Publication: The Economic Impact on Households and Nations of NCDs : A Review of Existing Evidence
Loading...
Files in English
1,691 downloads
Published
2011-09-14
ISSN
1081-0730
Date
2013-05-07
Author(s)
Editor(s)
Abstract
In developing countries, the noncommunicable disease (NCD) and risk factor burdens are shifting toward the poor. Treating chronic diseases can be expensive. In developing countries where generally much health care costs are borne by patients themselves, for those who live in poverty or recently escaped severe poverty, when faced with large, lifelong out-of-pocket expenses, impoverishment persists or can reoccur. These patterns have implications for national economic growth and poverty-reduction efforts. NCDs can change spending patterns dramatically and result in significantly reducing non–medical-related spending on food and education. In India, about 40% of household expenditures for treating NCDs are financed by households with distress patterns (borrowing and sales of assets). NCD short- and long-term disability can lead to a decrease in working-age population participation in the labor force and reduce productivity and, in turn, reduce per capita gross domestic product growth. To fully capitalize on the demographic dividend (i.e., aging of the population resulting in less dependent children, not yet more dependent elderly, and greater national productivity), healthy aging is necessary, which, in turn, requires effectively tackling NCDs. Last, from an equity standpoint, the economic effect of NCDs, evident at the household level and at the country level, will disproportionately affect the poor and vulnerable populations in the developing world.
Link to Data Set
Digital Object Identifier
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication The Economic Effect of Noncommunicable Diseases on Households and Nations : A Review of Existing Evidence(2011)In developing countries, the noncommunicable disease (NCD) and risk factor burdens are shifting toward the poor. Treating chronic diseases can be expensive. In developing countries where generally much health care costs are borne by patients themselves, for those who live in poverty or recently escaped severe poverty, when faced with large, lifelong out-of-pocket expenses, impoverishment persists or can reoccur. These patterns have implications for national economic growth and poverty-reduction efforts. NCDs can change spending patterns dramatically and result in significantly reducing non?medical-related spending on food and education. In India, about 40% of household expenditures for treating NCDs are financed by households with distress patterns (borrowing and sales of assets). NCD short- and long-term disability can lead to a decrease in working-age population participation in the labor force and reduce productivity and, in turn, reduce per capita gross domestic product growth. To fully capitalize on the demographic dividend (i.e., aging of the population resulting in less dependent children, not yet more dependent elderly, and greater national productivity), healthy aging is necessary, which, in turn, requires effectively tackling NCDs. Last, from an equity standpoint, the economic effect of NCDs, evident at the household level and at the country level, will disproportionately affect the poor and vulnerable populations in the developing world.Publication Capitalizing on the Demographic Transition : Tackling Noncommunicable Diseases in South Asia(World Bank, 2011-06-02)This book looks primarily at Cardio Vascular Disease (CVD) and tobacco use because they account for a disproportionate amount of the Non Communicable Disease (NCD) burden the focus is strategic rather than comprehensive. It considers both country and regional level approaches for tackling NCDs, as many of the issues and challenges of mounting an effective response are common to most South Asian countries. The prevention and control of NCDs constitute a development issue that low-income countries in South Asia are already facing. Both country and regional-level strategies are important because many of the issues and challenges of mounting an effective response to NCDs are common to most South Asian countries, even though their disease burden profiles vary. Hence, the rationale for this book is that strategic decisions for prevention and treatment of NCDs can effectively address the future burden of disease, promote healthy aging, and increase the potential benefit from the demographic transition, thus contributing to economic development. This book's goal is to encourage countries to develop, adopt, and implement effective and timely country and regional responses that reduce the population-level risk factors and NCD disease burden.Publication The Economic Burden of Cancers on Indian Households(Public Library of Science, 2013-08-12)We assessed the burden of cancer on households’ out-of-pocket health spending, non-medical consumption, workforce participation, and debt and asset sales using data from a nationally representative health and morbidity survey in India for 2004 of nearly 74 thousand households. Propensity scores were used to match households containing a member diagnosed with cancer (i.e. cancer-affected households) to households with similar socioeconomic and demographic characteristics (controls). Our estimates are based on data from 1,645 households chosen through matching. Cancer-affected households experienced higher levels of outpatient visits and hospital admissions and increased out-of-pocket health expenditures per member, relative to controls. Cancer-affected households spent between Indian Rupees (INR) 66 and INR 85 more per member on healthcare over a 15-day reference period, than controls and additional expenditures (per member) incurred on inpatient care by cancer-affected households annually is equivalent to 36% to 44% of annual household expenditures of matched controls. Members without cancer in cancer-affected households used less health-care and spent less on healthcare. Overall, adult workforce participation rates were lower by between 2.4 and 3.2 percentage points compared to controls; whereas workforce participation rates among adult members without cancer were higher than in control households. Cancer-affected households also had significantly higher rates of borrowing and asset sales for financing outpatient care that were 3.3% to 4.0% higher compared to control households; and even higher for inpatient care.Publication The Economic Implications of Non-Communicable Disease for India(World Bank, Washington, DC, 