Table of Contents
Introduction
The Article Talks about a plan called Healthy Longevity Initiative published in the recent report of The World Bank called Unlocking the Power of Healthy Longevity tackles a rising global health issue: as people live longer, chronic diseases like heart disease, cancer, diabetes, and respiratory illnesses are becoming the primary causes of death, especially in low- and middle-income countries (LMICs). With ageing populations in these regions, deaths due to these non-communicable diseases (NCDs) are expected to increase dramatically—from 61 million in 2023 to 92 million by 2050. This rise will create an overwhelming demand on healthcare systems for hospital beds and long-term care. The World Bank predicts that with proactive and practical health policies, millions of lives could be saved annually by 2050, which would also help LMICs meet key health targets.
The report proposes a plan called the Healthy Longevity Initiative (HLI), which aims to help people remain healthy throughout their lives by reducing preventable deaths and illnesses, especially as they get older. This approach encourages a healthcare system that makes quality care accessible, with well-trained and compassionate healthcare providers, well-equipped hospitals, and an emphasis on early detection and treatment of chronic diseases. However the report notes that achieving these goals may be difficult for many LMICs, where resources are often limited, and healthcare systems face challenges like underfunding and corruption. This is particularly true in India, a country where these barriers are especially high.
India’s Challenges with Aging and Healthcare
India has the world’s second-largest elderly population, with around 140 million people aged 60 and above. This older population is growing three times faster than the overall population, which is putting more pressure on healthcare. Older adults in India face high rates of NCDs, which not only cause health issues but also create financial strain for families and increase healthcare costs, slowing economic growth. The government has to balance addressing both NCDs and infectious diseases, which is a heavy fiscal burden.
In India, NCDs now account for the majority of deaths, and the numbers keep rising. NCDs were responsible for 40% of all deaths in 1990, and that number is projected to reach 75% by 2030. The leading NCDs—heart disease, cancer, respiratory disease, and diabetes—cause about half of all deaths in the country. Factors like smoking, alcohol use, poor diet, and lack of exercise play a significant role in this rise, especially in rural areas where healthcare access is limited, making it harder for people to receive early treatment.
The Role of Social Security and Healthcare Programs
Social security schemes like pensions offer some support for older adults, helping them cover some of the costs of healthcare. In India, healthcare is often expensive, so hospital visits are unavoidable for NCD treatment. Unfortunately, travel costs, doctor’s fees, and medications result in large out-of-pocket expenses, leaving many families in debt. Health insurance could ease this burden, but it’s underutilized due to confusing eligibility requirements, delays in claim processing, and claim rejections.
Ayushman Bharat, an insurance scheme launched in India, aims to provide health coverage for the poorest 40% of families. However, funding challenges, eligibility rules and reports of corruption limit the program’s effectiveness. In 2023, a report by the Comptroller and Auditor General of India found that Ayushman Bharat has been hampered by widespread issues, including long delays in hospital approvals, surgeries marked as performed post-discharge, and irregularities in beneficiary eligibility. This prevents many eligible families from getting quality care.
Diet, Lifestyle, and the Growing NCD Burden
Diet and lifestyle habits are major contributors to the rise in NCDs. In India, high consumption of refined grains, excess rice intake, and frequent consumption of red meats have been linked to higher risks of diabetes and heart disease. As prices for fat-dense foods like oil and sugar rise, access to healthier food options becomes more difficult, leading to an increase in obesity and lifestyle-related health issues. Additionally, diabetes and heart disease become more common with age due to factors like sedentary lifestyles, high-calorie diets, and genetic predisposition, especially in India where diabetes often appears earlier and at lower body weights than in Western countries.
Private Healthcare Costs and Regulation
Private hospitals in India often charge high prices, making healthcare unaffordable for many families. To address this, the Supreme Court of India recently asked the government to set fair price limits on medical procedures, with the hope of making healthcare more affordable. However, without strong enforcement, this price control may only have a temporary effect.
The Importance of Behavioral and Policy Changes
Aside from healthcare improvements, the report stresses that lifestyle changes are crucial to preventing NCDs. Habits like smoking, consuming high-calorie diets, and not exercising enough contribute to obesity and increase the risk of diseases like diabetes and heart disease. Tobacco reduction policies and education on healthy lifestyles could help, though they require broad community support and effective government policies to encourage lasting change. Taxes on unhealthy products, such as sugary foods and tobacco, may also motivate people to make healthier choices.
Conclusion
The World Bank report emphasizes that as populations age, both healthcare improvements and lifestyle changes are necessary to manage the rising burden of chronic diseases. However, it also acknowledges that these changes will take time, investment, and collaboration across all levels of society. Whether these policy reforms will be fully implemented remains uncertain, but addressing these challenges is essential for a healthier future.
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