Development equalizes the bad health of the planet

Noncommunicable diseases such as cancer or heart disease cause 71% of deaths worldwide.

While the world keeps a guarded eye on pandemics like covid, monkeypox, avian influenza or HIV, the majority of deaths all over the globe are actually caused by noncommunicable diseases like cancer and heart disease. More specifically, these are the causes behind 71% of all deaths, as stated in the World Health Organization’s latest report.

Out of 41 million lost lives, heart disease represents almost 44% of deaths (around 18 million), followed by oncologic pathologies (9 million), respiratory diseases (3.9 million) and diabetes (1.6 million deaths if induced by obesity), according to WHO.

Merely 150 years ago, infectious diseases –tuberculosis, malaria, dysentery, the flu and others caused by bacteria, viruses and fungi– were the reason behind the majority of passings in the planet. However, “developing countries find themselves in a transition: they are moving from communicable diseases on to noncommunicable ones”, says Andrés Íñiguez, president of the Spanish Heart Foundation (Fundación Española del Corazón), who highlights that heart disease is the leading cause of death in countries like Spain, “also in women”.

And this trend is growing rapidly. According to findings by Index Mundi –an organization that compiles statistical data– only in 25 out of 180 countries analyzed in 2019 did communicable and perinatal diseases cause more than 50% of total deaths. In 2010 the number of nations in this same situation was up to 39. In both years, the countries with most deaths attributed to communicable diseases belonged to Africa, a continent that at the end of the last century added the impact of HIV to the infections it considered “traditional”.

This shift in the group of most deathly diseases comes down to two main factors. The decrease in death by contagious disease can be explained through breakthroughs like water purification, antibiotics and other biocides and vaccines. And the increase of communicable diseases has one determining factor: aging, accompanied by a change in daily habits.

If we look at the improvement in our life expectancy, this is a positive change for humankind because it leads to a continuously longer average life. Íñiguez explains: “mortality [caused by noncommunicable disease] experiences a general decrease thanks to better treatment options, but there is an increase in morbidity [number of affected people]”.

Enriqueta Felip, president of the Spanish Society of Medical Oncology (Sociedad Española de Oncología Médica), agrees but remarks that there are two relevant aspects in this generalized evolution. The first being inequality in treatment access. This is what the oncologist defines as the postcode impact, a phenomenon used to explain that places with a higher income have a lower mortality rate because there is better access to new treatments. And if this is the case in countries like Spain, the gap gets even wider between rich and poor countries, or within the latter, adds Íñiguez.

The impact of this change in habits –a process that could qualify as an occidentalizing of diets and lifestyles– has a clear effect in different cancers, heart disease and obesity, which underlies diabetes. The incidence of these conditions “is increasing in our countries and in those less developed”, states Alberto Lecube, vice-president of the Spanish Society for the Study of Obesity (Sociedad Española para el Estudio de la Obesidad – SEEDO), and this “has to do with changes” spread due to economic development, “much like sedentariness”.

And there is yet another threat that keeps gaining prominence, even though it might not cause as many deaths. As manifested by the covid pandemic, there is a worldwide deficit of attention for people with mental health issues, points out Marina Díaz, department head at the Hospital Clínico de Madrid. Díaz considers that these disorders impact countries more evenly, regardless of their level of development. She also considers that “the increase of cases is accompanied by a low mortality rate. There are patients with very serious diagnoses that can lead a normal life thanks to our existing treatments”.

All specialists agree that in many cases there is a simple rule to reduce the impact of noncommunicable diseases: not smoking, drinking as little alcohol as possible, following a good diet and exercising. However, these habits are hard to put into practice.

Furthermore, there is one thing that cannot be forgotten: regardless of what we do, humans are mortal by definition. The goal is to meet our end as late as we can and in the best possible conditions.