Almost half (49.8%) of India’s medically certified deaths were on account of either cardiovascular or respiratory causes in India in 2024, according to data released by the Office of Registrar General of India (ORGI), which works under the home ministry. These numbers, while they need to be read with several caveats, point towards an increasing trend in mortality burden from lifestyle diseases and possibly also the adverse effects of India’s polluted air, an issue which is often flagged by health agencies in India and abroad.
Event Context
To be sure, the distribution of deaths by cause recorded in the MCCD must be read with the fact that it covers less than 25% of registered deaths in the CRS which itself does not cover all deaths in India. For example, death registration in the CRS was estimated at 99% of all deaths only in 2021 and 2024, although the proportion has been higher than 95% every year starting 2019. The proportion was lower than 90% before 2019.
Despite the low level of medical certification, the broad result of the MCCD report is in line with survey-based estimate from the Sample Registration System (SRS) reports of the ORGI. As HT reported on May 22, the SRS reports also show that the share of deaths from cardiovascular diseases has been increasing over time.
Match Outlook
To be sure, some of the increase in these numbers could just be better reporting as the medically certified deaths are still a small proportion of not just overall but even registered deaths in India.
A total of 2,066,117 deaths were medically certified in 2024—23.1% of all deaths registered in the year by the Civil Registration System (CRS), the formal record of all births and deaths in the country. The 2024 share of medically certified deaths was 1.1 percentage points higher than in 2023 and the highest since 2021 (the peak of the Covid-19 pandemic in India) when this number was 23.4%.
The trends described above are from the Report on Medical Certification of Cause of Death-2024 released by the ORGI on Thursday. The report results from the mandate under the Registration of Births and Deaths Act, 1969 that requires medical practitioners to issue a Medical Certificate of Cause of Death (MCCD) if a death is attended by them.
The MCCD report also shows that 38.8% medically certified deaths in 2024 were from diseases of the circulatory system, which includes diseases related to the heart, blood vessels, hypertension, etcetera. The share of circulatory diseases in deaths in 2024 was 2.4 percentage points higher than in 2023 and the second highest share after 2021, when such diseases accounted for 40.8% of MCCD deaths.
The report also shows that deaths related to or directly caused by Covid-19 decreased to just 497 in 2024, less than 0.02% of the 2 million MCCD deaths. The number of Covid-19 related deaths recorded in MCCD was 2,040 in 2023, 25,393 in 2022, 4,13,580 in 2021, and 160,618 in 2020.
