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The World Health Organization (WHO) adopted a global noncommunicable disease monitoring framework in 2013 with a target of a 25% reduction in premature mortality from four noncommunicable diseases (NCDs) such as cancer, diabetes, cardiovascular disease (CVD) and chronic respiratory disease (CRD) by 2025 compared to 2010. The Sustainable Development Goals (SDGs) target to reduce premature deaths from the four major NCDs by one‐third from 2015 to 2030. The objective of this study was to estimate the trend and reduction in premature mortality in India due to 4 major NCDs combined and separately between 2001 and 2030 and compare its progress toward the WHO and SDG target achievement. The publicly available data from the census for population and the Sample Registration System (SRS) for cause of death by 5‐year‐age groups were extracted. Age standardized premature mortality rates, unconditional probability of dying and annual percent change (APC) were computed. The premature mortality for four major NCDs decreased by −13.9% from 2010 to 2025 and by −15.6% from 2015 to 2030. The percentage changes in premature mortality from 2010 to 2025 were −33.9%, −17.4%, −9.3%, and 6.9% for CRD, cancer, CVD and diabetes respectively. For 2015–2030, these changes were −21.7%, −11.5%, −15.4%, and −15.1%. A significant reduction trend was observed for CRD with an average APC of −5.2%. The current reduction trend in premature mortality indicates that either the 25% reduction by 2025 or a one‐third reduction by 2030 will require intensive implementation of policies and program for NCD reduction. [ABSTRACT FROM AUTHOR]

Introduction: India contributes two‐thirds of the global mortality due to oral cancer and has a younger population at risk. The societal costs of this premature mortality are barely discussed. Methods: Using the human capital approach, we aimed to estimate the productivity lost due to premature mortality, valued using individual socioeconomic data, related to oral cancer in India. A bottom‐up approach was used to prospectively collect data of 100 consecutive patients with oral cancer treated between 2019 and 2020, with a follow‐up of 36 months. Results: The disease‐specific survival for early and advanced stage was 85% and 70%, with a median age of 47 years. With 671 years lost prematurely, the loss of productivity was $41 900/early and $96 044/advanced stage. Based on population level rates, the total cost of premature mortality was $5.6 billion, representing 0.18% of GDP. Conclusion: India needs to implement tailored strategies to reduce the economic burden from premature mortality. [ABSTRACT FROM AUTHOR]

A nested 3d-chemical transport model, GEOS-Chem, was used to estimate the burden of disease (BoD) from PM2.5 exposure in fifty-three urban agglomerations (UAs) in India with population of 1 million or more, and the contribution of different chemical components to the PM2.5 burden in these locations. Premature mortality due to four diseases (ischemic heart disease, IHD, chronic obstructive pulmonary disease, COPD, stroke and lung cancer) caused by exposure to PM2.5 was estimated using an integrated exposure response function. The studied 53 UAs accounted for approximately 20% of the total premature mortality of 0.54 (0.45-0.63) million in India. Delhi had the maximum premature mortality (11945) followed by Kolkata (9204), Mumbai (8817), Bangalore (4528) Hyderabad (4157) and Chennai (3818). Premature mortality was 2% to 59% higher than the country average in model regions containing UAs. Contribution from different chemical components was in the order: organic carbon (18-30%) > NO3- (8-21%) > SO42- (5-16%) > NH4+ (6-9%) > black carbon (2.5-4%). Our estimates suggest policies targeting multiple compounds are required to achieve large reductions in PM2.5 pollution in urban regions. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 infections and deaths have largely been uneven within and between countries. With 17% of the world's population, India has so far had 13% of global COVID-19 infections and 8.5% of deaths. Maharashtra accounting for 9% of India's population, is the worst affected state, with 19% of infections and 33% of total deaths in the country until 23rd December 2020. Though a number of studies have examined the vulnerability to and spread of COVID-19 and its effect on mortality, no attempt has been made to understand its impact on mortality in the states of India.Method: Using data from multiple sources and under the assumption that COVID-19 deaths are additional deaths in the population, this paper examined the impact of the disease on premature mortality, loss of life expectancy, years of potential life lost (YPLL), and disability-adjusted life years (DALY) in Maharashtra. Descriptive statistics, a set of abridged life tables, YPLL, and DALY were used in the analysis. Estimates of mortality indices were compared pre- and during COVID-19.Result: COVID-19 attributable deaths account for 5.3% of total deaths in the state and have reduced the life expectancy at birth by 0.8 years, from 73.2 years in the pre-COVID-19 period to 72.4 years by the end of 2020. If COVID-19 attributable deaths increase to 10% of total deaths, life expectancy at birth will likely reduce by 1.4 years. The probability of death in 20-64 years of age (the prime working-age group) has increased from 0.15 to 0.16 due to COVID-19. There has been 1.06 million additional loss of years (YPLL) in the state, and DALY due to COVID-19 has been estimated to be 6 per thousand.Conclusion: COVID-19 has increased premature mortality, YPLL, and DALY and has reduced life expectancy at every age in Maharashtra. [ABSTRACT FROM AUTHOR]