2010-01)This report contributes to the literature on the economic implications of non-communicable disease (NCDs) in developing countries by focusing on the case of India. First, the authors examine available evidence on the economic impact of NCDs in India. Second, the authors present new estimates of impact of NCDs, both on household economic well being as well as on aggregate economic outcomes in India. India is a worthwhile case to study for many reasons, beginning with the large numbers involved. In the year 2004, an estimated 8.1 million Indians died from all causes. Based on WHO data on the distribution of deaths by cause, estimated deaths from non-communicable conditions (including injuries) amounted roughly to 4.8 million, or about 59.4 percent of all deaths in the year. Moreover, about 24 percent of these deaths from non-communicable conditions occurred in the 35-64 age groups as per data from medically certified deaths from hospitals located in urban areas of India. Available data also indicate that 34 percent of all injury-related deaths occurred among individuals in the 35-64 year age group. India's population is also ageing over time, an issue of concern given the higher incidence of NCDs in older age groups. All of these developments are occurring in a setting where health expenditures are growing rapidly led by an unregulated private sector and where health insurance and pension coverage are still limited. These financial concerns are further exacerbated by the emerging evidence that the India's poor are at heightened risk of acquiring NCDs owing to high rates of smoking and tobacco use, occupational risks, and residential living conditions.Publication Tackling Noncommunicable Diseases in Bangladesh : Now is the Time(Washington, DC: World Bank, 2013-08-21)This report is organized in such a way that the key policy options and strategic priorities are based on the country context, including the burden of non-communicable diseases (NCDs) and associated risk factors and the existing capacity of the health system. Chapter one describes the country and regional contexts and the evidence of the demographic and epidemiological transitions in Bangladesh; chapter two outlines the disease burden of major NCDs, including the equity and economic impact and the common risk factors; chapter three provides an assessment of the health system and its capacity to prevent and control major NCDs; chapter four summarizes ongoing NCD interventions and activities in Bangladesh and highlights the remaining gaps and challenges; and chapter five presents key policy options and strategic priorities to prevent and control NCDs.
Users also downloaded
Showing related downloaded files
Publication Global Economic Prospects, January 2025(Washington, DC: World Bank, 2025-01-16)Global growth is expected to hold steady at 2.7 percent in 2025-26. However, the global economy appears to be settling at a low growth rate that will be insufficient to foster sustained economic development—with the possibility of further headwinds from heightened policy uncertainty and adverse trade policy shifts, geopolitical tensions, persistent inflation, and climate-related natural disasters. Against this backdrop, emerging market and developing economies are set to enter the second quarter of the twenty-first century with per capita incomes on a trajectory that implies substantially slower catch-up toward advanced-economy living standards than they previously experienced. Without course corrections, most low-income countries are unlikely to graduate to middle-income status by the middle of the century. Policy action at both global and national levels is needed to foster a more favorable external environment, enhance macroeconomic stability, reduce structural constraints, address the effects of climate change, and thus accelerate long-term growth and development.Publication Global Economic Prospects, June 2025(Washington, DC: World Bank, 2025-06-10)The global economy is facing another substantial headwind, emanating largely from an increase in trade tensions and heightened global policy uncertainty. For emerging market and developing economies (EMDEs), the ability to boost job creation and reduce extreme poverty has declined. Key downside risks include a further escalation of trade barriers and continued policy uncertainty. These challenges are exacerbated by subdued foreign direct investment into EMDEs. Global cooperation is needed to restore a more stable international trade environment and scale up support for vulnerable countries grappling with conflict, debt burdens, and climate change. Domestic policy action is also critical to contain inflation risks and strengthen fiscal resilience. To accelerate job creation and long-term growth, structural reforms must focus on raising institutional quality, attracting private investment, and strengthening human capital and labor markets. Countries in fragile and conflict situations face daunting development challenges that will require tailored domestic policy reforms and well-coordinated multilateral support.Publication The Container Port Performance Index 2023(Washington, DC: World Bank, 2024-07-18)The Container Port Performance Index (CPPI) measures the time container ships spend in port, making it an important point of reference for stakeholders in the global economy. These stakeholders include port authorities and operators, national governments, supranational organizations, development agencies, and other public and private players in trade and logistics. The index highlights where vessel time in container ports could be improved. Streamlining these processes would benefit all parties involved, including shipping lines, national governments, and consumers. This fourth edition of the CPPI relies on data from 405 container ports with at least 24 container ship port calls in the calendar year 2023. As in earlier editions of the CPPI, the ranking employs two different methodological approaches: an administrative (technical) approach and a statistical approach (using matrix factorization). Combining these two approaches ensures that the overall ranking of container ports reflects actual port performance as closely as possible while also being statistically robust. The CPPI methodology assesses the sequential steps of a container ship port call. ‘Total port hours’ refers to the total time elapsed from the moment a ship arrives at the port until the vessel leaves the berth after completing its cargo operations. The CPPI uses time as an indicator because time is very important to shipping