India
India is in the early stages of the demographic transition, which is expected to advance in the future (Figure 2.4). The proportion of the population 65 years and older will move from 4.4 percent in 2000 to 7.6 percent in 2025.
Figure 2.4 Age stru cture in India, 2000 and 2025
Source: U.S. Census Bureau. www.census.gov/ipc, accessed July 1, 2010.In 2004, NCDs accounted for 62 percent of the total burden of forgone DALYs, with the remainder from communicable diseases and MCH issues. Of the total DALY burden, CVD accounts for 12.7 percent, mental health 11.6 percent, cancer 3.5 percent, respiratory diseases 4.6 percent, diabetes 1.1 percent, and injuries 12.5 percent.
The Particular trends are as follows:
* CVD:
Expected to emerge by 2030 as the main cause of death (36 percent). It is characterized by early occurrence compared to the rest of the world, higher case fatality rates, and disease onset at lower risk factor thresholds, particularly for those who are overweight or obese.
* Diabetes:
Prevalence, increasing in both urban and rural areas, is in the range of 5–15 percent
among urban populations, 4–6 percent in semi-urban populations, and 2–5 percent in rural
populations. Diabetes is particularly increasing among the marginalized and the poor.
* Hypertension:
Present in 25 percent of the urban and 10 percent of the rural population. The number of people with hypertension will rise from 118.2 million in 2000 to 213.5 million by 2025.
* COPD:
Prevalence among men is in a range of 2–9 percent in north India and 1–4 percent in
south India. Among males, tobacco smoke is the major cause of COPD, while smoke from indoor
combustion of solid fuels is the major cause for women.
* Cancer:
Over 70 percent of cases are diagnosed during the advanced stages of the disease,
resulting in poor survival and high case mortality rates. Tobacco use is the major cause of cancer
for both lung and oral cavity diseases.
* Smoking:
Prevalence is similar to other South Asian countries (males 33 percent, females 4 percent) while smoking prevalence among youth is higher (boys 17 percent, girls 9 percent).
Smoking accounts for 1 in 5 deaths among men and 1 in 20 deaths among women, accounting
for an estimated 930,000 deaths in 2010.
* Alcohol:
A study on CVD risk factors in industrial populations found higher alcohol consumption
conferred a higher risk for CVD.11 The reasons for the lack of protective effect found in other
populations could include (i) unfavorable enzymatic metabolism of alcohol in Indians that is
known to impact CVD, (ii) harmful drinking patterns with irregular heavy or binge drinking that is associated with CVD, and (iii) consumption mostly among the disadvantaged and poor who carry a higher risk of CVD than others.
* Injuries:
Road traffic injuries and deaths are on the increase along with the rapid economic
growth. Annually, they result in more than 100,000 deaths, 2 million hospitalizations, and
7.7 million minor injuries. Nonfatal road traffic injuries are highest among pedestrians,
motorized two-wheeled vehicle users, and cyclists. This is a major problem among young
populations, with three-quarters occurring among 15—45 year olds, predominantly among men.
If the present pace of increase continues, in 2010 150,000 deaths and 2.8 million
hospitalizations are likely and, in 2015, these numbers will rise to 185,000 and 3.6 million.
* Diet:
Exact data on consumption of oils/fats at the individual and household level are missing.
However, national aggregate statistics show high consumption of unhealthy oils. The share of
raw oil, refined oil, and vanaspati oil (hydrogenated oil) in the total edible oil market is
estimated at 35 percent, 55 percent, and 10 percent, respectively. Trans fats are added to
vanaspati oil, which is widely used in the commercial food industry to lengthen shelf life.
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