Health Talk: Chronic disease deaths rose in India as global rates fell

The rise in mortality was mainly due to ischaemic heart disease and diabetes, including diabetic kidney disease, affecting both men and women, the authors said

A paper published in The Lancet last week said that death rates from chronic diseases such as cancer, heart disease, and stroke increased in India in the decade leading up to the COVID-19 pandemic — even as they fell in four out of five countries covered by the study.

The paper --- Benchmarking progress in non-communicable diseases: a global analysis of cause-specific mortality from 2001 to 2019 --- said the increase was larger for Indian females than for males. (Representative photo)

The paper --- Benchmarking progress in non-communicable diseases: a global analysis of cause-specific mortality from 2001 to 2019 --- said that the increase was larger for Indian females than for Indian males, for whom the probability of dying from a non-communicable disease (NCD) between birth and age 80 increased by only 0.1 percentage points. The increase in the probability of dying from an NCD between birth and age 80 was driven by a rise in mortality above age 40 for females and above age 55 for males, the paper added.

The authors attributed the increase in mortality to particularly large contributions from ischaemic heart disease and diabetes (including chronic kidney disease due to diabetes) for both sexes. There were, however, decreases in mortality from cirrhosis of the liver and the residual category of all other NCDs for both sexes, with additional improvements for males in stomach cancer, Chronic Obstructive Pulmonary Disease (COPD), stroke, and the residual category of all other circulatory diseases.

The 2010–2019 change, the authors said, was a deterioration (going from a decrease to an increase) compared with the preceding decade for females, but an improvement (smaller increase) compared with the preceding decade for males.

For females, this occurred due to deterioration in the direction or size of change for all causes of death except cirrhosis of the liver, COPD, and the residual category of all other NCDs. For males, it was the result of improvement in the direction or size of change for eight of the 20 NCD causes of death analysed — including COPD, ischaemic heart disease, and cirrhosis of the liver — countered by less favourable (but smaller) changes in some other causes of death (upper aerodigestive tract cancers and stroke).

The authors, however, also added that these results are subject to substantial uncertainty because mortality data are limited, with quality evaluated as very low.

According to the Indian Council of Medical Research’s (ICMR) NCD data, it is estimated that the proportion of deaths due to NCDs in India increased from 37.9% in 1990 to 61.8% in 2016. The four major NCDs are cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes — all of which share four behavioural risk factors: unhealthy diet, lack of physical activity, tobacco use, and alcohol consumption.

What is driving this surge?

“India is definitely seeing an increase in cases of NCDs as people here have adopted the kind of lifestyle — smoking, alcohol consumption, sedentary life, high junk intake etc. — that did damage in the western countries earlier. They have improved and we are deteriorating. We are seeing a rise in CRM, which is cardiac, renal, and metabolic syndrome, and this is a huge concern,” R.R. Kasliwal, chairman of Clinical and Preventive Cardiology, Medanta – The Medicity, said.

There is nothing to disagree with there, as the surge in NCD cases is a matter of grave concern, and needs the immediate attention of all stakeholders to avoid an explosion in the not-so-distant future.