Status of Non-communicable Diseases in India in Global Context

Seminar on Nutrition & Lifestyle for Emerging NCD Challenges 26th April 2012
Dr. Damodar Bachani Director Professor & Head, Community Medicine, Lady Hardinge Medical College, New Delhi

DiseaseBurdenduetoNCDs

MortalityestimatesduetoNCDs
Globallyalldeaths(2005) 58million* GloballydeathsduetoNCD(2005) 35million* (60.3%) AlldeathsinIndia(2004) DeathsduetoNCDsinIndia(2004)
*Source:WHO
#Source:ICMR

10.3million# 5.2million# (50.5%)

PercentageofNCDdeaths,bycausein WHORegions,2008
100% 80% Other NCDs Diabetes Respiratory diseases Cancers Cardiovascular diseases

% of Death

60% 40%

20% 0%
ed ite rr an ea n Am er ica s So ut hEa s Eu ro pe Pa cif ic Af ri tA sia ca

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

Th e

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

Ea st er n

es te rn

Distribution of deaths by major cause-India 2001-2003

Others 9.9% (N=11,242) Injuries 9.6% (N=10,890) Noncommunicable disease 42.4% (N=48,170)

Communicable disease, maternal & perinatal conditions, nutritional deficiencies 38.2% (N=43,390)

Deaths due to NCDs outnumber deaths due to communicable diseases, maternal and perinatal causes and nutritional conditions combined

Source: RGI-CGHR Million Death Study

Distribution of deaths by major cause among men and women, India: 2001-03
50 45 40 35 30 25 20 15 10 5 0 Com m unicable, m aternal, perinatal and nutritional conditions Non com m unicable dis eas es Injuries Sym ptom s , s igns and ill defined conditions

Male

Fem ale

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

Source: RGI-CGHR Million Death Study

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

Cardiovascular Diseases Malignant & other Neoplasms COPD, Asthma & other Respiratory Diseases Diabetes Mellitus 4.3 Motor vehicle accidents 7.7 3.3 5.8 3.6 3.7 2.8 7.7 11.3 Unintentional Injuries Digestive Diseases Genito-urinary diseases Tuberculosis Symptoms, signs & ill defined conditions Other causes

17 32.8

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

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

Cardiovascular Diseases COPD, Asthma, other Respiratory Diseases Malignant & other Neoplasms Unintentional Injuries 5.5 Intentional Self harm Digestive Diseases 5.5 3.1 10.9 Tuberculosis Malaria Diarrhoeal Diseases 8.9 4.9 3.1 4.9 Symptoms, signs & ill defined conditions Other Causes

19.6

22.9

10.7

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

DiseaseBurdenduetoNCDs
More than 20% of the population have at least one chronic disease More than 10% have more than one chronic disease

CurrentStatus&FutureTrendson KeyNCDsinIndia
Diseases Cancer Cardiovascular Diseases Stroke Diabetes Chronic Kidney Disease Chronic Lung Disease Mental Disorders Existing Burden and Trends 28 lakh (2010); Incidence 10 lakh in a year; 20-25% increase in 5 years 2.9 crore (2000); Expected to rise to 6.4 crore by 2015 20 lakh 5.1 crore (2010); Expected to rise to 8 crore by 2030 Incidence of End Stage Renal Disease /year = 175/ million population Burden: 3.9 crore 6-7% of population; 1-2% have severe mental disorders;

RiskFactors& DeterminantsofNCDs

NCD:FromRiskFactorstoDisease
Evidence,Policy,Action,Partnership
Behavioural Risk Factors Tobacco use Unhealthy Diet Alcohol Phys. Inactivity

Intermediate Risk Factors

Raised BP High BMI Dyslipidemia Raised blood glucose

Endpoints
CVD Cancers COPD Diabetes

Determinants and Facilitators Social Age Economic Gender Cultural Environmental Genes

ThefourmajorNCDsarecausedbyfourcommon lifestylerelatedriskfactorstobaccouse,unhealthy diet,physicalinactivityandharmfuluseofalcohol

Shared Risk Factors NCDs
Tobacco use Unhealthy diets Physical inactivity Harmful use of alcohol

Cardiovascular diseases

Diabetes (Type II)

Cancer

Chronic respiratory disease

DeathscausedbyNCDRiskFactorsinIndia

Disease Prevention and Health Promotion

MI CHD DIABETES STROKE OVERWEIGHT SMOKING ALCOHOL UNHEALTHY DIET ENVIRON. POLLUTION PHYSICAL INACTIVITY Social Determinants HT COPD

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