# What kills Indians? > Non-communicable diseases have overtaken infections as the top killers. Cardiovascular disease, cancers, and respiratory illnesses lead, but injuries and suicide hit working-age Indians hardest. **Heart disease kills 3.1 million Indians a year, more than the next two causes combined** In 2023, cardiovascular disease alone killed 3.12 million Indians, according to the Global Burden of Disease. That is more than cancers (1.06 million) and chronic respiratory disease (1.25 million) combined. Diabetes killed 5.95 lakh, while infectious diseases like tuberculosis (3.35 lakh) and diarrhoea (4.62 lakh) have fallen sharply from their 1980 levels. Neonatal disorders claimed 2.98 lakh, road injuries 2.47 lakh, and suicide 2 lakh. The story is one of epidemiological transition: India now dies the way richer, older countries do, of chronic diseases. But beneath the all-ages chart, the picture shifts. For babies, birth complications dominate. For schoolchildren, drowning. For young adults, injuries and suicide. The best India-specific check, the SRS Cause of Death survey, finds cardiovascular disease at 32.1% of all deaths, with non-communicable diseases overall at 60.1%. These numbers are estimates, not certified counts, but they paint a clear direction. ## What kills the most Indians, 2023? Heart disease, and it is not close. Cardiovascular disease, heart attacks and strokes, killed 3.12 million Indians in 2023, according to the Global Burden of Disease study. That is more than the next two causes combined: chronic respiratory disease (1.25 million) and cancers (1.06 million). Diabetes caused 5.95 lakh deaths, and diarrhoeal diseases 4.62 lakh. Even lower respiratory infections, which topped the charts a generation ago, are now at 4.12 lakh. This pyramid of death is the signature of an epidemiological transition. India has moved from dying of infections, diarrhoea, TB, pneumonia, to dying of non-communicable diseases, or NCDs. These are chronic, non-infectious conditions driven partly by ageing, partly by lifestyle and environment. The catch: these are modelled estimates, not certified death counts. Most Indians still die at home, without a doctor to record why. The GBD fills those gaps with statistical models, making it the best comparative picture, but not a tally of death certificates. ## What kills babies (under 5)? For the youngest, death looks nothing like the all-ages chart. The biggest killer is being born too soon: preterm birth complications killed 1.57 lakh children under five in 2023. Lower respiratory infections were next (1.35 lakh), then birth asphyxia and trauma (85,600). Congenital defects (80,900) and diarrhoeal diseases (35,300) follow, with neonatal sepsis at 31,600. The pattern is clear, birth and the first month are the most dangerous period. These are not chronic lifestyle diseases; they are conditions of early infancy, closely tied to maternal health and care around delivery. The decline in diarrhoeal deaths from 8.2 lakh in 1980 to 35,300 today is one of India’s great public health victories, driven by oral rehydration salts and better sanitation. ## What kills children (5 to 14)? Once a child passes their fifth birthday, the threats shift dramatically. In 2023, drowning was the leading cause of death among 5- to 14-year-olds, killing 7,800 children. Cancers came second (7,300), followed by diarrhoeal diseases (6,800), road injuries (6,000), lower respiratory infections (5,800), and cardiovascular diseases (4,100). Drowning is a stark but often overlooked danger, open water bodies, lack of swimming skills, and weak supervision turn a routine bath or swim into a tragedy. The numbers are small relative to adult mortality, but each is a child lost to a cause that is largely preventable. The presence of cancers on this list is a reminder that childhood malignancies, though rare, are real and require specialized care. ## What kills young adults (15 to 49)? Working-age Indians die in ways the all-ages ranking hides. Cardiovascular disease still leads, with 3 lakh deaths, but road injuries (1.48 lakh) and suicide (1.46 lakh) are right behind, making them the third and fourth biggest killers in this age band. Cancers killed 1.87 lakh, digestive diseases 99,500, and tuberculosis 80,700. This is the tragedy of dying young. Road crashes and self-harm are not diseases but injuries, largely preventable and often concentrated in the prime earning years. The suicide figure (2 lakh nationally, but 1.46 lakh in the 15-49 group) is a red flag. India’s police records report a lower 1.7 lakh suicides overall, but GBD models a higher number, and stigma ensures undercounting everywhere. TB’s persistence among young adults is another reminder that infectious threats have not vanished, only receded. ## What kills the middle-aged (50 to 69)? In middle age, non-communicable diseases take over completely. Cardiovascular disease killed 1.22 million people aged 50-69 in 2023, a staggering number. Cancers were next at 5 lakh, followed by chronic respiratory disease (3.69 lakh), diabetes (2.46 lakh), tuberculosis (1.34 lakh), and digestive diseases (1.32 lakh). The dominance of cardiovascular is so complete