Burden of lifestyle disease on healthcare is already high and this study says it will not only go up further but also increase mortality.
Diabetes has increased by 158% in rural Tamil Nadu. (Wikimedia Commons)
Deaths owing to heart attacks, cancer, diabetes, chronic respiratory diseases, trauma, and stroke, besides mental health disorders, are common. However, are we doing enough to control these diseases? Hardly, it seems.
A recent study has shed light on India’s alarming rise in lifestyle also known as non-communicable diseases (NCDs), stressing an urgent need for robust preventative measures.
These diseases — often referred to as lifestyle diseases — are non-transmissible illnesses but stem from genetic, physiological, environmental, and behavioural factors.
The study, “The Burden of Lifestyle Diseases and Their Impact on Health Service in India,” published in the May 2024 edition of Family Medicine and Primary Care, stated that NCDs and injuries account for 52 percent of fatalities in India.
It also warned that the number would increase in the absence of significant interventions in India.
The study highlighted that NCDs are the leading causes of illness, disability, and death in India.
A World Health Organisation (WHO) report said that 40.5 million people worldwide succumbed to NCDs in 2016, with India accounting for 63 percent of deaths.
The Ministry of Health and Family Welfare (MoHFW) said that the NCD mortality rate surged from 37 percent in 1990 to 62 percent in 2016. By 2030, the global mortality rate from NCDs is likely to reach 70 percent.
India has a significant number of the global diabetes population, with 77 million individuals affected, the study noted. The affected population number is projected to rise to 134 million by 2045.
The researchers stated that cardiovascular diseases account for one-fourth of deaths in India, many occurring at a young age.
The National Family Health Survey (NFHS) of 2015-16 revealed that 11 percent of women and 15 percent of men aged 15 to 49 grappled with hypertension, with over 60 percent never having their blood pressure checked.
Dr V Mohan, the Chairman of Madras Diabetes Research Foundation (MDRF) that coordinated the national survey by the Indian Council of Medical Research-India Diabetes in 2021, said Kerala, Puducherry, Goa, Sikkim and Punjab reported the highest prevalence of NCDs as compared to other states.
Meanwhile, the survey also found high diabetes prevalence in the southern and northern regions, with urban areas having a high plurality throughout.
Dr Mohan had told South First that an alarming number of people with prediabetes were found than the number of those with diabetes. He meant that we could expect further prevalence in diabetes in the coming years.
Dr Kaiser Raja of Aster Hospital earlier told South First that there has been an increase in the population with abdominal fat, leading to fatty liver.
The research identified six major NCDs affecting India:
Cardiovascular diseases: Accounting for 26 percent of fatalities, cardiovascular disorders are primarily due to a lack of exercise. Promoting physical activity through infrastructure and policies is crucial.
Diabetes: With one in 10 Indians affected, the prevalence of diabetes is high. Preventative measures include promoting exercise, healthy diets, and reducing exposure to pollutants.
Cancer: Experts estimate that up to 20 percent of cancer cases may be caused by environmental toxins such as smoking, drinking, meat-heavy diets, air pollution, and low vegetable intake. These warnings are often ignored, and cancer treatment and monitoring remain expensive. Cancer prevention focuses on reducing exposure to environmental toxins and promoting healthy lifestyles.
Respiratory diseases: In 2016, 22.2 million Indians had COPD (Chronic obstructive pulmonary disease) and 35 million had severe asthma. Addressing air pollution and promoting clean energy are key steps.
Mental health: Affecting 10 percent of people over 18, mental health disorders require societal support, dietary changes, and economic stability.
Obesity: Increasing rates of obesity, with 20.7 percent of women and 18.6 percent of men aged 15 to 49 overweight or obese, necessitate promoting physical activity and healthy diets.
The researchers said that the Indian government has been proactive in addressing NCDs through several initiatives.
“Since the 1980s, various programmes aimed at prevention and control have been launched, significantly intensifying under the 11th Five-Year Plan,” the paper said.
Meanwhile, it stated that in 2008, the government launched the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS). This programme improved guidelines for practical inspection, treatment plans, and management of chronic illnesses.
In 2013, NPCDCS merged with the National Health Mission (NHM), focusing on prevention, early recognition, care, and treatment of NCDs.
The initiative now engages the private sector and has expanded to over 150 districts nationwide, promoting accurate diagnosis and raising awareness about common risk factors for NCDs.
However, doctors not connected with the research stressed that this is not enough and there should be policy changes, front-pack labelling of ultra-processed foods, proper awareness about obesity, dangers of sedentary lifestyle, importance of good sleep and nutrition among general public, both rural and urban.
The doctors also said that child obesity must be addressed as they welcome the early onset of adult diseases such as diabetes, thyroid, fatty liver and other conditions.
The study said that NCDs affect everyone and everywhere. However, avoiding unhealthy diet, smoking, physical inactivity, air pollution, and alcohol consumption could prevent most NCDs with five modifiable risk factors.
The researchers argued that the scope of the issue prevents the current medical systems from implementing population-level NCD treatment.
“Programme management usually requires additional skills for developing, planning, executing, monitoring, and evaluating NCD initiatives due to insufficient education resources, processes, tools and lack of data systems, and inefficient use of technology,” the researchers found.
Hence, they opined, the NCD programme must shift from the present-day “screening-centric” paradigm at the primary healthcare level to a combined approach that includes “community involvement” for health promotion, reduction of risk in the community, and “provider and facility preparation” for effective treatment.
The necessity for alignment and preparedness in India’s healthcare system to manage chronic diseases is a key hurdle to providing treatment and referral services for NCDs.
Due to inadequate training materials, techniques, and tools and a lack of data systems and technology use, programme managers usually require more skills to conceive, plan, control, monitor, and assess NCD initiatives.
The study emphasised the need for preventative measures to reverse the lifestyle diseases trend.
“Active public health policies are necessary to promote healthy lifestyles and enhance health worldwide. Promoting physical exercise is a problem that governments and the general public must address,” the researchers asserted.
The study noted that the surroundings, sports and leisure facilities, and governmental regulations influence a person’s decision to engage in vigorous physical activity.
“Finance, economic planning, governance, media, culture policy, education, sports and information, and transportation are some areas where cooperation across sectors is necessary,” it said.
A healthy lifestyle may frequently be used to cure chronic conditions. Future improvements in healthcare management depend on developing therapeutic education communication technologies that fill the gap between recommendations and the actual adoption of healthy living habits.
India must focus on early recognition, prevention, early therapy, and innovative treatment modalities. Monitoring NCDs and the factors that increase their risk should be integral to health systems.
The key findings of the burden of NCDs research stressed the role of lifestyle choices in the prevalence of NCDs.
“Factors such as diet, stress management, sleep patterns, and physical activity significantly influence vulnerability to diseases like heart disease, COPD, diabetes, stroke, metabolic syndrome, obesity, and various cancers. Notably, skipping meals, inactivity, and nicotine use are critical risk factors,” the researchers stated.
By taking these steps, the researchers opined that India could mitigate the impact of NCDs, reduce mortality rates, and improve the quality of life for its citizens.
The researchers said the journey ahead would be challenging, but with sustained effort and collaboration, a healthier future is within reach.
Researchers from the Department of Community Medicine and Public Health, Datta Meghe Institute of Higher Education and Research in Maharashtra; Indian Institute of Technology, Hyderabad; and Government Medical College, Kanker in Chhattisgarh, participated in the study.
(Edited by Majnu Babu).
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