India can safely claim that infectious diseases are no longer the leading cause of death in the nation. However, there’s still absolutely nothing to celebrate. For decades now, public health policy in the nation has been dictated by infectious diseases like tuberculosis, diarrhoea, pneumonia; also labelled as the scourges of underdevelopment. As per a recent study published in The Lancet, by 2023 deaths from chronic non-communicable diseases now formed the majority in India. Simply put, chronic lifestyle diseases now kill more Indians than infections.
The Global Burden of Disease (GBD) report launched at the World Health Summit, Berlin, lays open both statistics and also a few crucial observations. The shift in morbidity is being caused by rising rates of heart diseases, chronic lung disease and stroke.
Why does the shift matter?
In the nineties, diarrheal diseases were the leading cause of death in India. With the shifting profile of disease burden, the public health policy needs to reflect the current challenges. As does the healthcare infrastructure. Globally, too, with changing lifestyles, non-communicable diseases (NCD) now form a staggering two-thirds majority of the world’s deaths; with ischemic heart disease, stroke, and diabetes leading the cause of death.
The GBD report, produced with the network of over 16,500 collaborating experts, provides key insights for public health policymakers, healthcare professionals, and researchers in the field to address the evolving health challenges. Health experts warn that public health focus now needs to shift to preventing non communicable diseases.
Speaking about the report, Dr Soumya Swaminathan, former chief scientist at WHO, said, “With the population living longer but experiencing higher levels of morbidity, the focus must shift towards healthy ageing. Preventing NCDs should be a priority.” The report also highlights that Covid-19 the leading cause of death in 2020, had moved to the 20th place in 2023; followed by chronic obstructive pulmonary disease, lower respiratory infections and neonatal disorder.
What it says about Indians’ state of health
Often labelled as the diabetes capital of the world, India lags behind when it comes to ‘healthy’ nations of the world. Despite recent surges and waves in health conscious youngsters and urban dwellers, the nation largely battles morbidity due to non-communicable diseases in concerning numbers. Several studies in the field corroborate each others’ findings.
As per a recently-published study led by ICMR (Indian Council of Medical Research), over 71 per cent of Indians are metabolically unhealthy even though they might appear to be slim or within normal weight. The study also highlights how millions of Indians though appearing healthy on the outside harboured silent threats like high blood sugar, bad cholesterol and hidden body fat.
The large-scale survey, a part of the ongoing research initiated by ICMR-INDIAB in 2012, was conducted across 31 states and UTs and covered a representative sample of 113043 individuals over the age of 20 in both rural and urban areas.
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Dr Prashant Joshi, CEO AIIMS Nagpur and one of the co-authors of the study underscored the dismally small fraction of healthy Indians. “Our study shows that only about 26.6 per cent of Indians are metabolically healthy.” This means that even young and lean-looking Indians are at risk of serious diseases like diabetes and heart problems because of hidden metabolic issues.
Rapid dietary transitions in India have been cited as one of the reasons behind an alarming rise in cardiometric diseases. A study using data from the national Indian Council of Medical Research-India Diabetes survey, conducted on 18,090 adults, found that Indian diets are characterised by high intakes of low-quality carbohydrates (white rice, milled whole grains and added sugar), high levels of saturated fat and low intakes of protein.
India and its burgeoning cardiovascular disease epidemic
For health experts who have long been flagging concerns about India’s burgeoning cardiovascular disease epidemic, the shift has been long coming and did not happen overnight. A 2024-study titled Young Hearts Under Attack, finds that India has seen a significant increase in deaths due to heart attacks, post Covid.
As per the data shared by NCRB (National Crime Records Bureau), the country saw a 12.5 per cent rise in cases in 2022 alone, leading to 32,457 deaths. The rise is attributed to lingering effects of Covid-19, apart from lifestyle factors, genetic predisposition and socio-economic changes. The Indian Heart Association reports that of all the heart attacks reported in the nation, nearly half the percentage occurs in men under the age of 50 and a quarter under 40.
But unfortunately, any purposeful conversation around health enters the national platforms only after a young public life is lost, before fading away in the background. Which is what happened recently, after 42-year-old Shefali Zariwala, 40-year-old actor Sidharth Shukla and businessman Sunjay Kapur, apart from several other public figures lost their lives to sudden cardiac arrests and heart attacks. The nation has received enough wake-up calls, now it needs measures.
By Manpriya Singh
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