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Experts are fast realising that mid-life death and disability caused by cardiovascular diseases -- CVDs -- have disastrous consequences on families who lose wage earners, resulting in loss in productivity.
This adversely affects the nation's economy and national development, they say.
A study conducted by the Earth Institute at Columbia University -- in collaboration with India, South Africa, Russia and Brazil -- reveals that many CVD-related deaths in India occur at a younger age compared to the West and this will result in a loss of 17.9 million years of potential productive years of life (PPYLL) by 2030, imposing a huge burden on the country's economy.
India lost $198 million on account of payroll losses due to CVDs related deaths in the 35- to 64-year age group in the workforce in 2000. About 35 per cent of all CVD deaths in India in the next 26 years will occur in the productive workforce, reports say.
"Over the past 40 years, the prevalence of CVD in urban India has increased by about 10 per cent among people in the age group of 35 to 64 years. But it is still viewed by many as a disease of the elderly, one without much economic impact."
"But available data clearly shows that early premature deaths due to CVD have a major effect on the PPYLL which in turn puts lot of economic burden," says Dr K Srinath Reddy, Professor and Head of Cardiology, All India Institute of Medical Science, New Delhi.
"While fighting communicable disease such as AIDS and malaria is crucial, we must not forget to address these other potentially devastating and preventable conditions. For instance, in India, about 5 million people die of CVDs each year and as any as 28 per cent of the deaths occur among people less than 65. These premature deaths in the workforce have adverse effect on the households," says Dr Reddy, who headed the Indian chapter of Earth Institute's study.
"Another study has found that when there is a death of an adult member in a family, a child of less than two years has a 12-fold higher probability of death," he says, adding that the risk factor profile portends a major rise in deaths and disability due to CVDs in Indian workforce in the next two decades, perhaps much more than estimated by the study.
According to the Earth Institute study, there is increasing evidence that lower middle class and urban poor are becoming highly vulnerable to CVD as the epidemic advances in the country.
"Additionally poor patients with CVD are likely to be marginalised and their increasing numbers, as the CVD epidemic matures, will probably lead to great inequalities in healthcare. Furthermore, there would be serious implications for women, who have fewer opportunities to access care in a gender-based culture," Reddy says.
"The rate of CVD deaths must be checked otherwise the growth rate projected for India in next 20 years is going to be affected drastically," he adds.
Recent studies suggest that higher income levels are relatively protective against heart attacks, in comparison to lower incomes in urban areas, the report says.
About the way out, Dr Reddy says prevention of an economic epidemic due to CVD warrant changes at several levels. "There is need to bring behavioural, social, political and economic will to forge such changes among individuals, communities, health systems and health policy makers. We should, therefore, recognise and include prevention of CVD as part of the primary health care strategy," he says.
Recommending simple intervention which can reduce the risk of CVD at mass level, Dr Reddy says, "Experience in Finland, Poland, Mauritius and other countries has demonstrated that dietary changes in the population can have profound effect on CVD mortality and CVD risk factor levels."
"In Mauritius, government action to substitute soybean oil for palm oil as the subsidised, rationed oil resulted in a remarkable reduction in cholesterol levels. Changes in economic policy that increased the availability of fresh fruits and vegetables and helped to substitute vegetable fats for animal fats led to a sharp decline in mortality from cardiovascular cases in Poland," he explains.
"Such changes require both policy level interventions (agriculture production, pricing and distribution) as well as altered consumer behaviour (choice of healthy foods). Policy level interventions (for tobacco control, healthy nutrition and urban design for physical activity) are essentially important," he adds.