WHO measures true scale of inequality in chronic illnesses

NON-communicable diseases account for three-quarters of deaths worldwide but affect different population groups in different ways, a World Health Organisation study shows.

In its biggest-ever look at inequality in health and non-communicable diseases (NCDs), WHO studied the top four killers — cancer, cardiovascular diseases, chronic respiratory diseases and diabetes.

It also looked at the five main risk factors driving them — tobacco use, alcohol consumption, obesity, unhealthy diets, physical inactivity and air pollution.

The report then scanned this across differences in NCD burden, prevention and care — by age, gender, economic status, education, place of residence, disability status, employment and migration status.

"This is the first effort to systematically measure inequalities in NCDs and their risk factors on a global scale," says Ahmad Reza Hosseinpoor, who leads the WHO's health inequality monitoring team.

"The findings show which populations are being left behind."

NCDs cover eight of the top 10 causes of death, with cardiovascular diseases the biggest killer by far, claiming almost 20 million deaths a year.

The 10 years of national data, collected between 2013 and 2022, confirm that socio-economic status influences health at every stage — from initial exposure to risk factors, through to diagnosis, treatment and disease management.

For example, the report found that in low- and middle-income countries, less educated populations suffer higher rates of hypertension and diabetes.

Cervical cancer screening rates are very low among the poorest and least-educated women, while tobacco use remains higher among less-educated men than among more educated men.

Looking at geographical factors, the study found that people in rural areas have significantly more limited access to hypertension diagnosis and cancer screening.

Gender and age also play a role. Men with hypertension are diagnosed and treated less frequently than women, even though they consume more tobacco and alcohol.

Conversely, obesity is more common among women, particularly in developing countries.

The study confirms that social marginalisation, disability and migrant status were significant factors contributing to increased risk.

The United Nations' health agency urges governments to raise health-related taxes on tobacco, alcohol and sugary drinks — measures that are particularly effective among low-income populations.

Countries are also encouraged to tailor insurance schemes or subsidies for underserved communities and to incorporate inequality indicators into their national health systems. — AFP