The global rise of life expectancy at birth has attracted worldwide interest, especially in understanding the pace of mortality transition in developing countries. In this study, we assess the progress of mortality transition in India during four decades between 1970 and 2013. We estimate measures of mortality compression and variability in age at death to assess the trends and patterns in mortality compression for India as a whole and its twelve biggest states. The results reveal an unequivocal convergence pattern in mortality compression across the states underpinned by the reduction in premature mortality and emerging homogeneity in mortality. Results by gender show that women are more homogenous in their mortality across the country because of an explicit reduction in the Gini coeffi cients at age 10 by the age group of 15-29 years. Mortality compression has changed in recent decades because of the increased survival of women in their reproductive ages, which marked a distinct phase of mortality transition in India. The pace of mortality transition, however, varies; adult mortality decline was greater than senescent mortality decline. These results show that India has passed the middle stage of mortality transition and has entered an early phase of low mortality. [ABSTRACT FROM AUTHOR]

Particulate air pollution is becoming a serious public health concern in urban cities in India due to air pollution-related health effects associated with disability-adjusted life years (DALYs) and economic loss. To obtain the quantitative result of health impact of particulate matter (PM) in most populated Mumbai City and most polluted Delhi City in India, an epidemiology-based exposure-response function has been used to calculate the attributable number of mortality and morbidity cases from 1991 to 2015 in a 5-year interval and the subsequent DALYs, and economic cost is estimated of the health damage based on unit values of the health outcomes. Here, we report the attributable number of mortality due to PM in Mumbai and Delhi increased to 32,014 and 48,651 in 2015 compared with 19,291 and 19,716 in year 1995. And annual average mortality due to PM in Mumbai and Delhi was 10,880 and 10,900. Premature cerebrovascular disease (CEV), ischemic heart disease (IHD), and chronic obstructive pulmonary disease (COPD) causes are about 35.3, 33.3, and 22.9% of PM-attributable mortalities. Total DALYs due to PM10 increased from 0.34 million to 0.51 million in Mumbai and 0.34 million to 0.75 million in Delhi from average year 1995 to 2015. Among all health outcomes, mortality and chronic bronchitis shared about 95% of the total DALYs. Due to PM, the estimated total economic cost at constant price year 2005 US$ increased from 2680.87 million to 4269.60 million for Mumbai City and 2714.10 million to 6394.74 million for Delhi City, from 1995 to 2015, and the total amount accounting about 1.01% of India's gross domestic product (GDP). A crucial presumption is that in 2030, PM levels would have to decline by 44% (Mumbai) and 67% (Delhi) absolutely to maintain the same health outcomes in year 2015 levels. The results will help policy makers from pollution control board for further cost-benefit analyses of air pollution management programs in Mumbai and Delhi. [ABSTRACT FROM AUTHOR]

