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Context

A study in The Lancet reveals rise in Non-communicable diseases (NCDs) death risk in India, with women experiencing a sharper increase than men.

What is Non-Communicable Diseases (NCDs)?

NCDs, also known as chronic diseases, are medical conditions not caused by infectious agents. They result from a combination of genetic, physiological, environmental, and behavioral factors.

Global Trends:

From 2010 to 2019, global NCD mortality declined in 80% countries, covering 70% of the world’s population, due to reductions in cardiovascular diseases, stomach, colorectal, cervical, breast, lung, and prostate cancers. (Source: The Lancet)

However, global progress slowed in 2010-2019, due to rising deaths from dementia, neuropsychiatric conditions, and cancers like pancreatic and liver. The World Health Organization (WHO) projects NCD deaths to rise to 55 million by 2030 without interventions.

India’s Trends

Unlike global declines, India saw an increase in NCD mortality risk from 2010 to 2019. 

• For men, the probability of dying from NCDs rose from 56% in 2001 to 57.9% in 2019; for women, it increased from 46.7% in 2001 to 48.7% in 2019. (Source: The Lancet)

Against SDG 3.4 (reduce premature NCD deaths by one-third by 2030), India’s rising mortality trends signal a failure to meet global targets, exacerbated by poor healthcare access and socioeconomic challenges.

India’s Rising NCD Burden

Scale: An estimated 5.8 million Indians die from NCDs each year. Approximately one in four Indians faces the risk of dying from an NCD before reaching the age of 70. (Source: The Hindu)

Key Diseases: Cardiovascular diseases, chronic respiratory diseases, diabetes, and cancers (e.g., lung, upper aerodigestive tract) dominate, with heart disease and diabetes driving the rise.

Economic Impact: NCDs impose high out-of-pocket expenditure (OOPE) and catastrophic health expenditure (CHE), cause productivity losses, absenteeism, and a double burden alongside infectious diseases.

Regional Variations: High epidemiological transition level (ETL) states (e.g., Kerala, Tamil Nadu) show higher NCD prevalence due to aging and lifestyle changes, while poorer states face access barriers.

Risk Factors and Lifestyle Triggers

Behavioral Risk Factors

Tobacco Use: Prevalent in northeastern and eastern regions, contributing to lung cancer and cardiovascular diseases.

Unhealthy Diet: High consumption of refined grains, rice, and red meat increases diabetes and heart disease risk.

Physical Inactivity: Nearly 50% of Indian adults are insufficiently active, with higher prevalence among women and urban populations. (Source: The Hindu)

Alcohol Use: Rising alcohol consumption exacerbates liver cirrhosis and cancers.

Environmental Factors

Air Pollution: Accounts for 5.6 million NCD deaths globally, including stroke, heart disease, and lung cancer.

• Outdoor air pollution from all sources accounts for 2.18 million deaths per year in India. (The Hindu)
• 464 children under 5 die daily in India due to air pollution, surpassing tobacco & diabetes as leading cause of death. (State of Global Air)

Urbanization: Rapid urban growth drives sedentary lifestyles and processed food consumption.

Socio-Demographic Factors

Low socioeconomic status (SES) and education levels correlate with higher NCD risk, particularly in rural areas.

Aging populations increase NCD prevalence, with India’s elderly facing higher rates of diabetes and heart disease.

Genetic Factors: Family history predisposes individuals to cardiovascular diseases, diabetes, and certain cancers.

Policy and Government Initiatives

National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDC): Focuses on health promotion, screening, and treatment, but faces implementation challenges due to state-level deprioritization and weak monitoring.

National Multisectoral Action Plan (NMAP): Targets key NCD risk factors through multi-sectoral collaboration, including tobacco control and healthy diet promotion.

Ayushman Bharat Scheme: Provides health insurance for NCD care, but struggles with funding and access issues, particularly for women.

Population-Based Screening: Targets diabetes, hypertension, and cancers (oral, breast, cervical) at primary healthcare levels.

Tobacco and Alcohol Control: National Tobacco Control Programme and awareness campaigns aim to curb usage, though enforcement varies.

Fit India Movement and Poshan Abhiyaan: Promote physical activity and nutrition to address lifestyle triggers.

Way Forward

Strengthen Healthcare Access

• Expand primary healthcare infrastructure, especially in rural areas, to ensure early NCD detection and treatment.
• Scale up telemedicine and mobile health units, integrating NCD care with other health programs.
• Leverage ASHA workers and SHGs for NCD awareness and screening in rural and urban slums.

Gender-Specific Interventions

• Develop targeted screening programs for women (e.g., breast, cervical cancer) and address obesity and inactivity through community-based SHGs.
• Integrate NCD management into reproductive health policies to tackle gestational diabetes and hypertension risks.

Address Social Determinants

• Improve access to healthy foods through subsidies and urban planning to reduce reliance on processed diets.
• Tackle poverty and education gaps through skill development and employment programs.

Policy Enforcement

• Enforce tobacco and alcohol control laws strictly, with higher taxes and public smoking bans.
• Accelerate NMAP implementation through inter-ministerial coordination (health, education, agriculture).

Environmental Measures

• Strengthen air pollution control through stricter Bharat Stage norms and urban green spaces to reduce NCD-linked environmental risks.
• Improve water and sewage management by preventing exposure to chemical and microbial contaminants and ensuring access to safe, clean water. 

Investment and Funding

• Increase health budget allocations and channel CSR funds to NCD programs.
• Restructure Ayushman Bharat to ensure coverage for chronic NCD care, especially for women.

Conclusion

India’s rising NCD burden threatens SDG 3.4, requiring a multi-sectoral, equity-focused, and community-driven approach for effective prevention and care.

Source: DOWNTOEARTH