Sta Status of us of Non-comm Non-communica unicable Diseases e Diseases in India in India in Global Conte in Global Context Seminar on Nutrition & Lifestyle for Emerging NCD Challenges 26 th April 2012 Dr. Damodar Bachani Director Professor & Head, Community Medicine, Lady Hardinge Medical College, New Delhi 1
Disease Burden due to NCDs
Mortality estimates due to NCDs • Globally all deaths (2005) 58 million* • Globally deaths due to NCD (2005) 35 million* (60.3%) • All deaths in India (2004) 10.3 million # • Deaths due to NCDs in India (2004) 5.2 million # (50.5%) * Source: WHO # Source: ICMR
Percentage of NCD deaths, by cause in WHO Regions, 2008 100% Other NCDs 80% Diabetes 60% Respiratory % of Death diseases 40% Cancers Cardiovascular 20% diseases 0% Eastern Mediterranean South-East Asia Western Pacific Africa The Americas Europe Four major NCDs cause 80% of deaths due to NCDs in all WHO Regions Source: WHO global Health observatory 2011 http://apps.who.int/ghodata/
Distribution of deaths by major cause-I ndia 2001-2003 Others 9.9% (N= 11,242) Injuries Noncommunicable 9.6% disease (N= 10,890) 42.4% (N= 48,170) Communicable disease, maternal & perinatal conditions, nutritional deficiencies 38.2% (N= 43,390 ) Deaths due to NCDs outnumber deaths due to communicable diseases, maternal and perinatal causes and nutritional conditions combined Source: RGI-CGHR Million Death Study
Distribution of deaths by major cause among men and women, India: 2001-03 50 45 40 35 30 % 25 20 15 10 5 0 Communicable, Non Injuries Symptoms, signs maternal, communicable and ill defined perinatal and diseases conditions nutritional conditions Male Female Among men, NCDs cause majority of deaths whereas ; among women, communicable diseases along with maternal and child health and nutritional conditions are leading Source: RGI-CGHR Million Death Study causes of deaths closely followed by NCDs
Causes of Death (%) in Urban Population (25 to 69 years) India: 2001-2003 Cardiovascular Diseases Malignant & other Neoplasms 17 COPD, Asthma & other Respiratory Diseases 32.8 Diabetes Mellitus 4.3 Motor vehicle accidents 7.7 Unintentional Injuries 3.3 Digestive Diseases 5.8 Genito-urinary diseases 3.6 11.3 Tuberculosis 3.7 2.8 7.7 Symptoms, signs & ill defined conditions Other causes 4 major NCDs- Cardiovascular diseases, Malignant & other Neoplasms, COPD, Asthma & other respiratory Source :Special Survey of Deaths, diseases & Diabetes Mellitus contributes to 55% of the Registrar General of India total reported deaths in urban area
Causes of Death (%) in Rural Population (25 to 69 years) India: 2001-2003 Cardiovascular Diseases COPD, Asthma, other 19.6 22.9 Respiratory Diseases Malignant & other Neoplasms Unintentional Injuries Intentional Self harm 5.5 Digestive Diseases 5.5 10.9 Tuberculosis 3.1 Malaria Diarrhoeal Diseases 10.7 8.9 Symptoms, signs & ill 4.9 4.9 3.1 defined conditions Other Causes 3 major NCDs-Cardiovascular diseases, COPD, Asthma & other respiratory diseases, Source :Special Survey of Deaths, Malignant & other Neoplasms contributes to Registrar General of India 43% of the total reported deaths in rural area
Disease Burden due to NCDs • More than 20% of the population have at least one chronic disease • More than 10% have more than one chronic disease
Current Status & Future Trends on Key NCDs in India Diseases Existing Burden and Trends Cancer 28 lakh (2010); Incidence 10 lakh in a year; 20-25% increase in 5 years Cardiovascular Diseases 2.9 crore (2000); Expected to rise to 6.4 crore by 2015 Stroke 20 lakh Diabetes 5.1 crore (2010); Expected to rise to 8 crore by 2030 Chronic Kidney Disease Incidence of End Stage Renal Disease /year = 175/ million population Chronic Lung Disease Burden: 3.9 crore Mental Disorders 6-7% of population; 1-2% have severe mental disorders;
Risk Factors & Determinants of NCDs
NCD: From Risk Factors to Disease “ Evidence, Policy, Action, Partnership ” Behavioural Intermediate Endpoints Risk Factors Risk Factors • CVD • Raised BP • Tobacco use • Cancers • High BMI • Unhealthy Diet • COPD • Alcohol • Dyslipidemia • Diabetes • Phys. Inactivity • Raised blood glucose Determinants and Facilitators Social Economic Cultural Environmental Age Gender Genes
The four major NCDs are caused by four common lifestyle related risk factors—tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol Shared Risk Factors NCDs Tobacco Unhealthy Physical Harmful use use diets inactivity of alcohol � � � � Cardiovascular diseases � � � � Diabetes (Type I I ) � � � � Cancer � Chronic respiratory disease
Deaths caused by NCD Risk Factors in India
Disease Prevention and Health Promotion MI HT COPD CHD DIABETES OVERWEIGHT STROKE SMOKING ALCOHOL UNHEALTHY DIET ENVIRON. POLLUTION PHYSICAL INACTIVITY Social Determinants Hit the Route & Trunk, branches will fall automatically
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