ArticleCureus2026
Injury Burden in India, 1990 to 2023: National and Subnational Trends From the Global Burden of Disease 2023 Study.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIn India, injuries are considered a public health issue since they cause a great deal of death, disability and pressure on the healthcare system; yet there has been no thorough evaluation of the national and subnational temporal trends in the burden of injury using the data from the Global Burden of Disease (GBD) estimates.
objectivesTo assess temporal trends in the aggregate burden of all injuries, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs), in India and its states and union territories from 1990 to 2023, and to describe variations in injury burden by age and sex. Temporal trends were evaluated using estimated annual percentage change (EAPC) and Joinpoint regression.
methodsWe conducted an ecological time-trend study using GBD 2023 estimates for India and its states and union territories. Age-standardized incidence, prevalence, death and DALY rates were analysed from 1990 to 2023. Temporal trends were examined using EAPC and Joinpoint regression analysis. State-level differences, changes in rankings, and age- and sex-specific patterns were also examined. A burden-trend quadrant analysis was used to identify states with high burden and slower or faster improvement.
resultsBetween 1990 and 2023, incident cases increased from 100.99 million to 126.36 million; prevalent cases increased from 163.01 million to 271.61 million; deaths increased from 660,695 to 953,809; and DALYs increased from 44.38 million to 52.51 million. On the other hand, age-standardized incidence, prevalence, death and DALY rates declined by 26.8%, 20.5%, 27.5% and 34.1%, respectively. Joinpoint analysis showed significant overall declines in age-standardized incidence rate (ASIR) (average annual percent change (AAPC) -0.92%), age-standardized prevalence rate (ASPR) (-0.67%), age-standardized death rate (ASDR) (-0.89%) and age-standardized DALY rate (ASDAR) (-1.15%) (all P<0.001). Considerable interstate variation persisted, with Telangana, Uttarakhand and Chhattisgarh being the states with the highest DALY rates in 2023. Males had higher mortality and DALY rates than females, while mortality and DALY rates increased markedly with increasing age.
conclusionIndia faced a decline in age-standardized injury burden from 1990 to 2023 despite increasing absolute numbers. Persistent geographic, sex and age-related differences point toward the need for specific injury prevention, strengthened surveillance and state-specific public health strategies.
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