Non-communicable diseases (NCDs) such as heart disease, stroke, cancer, diabetes, and chronic respiratory ailments are responsible for a staggering 74% of all deaths globally. Particularly alarming is the disproportionate burden borne by low- and middle-income countries, where 86% of the 17 million premature deaths (occurring before age 70) due to NCDs take place. The rising prevalence of these diseases underscores an urgent need for preventive measures, better healthcare systems, and robust policies.
What Are the Major Risk Factors Driving NCDs?
The emergence of NCDs is intrinsically tied to specific behavioral and environmental risk factors:
- Tobacco Use: Tobacco contributes to the deaths of 6 million people annually, including those affected by secondhand smoke. Despite global efforts to curb smoking, 22% of people aged 15 and older remain active smokers.
- Harmful Alcohol Consumption: Annually, 3.3 million deaths are attributable to alcohol abuse, with over 60 diseases directly linked to it. Paradoxically, a 2010 survey revealed that 62% of adults abstained from alcohol in the previous year, suggesting that harmful consumption is concentrated among certain groups.
- Physical Inactivity: A sedentary lifestyle causes 3.2 million deaths globally, with nearly 23% of adults not engaging in sufficient physical activity. This contributes significantly to obesity and related metabolic disorders.
- Unhealthy Diets: Diets low in fruits and vegetables lead to approximately 1.7 million deaths annually, highlighting the need for nutritional education and affordable access to healthy foods.
- Air Pollution: A less discussed but crucial factor, air pollution exacerbates respiratory and cardiovascular diseases, adding to the burden of NCDs.
These behaviors lead to physiological changes such as raised blood pressure (affecting 22% of adults), high blood glucose (8.5% prevalence), elevated cholesterol (39% of adults aged 25+), and obesity (39% overweight and 13% obese globally).
How Do NCDs Impact Urban and Marginalized Populations?
Urban environments intensify the risks of NCDs, especially for vulnerable populations like informal workers, gig workers, and those in marginalized communities. Cities, while being hubs of economic opportunity, also present hazardous living and working conditions. These challenges include:
- Hazardous Work Environments: Urban laborers such as cab drivers, waste collectors, and gig workers often operate under poor hygiene conditions and without health insurance.
- Limited Access to Healthcare: Fragmented and overburdened urban health systems fail to provide adequate primary care. This is particularly critical in informal settlements where nearly 49% of the urban population resides.
- Financial Vulnerability: Out-of-pocket (OOP) healthcare expenses for NCDs lead to economic instability, affecting entire families and perpetuating cycles of poverty.
The situation is further compounded by rapid urbanization. With over half the world’s population now living in cities, projected to rise to 70% by 2050, cities are struggling to meet the health needs of their growing populations.
Why Is Prevention Crucial in Combating NCDs?
Prevention is the cornerstone of mitigating the NCD epidemic. While adopting healthier lifestyles is essential, even young and seemingly fit individuals are not immune to these diseases. High-profile cases such as cricketer Yuvraj Singh being diagnosed with cancer in his 30s and 27-year-old footballer D. Venkatesh’s sudden death due to a heart attack highlight the unpredictability of NCDs.
Early detection through regular health screenings can significantly reduce the impact of NCDs. Annual checkups for conditions like hypertension, diabetes, and cancer can help individuals take preventive action before the disease progresses. Preventive screenings, now available in major cities across India, must be made accessible to underserved populations.
What Role Do Policies and Systems Play?
India has a national NCD surveillance policy designed to encourage preventive care and community-level screenings. However, the poor implementation of these policies renders them largely ineffective. Urban health systems, characterized by fragmentation and underfunding, fail to address the unique needs of marginalized populations.
Despite a decline in tobacco and alcohol consumption over the years, as evidenced by National Family Health Survey (NFHS) data, the rates of hypertension, diabetes, and obesity have surged. This suggests a dire need for more holistic and integrated approaches to health promotion and disease prevention.
How Can Technology and Community-Based Models Help?
Digital health technologies hold immense potential in addressing NCDs. By enabling real-time monitoring of vital parameters like blood pressure and glucose levels, technology can empower individuals to manage their health. Community-based interventions can also play a critical role in:
- Raising awareness about NCD risks and promoting early detection through health education campaigns.
- Creating referral systems to guide patients toward affordable and reliable healthcare options.
- Implementing social protection schemes to reduce the financial burden of healthcare expenses.
Community-led surveillance systems can further help in identifying high-risk groups, enabling targeted interventions. For example, in cities, local bodies can collaborate with health departments and community organizations to create programs tailored to specific needs, such as mobile health clinics for informal settlements.
What Steps Can Be Taken to Build Healthier Cities?
Building healthier urban environments requires a multi-sectoral approach involving governments, employers, and civil society. Key strategies include:
- Strengthening Primary Healthcare: Public health systems must prioritize accessibility for marginalized communities, ensuring universal health coverage that minimizes OOP expenditures.
- Policy Integration: Municipalities, traffic systems, schools, and employers must collaborate to design policies that promote physical activity, reduce workplace hazards, and provide health insurance.
- Scaling Up Successful Models: Community-led health initiatives, such as those focusing on NCD screening and health promotion, should be scaled up and replicated in other cities.
Why Must Action Be Taken Now?
The rising tide of NCDs is not just a health crisis but a socioeconomic one. The World Health Organization (WHO) emphasizes that the prevention and control of NCDs are critical development imperatives for the 21st century. Without immediate action, these diseases will continue to overwhelm health systems, deplete household incomes, and hinder economic progress.
By combining technological advancements, policy reforms, and community-driven solutions, it is possible to curb the growing burden of NCDs and create healthier, more equitable societies. The time to act is now, not only to save lives but also to secure a sustainable future for generations to come.