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An Epidemic of Chronic Diseases – The REAL Threat



Now that we have examined the real threat posed by Corona virus, without the usual hype and fear mongering associated with it, in my previous blog, let’s move on to examine the much ignored and rarely hyped, but ever growing, real danger posed to us, individually and collectively, by the epidemic of chronic lifestyle diseases, the real threat to our health, wealth and wellbeing. Let’s start by examining the facts


Heart Disease

  • According to WHO, Cardio Vascular Diseases (CVDs) are the No. 1 cause of death globally accounting for 31.8% i.e. 17.8 M of global deaths, expected to go up to 23.6 M by 2030.

  • In the US CVDs are No. 1 cause of death accounting for 1 in every 4 deaths, 647,000 Americans lives each year, killing 1 person every 37 seconds

  • In India too CVDs are No. 1 cause of death accounting for 28% of deaths, expected to go up to 35.9% by 2030. In 2016, 2.8M Indians died from CVDs.




Cancer

  • According to estimates from the International Agency for Research on Cancer (IARC), in 2018 there were 17 M new cancer cases and 9.5 M cancer deaths worldwide. By 2040, these are expected to grow to 27.5 Million new cancer cases and 16.3 M cancer deaths.

  • According to WHO cancer is the 2nd leading cause of death accounting for 17% of the deaths globally. WHO has warned that the world may witness a 60% increase in cancer cases over the next two decades, with an 81% increase happening in low and middle-income countries, if the current trend continues.

  • Cancer is the 2nd leading cause of death in the US accounting for 21% of the American deaths. In 2020, there will be an estimated 1.8 M new cancer cases diagnosed and 606,520 cancer deaths in the US

  • India has some of the highest cancer rates in the world. According to WHO, International agency for research on Cancer, 1.15M new cancer cases were diagnosed (with 5-year total cases being 2.25M) and 784,821 died from cancer in 2018 in India.

  • One in every 10 Indians will develop cancer and one in every 15 will die of the disease according to the WHO.


Diabetes

  • According to International Diabetic Federation, in 2019 ~463M adults (20-79 years) were living with diabetes; by 2045 this is expected to rise to 700M

  • Globally 1 in 5 of people above 65 have diabetes; 1 in 2 (232M) have undiagnosed diabetes; Diabetes caused 4.2M deaths and 374M people are at increased risk of developing type 2 diabetes

  • In India Diabetes is the fastest growing disease for 16 years leading upto 2016. 72 M cases recorded in 2017, expected to nearly double to 134 M by 2025.

  • India currently represents 49% of the world’s diabetes burden. Diabetes prevalence has increased by 64% across India over the quarter-century, according to a November 2017 report by ICMR

  • More than 100M U.S. adults are now living with diabetes or prediabetes, according to a 2017 CDC report



Diabetes dramatically increases the risk of heart disease, stroke, cancer and Alzheimer’s. It compromises our immunity and increases the risk of a horde of infectious diseases, including Covid19


Chronic Respiratory Disease


Chronic respiratory disease refers to a group of lung conditions that block the airflow and cause breathing-related issues. These diseases include: chronic obstructive pulmonary disease (COPD), bronchitis, emphysema, asthma and so on

  • About 65 M people suffer from COPD and 3 M die from it each year, making it the third leading cause of death worldwide.

  • About 334 M people suffer from asthma, the most common chronic disease of childhood affecting 14% of all children globally.

  • COPD was the second highest cause of death in India after heart disease in 2017, killing 1 M Indians

  • According to CDC, these diseases are the 4th major cause of death in the US accounting for over 160,000 deaths in 2017


Obesity


Obesity has emerged as a global epidemic of massive proportions with serious implications for our health and wellbeing. It’s is a key risk factor for a range of chronic diseases like diabetes, heart disease, chronic kidney disease and cancer. As obesity has become more common, so has the toll from these diseases.

Globally, according to WHO

  • obesity has nearly tripled since 1975.

  • In 2016, more than 1.9 B (39%) adults were overweight. Of these over 650 M (13%) were obese.

  • 40 M children under the age of 5 were overweight or obese. Over 340 M children and adolescents aged 5-19 were overweight or obese.

In the US, according to CDC,

  • The prevalence of obesity overall increased from 30.5% in 1999–2000 to 42.4% in 2017–2018

  • The prevalence of obesity was 40% among young adults (20 t0 39 years), 44.8% among middle aged adults (40 to 59 years) and 42.8% among older adults (60+)

  • The prevalence of obesity was 18.5% (~13.7 M) among children and adolescents. It was 13.9% among 2 to 5 year-olds, 18.4% among 6 to 11 year-olds, and 20.6% among 12 to 19 year-olds.

