Decades of effort have not yet turned the tide on non-communicable diseases (NCDs) in the OECD, where one in eight people lived with cardiovascular disease (CVD), and one in ten with diabetes in 2023. Gains achieved in lowering risk factors such as air pollution and smoking have been outweighed by steep increases in obesity, while population ageing continues to drive up the burden of NCDs.
NCDs profoundly undermine people’s health, well-being and the wider economy. OECD modelling shows that four major NCDs: cancer, cardiovascular diseases, chronic obstructive pulmonary disease (COPD) and diabetes, account for 44% of premature deaths in the OECD and increase the risk of mental ill‑health by up to 25%. Their impact extends beyond health, lowering wages, reducing productivity and increasing pressure on health systems: eliminating these NCDs would reduce health spending by 41% and contribute to an average 3.8% increase in annual GDP over the period 2026 to 2050.
Much of the NCD burden is avoidable, with prevention delivering greater benefits than improvements in disease management, as measured through improvements in survival. For example, aligning key risk factors to the top 25% of OECD and EU countries (Top Quartile) yields substantially larger reductions in premature mortality and stronger economic benefits than improving the management of patients who have already developed cancer or CVDs. If all OECD countries achieved the Top Quartile risk factor levels, the OECD model estimates that GDP would be 1.3% higher and premature mortality would be 11.4% lower, corresponding to almost 495 000 fewer premature deaths annually. By contrast, improvements in patient management aligning both cancer and CVD survival would only reduce premature mortality by 3.2% and increase GDP by 0.1%.
According to OECD analysis, countries can achieve a large majority of the gains associated with reaching Top Quartile performance by focussing on three key country-specific risk factors. On average across the OECD, addressing the country’s leading priority alone, typically tackling obesity, delivers about half of the total potential impact on NCD cases, healthcare expenditure and GDP.
To effectively tackle NCD risk factors, comprehensive strategies are useful to address the full range of underlying determinants. Any successful approach should be anchored in three interconnected pillars: empowering individuals through information and education; shaping environments that make healthier choices easier; and building responsive health systems that deliver both prevention and care.
The benefits of addressing non‑communicable diseases in OECD countries
NCDs are long-lasting health conditions, that typically develop slowly and progress over time. NCDs include cardiovascular diseases (CVDs) (such as chronic heart failure and strokes), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease (COPD)), and diabetes. Despite international commitments, national policy initiatives and health promotion programmes, the burden of NCDs continues to pose a substantial challenge across OECD countries. Between 1990 and 2023, the prevalence of cancer and COPD increased by approximately 36% and 49% respectively in the OECD, while CVD prevalence has risen by more than 27%. Diabetes prevalence rose even more: by 87% in the OECD (GBD Collaborative Network, 2024[1]). As a result, NCDs now represent one of the greatest challenges to population health and to the well-being of societies: in 2023, one in ten people in the OECD had diabetes, and one in eight lived with CVD. NCD risk factors account for a large share of this burden, particularly obesity, which affected nearly one in five adults in the OECD in 2023 (OECD, 2025[2]).
Progress since 2010 on addressing NCD risk factors has been outweighed by rising obesity prevalence in many OECD countries
Risk factor levels are dynamic and influenced by social, cultural and economic factors, including policy action. Analyses using the OECD Strategic Public Health Planning for Non-Communicable Diseases (SPHeP-NCD) model indicate that, at the OECD level, the health gains from reductions in air pollution, smoking, harmful alcohol use and physical activity since 2010 have been completely wiped out by the negative impact of rising obesity and unhealthy diets (Figure 1). As a result, the incidence of new NCD cases has increased relative to a scenario where 2010 risk factor levels persisted. Over the period 2026 to 2050, the model projects an average of 233 677 more new NCDs per year, than if risk factors had remained at their 2010 levels. Had obesity alone remained at 2010 levels, OECD countries would instead see 1 127 303 fewer cases, due to changes across the other risk factors.
Impact of progress on risk factors between 2010 and 2022 on the number of new cases of four major NCDs per year, on average over 2026-2050, for the 38 OECD countries combined
Note: The results compare the annual number of new NCD cases in a scenario where 2022 risk‑factor levels continue against a scenario in which risk‑factor levels remain at their 2010 values. Figures show the average number of new cases per year over 2026-2050. The estimates for physical inactivity and unhealthy diet exclude their effects on body weight, which are captured under obesity. Totals also exclude the small changes in NCD cases that stem from population‑size shifts rather than direct links between risk factors and diseases.
Source: OECD SPHeP NCDs model, 2025.
