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Non-communicable Diseases, Affluence, and Gender
Whether the burden of non-communicable diseases has shifted to older men and women, and whether it varies by marital status and affluence of the household has been examined. The analysis is based on the 60th and 71st rounds of the National Sample Survey for 2004 and 2014. Even though comparisons of prevalence and shares between men and women are relied on in the analysis, some glaring disparities emerge. The growing menace of NCDs in the context of a rapidly increasing older population calls for bold policy initiatives, which are currently either underfunded or limited in coverage and uncoordinated. A drastic overhaul of the health system and behavioural changes are thus emphasised.
The authors are grateful to the anonymous reviewer, Jere Behrman, and N Chandramohan for their constructive suggestions. The views expressed are those of the authors.
A recent Lancet study (Jan et al 2018: 2047) draws attention to the devastation that “non-communicable diseases (NCDs) wreak and are likely to if timely action to prevent its continuing rapid rise is not taken.” Old-age morbidity is a rapidly worsening curse in India. The swift descent of the elderly (60+ years) in India into NCDs (for example, cardiovascular diseases [CvDs], cancer, chronic respiratory diseases [CrDs], and diabetes) could have disastrous consequences in terms of impoverishment of families, excess mortality, lowering of investment, and consequent deceleration of economic growth. Indeed, the government has to deal simultaneously with the rising fiscal burden of NCDs and substantial burden of infectious diseases (Bloom et al 2014a, 2014b). As a recent Lancet report (Ghebreyesus 2018) points out, failure to devise a strategy and make timely investment now will jeopardise achievement of sustainable development goal 3 (SDG) and target 4 of a one-third reduction in premature mortality from NCDs by 2030.
Four NCDs (CvDs, cancer, CrDs, and diabetes) accounted for 42% of all deaths in India in 2010. These diseases contributed 22% of disability-adjusted life years (or DALYs—the combination of years lived with serious illness and those lost due to premature death) in India in 2010 (Bloom et al 2014b). So, the cost in terms of lives lost is horrendous. Besides, NCDs hamper growth in different ways. They reduce the supply of labour and redirect resources from productive investments to healthcare, and thus drain the public and private budgets, raise business costs, and undermine competitiveness. In fact, based on the Environmental Policy Integrated Climate (EPIC) model of the World Health Organization (WHO), the potential cumulative losses to India’s economy during 2012–30 are projected to be $6 trillion (Bloom et al 2014b), nearly thrice of India’s gross domestic product (GDP) in 2017.1
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