Is the Growing Burden of Non-Communicable Diseases in India Preventable?

NCD morbidity and mortality as shares of total morbidity and mortality have risen steadily in India
and projected to surge rapidly. In 1990, NCDs accounted for 40% of all Indian mortality and are now
projected to account for three quarters of all deaths by 2030. Currently, cardiovascular diseases,
cancer, respiratory illness, and diabetes are the leading causes of death in India, accounting for almost
50% of all deaths. Underlying these rising shares are growing risks that are common to several NCDs.
NCDs are chronic in nature and take a long time to develop. They are linked to aging and affluence
and have replaced infectious diseases and malnutrition as the dominant causes of ill health and death
in much of the world including India. Some NCDs cause others and create clusters of co-morbid
conditions (e.g., diabetes can lead to kidney failure and blindness). Old-age morbidity is a rapidly
worsening curse in India. The swift descent of the elderly in India (60 years +) into noncommunicable diseases (e.g., cardiovascular diseases, cancer, chronic respiratory diseases, and
diabetes) could have disastrous consequences in terms of impoverishment of families, excess
mortality, lowering of investment and deceleration of economic growth. Indeed, the government must
deal simultaneously with the rising fiscal burden of NCDs and substantial burden of infectious
diseases. The present study seeks to answer three questions: Why has the prevalence of two NCDs,
diabetes and heart diseases risen in recent years? Given the surge in these diseases, whether social
protection policies and restructuring of medical services can mitigate such surges in the near future? A
related but equally important concern is whether lifestyle and dietary changes could be induced to
further prevent the rising burden of these NCDs. Our analysis is based on the only all-India panel
survey-India Human Development survey that covers 2005 and 2012. This survey was conducted
jointly by University of Maryland and National Council of Applied Economic Research, New Delhi.
A robust econometric methodology-specifically, 2SLS- is used to address the endogeneity of key
explanatory variables. The results here stress the need to make sure that pension and healthcare
reforms are accompanied by greater awareness, expansion of old age pensions and public hospitals,
and effective regulation of both public and private hospitals.