The future prevalence of NCDs will be driven by several factors. First, risk factor levels in the population, notably obesity, tobacco and air pollution, will play a decisive role in the determining the number of new NCD cases. Second, advances in early detection, treatment, and disease management mean that people live longer with NCDs. While this is an unequivocal public health success, it does mean that there will be more people living with NCDs, increasing the demand for healthcare services. Third, population ageing will continue to increase the NCD burden – across the OECD, the share of the population aged 65 and older increased from 15.7% in 2014 to 18.5% in 2024, and is projected to increase to 26.4% in 2050 (OECD, 2025[2]; OECD, 2025[3]).
Due to these factors, across the OECD, even if risk factor prevalence, survival rates and population size were to remain constant at current levels, by 2050, there would be a:
31% increase in the number of NCD cases;
75% increase in the number of people living with at least two concurrent NCDs;
52% increase in per capita health spending on NCDs.
NCDs affect far more than health outcomes: they influence how people live and work, strain families and communities, and impose a growing burden on health systems and economies. OECD analyses find that, in the OECD:
Forty-four per cent of all premature deaths (i.e. deaths before the age of 75) are attributable to the four NCDs examined, with men facing a 76% higher risk of premature mortality from NCDs than women. Of all premature deaths, 24% are due to cancer, 15% due to cardiovascular diseases, 1% due to diabetes and 3% due to COPD.
Beyond the substantial burden caused by NCD themselves, they also contribute to hundreds of thousands of depression cases, further reducing quality of life. People with NCDs face a 15% to 25% higher risk of developing mental illness depending on the condition, with risks rising even further among those with multiple comorbidities (Everard et al., 2025[4]).
NCDs make up a substantial and increasing share of healthcare expenditure. If the four NCDs covered in the analysis were eliminated, total annual health expenditure would be 41% lower, on average over the period 2026 to 2050.
If there were no NCDs, the workforce would be healthier and more productive, with lower absenteeism and presenteeism, resulting in a gain equivalent to an additional 18 million full-time equivalents (FTEs).
Being in very poor health, such as living with cancer, is associated with a reduction in annual wages of approximately USD PPP 3 300 per capita per year in the OECD (OECD, 2024[5]). This is due to reduced participation in training and subsequent skills acquisition, as well as the psychological impact of very poor health on job performance and career progression.
At the macroeconomic level, reduced premature mortality and increased productivity would translate into a 3.8% boost in annual GDP across the OECD, on average over the period 2026 to 2050, with national gains ranging from 2.4% in France to 5.8% in Korea (Figure 2). The absence of CVDs and COPD contribute 0.9% each respectively, while 1% is due to the absence of cancer and 1.1% due to the absence of diabetes.
Note: Contributions of mortality reduction to GDP here refer to the impact of a larger working age population resulting from the absence of NCDs. Contributions of morbidity reduction contribution refer to the impact on labour productivity – that is, increased likelihood of employment, reduced likelihood of part-time work, and lower absenteeism and presenteeism due to the absence of NCDs. For further information on the GDP model see the SPHeP model documentation, http://oecdpublichealthexplorer.org/ncd-doc/, and the main report, OECD (2026[6]), The Health and Economic Benefits of Tackling Non-Communicable Diseases, https://doi.org/10.1787/e20cbbc3-en.
Source: OECD SPHeP NCDs model, 2025.
To improve health, economic and societal outcomes, there are different levels at which policy can act. Primary prevention aims to stop diseases before they occur, by promoting healthier lifestyles and reducing environmental risks. Once a disease has already developed, the focus should shift to secondary and tertiary prevention, which consist of identifying the disease early and treating it promptly and effectively, to prevent complications or death.
The OECD identified priority areas for action by assessing the impact of aligning the prevalence of NCD risk factors and the quality of care to levels observed in the top 25% of OECD and EU countries for each age and sex group (Top Quartile1).
Results from this analysis show that, while action is needed on both fronts, comprehensive primary prevention efforts to promote healthier lifestyles are likely to generate a larger impact on population health and the economy than investments aimed at enhancing quality of care to improve survival among those who become ill.
Improving the management of CVD and cancer to align survival rates in OECD countries to the Top Quartile would together reduce annual premature NCD mortality by about 3.2%, increase the workforce by 225 000 FTEs, and boost GDP by approximately 0.1%, on average over the period 2026 to 2050 (Figure 3).
