Status of Non-communicable Diseases in India in Global Context

Seminar on Nutrition & Lifestyle for Emerging NCD Challenges

26th April 2012

1

Dr. Damodar BachaniDirector Professor & Head, Community Medicine,

Lady Hardinge Medical College, New Delhi

Disease Burden due to NCDs

Mortality estimates due to NCDs 

• Globally all deaths (2005) 58 million*• Globally deaths due to NCD (2005)          35 million*        

(60.3%)                

• All deaths in India (2004) 10.3 million #• Deaths due to NCDs in India (2004) 5.2 million # 

(50.5%)* Source: WHO 

# Source: ICMR

Percentage of NCD deaths, by cause in WHO Regions, 2008

0%

20%

40%

60%

80%

100%

Afric

aTh

e Am

erica

sEa

stern

Med

iterra

nean

Euro

peSo

uth-E

ast A

siaW

este

rn P

acific

% o

f Dea

th

Other NCDs

Diabetes

Respiratorydiseases

Cancers

Cardiovasculardiseases

Four major NCDs cause 80% of deaths due to NCDs in all WHO Regions

Source: WHO global Health observatory 2011 http://apps.who.int/ghodata/

Distribution of deaths by major cause-India 2001-2003

Deaths due to NCDs outnumber deaths due to communicable diseases, maternal and perinatal

causes and nutritional conditions combined

Others 9.9% (N=11,242)

Communicable disease, maternal

& perinatal conditions, nutritional

deficiencies38.2%

(N=43,390)

Noncommunicable disease42.4%

(N=48,170)

Injuries9.6%

(N=10,890)

Source: RGI-CGHR Million Death Study

Distribution of deaths by major cause among men and women, India: 2001-03

Source: RGI-CGHR Million Death Study

Among men, NCDs cause majority of deaths whereas ; among women, communicable diseases along with maternal and child health and nutritional conditions are leading causes of deaths closely followed by NCDs

05

101520253035404550

Communicable,maternal,

perinatal andnutritionalconditions

Noncommunicable

diseases

Injuries Symptoms, signsand ill defined

conditions

%

Male Female

Causes of Death (%) in Urban Population (25 to 69 years) India: 2001-2003

4 major NCDs- Cardiovascular diseases, Malignant & other Neoplasms, COPD, Asthma & other respiratory diseases & Diabetes Mellitus contributes to 55% of the total reported deaths in urban area

Source :Special Survey of Deaths, Registrar General of India

17

4.3

32.8

7.7

3.3

5.8

3.63.7

2.8 7.7

11.3

Cardiovascular Diseases

Malignant & otherNeoplasmsCOPD, Asthma & otherRespiratory DiseasesDiabetes Mellitus

Motor vehicle accidents

Unintentional Injuries

Digestive Diseases

Genito-urinary diseases

Tuberculosis

Symptoms, signs & illdefined conditionsOther causes

Causes of Death (%) in Rural Population (25 to 69 years) India: 2001-2003

3 major NCDs-Cardiovascular diseases, COPD, Asthma & other respiratory diseases, Malignant & other Neoplasms contributes to 43% of the total reported deaths in rural area

Source :Special Survey of Deaths, Registrar General of India

22.9

10.9

8.94.93.14.9

10.7

3.1

5.5

5.5

19.6

Cardiovascular Diseases

COPD, Asthma, otherRespiratory DiseasesMalignant & otherNeoplasmsUnintentional Injuries

Intentional Self harm

Digestive Diseases

Tuberculosis

Malaria

Diarrhoeal Diseases

Symptoms, signs & illdefined conditionsOther Causes

Disease Burden due to NCDs

• More than 20% of the population have at least one chronic disease

• More than 10% have more than one chronic disease

Diseases Existing Burden and TrendsCancer 28 lakh (2010); Incidence 10 lakh in a year;

20-25% increase in 5 yearsCardiovascular Diseases 2.9 crore (2000);

Expected to rise to 6.4 crore by 2015Stroke 20 lakh

Diabetes 5.1 crore (2010);Expected to rise to 8 crore by 2030

Chronic Kidney Disease Incidence of End Stage Renal Disease /year =175/ million population

Chronic Lung Disease Burden: 3.9 crore

Mental Disorders 6-7% of population;1-2% have severe mental disorders;

Current Status & Future Trends on Key NCDs in India

Risk Factors & Determinants of NCDs

• CVD• Cancers• COPD• Diabetes

EndpointsIntermediateRisk Factors• Raised BP• High BMI

• Dyslipidemia• Raised blood

glucose

• Tobacco use• Unhealthy Diet • Alcohol • Phys. Inactivity

BehaviouralRisk Factors

NCD: From Risk Factors to Disease“Evidence, Policy, Action, Partnership”

Determinants and Facilitators

Social Economic Cultural Environmental

Age Gender Genes

The four major NCDs are caused by four commonlifestyle related risk factors—tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol

NCDs

Shared Risk Factors

Tobacco use

Unhealthy diets

Physical inactivity

Harmful use of alcohol

Cardiovascular diseases

Diabetes (Type II)

Cancer

Chronic respiratory disease

Deaths caused by NCD Risk Factors in India

STROKE

COPD

CHD

MI

DIABETES

HT

OVERWEIGHT

SMOKING

ALCOHOL

UNHEALTHY DIET

PHYSICAL INACTIVITY

ENVIRON. POLLUTION

Hit the Route & Trunk, branches will fall automatically

Disease Prevention and Health Promotion

Social Determinants