In India, according various studies

  • The prevalence of overweight and obesity is increasing faster than the world average.

  • Prevalence of overweight is expected to more than double among adults (20–69 years) between 2010 and 2040, while the prevalence of obesity will triple. Prevalence of overweight and obesity is expected to reach 30.5% and 9.5% among men, and 27.4% and 13.9% among women, respectively, by 2040

  • Childhood overweight and obesity combined prevalence is estimated to be 19.3%. It’s a worrying trend on a rapid upward trajectory



Obesity now kills 4M people worldwide, more than car crashes, terror attacks, and Alzheimer’s combined, concludes a new study, largest of its kind, covering 195 countries, published in New England Journal of Medicine

Childhood obesity is growing faster than adult obesity, the US rate is one of the worst.


Apart from the above, several other chronic lifestyle diseases like auto-immune and Alzheimer’s have been increasingly making their presence felt globally.


And striking them young


The global trends shows, that unlike Covid19, over the years we have been witnessing the onset of these chronic lifestyle diseases at a younger and younger age.

A 2018 study by American Heart Association involving 28,000 people hospitalized for heart attacks across the country from 1995 to 2014 showed that 30% of these patients were young, age 35 to 54. Heart attacks were increasingly striking the young, from 27% at the start of the study to 32% at the end. Among women having heart attacks, the increase in young patients went from 21% to 31%

According to a study published in Journal of Clinical & Diagnostic Research in 2016 Coronary Artery Disease (CAD) occurs at a younger age in Indians, with over 50% of CAD mortality occurring in individuals aged less than 50. One-fourth of all acute Myocardial Infarctions (MIs) are reported in patients below 40.


Projections suggests that by 2015, 62 M Indians will have CAD of which 23 M are expected to be below 40.


A study titled ‘Emerging cancer trends among young adults in the USA published in the Lancet published in 2019 concluded that from 1995 to 2014 out of 14.6 M reported cases for 30 types of cancer, incidence significantly increased for 6 obesity-related cancers in young adults (25–49 years), with steeper rises in successively younger generations.

About 80,000 young adults aged 20 to 39 are diagnosed with cancer and about 9,000 of them die from cancer each year in the US. About 4% of all cancers are diagnosed in people in this age range. Cancer is the 4th leading cause of death in the US in this age group, behind only accidents, suicide, and homicide.


“Breast cancer is now occurring increasingly in younger age groups in India when compared with western countries and a more aggressive nature of the disease strikes Indian women in their reproductive period.” Clinical Cancer Investigation Journal, 2014


In India, about 5.8% of all cancer cases registered are in those aged 15 to 29 years in most urban cancer registries.

According to the Canada Journal of Diabetes, type 2 diabetes in children has increased in frequency around the world over the past two decades.



An unparalleled crises that dwarfs Covid19


Globally these Chronic diseases are becoming widely prevalent, growing rapidly and wreaking havoc with people’s health and wellbeing, accounting for 60-70% of the deaths, and striking younger and younger people. Further once they strike, by and large, it’s a lifelong affliction, requiring constant and ever-increasing medication with serious long-term side effects; which again leads to more medication and more side effects thus creating a vicious cycle; destroying our immunity and making us vulnerable to any and all kinds of diseases. These also account for ever increasing public health costs worldwide, having a huge economic impact – directly and indirectly, bankrupting many families and creating havoc in our societies.



Why then the tepid response?


Then how come this epidemic which has spread its tentacles across the globe and become a monstrous threat to our health, wealth and wellbeing is not treated as a crisis, as an emergency, requiring absolutely urgent and comprehensive action to tackle it. How come the media which is going into a frenzy on Covid19, is hardly paying attention to these diseases that have assumed horrendous epidemic proportions, are striking our young, causing large scale premature deaths and ruining health on such a massive scale – that the Corona impact and deaths pale into insignificance in comparison. How come the Governments, academia and health care industry are not seized of the matter the same was as Covid19? Isn’t it strange to say the least?


But irrespective of how the Govts, media and health care industry are reacting, can we as individuals and communities and societies afford to be complacent and ignore this looming threat to our life, health and wellbeing? Aren’t these diseases preventable? Or are they purely genetic, as some would have us believe? Are they reversible? If yes, what do we need to do, in our own interest, to prevent and/or reverse these chronic diseases?


These are the questions I want address in my next blog.


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