However, investing in primary prevention to align key risk factors to the Top Quartile yields larger gains. Relative to maintaining current prevalence levels, reducing obesity alone would, on average over 2026‑2050, lower annual premature mortality by 5.6%, expand the workforce by 4.5 million FTEs and boost GDP by 0.6%. Aligning smoking prevalence would reduce premature mortality by 2.1%, increase the workforce by 733 000 FTEs and increase GDP by 0.2%.
NCD cases prevented (thousands and as a percentage of total new NCD cases), premature NCD deaths avoided (thousands and as a percentage of total premature deaths), health expenditure saved (USD PPP billions and as a percentage of total health expenditure), workforce output increase (full-time equivalents), GDP increase (% of GDP), if all countries achieve the Top Quartile level for each risk factor and for CVD and cancer survival rates, total for EU countries, per year, average over 2026‑2050
Note: Cancer and CVD survival reflect improvements in diseases management, whereas the other indicators capture gains arising from reduced risk‑factor prevalence through prevention and health promotion. The results compare a business-as-usual scenario to one in which countries achieve the Top Quartile risk factor prevalence or survival rates. Cases of NCDs and premature mortality are disease‑specific, while the impact on health expenditure, workforce output and GDP is a combined effect of the risk factor on all diseases (e.g. including the effects on other diseases like dementia and alcohol use disorders and including comorbidity effects) and on productivity. The increase in health expenditure shown for improved survival rates represent the increased cost of people living with NCDs for longer and does not include any expenditure required to improve the survival rates. CVDs and cancer account for 90% of deaths from NCDs, and survival rates for COPD and diabetes were therefore not considered. In this figure, percentages are calculated using OECD-wide totals, capturing the total impact across OECD countries rather than a simple average of country-level effects.
Source: OECD SPHeP NCDs model, 2025.
This difference arises from several key reasons. First, risk factors also have a direct influence on productivity and economic performance through their links with reduced employment and work productivity. Second, behavioural and metabolic risk factors affect multiple diseases simultaneously, so their improvement has a wider impact on overall health. Finally, as survival rates are already relatively similar across countries, aligning to the Top Quartile survival rate only delivers limited additional gains. In other words, there is less left to gain. As a result, tackling risk factors produces broader benefits for both public health and the economy than improving survival rates alone.
All countries can achieve major results by focussing on one or two key NCD and risk factors priorities
If OECD countries were to achieve the current Top Quartile prevalence across all six risk factors (i.e. air pollution, alcohol, diet, obesity, physical activity and smoking) starting in 2026, then on average over 2026-2050 across the OECD, compared to current projections:
There would be 6.2 million fewer new NCD cases per year
Annual premature mortality (i.e. deaths below the age of 75) would be 11.4% lower, corresponding to almost 495 000 fewer premature deaths annually across the OECD
Total annual health expenditure would be 6.3% lower
The workforce would gain 7.6 million full-time equivalents (FTEs)
Annual GDP would be 1.3% higher
Comprehensive efforts to promote healthy lifestyles are essential to ensure good health for all. However, OECD analyses show that a substantial share of the benefits from risk-factor prevention can be achieved by focussing on two or three key priority risk factors. On average across OECD countries, addressing the country’s leading priority alone, typically obesity, delivers about half of the total potential impact on cases, healthcare expenditure and GDP. Tackling the top two covers nearly 75%, while the top three account for almost 90% of the total. For premature mortality, which is affected by both risk factor and survival rates, addressing the top two priorities generates approximately half of the impact on average. For most OECD countries, and consistently across indicators, preventing the onset of NCDs through healthier lifestyles ranks more prominently among the top three priorities than improving cancer or CVD survival (Figure 4).
Proportion of the total impact – arising from bringing all risk factor prevalence and CVD and cancer survival rates to the Top Quartile level – that is achieved by the top three priority areas
Note: Improved survival rates do not affect the indicator on cases of NCDs and increase healthcare cost as people live longer with these conditions. Categories are shown in order of their relative importance in the country. In this figure, the OECD average reflects the overall impact of addressing shared priorities across countries, which results in a lower value than the average of country-specific priorities.
Source: OECD SPHeP NCDs model, 2025.
Focusing solely on the highest-priority risk factor would still yield substantial health and economic gains. If all countries in the OECD were to achieve the Top Quartile obesity prevalence, over 2026-2050 total NCD incidence would fall by 11%, equivalent to about half (51%) of the 6.7 million NCD cases that could be avoided each year by aligning all risk factors to the Top Quartile level, the majority of which would be cardiovascular diseases. Premature mortality would decrease by 5.6%, and total health expenditure by 3.3%, on average over 2026-2050. Workforce output would increase by the equivalent of 4.5 million full-time workers and annual GDP would increase by 0.6% on average.
