How will the main risk factors contribute to the burden of non-communicable diseases under different scenarios by 2050? A modelling study.

Marion Devaux,Andrea Ricci,David Cantarero,Susanne Giesecke,Sara Baiocco,Aliénor Lerouge,Giovanna Giuffre,Bruno Ventelou,Michele Cecchini,Francisco Reyes

doi:10.1371/journal.pone.0231725

Abstract

BackgroundThe future burden of non-communicable diseases (NCDs) depends on numerous factors such as population ageing, evolution of societal trends, behavioural and physiological risk factors of individuals (e.g. smoking, alcohol use, obesity, physical inactivity, and hypertension). This study aims to assess the burden of NCDs in Europe by 2050 under alternative scenarios.MethodsThis study combines qualitative and quantitative forecasting techniques to examine how population health in Europe may evolve from 2015 to 2050, taking into account future societal trends. Four scenarios were developed (one business-as-usual scenario, two response scenarios and one pessimistic scenario) and assessed against ‘best’ and ‘worst’-case scenarios. This study provides quantitative estimates of both diseases and mortality outcomes, using a microsimulation model incorporating international survey data.FindingsEach scenario is associated with a different risk factor prevalence rate across Europe during the period 2015–2050. The prevalence and incidence of NCDs consistently increase during the analysed time period, mainly driven by population ageing. In more optimistic scenarios, diseases will appear in later ages, while in the pessimistic scenarios, NCDs will impair working-age people. Life expectancy is expected to grow in all scenarios, but with differences by up to 4 years across scenarios and population groups. Premature mortality from NCDs will be reduced in more optimistic scenarios but stagnate in the worst-case scenario.InterpretationPopulation ageing will have a greater impact on the spread of NCDs by 2050 compared to risk factors. Nevertheless, risk factors, which are influenced by living environments, are an important factor for determining future life expectancy in Europe.

Highlights

In the coming decades, countries will continue to experience an increase in the burden of noncommunicable diseases (NCDs), which is associated with considerable medical and non-medical costs
Population ageing will have a greater impact on the spread of non-communicable diseases (NCDs) by 2050 compared to risk factors
For Cardiovascular diseases (CVD), the incidence of disease will increase in all scenarios; the number of CVDs will increase by 50% in Central-Eastern Europe, by 98% in Northern Europe and by 100% in Southern Europe, with the variation across scenarios ranging from 26% to 36% depending on the region

Summary

Introduction

Countries will continue to experience an increase in the burden of noncommunicable diseases (NCDs), which is associated with considerable medical and non-medical costs. A large share of NCDs are preventable through the reduction of four behavioural risk factors (RFs): tobacco use, physical inactivity, harmful use of alcohol, and unhealthy diet [3]. The future health outlook will depend heavily on how major societal trends–e.g. migration, technology, economy, urbanisation, climate change, agriculture, citizen empowerment, and equity–improve or deteriorate peoples’ living environment, and how this may increase, or mitigate, the growth of NCDs. The future burden of non-communicable diseases (NCDs) depends on numerous factors such as population ageing, evolution of societal trends, behavioural and physiological risk factors of individuals (e.g. smoking, alcohol use, obesity, physical inactivity, and hypertension). This study aims to assess the burden of NCDs in Europe by 2050 under alternative scenarios

Objectives

Methods

Results

Conclusion