Background: We present a systematic review of studies assessing the association between ambient particulate matter (PM) and premature mortality and the results of a Bayesian hierarchical meta-analysis while accounting for population differences of the included studies., Methods: The review protocol was registered in the PROSPERO systematic review registry. Medline, CINAHL and Global Health databases were systematically searched. Bayesian hierarchical meta-analysis was conducted using a non-informative prior to assess whether the regression coefficients differed across observations due to the heterogeneity among studies., Results: We identified 3248 records for title and abstract review, of which 309 underwent full text screening. Thirty-six studies were included, based on the inclusion criteria. Most of the studies were from China ( n = 14), India ( n = 6) and the USA ( n = 3). PM 2.5 was the most frequently reported pollutant. PM was estimated using modelling techniques (22 studies), satellite-based measures (four studies) and direct measurements (ten studies). Mortality data were sourced from country-specific mortality statistics for 17 studies, Global Burden of Disease data for 16 studies, WHO data for two studies and life tables for one study. Sixteen studies were included in the Bayesian hierarchical meta-analysis. The meta-analysis revealed that the annual estimate of premature mortality attributed to PM 2.5 was 253 per 1,000,000 population (95% CI: 90, 643) and 587 per 1,000,000 population (95% CI: 1, 39,746) for PM 10 ., Conclusion: 253 premature deaths per million population are associated with exposure to ambient PM 2.5 . We observed an unstable estimate for PM 10 , most likely due to heterogeneity among the studies. Future research efforts should focus on the effects of ambient PM 10 and premature mortality, as well as include populations outside Asia. Key messages: Ambient PM 2.5 is associated with premature mortality. Given that rapid urbanization may increase this burden in the coming decades, our study highlights the urgency of implementing air pollution mitigation strategies to reduce the risk to population and planetary health.

This study estimates the health risk due to PM 2.5 and ADE primarily in 4 regions across Northern Hemisphere during 2013–2017. Mortality in China due to PM 2.5 dipped from 1.15 million (95%CI (Confidence Interval) 0.64–1.6 million) to 1.02 million (95%CI 0.59–1.49 million) during 2013–2017 as a result of reduction in PM 2.5 population weighted concentration (PWC) from 29.26 μg/m3 to 22.05 μg/m3 while India overtook China in terms of death due to PM 2.5 which increased to 1.16 million (95%CI 0.72–1.67 million) from 1.07 million (95%CI 0.62–1.53 million) as a result of increase in PWC from 38.18 to 44.47 μg/m3. The years of life lost per person (YLL/person) due to PM 2.5 was still observed to be high in China with 5.58 YLL/person followed by India (4.13), Europe (2.19) and US (0.46) in 2017. Aerosols such as PM 2.5 have the capability to scatter or absorb solar radiation resulting in perturbation of ground meteorology which further affects dispersion of pollutants and it's resultant health impacts. ADE resulted in 7.27% of total or 77,866 deaths in India during 2013 which increased to 8.05% or 93,575 deaths in 2017 which was highest among all regions while in China ADE deaths reduced from 59,529 (5.15% of total) to 40,470 (3.94% of total) deaths during the same period, other regions too reported reduction in ADE deaths with US reporting 906 (−1.27%) lower deaths while Europe also reported 785 (−0.46%) lower deaths in 2017 as compared to 2013. ADE resulted in increased YLL/person in India from 0.29 to 0.33 during 2013–2017 while it was observed to reduce in all other regions, in China it reduced from 0.37 to 0.22 likewise YLL/person also reduced in US from 0.04 to 0.01 and in Europe from 0.01 to 0.002. • PM 2.5 deaths in China dipped from 1.15 to 1.02 million while in India it increased to 1.16 from 1.07 million during 2013-2017 • ADE deaths in India increased from 77,866 to 93,575 while in China it reduced from 59,529 to 40,470 during 2013-2017 • ADE proportion to PM 2.5 mortality in India rose by 0.78% while US, China & Europe fell by 1.27%, 1.21% & 0.46% in 2013-2017 • ADE resulted in increase of 0.04 YLL/person in India while reduction in YLL/person in China (0.15), US (0.03) & Europe (0.08) [ABSTRACT FROM AUTHOR]

