NCDs are the leading cause of death across OECD and EU countries and impose a substantial burden that extends well beyond mortality. NCDs reduce quality of life, drive long-term disability, and place sustained pressure on health systems through ongoing treatment and care needs. They also have wide‑ranging social and economic consequences, contributing to premature mortality, poorer mental health, and widening inequalities, including marked gender gaps linked to differential exposure to risk factors. NCDs weaken labour markets by reducing employment, working hours and productivity through absenteeism, presenteeism and early retirement, thereby constraining economic growth. The cumulative impact on health expenditure and economic output is large, highlighting that NCDs are not only a public health challenge but also a major economic one. Sustained and effective action to prevent and better manage NCDs should therefore be seen as an investment in population well-being, economic performance and health system resilience.
The Health and Economic Benefits of Tackling Non‑Communicable Diseases
Abstract
The economic and societal burden of NCDs
NCDs are the leading cause of death in OECD and EU countries, responsible for six to seven in ten deaths. Yet their impact extends far beyond mortality. NCDs are chronic illnesses that reduce quality of life, cause long-term disability, increase healthcare spending, and weaken economic productivity. Understanding these broader social and economic consequences is essential for policymakers to justify sustained investment in prevention and management. Preventing NCDs is not only a public health priority but also an economic strategy that can produce significant returns through healthier populations, stronger economies, and more resilient health systems.
NCDs are a major cause of premature mortality (defined as deaths before age 75). The public health amenable NCDs covered in the OECD SPHeP NCDs model account for 44% of premature deaths across the OECD and 46% in the EU. Cancers and cardiovascular diseases together account for about 40%.
The burden is heavier among men, who engage in more risky behaviours such as smoking, harmful alcohol use, and being overweight. In the OECD, the premature death rate from NCDs for men is 162 per 100 000, which is 77% higher than the rate for women at 92 per 100 000. In the EU, the premature death mortality rate from NCDs is almost twice as high for men compared to women.
Beyond physical illness, NCDs also take a major toll on mental health. OECD analysis shows that people with NCDs are significantly more likely to develop depression, even after accounting for factors such as age, income, and lifestyle. The risk rises sharply with multimorbidity: those with one NCD have a 21% higher likelihood of depression, two NCDs raise the risk by 42%, and three or more increase it by 50%.
NCDs also impose a heavy and sustained financial burden on health systems, because they are long-term conditions requiring continuous treatment and management. Health expenditure over the next 25 years would be about 40% lower if there were no NCDs, equivalent to USD PPP 2.2 trillion annually across the OECD and USD PPP 561 billion in the EU. This total spending equals roughly the entire GDP of Italy.
NCDs reduce employment rates, working hours, and productivity through absenteeism, presenteeism, and early retirement. When these effects are aggregated, the labour force of OECD countries effectively loses the output of 18 million full-time workers to NCDs, while the EU loses the equivalent of 5 million workers.
Premature mortality, reduced employment, and lower productivity all weaken economic growth. Overall, annual GDP would be nearly 4% higher across the OECD and EU on average over the period 2026 to 2050 if there were no NCDs. Each of the four major NCD groups, cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes, accounts for roughly one‑quarter of this total economic loss.
NCDs are the main cause of mortality in the OECD and the EU (OECD, 2025[1]). In 2023, more than six in ten deaths in the OECD were due to CVDs, cancer, diabetes or COPD, and nearly seven in ten in the EU (Global Burden of Disease Collaborative Network, 2024[2]). But their burden goes well beyond mortality: NCDs cause long-term disability, reduce quality of life, increase healthcare costs, and lower economic productivity.
For policymakers, understanding the wider economic and societal impact of NCDs is vital to making the case for sustained investment in the prevention and treatment of NCDs. By quantifying the economic, social and well-being costs, policymakers can make the case that prevention is not only a health imperative but also a sound investment: effective measures on NCDs can yield substantial returns in the form of healthier populations, stronger economies, and more resilient health systems.
NCDs are a major cause of premature mortality, defined as deaths before the age of 75 (OECD/Eurostat, 2022[3]). Premature mortality reduces life expectancy, but it also puts a significant psychological and financial strain on households and communities. The four NCDs covered in the OECD SPHeP NCDs model (Chapter 2, Box 2.1) account for an estimated 44% of premature mortality across the OECD (46% in the EU), with cancers and cardiovascular diseases alone account for around 40% (Figure 3.1). This burden is even greater among men (Box 3.1). When all cancers and CVDs are considered, the four NCDs accounted for 62% of all premature deaths in the OECD in 2023 (70% in the EU) (IHME, 2025[4]).
Premature mortality (deaths in people under the age of 75) due to public health amenable cancers, CVDs, diabetes and COPD, as a percentage of total premature mortality, average over 2026‑2050
Note: the results compare premature mortality in a business-as-usual scenario to one in which the four NCDs are eliminated, and reflect the change in premature deaths from NCDs, averaged over 2026-2050. As the OECD SPHeP NCDs model focusses on public health-amenable conditions, it does not cover all cancers and CVDs. Therefore, the premature mortality burden presented is an underestimation of the total premature mortality burden from those diseases. In this figure, EU, OECD and G20 averages are reported as simple (i.e. unweighted) means across member countries.
