A few days before my last post and still about the UN High Level Meeting on Prevention and Control of Non-communicable Diseases, The Economist issued a daily chart showing that non-communicable diseases (NCDs) account for the majority of deaths worldwide. I copy the chart below:

I have nothing to add about the chart on the left (except I don’t think stacked bars are really useful to visually distinguish between quantities ; ok, I added something). My first reaction to the chart on the right was: these countries in the lower middle income group should really do something to tackle non communicable diseases: they represent more than the double amount of deaths than the total number of deaths in other income groups. Even for communicable diseases, they should do something: from the chart, it seems to be a bit less than 10m deaths from communicable diseases, i.e. approximately the same amount as the total number of deaths in other income groups too!

Just for you information (and because I also had to recall which countries were in that lower middle income group), here are some countries in the various groups (*):

• Low income group: Afghanistan, Bangladesh, Ethiopia, North Korea, Nepal, Somalia, Togo, a.o.
• Lower middle income group: Angola, Bolivia, Congo, Georgia, India, Iraq, Morocco, Pakistan, Sudan, Ukraine, Vietnam, a.o.
• Upper middle income group: Algeria, Brazil, China, Cuba, Libya, Malaysia, Russian Federation, Serbia, South Africa, Thailand, a.o.
• High income group: E.U. countries, Japan, Singapore, Switzerland, USA, a.o.

(*) Technically it follows the way the World bank classifies countries: economies are divided according to 2010 GNI per capita, calculated using the World Bank Atlas method. The groups are: low income, $1,005 or less; lower middle income, $1,006 – $3,975; upper middle income, $3,976 – $12,275; and high income, $12,276 or more.

Then you realize that if you just take the absolute number of deaths and compare these group of countries (as it’s done in the chart on the left), you don’t compare exactly on the same basis. What if some groups have more countries or lower/higher population? What if the total surface of countries in one group are much higher (lower) than in other groups? Idem for the population density, etc.

Fortunately, the WHO has a parameter one can use in order to objectivize a little bit this issue: the “Age-standardized mortality rate by cause (per 100 000 population)”. If you plot this parameter in the same way as above, you obtain this chart:

From this you can now say that low income countries should really do something about NCDs but also communicable diseases, etc.

Presented like this, the number of deaths due to injuries and communicable diseases (per 100,000 pop.) decreases if the income of the country increases. In other word, more income you have, relatively less risk you have to die from injuries or communicable diseases. That explains why 1 death under a fallen wall is reported as a big sad news in Belgium while 60 deaths in a bus crash are not even reported in the news in India.

Another striking conclusion is that in low income countries there is approximately the same number of deaths (per 100,000 pop.) due to NCDs and due to communicable diseases (+/- 20%). We are all aware of tuberculosis, malaria, AIDS/HIV, etc. in less rich countries but it seems NCDs are an equally important issue.

But the most frightful conclusion from these numbers is that there is approximately the same number of deaths (per 100,000 pop.) due to NCDs in all income groups (674 ± 75) except the high income one. In other words, irrespective of you location or your income (except high income), you have the same chances to be affected by a non communicable disease. And irrespective on your income (and this time, even for high income countries), you have more chances to die from a non communicable disease than a communicable disease.

Ways to mitigate risk factors for NCDs (end of previous post) are still on.

N.B. WHO numbers are from 2008 for both charts.