Non-communicable diseases (NCDs) such as diabetes, cardiovascular diseases, and cancers pose a significant threat to India’s productivity. They account for nearly 60% of deaths in the country and result in annual economic losses estimated at $6 trillion globally.
WHO in a recent report published before COP29 highlighted the need to keep health at the centre stage and how extreme weather events were costing lives and fuelling diseases. The changing climate exacerbates the underlying determinants of health, creating conditions that fuel NCDs and increase healthcare inequalities. Pollution also has a direct impact on heart health. Studies show that prolonged exposure to polluted air significantly raises the chances of heart attacks and strokes. Rising temperatures, erratic rainfall patterns, and unpredictable weather are making it more difficult to grow the crops that people rely on for food. As a result, many farmers are turning away from traditional crops in favour of more profitable crops. With rising temperatures and more frequent heatwaves, physical activity levels are dropping. People are staying indoors to escape the heat, leading to more sedentary lifestyles.
These are the leading cause of mortality in India, contributing to nearly 65% of all deaths. Cardiovascular diseases (CVDs), cancers, chronic respiratory diseases, diabetes, and mental health disorders dominate the NCD landscape. India is often referred to as the “Diabetes Capital of the World,” with over 77 million people living with diabetes in 2023, the second-highest globally. There are three-pronged facets of the NCDs on our nation’s health –
- Burden: India experiences 5.87 million NCD-related deaths annually
- Economic Impact: NCDs cost the Indian economy approximately $2.5 trillion between 2012 and 2030
- Rising Incidence: Hypertension and diabetes prevalence have surged to 25% and 11%, respectively, in adults aged 18+
India’s healthcare system, with only 2% GDP allocation for health, struggles with prevention, early detection, and equitable treatment, leading to significant out-of-pocket expenses. This is significantly lower than the global average. This underinvestment exacerbates the financial burden on households, as 63% of health expenses are out-of-pocket. NCD care accounts for nearly half of these expenditures, forcing families to divert income, savings, or resort to loans. The resulting financial stress often limits access to timely and quality care, further lowering productivity.
NuSocia’s studies across multiple regions also showed a significant and growing prevalence of non-communicable diseases (NCDs) in rural India. Historically considered urban-centric, conditions like diabetes, hypertension, and chronic respiratory diseases are now widespread in rural areas, driven by lifestyle changes, limited healthcare access, and lack of awareness. Rising cases in rural areas can be attributed to –
- Rising Risk Factors: Poor nutrition, tobacco use, and limited physical activity are increasing risk factors in rural communities.
- Healthcare Gaps: Inadequate infrastructure for early diagnosis and chronic care management worsens outcomes.
- Economic Strain: High out-of-pocket expenses in rural settings disproportionately affect low-income families.
These households rely on daily-wage labor, meaning illness can directly halt income. Poor awareness and limited access to diagnostic and treatment facilities lead to delayed care, worsening health outcomes. High out-of-pocket expenses for chronic conditions like diabetes or hypertension disproportionately affect low-income families, often leading to debt cycles or asset liquidation.
In urban areas, while healthcare access is better, the fast-paced lifestyle, stress, and sedentary behaviors significantly contribute to NCDs. Rising costs of healthcare and increasing cases of mental health disorders exacerbate productivity losses. For example, diabetes and hypertension, which are prevalent among the working-age population, increase hospital visits by over 300%, disrupting work routines. Illness-related losses in productivity due to NCDs are substantial and often invisible. Unlike acute illnesses, NCDs persist over time, causing chronic health challenges that affect physical and cognitive abilities.
- Absenteeism and Presenteeism: Employees with NCDs are more likely to take sick leave, and when they work, they may not perform at full capacity. For instance, mild-to-moderate hypertension or uncontrolled diabetes can reduce energy levels and focus, affecting job performance.
- Mental Health Impact: Mental health conditions, which are often categorized under NCDs, significantly influence productivity. Depression and anxiety, for instance, contribute to a global loss of productivity valued at approximately $1 trillion annually. In India, the stigma around mental health often delays treatment, exacerbating its impact on work.
- Caregiving Responsibilities: NCDs not only affect individuals but also impose additional caregiving responsibilities on their families. This indirect impact can lead to lost work hours for caregivers, compounding productivity challenges.
- Economic Loss: NCDs reduce economic output by lowering workforce participation. A healthier workforce is vital for industries dependent on consistent output, such as manufacturing and services.
Investing in preventive healthcare, such as regular screenings, vaccination programs, and health awareness campaigns, can significantly reduce the prevalence and impact of NCDs. Increased public spending on health, coupled with policy measures to enhance primary care and access to affordable medicines, is crucial for mitigating the economic and productivity losses associated with NCDs. At organizational levels, it is important to invest in preventive health measures, such as regular health check-ups, offer regular health screenings, incentivize physical activity through gym memberships, and stress management.
Addressing the NCD challenge demands a multi-stakeholder approach, balancing individual, corporate, and government responsibilities to promote a healthier and more productive workforce.
