The Updated 2023 CBD Data on Risk Factors and Diseases That Cause Death and Disability
It is important to know what risk factors and diseases kill us, so that we can take action to mitigate risk and prevent disease
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Bhavin Jankharia
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Bhavin Jankharia
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In May 2024, I discussed the updated GBD 2021 data that had just been published on risk factors and diseases that kill us in India. The 2023 data has just been made available and while there are no surprises, it is always good to know where we stand and what we can do to reduce risk and to live long, healthy.
In 2021, air pollution was the biggest killer, followed by high blood pressure and then dietary risks followed by tobacco.
This is unchanged in 2023 at a macro level.
But what I didn’t do in the last piece was drill down into individual causes.
As you can see here, high blood pressure is the biggest single killer, unchanged from 2021, followed by high fasting plasma glucose and then ambient air pollution. Household air pollution has dropped one rung compared to smoking and then comes high LDL.
If you then take their individual percentage contribution to deaths, high blood pressure is at 19%, followed by high fasting plasma glucose at 11% and then air pollution at 10%, smoking at 9.3% and high LDL at 8.4%.
Household air pollution and lead are not of much concern to those reading this piece and affect mainly those in low income houses.
If you then take out air pollution, over which we do not have control, then managing high blood pressure, high fasting plasma glucose and high LDL levels would take care of 38% of the country’s risk of death and not smoking would take that to 47%. Imagine if we could reduce the risk of death by half.
At an individual level therefore, these are the biggest risk factors we have to worry about as I mentioned in the syndemic article in July 2025.
So why the cancer hype?
If you take tumors as a group, then they are the 2nd commonest cause of death at 7.91%, while cardiovascular diseases are at 14.7%.
But all cancers are not the same and lumping them together makes no sense. So if you take the individual causes of death, then we get this.
Lung cancer at no 12 causes 1.8% of deaths, followed by breast cancer at no 14 responsible for 1.4% of deaths, lower than falls-related deaths which are also at 1.8%. And if you substitute death for disability (DALYs), then falls-related morbidity moves to no 6 and breast cancer moves to no 20. This is important because we give more more importance to the diagnosis and management of breast cancer than we do to prevention of falls and the diagnosis of osteoporosis, sarcopenia and frailty, factors that cause falls.
This is why data is so important…to help us gain perspective about what is more important and perhaps what is less so.
What does this mean for you and I?
While prevention of and screening for cancers is helpful, where these steps help, it is much more important to take care of the cardiovascular risk factors, i.e high blood pressure, high plasma fasting glucose and high lipid levels, and not smoke.
Bhavin Jankharia
Air pollution is the 3rd biggest killer and controlling this indoors with air purifiers (since we have no control otherwise) is important.
Not falling is important and all steps that we take to prevent sarcopenia and frailty and not to fall will make a difference.
The rest…please go through the May 2024 article. It says everything else that needs to be said.
Bhavin Jankharia
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