that it accounts for more deaths than the next three causes combined. This is the stage when risk factors like high blood pressure, smoking, and air pollution exact their toll. TB, though lower than in younger adults, still claims over a lakh lives, a reminder that some infectious diseases linger into older age cohorts. ## What kills the elderly (70 and older)? Among Indians who live past 70, cardiovascular disease is overwhelming. It killed 1.59 million elderly people in 2023, more than the next three causes put together. Chronic respiratory disease (8.32 lakh) was a distant second, followed by cancers (3.55 lakh), diabetes (3.1 lakh), and diarrhoeal diseases (2.97 lakh). Dementia (1.21 lakh) makes its first appearance in the top six. In one sense, this is a mark of success: people are surviving childhood and middle age only to encounter the diseases of very old age. But it also signals a new challenge: managing chronic multimorbidity and conditions like dementia that are poorly captured in India’s healthcare and death data. The diarrhoeal numbers among the elderly show that even in age, infections remain dangerous when immunity wanes. ## How do men and women die differently? India’s own death survey, the SRS Cause of Death, offers a rare look at sex differences. In 2022-24, non-communicable diseases caused 62.3% of male deaths and 56.9% of female deaths. But the sharpest gap is injuries: 12.6% of male deaths were due to injuries versus only 7.5% of female deaths. Conversely, ill-defined causes, where the reason remains unclear, were far more common among women (12.9%) than men (7.4%). Men’s higher injury share reflects greater exposure to road traffic, workplace hazards, and violence. The higher ill-defined share for women suggests that their causes of death go less often recorded or are not probed as deeply by verbal autopsy. This is not a biological difference but a social one, hinting at gaps in how India investigates why its women die. ## How did heart disease deaths triple since 1980? In 1980, cardiovascular disease killed 9.73 lakh Indians. By 2023, that number had more than tripled to 3.12 million. The line chart rises sharply, especially after 2000. This is not because Indians suddenly developed weaker hearts. It is because the population has grown, people live longer, and an older population has more heart attacks. Critically, this measures absolute deaths, not the age-adjusted risk. If you accounted for ageing, the risk might look flatter. But even so, the raw count matters: health systems must treat 3.12 million heart attacks and strokes each year, triple the load of 1980. Urbanisation, dietary changes, physical inactivity, and rising diabetes all play a role, but the chart alone cannot prove causation, it shows the result. ## What are the four non-communicable killers driving India’s death toll? Cardiovascular, cancers, chronic respiratory, and diabetes, these four NCDs have been rising in parallel. Cardiovascular deaths leaped from 9.73 lakh in 1980 to 3.12 million in 2023. Chronic respiratory rose from 3.58 lakh to 1.25 million. Cancers increased from 2.52 lakh to 1.06 million. Diabetes, once rare, surged from 74,700 to 5.95 lakh. The slopes differ. Cardiovascular is the steepest by far, but diabetes saw the most dramatic relative rise, an eightfold increase. Chronic respiratory and cancers climbed more slowly. Together, these four likely account for the majority of Indian deaths today, and their collective weight is still rising. The lines are not merely a curiosity; they show where India’s preventive, diagnostic, and treatment efforts are increasingly needed. ## What does India’s own death survey find? The SRS Cause of Death survey (2022-24) is India’s own nationally representative cause data, using verbal autopsy on a sample of deaths. It finds cardiovascular disease at 32.1% of all deaths, a number that remarkably echoes the GBD’s message. Cancers are at 7%, respiratory diseases 6%, digestive 5.9%, respiratory infections 5.7%, and fever of unknown origin 4.1%. Unintentional injuries account for 4.1%, diabetes 3.6%, genito-urinary 3.4%, and TB 2.6%. Broadly, non-communicable diseases caused 60.1% of deaths, communicable, maternal and nutritional diseases 19.7%, and injuries 10.5%. Ill-defined causes were 9.7%. This survey counts the rural and at-home deaths that hospital records miss, making it the important reality check. Unlike the GBD, it is not a long time-series, it’s a single snapshot, but it confirms the heart is at the root of India’s mortality. ## What was the COVID scar and how did it recover? COVID-19 killed an estimated 52,400 Indians in 2023, according to GBD. But the line chart shows a spike in 2020 and 2021, the pandemic years, before falling back. The GBD peak is lower than some excess-death studies, which suggested far larger tolls, but every source agrees the spike was sharp and then receded. The point is not to argue about the absolute count, COVID mortality is genuinely uncertain, but to note that COVID was a shock, not a permanent shift. By 2023, its direct death toll had already dropped below many chronic diseases. The bigger story is the disruption COVID caused to other