BHUBANESWAR: Heart attacks and strokes are striking early and India is in the grip of a health emergency. As per a new global study, there has been a staggering uptick in non-communicable diseases (NCDs) across the south Asia region (SAR), with India shouldering a disproportionate burden.
Researchers from seven universities and institutes of repute, including Rourkela-based National Institute of Technology (NIT), Amaravati-based SRM University, and US-based Kent State University and Harvard University, found that NCDs such as diabetes, cardiovascular diseases (CVDs), cancer, and chronic respiratory diseases have emerged as the leading causes of death and disability, surpassing infectious diseases.
The study, which analysed the Global Burden of Disease data 2021, said India recorded the highest age-standardised prevalence rate (ASDPR) of NCDs in the region, with 92,134 per one lakh population, well above the global average. While age-standardised death rates decreased marginally by 1% between 2010 and 2021, the absolute number of deaths and disability-adjusted life years (DALYs) lost to NCDs continued to rise, driven largely by factors like rapid population growth, ageing demographics, and sedentary lifestyle.
Among the states, Gujarat reported the highest ASDPR of 93,527, followed by Madhya Pradesh (93,107), Assam (92,649), Chhattisgarh (92,555), Bihar (92,547), Jharkhand (92,247), Telangana (92,208), Tripura (92,182), Meghalaya (92,169), Uttar Pradesh (92,064) and Uttarakhand (92,013). The ASDPR in the rest of the states is below the national average.
Even as the ASDIR for CVDs dropped by only 1% and respiratory diseases came down by 13% between 2010 and 2021, diabetes incidence rose by 21% and cancer by 13% during the same period. The age-standardised prevalence rate (ASDPR) of CVDs increased by 2% and cancer and diabetes prevalence surged by 26% over the past decade.
Lead author of the study, Jalandhar Pradhan, professor of health economics in humanities and social sciences department, NIT-Rourkela, said environmental factors were a major contributor to NCDs, accounting for 20.25% of cases, whereas metabolic factors account for 24.69% of DALY cases with high blood pressure contributing 44.75% to CVD DALYs. “Air pollution is the primary contributor to DALYs for CVDs (32.79%) and respiratory diseases (51.09%). It also leads in DALYs for cancer and diabetes, affecting 2.73% and 18.81%, respectively,” he said.
Across all NCDs, the mortality change factor is maximum for diabetes (63.1%), followed by cancer (44.7%), CVDs (37.9%), and respiratory diseases (31.7%) in SAR. India has the highest contribution to behavioural factors for DALY cases from NCDs at 23.95%. Tobacco consumption is the prime behavioural risk factor that contributes 26.69% as the cause of respiratory diseases.
Besides, dietary risks are the most significant contributor for NCDs accounting for 38.34% of CVD cases and 26.69% cases of respiratory diseases. “India’s public health system now faces a dual challenge, battling infectious diseases on one hand and an overwhelming surge of NCDs on the other. Without immediate and coordinated action, the socio-economic costs will be devastating,” Pradhan warned.
The demographic breakdown of the study paints an equally troubling picture. While children aged between 5-9 years showed a high incidence rate of NCDs, the most devastating impact in terms of deaths and DALYs was observed among older adults, especially those between 60 and 69 years. Women showed higher rates of incidence than men from adolescence onwards and experienced higher death counts in the 80+ age group.
The analysis reveals that population aging and growth alone account for over 40% of the increase in NCD-related deaths in India. Despite minor improvements in death rates, the total DALY burden remains high, pointing to prolonged disability, economic loss, and poor quality of life. The increase in cancer cases are attributed to local environmental factors, exposure to occupational carcinogens, living conditions, medical factors, and limited healthcare resources.
Study co-author SV Subramanian, professor of population health and geography at Harvard University, said the NCD surge is a warning signal for India’s health planners. The health system needs to transform to deal with chronic diseases in an aging population and the nation needs to embark on a mass movement towards healthy living with the same sense of urgency it had during the COVID-19 pandemic.
Attention needs to be given to preventing diabetes and hypertension. If strong interventions are not put in place, India will lose millions of lives and billions of economic productivity to diseases that are preventable, he implied.
What are NCDs?
Non-communicable diseases are illnesses that are not transmitted from one individual to another. Unlike infectious diseases, which are caused by bacteria, viruses, or other pathogens, NCDs result from a mix of genetic, physiological, environmental, and behavioural factors
They are chronic in nature, usually developing gradually but persisting for extended periods, and in most instances, for life
The four principal categories of NCDs are cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes.
Several of the risk factors that lead to the development of NCDs are tobacco use, unhealthy food habits, physical inactivity, and harmful alcohol consumption
Air pollution and occupational health hazards also contribute significantly. Other risk factors like age, genetic disposition and ethnicity increase the vulnerability too.
Preventive mechanism
NCDs are largely avoidable. Successful approaches include healthy diets, promotion of regular physical activity, tobacco control interventions, limiting the harmful use of alcohol, and ensuring clean air
Worrying trend
NCDs are leading cause of mortality, particularly in low and middle-income countries
NCDs now account for around 74% of global deaths, up from 59.5% in 2000
Annually, around 15 million people aged 30–69 years die prematurely due to NCDs
Four major NCD groups - cardiovascular diseases (17.9 million deaths), cancer (9 million), respiratory diseases (3.9 million), and diabetes (1.6 million) are among major contributors to global mortality