) demonstrated the greatest relative increases, whereas Manipur showed minimal improvement (3.23%). Chhattisgarh exhibited the widest sex disparity in HALE change.

Conclusion: HALE in India improved modestly between 1990 and 2021; however, substantial disparities persist across states, sexes, and age groups. Targeted public health interventions and healthy aging strategies are needed to reduce inequities and improve healthy longevity.

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1990-2021年印度各邦和联邦直辖区健康调整预期寿命趋势：利用2021年全球疾病负担研究数据进行生态分析

背景：在过去三十年中，印度经历了重大的人口和流行病学转变。虽然预期寿命有所提高，但传统的死亡率指标并不包括患病或残疾的年数。健康调整预期寿命（HALE）通过综合死亡率和发病率，提供了一种更全面的人口健康衡量标准。目的：本研究的目的是利用2021年全球疾病负担（GBD）研究的估计值，按邦、性别和年龄组评估1990年至2021年印度HALE的趋势。材料和方法：本生态分析使用了印度所有28个邦和8个联邦属地的2021年GBD研究中公开提供的HALE估计。1990年至2021年间，按性别、年龄组和地理位置分析了HALE的百分比变化。估计以95%的不确定区间（UI）表示。结果：全国HALE从1990年的15.20年（95% UI: 13.95 ~ 16.33）增加到2021年的16.00年（95% UI: 14.63 ~ 17.27），增长5.25%。女性HALE的改善程度略高于男性（5.36% vs. 5.28%）。在20-24岁的个体中观察到最大的增长，而在≥75岁的男性中HALE下降。2021年，果阿邦的HALE最高（19.31年），而北阿坎德邦的HALE最低（14.78年）。贾坎德邦（22.15%）、安得拉邦（20.83%）、奥里萨邦（18.68%）和特伦甘纳邦（18.54%）的相对增长最大，而曼尼普尔邦的改善最小（3.23%）。恰蒂斯加尔邦在HALE变化中表现出最大的性别差异。结论：1990年至2021年间，印度的HALE略有改善；然而，各州、性别和年龄组之间仍然存在巨大差异。需要有针对性的公共卫生干预措施和健康老龄化战略，以减少不平等现象并延长健康寿命。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian journal of public health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

2.40

自引率

0.00%

发文量

审稿时长

21 weeks

期刊介绍： Indian Journal of Public Health is a peer-reviewed international journal published Quarterly by the Indian Public Health Association. It is indexed / abstracted by the major international indexing systems like Index Medicus/MEDLINE, SCOPUS, PUBMED, etc. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles. The Indian Journal of Public Health publishes articles of authors from India and abroad with special emphasis on original research findings that are relevant for developing country perspectives including India. The journal considers publication of articles as original article, review article, special article, brief research article, CME / Education forum, commentary, letters to editor, case series reports, etc. The journal covers population based studies, impact assessment, monitoring and evaluation, systematic review, meta-analysis, clinic-social studies etc., related to any domain and discipline of public health, specially relevant to national priorities, including ethical and social issues. Articles aligned with national health issues and policy implications are prefered.