While focussing on the risk factors where the largest health and economic gains can be achieved is important given the growing burden of NCDs and strain on health systems, this should not lead to neglecting other risk factors that may have a smaller impact but still carry significant consequences for certain population groups. Action should also address less prevalent risk factors, which may still have profound effects on individuals, families, and communities. A balanced strategy should therefore combine population-level prioritisation with targeted interventions for vulnerable or high-risk groups. There may also be other societal co-benefits from addressing certain risk factors (Box 1). Similarly, while most gains may come from strengthening primary prevention, investment in secondary and tertiary prevention remains essential to ensure timely access to care and better outcomes and quality of life for those already affected by disease.
Healthier diets would reduce emissions by the equivalent of 58 million cars in the OECD
There are strong links between diets and emissions of carbon dioxide (CO2), methane (CH₄), and nitrous oxide (N₂O). About one‑third of all anthropogenic (human-caused) emissions linked to food systems (Crippa et al., 2021[7]). In the Top Quartile scenario, where consumption rates of meat, fruit, vegetable and whole grain are aligned to the best 25% of countries across the OECD and EU, this is estimated to reduce emissions by 243 Mt of CO2‑equivalent per year, for the OECD as a whole. This is the amount of emissions associated with more than 58 million gasoline‑powered passenger vehicles (US EPA, 2023[8]) or the number of cars in Germany and the Netherlands combined.
Addressing harmful alcohol use could prevent 5% of premature deaths due to homicide and road traffic accidents in the OECD
Harmful alcohol use has a direct impact on societal safety, as it can lead to road traffic accidents and violence due to its effects on cognitive function, co‑ordination, and behaviour. If all countries were to align alcohol consumption to the level observed in the best performing 25% of OECD and EU countries, this would prevent a total of 5 367 premature deaths due to road traffic accidents per year in the OECD. This is 4.8% of the total premature mortality from road traffic accidents. It would also prevent 2 358 premature deaths due to interpersonal violence each year in the OECD, 4.8% of the total premature mortality from this cause. Variation between countries is driven both by current alcohol consumption and premature mortality rates.
Source: OECD SPHeP NCDs model, 2025.
Although the mix of actions will differ across countries depending on their specific risk factor profiles and health priorities, there are three interlinked pillars that underpin all successful NCD strategies: empowered individuals, supportive environments, and responsive health systems. These three pillars are mutually reinforcing. Empowering individuals with information and education is critical, but its impact is amplified when the environment around people makes healthier choices the easier, more affordable, and more accessible ones. At the same time, even the most informed and motivated individuals may need support from a responsive health system to detect problems early and prevent complications. In turn, primary care plays a crucial role in providing individuals with information and education.
Pillar 1: Empowering individuals through information and education
Sustained progress depends on individuals having the knowledge, motivation, and skills to make healthier choices. Information should go beyond simply raising awareness of risks, by fostering motivation through personal and social incentives, and equipping people with the skills to translate intentions into action. Information, motivation, and behavioural (IMB) skills should be reinforced across all layers of society, from interpersonal relationships to public policy. The IMB model (Fisher and Fisher, 1992[9]) has been used extensively since its conception to improve health, including improving patient self-management of COPD (Chen et al., 2025[10]) and diabetes (Gao et al., 2013[11]), as well as health promotion behaviours, such as exploring the smoking cessation needs of patient living with diabetes (Grech, Norman and Sammut, 2024[12]) and to explain differences in physical activity levels among patients (Ferrari et al., 2021[13]).
Concrete actions can include sharing practical health information within families and peer groups, strengthening education efforts in schools and workplaces, and supporting community‑based campaigns that resonate locally. Social norms, role models and collective initiatives can further reinforce motivation. Practical skills can then be developed through group activities, workshops or accessible digital tools that guide everyday healthy behaviours.
Pillar 2: Creating environments that support healthier choices
Environments where people live, work, and learn strongly influence their risk of NCDs. Policies that create health-promoting environments, by reducing barriers, addressing the impact of social, environmental, economic, commercial and market factors, and making healthier options more accessible, are therefore key to supporting behaviour change and shifting social norms.
Many policies to promote healthy behaviours also contain an element of education and information. For example, food and menu labelling provide nutritional information at the point of purchase, helping consumers make more informed food choices. Most policies return more in economic benefits than they cost to implement, with some returning more than USD 5 for every USD 1 invested (Figure 5) (OECD, 2019[14]; OECD, 2021[15]).
