Noncommunicable diseases (NCDs), including heart disease, stroke, cancer, diabetes and chronic lung disease, are collectively responsible for 74% of all deaths worldwide. More than three-quarters of all NCD deaths, and 86% of the 17 million people who died prematurely, or before reaching 70 years of age, occur in low- and middle-income countries.
NCDs share four major risk factors: tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets.
The epidemic of NCDs poses devastating health consequences for individuals, families and communities, and threatens to overwhelm health systems. The socioeconomic costs associated with NCDs make the prevention and control of these diseases a major development imperative for the 21st century.
WHO’s mission is to provide leadership and the evidence base for international action on surveillance, prevention and control of NCDs. Urgent government action is needed to meet global targets to reduce the burden of NCDs.
People at risk
People of all age groups, regions and countries are affected by NCDs. These conditions are often associated with older age groups, but evidence shows that 17 million NCD deaths occur before the age of 70 years. Of these premature deaths, 86% are estimated to occur in low- and middle-income countries. Children, adults and the elderly are all vulnerable to the risk factors contributing to NCDs, whether from unhealthy diets, physical inactivity, exposure to tobacco smoke or the harmful use of alcohol.
These diseases are driven by forces that include rapid unplanned urbanization, globalization of unhealthy lifestyles and population ageing. Unhealthy diets and a lack of physical activity may show up in people as raised blood pressure, increased blood glucose, elevated blood lipids and obesity. These are called metabolic risk factors and can lead to cardiovascular disease, the leading NCD in terms of premature deaths.
Risk factors
Modifiable behavioural risk factors
Modifiable behaviours, such as tobacco use, physical inactivity, unhealthy diet and the harmful use of alcohol, all increase the risk of NCDs.
- Tobacco accounts for over 8 million deaths every year (including from the effects of exposure to second-hand smoke) (1).
- 1.8 million annual deaths have been attributed to excess salt/sodium intake (1).
- More than half of the 3 million annual deaths attributable to alcohol use are from NCDs, including cancer.
- 830 000 deaths annually can be attributed to insufficient physical activity (1).
Metabolic risk factors
Metabolic risk factors contribute to four key metabolic changes that increase the risk of NCDs:
- raised blood pressure;
- overweight/obesity;
- hyperglycemia (high blood glucose levels); and
- hyperlipidemia (high levels of fat in the blood).
In terms of attributable deaths, the leading metabolic risk factor globally is elevated blood pressure (to which 19% of global deaths are attributed) (1), followed by raised blood glucose and overweight and obesity.
Prevention and control
One of the most important ways of reducing deaths from noncommunicable diseases (NCDs) is to control the risk factors that lead to their development. These include reducing the use of tobacco and the harmful use of alcohol, maintaining an active lifestyle and consuming a healthy diet. Actions towards these goals are cost-effective ways for countries to reduce the number of NCD deaths. Tackling these risk factors can not only save lives, but also provide a huge economic boost for countries.
Beyond prevention, management of NCDs is critical. This includes detection, screening and treatment of the diseases, as well as palliative care for those in need. The vast majority of premature deaths from NCDs occur in low- and middle-income countries, where universal health coverage or access to health care services is often limited. The development and promotion of universal health coverage is therefore essential in tackling NCDs and working to reduce the number of preventable global deaths.
Surveillance of NCDs is another vital action for providing the information needed for policy and programme development for NCD prevention and control. Tracking and reporting on NCD related global targets and indicators to understand progress in NCD prevention and control are key activities. Accurate data from countries are vital to reverse the global rise in death and disability from NCDs, to support evidence-based decision making, and to help monitor and evaluate the progress being made.