It will be useful to look at the age pattern of the next two top causes of disease burden, namely ischaemic heart disease (IHD) and falls. Age distribution of DALYs lost due to these two conditions is shown in the figure below. The burden on account of ischaemic heart disease occurs at older age groups. The age distribution of DALYs lost on account of falls is just the opposite. Most of the falls appear to occur at younger age groups. Children age group of 5 to 14 years are most vulnerable. Unfortunately, there is no initiative yet to study the causes of fall in children and how they can be prevented. Regarding ischaemic heart disease, a fairly large capacity of curative treatment of cardiac diseases have been developed in the state, mostly in the private sectors, and to some extent in the public sector. Attention on issue of lifestyle, and training of doctors in medical management of myocardial infarction are areas where some state intervention may be called for.

Among the leading causes of burden unique to the rural area, self-inflicted injury deserves attention. Clearly almost all of these deaths are in the adult age group 15 to 44 years. The DALYs lost due to self-inflicted injury are simply deaths due to suicide and most of it is in rural areas. The age distribution of burden due to fires is similar to age distribution for self-inflicted injuries. DALYs lost on account of fire accidents are mostly among adults and young children. The difference between the age-sex pattern of burden due to fires in urban areas and suicide in rural areas is in the gender distribution. Incidence of self inflicted injuries in rural areas appears to be nearly equal for females and males. In urban areas, females are the major victims of fire accidents. Although fires showed up in the ten leading causes of burden in urban areas, the problem is just as prevalent in rural areas. This is simply due to the large population in the rural areas. Fires have caused both premature mortality and disability.

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Road accidents are another cause for concern, rampant in both urban and rural areas. Although road accidents did not show up within the ten leading causes for rural areas, it happens to be the eleventh cause of burden in rural areas. Victims here are mostly in adults in age group 15-44, although all other age groups do suffer some burden due to road accidents. More males are affected.

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In urban areas, birth asphyxia and trauma are among the ten leading causes of DALYs. Most of this burden is on account of premature mortality. Appearance of the burden due to birth asphyxia and trauma in the urban areas, instead of the whole state, could be due to location of hospitals and nursing homes. Birth asphyxia and trauma are most probably reported from hospitals and nursing homes, most of which are located in urban areas. These would include cases from both rural and urban areas, since hospitals in urban areas do serve surrounding rural hinterlands. Hence, it would be reasonable to say that birth asphyxia and birth trauma is an important cause of disease burden for the whole state. This finding has important implications for policy regarding development of infrastructure for institutional deliveries and also for the quality of maternity services provided by hospitals and nursing homes. The above table shows the leading causes of burden due to premature mortality. Most of the leading causes of overall disease burden, for example, lower respiratory infections, diarrhoeal diseases, low birth weight, tuberculosis, etc are repeated here. In addition, malaria appears as a leading cause of mortality in rural areas.

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The above table shows leading causes of disability in the state. Falls and fires are among the leading causes of disability. This reflects the fact that falls and fires not only cause loss of life, but also produce a lot of disability. Protein energy malnutrition is a major cause of disability. The burden is on account of developmental disability suffered by children due to poor nutrition. Unipolar major depression is yet another leading cause of disability to be viewed this along with the fact that suicide is a leading cause of premature mortality. Cataract blindness, for which a control program is under implementation, is also among the leading causes of disability.