Benefit-cost ratios, in USD returned in GDP benefits for every USD invested in the policy, for interventions that only focus on information, and policies which combine information and environmental changes
Note: In this context, “environment” refers to the setting in which the interventions take place, such as school, workplace and community settings. Estimates are calculated by dividing the increase in GDP produced by the intervention on average over the period to 2050 by the cost of implementing the intervention in the countries analysed. Diet related interventions were analysed in 36 OECD countries, while interventions targeting harmful alcohol use interventions were analysed in selected EU and G20 countries in addition to OECD countries. For more details see OECD (2019[14]) and OECD (2021[15]). Interventions with a comparatively lower impact on GDP (and effectiveness on population health) may have a higher return of investment if they have a low implementation cost. This list provides only examples of evaluated interventions and is not intended to be exhaustive.
Source: OECD (2019[14]), The Heavy Burden of Obesity: The Economics of Prevention, https://doi.org/10.1787/67450d67-en; OECD (2021[15]), Preventing Harmful Alcohol Use, https://doi.org/10.1787/6e4b4ffb-en.
Pillar 3: Building responsive health systems that deliver prevention and care
Health systems need to be engaged across the entire NCD care pathway, not only in treating acute episodes. In particular, primary care providers have significant potential to deliver preventive care, by promoting healthier behaviours and addressing risk factors early. Yet this potential remains underused, with OECD analysis showing that, among people aged 45 and over who visited their primary care practice, fewer than one‑third of daily drinkers received counselling on harmful alcohol use and only about half of daily smokers received cessation advice (OECD, 2025[16]). The health system also plays a central role in screening and early detection, helping identify conditions such as cancer or chronic kidney disease before they progress. Once diagnosed, patient-centred long-term management in primary care is essential, through co-production of health and co‑ordination of care.
Read the full report:
OECD (2026), The Health and Economic Benefits of Tackling Non-Communicable Diseases, OECD Health Policy Studies, OECD Publishing, Paris, https://doi.org/10.1787/e20cbbc3-en.
Find out more about OECD’s work on public health:
References
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[7] Crippa, M. et al. (2021), “Food systems are responsible for a third of global anthropogenic GHG emissions”, Nature Food, Vol. 2/3, pp. 198-209, https://doi.org/10.1038/s43016-021-00225-9.
[4] Everard, C. et al. (2025), “Exploring the relationship between non-communicable diseases and depression”, OECD Health Working Papers, No. 178, OECD Publishing, Paris, https://doi.org/10.1787/02a1cfc5-en.
[13] Ferrari, M. et al. (2021), “The information-motivation-behavioral skills model explains physical activity levels for adults with type 2 diabetes across all weight classes”, Psychology, health & medicine, Vol. 26/3, pp. 381-394, https://doi.org/10.1080/13548506.2020.1749292.
[9] Fisher, J. and W. Fisher (1992), “Changing AIDS-risk behavior.”, Psychological Bulletin, Vol. 111/3, pp. 455-474, https://doi.org/10.1037/0033-2909.111.3.455.
[11] Gao, J. et al. (2013), “Validation of an information–motivation–behavioral skills model of self-care among Chinese adults with type 2 diabetes”, BMC Public Health 2013 13:1, Vol. 13/1, pp. 100-, https://doi.org/10.1186/1471-2458-13-100.
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[12] Grech, J., I. Norman and R. Sammut (2024), “Exploring the smoking cessation needs of individuals with diabetes using the Information-Motivation-Behavior Skills model”, Tobacco prevention & cessation, Vol. 10/February, pp. 1-13, https://doi.org/10.18332/tpc/181366.
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[3] OECD (2025), OECD Historical Population Data and Projections Database, 2025, https://data-explorer.oecd.org/ (accessed on 16 March 2026).
[5] OECD (2024), Tackling the Impact of Cancer on Health, the Economy and Society, OECD Health Policy Studies, OECD Publishing, Paris, https://doi.org/10.1787/85e7c3ba-en.
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[14] OECD (2019), The Heavy Burden of Obesity: The Economics of Prevention, OECD Health Policy Studies, OECD Publishing, Paris, https://doi.org/10.1787/67450d67-en.
[8] US EPA (2023), Greenhouse Gas Equivalencies Calculator, https://www.epa.gov/energy/greenhouse-gas-equivalencies-calculator#results (accessed on 30 November 2023).
Contact
OECD Public Health (✉ health.contact@oecd.org).
← 1. For each risk factor, cancer and CVD, the Top Quartile represents the prevalence or survival rate observed in the best-performing 25% of countries in the OECD and EU for each specific age, sex and category.