lines, ports, and the entire logistics chain. However, time, as captured by the CPPI, is not the only way to measure port efficiency, so it does not tell the entire story of a port’s performance. Factors that can influence the time vessels spend in ports can be location-specific and under the port’s control (endogenous) or external and beyond the control of the port (exogenous). The CPPI measures time spent in container ports, strictly based on quantitative data only, which do not reveal the underlying factors or root causes of extended port times. A detailed port-specific diagnostic would be required to assess the contribution of underlying factors to the time a vessel spends in port. A very low ranking or a significant change in ranking may warrant special attention, for which the World Bank generally recommends a detailed diagnostic.Publication The Container Port Performance Index 2020 to 2024: Trends and Lessons Learned(Washington, DC: World Bank, 2025-09-22)The Container Port Performance Index (CPPI) provides a global benchmark of how container ports perform in handling vessel calls. Developed jointly by the World Bank and S&P Global Market Intelligence, it measures the time ships spend in port and relates this to the number of containers moved during that time. This approach makes the CPPI a unique diagnostic tool that can highlight patterns in port operations and shed light on global and regional supply chain dynamics. Now in its fifth edition, the CPPI report covers the period from 2020 to 2024. It builds on a well-established methodology to generate scores for more than 400 container ports worldwide. Over time, the CPPI has become a trusted reference point for policymakers, industry stakeholders, and researchers who seek to understand how ports adapt to shocks, recover from disruptions, and identify opportunities for investments, reform and modernization. A major innovation in this edition is the introduction of multi-year trend analysis. Rather than presenting annual snapshots, the report now tracks how CPPI scores have changed across five years. This longitudinal perspective reveals shifts in port performance, showing where scores have risen, fallen, or remained stable. By linking these movements to external factors, the CPPI offers insights into how global and regional supply chains evolve under pressure. The results clearly mirror the crises that have shaken global trade. During the COVID-19 pandemic, CPPI scores in different regions declined sharply as congestion, equipment shortages, and delays overwhelmed many ports. By 2023, global averages rebounded in parallel with easing freight markets and reduced congestion. Yet 2024 brought new challenges: the Red Sea crisis disrupted major trade lanes, while climate-related constraints at the Panama Canal added further stress. These shocks were reflected in lower global and several regional average scores, underscoring the vulnerability of maritime transport to geopolitical and environmental events. The CPPI is not about comparing one port against another, but about understanding changes in performance over time. Ports that improved their scores often did so by reducing time at anchor, optimizing berth operations, investing in digital tools, and strengthening coordination across logistics partners. The evidence confirms that improvements are possible across ports of all sizes, and that rising scores are linked to deliberate actions to minimize time in port relative to containers moved. By consolidating five years of results, this edition transforms the CPPI into a long-term reference point. It shows how global crises have affected shipping, how different regions have adapted, and what lessons can be drawn for future resilience. The World Bank and S&P Global Market Intelligence remain committed to maintaining the CPPI as a global public good, providing transparency, comparability, and practical insights to support more reliable and sustainable maritime supply chains.Publication Digital Progress and Trends Report 2023(Washington, DC: World Bank, 2024-03-05)Digitalization is the transformational opportunity of our time. The digital sector has become a powerhouse of innovation, economic growth, and job creation. Value added in the IT services sector grew at 8 percent annually during 2000–22, nearly twice as fast as the global economy. Employment growth in IT services reached 7 percent annually, six times higher than total employment growth. The diffusion and adoption of digital technologies are just as critical as their invention. Digital uptake has accelerated since the COVID-19 pandemic, with 1.5 billion new internet users added from 2018 to 2022. The share of firms investing in digital solutions around the world has more than doubled from 2020 to 2022. Low-income countries, vulnerable populations, and small firms, however, have been falling behind, while transformative digital innovations such as artificial intelligence (AI) have been accelerating in higher-income countries. Although more than 90 percent of the population in high-income countries was online in 2022, only one in four people in low-income countries used the internet, and the speed of their connection was typically only a small fraction of that in wealthier countries. As businesses in technologically advanced countries integrate generative AI into their products and services, less than half of the businesses in many low- and middle-income countries have an internet connection. The growing digital divide is exacerbating the poverty and productivity gaps between richer and poorer economies. The Digital Progress and Trends Report series will track global digitalization progress and highlight policy trends, debates, and implications for low- and middle-income countries. The series adds to the global efforts to study the progress and trends of digitalization in two main ways: · By compiling, curating, and analyzing data from diverse sources to present a comprehensive picture of digitalization in low- and middle-income countries, including in-depth analyses on understudied topics. · By developing insights on policy opportunities, challenges, and debates and reflecting the perspectives of various stakeholders and the World Bank’s operational experiences. This report, the first in the series, aims to inform evidence-based policy making and motivate action among internal and external audiences and stakeholders. The report will bring global attention to high-performing countries that have valuable experience to share as well as to areas where efforts will need to be redoubled.