Country-level Aging and Disease Burden(cont...)

Bhutan

Bhutan is in the early stages of the demographic transition, but, because of significant reductions in fertility in the last 20 years, its expected to age more rapidly than some of its neighbors (Figure 2.3). The proportion of the population 65 years and older will move from 4.4 percent in 2000 to 7.3 percent by 2025. The prevalence of NCDs increases with age and thus the burden of disease caused by NCDs will also rise.

Figure 2.3 Age structure in Bhutan, 2000 and 2025

In 2004, NCDs accounted for 62.3 percent of total forgone DALYs, with the remainder stemming from communicable diseases and MCH issues. Of the total DALY burden, CVD accounted for 13.7 percent, mental health 12.1 percent, cancer 3.7 percent, respiratory diseases 4.3 percent, diabetes 1.1 percent, and injuries 11.1 percent. NCDs accounted for 68 percent of all deaths, with CVD (19 percent), cirrhosis of the liver (8 percent), and COPD/bronchial asthma (7 percent) being the three leading causes of death.

No country-level study has been conducted on NCDs or their major risk factors such as tobacco among adults. In 2007, a survey of risk factors of non-communicable diseases was carried out in Thimphu found only 7 percent of the population over 25 years of age smoke tobacco but 10 percent among those 25-34 years old. In 2006, a tobacco use survey carried out among youth (13–15 years) found the prevalence at 29 percent and 12 percent for boys and girls, respectively—these are the highest rates among youth in South Asia.

The 2007 study also found that 31 percent of the population over 25 had consumed alcohol in the last 30 days and 8 percent of men drank almost every day compared with 3 percent of women. Cancers, chronic rheumatic heart disease, and renal failure were the top three conditions referred abroad for tertiary care. MoH assessments using primarily institution-based patient diagnoses find increasing trends for hypertension, diabetes, and cancer. Circulatory disease deaths were the leading cause of inpatient mortality with 88 deaths. In 2006–7, road traffic injuries included 724 nonfatal and 111 fatal cases (93 percent of which were among men).