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It indicates that the state has not yet entered into the advanced stage of mortality transition.
In the first stage of mortality reduction, the shift occurs in the cause of death pattern from infectious to chronic-degenerative diseases (12).
Therefore, the emerging trends may indicate the beginning of a fourth stage of mortality reduction in Kerala as it has happened in developed countries.
In most developed countries, advanced stage of mortality reduction and further increase in longevity was achieved mainly due to the mortality shift from adult and older ages to oldest ages (Olshansky and Ault 1986).
However, these indicators are incapable of revealing the exact contribution of the different age groups to the decline in mortality, which in turn bring about changes to life expectancy, limiting the possibility of understanding the advanced stage of mortality decline.
Decomposition of contribution of mortality decline from different age groups to the gain in life expectancy is one of the best measurements for identifying the advanced stage of mortality decline and human longevity in Kerala.
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This draws parallels between Kerala's experience and that of other developing countries where primary healthcare has been more dominant than the socioeconomic improvements in the early stages of mortality reduction.
At the prepupal stage, the highest level of mortality was found in the spring of 2011 in most localities, again with the exception of Hirono, at which prepupal mortality peaked in the fall of 2011 (Additional file 5: Figure S3b).
Cirrhosis, the end stage of fibrosis, mortality rate which increases speedily worldwide, appears to be a large health burden in the world.
Nevertheless, the low performance of pace indices of TLE among older age groups, especially with regard to males than females, may be an indication of a lag in moving toward the stage of advanced mortality reduction in Kerala.
Depending on the stage of sepsis, mortality will be no more than 5%, in large part because we will finally accept that it is legitimate to die from natural causes, and those deaths will no longer be attributed to sepsis.
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