Background Asian-American subgroups (Asian-Indian, Chinese, Filipino, Korean, Japanese, and Vietnamese) display varied cardiovascular disease mortality patterns, especially at younger ages. This study aims to examine the years of potential life lost because of ischemic heart disease and cerebrovascular disease among the 6 largest Asian-American subgroups compared with non-Hispanic whites. Methods and Results We used National Center for Health Statistics Multiple Causes of Death mortality files from 2003 to 2012 to calculate race-specific life expectancy, mean years of potential life lost, and years of potential life lost per 100 000 population for each Asian subgroup and non-Hispanic whites. Asian-American subgroups display heterogeneity in cardiovascular disease burden. Asian-Indians had a high burden of ischemic heart disease; Asian-Indian men lost 724 years per 100 000 population in 2012 and a mean of 17 years to ischemic heart disease. Respectively, Vietnamese and Filipino men and women lost a mean of 17 and 16 years of life to cerebrovascular disease; Filipino men lost 352 years per 100 000 population in 2012. All Asian subgroups for both sexes had higher years of life lost to cerebrovascular disease compared with non-Hispanic whites. Conclusions Cardiovascular disease burden varies among Asian subgroups, and contributes to greater premature mortality in certain subgroups. Asian-Indian and Filipino populations have the highest years of life lost because of ischemic heart disease and Filipino and Vietnamese have the highest years of life lost because of cerebrovascular disease. Analysis of risk factors and development of subgroup-specific interventions are required to address these health disparities.

Quantification of spatial and temporal variations in premature mortality attributable to PM 2.5 has important implications for air quality control in South and Southeast Asia (SSEA). The number of PM 2.5 -induced premature deaths during 1999-2014 in SSEA was estimated using an integrated exposure-response model based on 0.01° × 0.01° satellite-retrieved PM 2.5 data, population density, and spatially and temporally variable baseline mortality data. The results showed extremely high premature death rates in North India and Bangladesh. PM 2.5 -induced premature deaths in SSEA increased with small interannual variations from 1999 to 2014 owing to the interannual variations in PM 2.5 concentrations. Moreover, four scenarios on the effects of premature deaths by PM 2.5 mitigation efforts based on World Health Organization (WHO) air quality guidelines (AQG) and interim targets (ITs) were investigated for each disease and each country during 1999-2014. Four scenarios based on WHO AQG (10 μg/m 3 ), IT-3 (15 μg/m 3 ), IT-2 (25 μg/m 3 ), and IT-1 (35 μg/m 3 ) resulted in 69.3%, 49.1%, 25.4%, and 12.8% reductions compared to the total reference premature deaths (1256,300), which was calculated using the original PM 2.5 datasets. Overall, stroke was the most serious disease associated with air pollution, causing 40% of total premature deaths. Ischemic heart disease was the largest contributor (58%) to the deaths in relatively cleaner air (Scenario 1). The annual rate of change in premature deaths in South Asian countries (India, Bangladesh, and Pakistan) was higher than that in Southeast Asian countries under all scenarios. The results for different scenarios provide insight into the largest health benefits of PM 2.5 reduction efforts., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Buildings consume nearly 40% of primary energy production globally. Certified green buildings substantially reduce energy consumption on a per square foot basis and they also focus on indoor environmental quality. However, the co-benefits to health through reductions in energy and concomitant reductions in air pollution have not been examined.We calculated year by year LEED (Leadership in Energy and Environmental Design) certification rates in six countries (the United States, China, India, Brazil, Germany, and Turkey) and then used data from the Green Building Information Gateway (GBIG) to estimate energy savings in each country each year. Of the green building rating schemes, LEED accounts for 32% of green-certified floor space and publically reports energy efficiency data. We employed Harvard's Co-BE Calculator to determine pollutant emissions reductions by country accounting for transient energy mixes and baseline energy use intensities. Co-BE applies the social cost of carbon and the social cost of atmospheric release to translate these reductions into health benefits. Based on modeled energy use, LEED-certified buildings saved $7.5B in energy costs and averted 33MT of CO 2 , 51 kt of SO 2 , 38 kt of NO x , and 10 kt of PM 2.5 from entering the atmosphere, which amounts to $5.8B (lower limit = $2.3B, upper limit = $9.1B) in climate and health co-benefits from 2000 to 2016 in the six countries investigated. The U.S. health benefits derive from avoiding an estimated 172-405 premature deaths, 171 hospital admissions, 11,000 asthma exacerbations, 54,000 respiratory symptoms, 21,000 lost days of work, and 16,000 lost days of school. Because the climate and health benefits are nearly equivalent to the energy savings for green buildings in the United States, and up to 10 times higher in developing countries, they provide an important and previously unquantified societal value. Future analyses should consider these co-benefits when weighing policy decisions around energy-efficient buildings.