6 days ago
9
A collaborative study on the global burden of disease (GBD) has revealed an encouraging trend – people across the world are living longer and dying less from infectious diseases, including HIV/AIDS, tuberculosis, diarrhoea, and malaria, since 1990.
On the flip side, deaths due to non-communicable diseases (NCDs) now account for two-thirds of global mortality. India is among the countries where top NCD killers are ischaemic heart disease, stroke, diabetes, cancer, and mental health disorders
According to the GBD Study 2023, published recently in The Lancet and the Journal of the American College of Cardiology (JACC), ischaemic (low supply of blood to a body part, leading to a lack of oxygen and nutrients for tissues and cells) heart disease was the leading cause of death in 2023.
In the 2023 list of fatal diseases, stroke took the third spot, followed by lower respiratory infections and diabetes. Lower respiratory infections occupied the third spot, stroke the fourth, ischaemic heart disease the fifth, and diabetes the 20th on the 1990 chart.
Fall in mortality, rise in inequities
The study noted the fall in the global mortality rates, but flagged the rise in health inequalities and chronic lifestyle-related diseases. “The rapid growth in the world’s ageing population and evolving risk factors have ushered in a new era of global health challenges. The evidence presented in the GBD study is a wake-up call, urging government and health leaders to respond swiftly to the disturbing trends reshaping public health,” contributor Christopher Murry, who is director of the Institute for Health Metrics and Evaluation at the University of Washington, said.
Double burden
Hemen Sarma associate professor at western Assam’s Bodoland University and one of the contributors to the GBD 2023 study, said that India mirrors the global trend, but is experiencing a “double burden” with an explosion of lifestyle disorders while infectious diseases persist in some regions.
“While life expectancy in the country has improved dramatically, reaching over 70 years on average, the healthy years of life, free from disease or disability, remain far fewer. The GBD 2023 data show that India has achieved a massive decline in infant and maternal mortality, but now faces rising threats from hypertension, obesity, diabetes, and air pollution,” he told The Hindu.
Citing the study report, released in Berlin a few days ago, he said nearly half of all deaths and disability worldwide can be prevented by addressing key modifiable risks, including high blood sugar, high body mass index (BMI), high blood pressure, smoking, and exposure to particulate air pollution.
What the analysis did
Researchers analysed 375 diseases and 88 risk factors across 204 countries and 660 subnational regions for the GBD 2023. They found that between 2010 and 2023, the rate of death and disability due to infectious and nutritional diseases fell globally by about 26%. However, NCD-related disability-adjusted life years (DALYs) — the total years of healthy life lost — surged primarily because of anxiety, depression, and other conditions linked to modern lifestyles.
“Our challenge is not just to treat disease, but to prevent it through environmental and behavioural change. India’s future health will depend on how effectively we address pollution, food systems, and mental well-being,” the Dr. Sarma said.
Grim picture for India
The JACCpaper, titled Global, Regional, and National Burden of Cardiovascular Diseases and Risk Factors, 1990-2023, painted a particularly alarming picture for India. The country contributed a significant share of cardiovascular diseases, responsible for 19.2 million deaths in 2023.
The researchers warned that India’s youthful population is not immune. Urbanisation, sedentary work culture, high stress, and dietary transitions are leading to early-onset heart disease. At the same time, underdiagnosis and inadequate follow-up care in rural regions make the challenge even more complex.
The GBD 2023 data also highlighted a global mental health emergency. Anxiety disorders have risen by 63%, and depression by 26% since 2010. Mental illness now ranks among the top 10 causes of health loss worldwide — particularly among young adults.
In India, suicide remains a leading cause of death among those aged 15-29 years. Yet, mental health receives less than 1% of the national health budget, and stigma often prevents people from seeking help, the study underscored.
“Mental health must be treated as a mainstream health issue. It affects productivity, education, and social stability. Investing in mental well-being is an investment in national development,” Dr Sarma said.
Another worry flagged is the increase in women’s mortality from cardiovascular disease, inching closer to that of men. A hurdle in addressing this challenge in South Asia is the “invisible patient” problem, referring primarily to women delaying treatment or care until advanced stages of illness.
The GBD 2023 study also marked South Asia for the highest DALY rates induced by air pollution. Particulate matter pollution was found to be the second leading environmental cause of global disease burden and India’s most urgent public health crisis.
“The environment is not separate from health. Clean air, safe food, and green infrastructure are as vital to health as hospitals and medicines,” Dr Sarma said.
The researchers said India has to do more than spend around 2% of its GDP on healthcare, among the lowest in the G20, the forum of 19 countries plus the European Union and the African Union. They noted that public hospitals in the country face overcrowding, and primary healthcare in rural areas is under-resourced.
English (US) ·