The Health and Economic Benefits of Tackling Non‑Communicable Diseases

Executive summary

Decades of effort have not yet turned the tide on NCDs

Despite decades of national efforts, non-communicable diseases (NCDs) continue to rise. Between 1990 and 2023, the prevalence of cancer and chronic obstructive pulmonary disease (COPD) has increased by 36% and 49% respectively in the OECD (39% and 41% respectively in the 27 Member States of the European Union (EU27, hereafter “EU”)), while the prevalence of cardiovascular diseases (CVDs) has increased by more than 27% (21% in the EU). Diabetes prevalence rose by 86% in the OECD, and 64% in the EU. In 2023, one in ten people in the OECD had diabetes, and one in eight lived with CVD (one in twelve and one in seven respectively in the EU).

The burden of NCDs is increasing, and projected to grow further

There are three main reasons why the prevalence of NCDs continues to grow.

• First, while progress has been made in reducing certain risk factors, such as air pollution, smoking, harmful alcohol consumption, and physical inactivity, this has been undermined by steep increases in obesity.

• Second, improvements in survival rates, an unequivocal public health success, mean that more people live for longer periods with chronic conditions, increasing the demand for care and the complexity of services.

• Third, population ageing means that more people are reaching the ages at which NCDs are most common. Even if risk factor prevalence, survival rates and population size remain constant, the number of new NCD cases is expected to grow by 31% in the OECD (and 29% in the EU) between 2026 and 2050 due to population ageing alone. The prevalence of multimorbidity is expected to rise by 75% in the OECD (70% in the EU) and annual per capita health spending on NCDs is projected to grow by more than 50% in the OECD (54% in the EU).

The economic, social and well-being case for action

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.

Public health amenable NCDs (those preventable through public health interventions) account for more than four in ten premature deaths (i.e. deaths occurring before the age of 75) across OECD and EU countries. In addition to improving physical health, action on NCDs can also improve mental health outcomes, as NCDs have been shown to increase the risk of depression.

The economic opportunities are equally substantial. According to calculations using the OECD Strategic Public Health Planning for Non-Communicable Diseases (SPHeP) NCDs model, if there were no NCDs, health expenditure would be about 40% lower, and average GDP nearly 4% higher, in the OECD and the EU over the next 25 years.

Identifying priorities for maximum impact

The challenge of addressing NCDs is complex, given the multiple risk factors and the wide range of policy entry points. However, clear priorities can be identified by assessing the relative impact of different risk factors on health and the economy, and by benchmarking performance against top performing countries. Applying a Top Quartile scenario, where each country’s risk factor levels and survival rates are aligned to the level in the top performing 25% of OECD and EU countries, shows that:

• Countries can achieve meaningful health and economic gains by addressing NCD risk factors. If all OECD countries reached the Top Quartile levels of NCD risk factors, an ambitious but achievable target, the model estimates that the annual premature mortality would be 11.4% lower, total healthcare expenditure would be 6.2% lower, and the annual GDP would be on average 1.3% higher, on average over the period 2026 to 2050 (11.5%, 4.6% and 1.4% respectively in the EU). For example, across the EU, this would equate to avoiding one premature death every 3.5 minutes and achieving savings in healthcare spending comparable to the entire health budget of Austria.

• Obesity offers the greatest opportunity to reduce the NCD burden in the OECD and EU. Obesity accounts for more than half of the total impact of aligning risk factors to the Top Quartile level in the OECD (42% in the EU). If all OECD countries achieved the performance of the Top Quartile countries in terms of obesity prevalence, the annual number of new NCDs would be 11% lower, premature mortality 5.6% lower, and annual health expenditure 3.3% lower, on average over 2026-2050 (7.0%, 3.6% and 1.6% respectively, for the EU). The annual GDP would also be 0.6% higher on average over the period 2026 to 2050 across the OECD and the EU.

• Prevention drives larger health and economic benefits than cure. Aligning CVD and cancer survival rates in OECD and EU countries to the Top Quartile would together reduce premature mortality by 3.2% annually, on average over the period 2026 to 2050. However, reducing key risk factors such as obesity and smoking to the Top Quartile would have larger impact on premature deaths. Moreover, the economic gains from addressing risk factors are far greater than those achieved through improved survival rates: the impact of reducing obesity prevalence on GDP is more than ten times larger than the impact of increasing CVD survival rates. While improved treatment outcomes are key, addressing the root causes of NCDs delivers broader health and economic gains.

• All countries can achieve major health results by focussing on one or two key priorities. On average across the 51 countries analysed, addressing a country’s leading NCD risk factor delivers around half of the total potential impact on NCD incidence, healthcare expenditure and GDP. Tackling the top two risk factors covers roughly 75%, while the top three account for about 90% of the total.

Successful NCD strategies are based on three interconnected pillars

Although the policy mix 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.

1. Empowering individuals through information and education. Sustained progress depends on individuals having the knowledge, motivation, and skills to make healthier choices. Information, motivation, and behavioural skills should be reinforced across all layers of society, from interpersonal relationships to public policy.

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.

3. Building responsive health systems that deliver prevention and care. Health systems, and primary care in particular, can act across the entire NCD care pathway, not only in curing acute episodes. Primary care providers play a critical role in promoting healthier lifestyle choices, but this potential is often underused. Primary care also plays a central role in promoting screening and early detection, and in providing patient-centred long-term disease management.