diseases and healthcare, but that is not visible in these cause-specific death numbers. ## Did India’s own death rate spike during COVID? The crude death rate from India’s Sample Registration System tells a similar story. In 2018, it was 6.2 per 1,000 population. During COVID, it shot up, SRS bulletins reported 7.5 in 2021, and then fell back to 6.4 by 2023. This is not an age-adjusted measure, so part of the bump is due to COVID deaths and part due to an ageing population. But the jump and decline are unmistakable: the pandemic temporarily pushed mortality higher across the country. The recovery to 6.4 suggests India’s underlying death rate is still close to its pre-pandemic level, though population ageing will keep gradual pressure upward. ## How have infectious disease deaths fallen? The other half of the epidemiological transition is the retreat of infectious killers. Lower respiratory infections fell from 6.75 lakh deaths in 1980 to 4.12 lakh in 2023. Diarrhoeal diseases crashed from 1.61 million, the biggest killer then, to 4.62 lakh today. Tuberculosis declined from 6.79 lakh to 3.35 lakh. HIV/AIDS, which emerged after 1980, peaked around 2005 and is now at 47,400. Malaria dropped from 1.22 lakh to 15,800. These declines are the result of immunization, antibiotics, oral rehydration, TB control programmes, insecticide-treated nets, and better water and sanitation. They are among India’s most significant health achievements. But TB remains substantial at over 3 lakh deaths, India still has a quarter of the world’s TB burden, and diarrhoeal diseases still kill nearly half a million, largely among children and the elderly. The job is not finished. ## How many Indians die from injuries and suicide? Injuries kill about 5.4 lakh Indians each year. Road injuries lead with 2.47 lakh deaths in 2023, up from 80,500 in 1980. Suicide is next at 2 lakh, up from 68,600 forty years ago. Drowning has declined to 49,900, and interpersonal violence is at 44,300. The injury burden is concentrated among the young and working-age, as the age-ladder charts showed. Suicide is widely believed to be undercounted even in the GBD; India’s police-based National Crime Records Bureau reports about 1.7 lakh suicides. Road deaths have risen with motorization, despite improvements in helmet use and road design. Drowning’s decline is welcome but still a leading cause in childhood. ## How dramatically has maternal mortality fallen? Maternal mortality, women dying from pregnancy or childbirth complications, has seen the steepest fall on this page. In 1985, India’s maternal mortality ratio was 658 per 100,000 live births, meaning one woman died every 152 births. By 2023, it had dropped to 80 per 100,000, a near 90% decline. This is a triumph of institutional deliveries, skilled birth attendance, emergency obstetric care, and the Janani Suraksha Yojana. The WHO/UN estimate for 2023 is 80, with an uncertainty range of 73-87. A blip occurred in 2021, when the ratio rose to 155 due to COVID-related service disruptions, but the long trend is unmistakably downward. India is now close to the global target of 70 by 2030. ## Is infant mortality still falling? The infant mortality rate (IMR) from the SRS declined from 32 per 1,000 live births in 2018 to 25 in 2023. It measures the probability of a child dying before their first birthday. This improvement, even over just six years, reflects better neonatal care, vaccination, and maternal health. India’s IMR is still higher than many developing countries, but the trend is solid. The SRS is the official source here, not the modelled GBD, so these numbers carry more weight for policy. The fall in IMR is one reason the overall death rate has not risen faster despite population ageing. ## How many total deaths occur each year? Total deaths in India have been rising, from 9.13 million in 2000 to an estimated 10.6 million by 2030, according to UN projections. In 2000, 4.8 million deaths were male and 4.3 million female. By 2030, the projection is 5.8 million male and 4.8 million female. This growth is not because people are dying at higher rates, the crude death rate has been fairly flat, but because the population is larger and, importantly, older. An older population produces more deaths even if each age group’s risk is falling. The male excess reflects higher male mortality at most ages. The denominator matters: when you see 3.12 million heart disease deaths, remember that is out of about 10 million total deaths each year. ## Sources - IHME Global Burden of Disease 2023: modelled estimates for cause-specific deaths, 1980–2023. - Sample Registration System (SRS) 2023: India's official vital registration sample, providing crude death rate and infant mortality. - SRS Cause of Death 2022-24: Nationally representative cause distribution using verbal autopsy. - WHO/UN Maternal Mortality Estimation Inter-agency Group (MMEIG): maternal mortality ratio estimates. - UN World Population Prospects 2022: total death projections. --- Source: [This Indian Life](https://thisindianlife.today/articles/what-kills-indians/) · Updated 2026-06-03. Licensed CC BY 4.0. Please cite as "This Indian Life — https://thisindianlife.today".