Summary

(August 2012) Noncommunicable diseases (NCDs) such as heart disease, cancer, diabetes, and lung disease are no longer only a problem for wealthy countries. These former "diseases of affluence" are now the leading causes of death in all the world's regions except sub-Saharan. And NCDs kill people earlier in poorer countries: The toll NCDs are taking (measured by years of life lost) on people ages 60 and older in low- and middle-income countries is much greater than for people in high-income countries.

This newsletter highlights some of the recent research by National Institute on Aging-supported investigators and others that can inform policies and programs to prevent, delay, and treat NCDs.

Disease Patterns: Higher education and income levels have been associated with better health and longer lives in high-income countries, but researchers are finding different patterns in low- and middle-income countries. Studies suggest that behaviors associated with urban living and economic development—including sedentary lifestyles and high-fat and high-calorie diets—may blunt or erase the health advantages conferred by education and income in low- and middle-countries. Also, a growing body of evidence suggests that poor conditions suffered early in life may be contributing to rapid increases in NCDs in low- and middle-income countries.

Risk Factors: Compared with older adults in high-income countries, older adults in low- and middle-income countries may have had lower levels of exposure to NCD risk factors such as smoking, sedentary lifestyles, and processed foods associated with urban living. But there is evidence that countries may go through a "lifestyle transition," as people adopt and then later abandon unhealthy behaviors, with richer and better-educated people at the forefront of the changes. In the wake of economic development and urbanization, NCDs may become concentrated among those with lower education and income.

Health Care: The volume and complexity of the prolonged health care needs of older adults with NCDs will challenge the health care systems of low- and middle-income countries. According to the World Health Organization, low- and middle-income countries do not appear to be successfully treating people with even the most common risk factor for NCDs—high blood pressure. While the share of older people with high blood pressure ranged from 32 percent to 78 percent in the six countries tracked in the Study on Global Ageing and Adult Health, only between 4 percent to 14 percent were receiving effective treatment. Given that rising levels of NCDs will take a heavy toll not only on human health and well-being but also on economic growth and development, researchers urge governments, civil society, and the private sector to commit to combating these diseases.