Source: OECD SPHeP NCDs model, 2025.
In addition to biological factors, men and women have different risk profiles for NCDs due to differences in behaviours. Men are generally more likely to engage in risky behaviours such as smoking and harmful alcohol use, and they are more prone to being overweight. While women are more likely to be insufficiently physically active, the difference with their male counterparts is relatively small (OECD, 2025[1]; WHO, 2025[5]).
As a result, men experience a higher burden of NCDs than women. The premature mortality rate from NCDs for men is 162 per 100 000 in the OECD, 77% higher than that of women at 92 per 100 000 (Figure 3.2). Almost every country sees this same trend, the only exception being Peru. In the EU, the premature death mortality rate from NCDs is almost twice as high for men compared to women, with some variation depending on NCDs. For instance, premature mortality is almost 40% higher in men than women for cancer, and 71% higher for diabetes.
Premature mortality (deaths in people under the age of 75) due to public health amenable cancers, CVDs, diabetes and COPD combined, rate per 100 000 population, average over 2026‑2050
Note: the results compare premature mortality in a business-as-usual scenario to one in which the four NCDs are eliminated, and reflect the change in premature deaths from NCDs, averaged over 2026-2050. As the OECD SPHeP NCDs model focusses on public health-amenable conditions, it does not cover all cancers and CVDs. Therefore, the premature mortality burden presented is an underestimation of the total premature mortality burden from those diseases. In this figure, EU, OECD and G20 averages are reported as simple (i.e. unweighted) means across member countries.
Source: OECD SPHeP NCDs model, 2025.
NCDs also contribute to declines in mental health and diminishes overall quality of life. OECD analysis of SHARE data shows that – even when adjusting for confounders such as age, sex, socio-economic status, country, smoking status, and frequency of alcohol consumption – people with NCDs were more likely to go on to develop depression than people without NCDs (Everard et al., 2025[6]). People with cancer or diabetes have a 15% increased risk of developing depression, 17% for heart failure, 21% for stroke and 25% for chronic lung disease. Moreover, the data shows that the risk increased with the number of NCDs. While people with one NCD have a 21% increase in the risk of depression, people with two NCDs have an 42% increased risk, and people with three or more NCDs a 50% increased risk of depression. It is estimated that the presence of NCDs contributes to hundreds of thousands of cases of depression in the OECD and EU every year.
There are several biological, psychological and social factors that can explain a potential causal relationship between NCDs and depression (Everard et al., 2025[6]). Psychologically and socially, loss of sense of self, social isolation from fatigue and lack of energy that drive loss of pursuit of normal activities, limitations to mobility, activities of daily living and chronic pain have all been associated. Fear and uncertainty of the incurable and unpredictable nature of certain NCDs contribute, as do beliefs about their NCDs and ability to self-manage their NCD. Biologically, neurodegeneration associated with certain NCDs and side effects of treatments can also play a role. An inverse relationship is also plausible, with depression increasing the risk of NCDs, for example by reducing motivation to exercise.
Non-communicable diseases place a sustained and growing burden on health systems because they are largely chronic conditions that require long-term management rather than short-term treatment. The costs of ongoing medication, regular monitoring, hospital care for complications, and the need for specialised services such as oncology or dialysis all drive up health expenditure.
If there were no NCDs, health expenditure would be 41% lower over the next 25 years (40% in the EU) (Figure 3.3). This adds up to a total of USD PPP 2.2 trillion annually across the OECD (USD PPP 561 billion in the EU) – equivalent to the total GDP of Italy. Despite cancer being a costly disease to treat at a case‑by-case basis, health expenditure on CVDs is greater, due to their large prevalence and lower mortality (meaning people live with the disease for longer, requiring ongoing care).
The impact of NCDs on overall health expenditure, in USD PPP per capita and as a percentage of total health expenditure, per year, average over 2026‑2050
Note: the results compare healthcare expenditure in a business-as-usual scenario to one in which the four NCDs are eliminated, and reflect the change in healthcare expenditure averaged over 2026-2050. The cost per disease shown here should not be interpreted as treatment cost of the disease. The model includes competing diseases, meaning that eliminating one disease leads to people living longer and developing other diseases. Moreover, the model includes comorbidity cost. In this figure, EU, OECD and G20 averages are based on using simple (i.e. unweighted) means of the per capita healthcare expenditure in USD PPP of the member countries in each grouping.
Source: OECD SPHeP NCDs model, 2025.
Through their impact on the size of the workforce, unemployment, part-time work, absenteeism, presenteeism and early retirement, NCDs reduce a country’s workforce participation and productivity. OECD analysis has shown that, adjusted for confounders, men and women with diabetes are 10% and 12% less likely to be employed compared to people without diabetes, respectively. Men and women with cancer who are in employment work on average 92% and 81% of the full-time equivalent, respectively, compared to 95% and 83% for men and women without any NCDs. When it comes to absenteeism, women with chronic lung disease have a 2.4% increased absence as a proportion of their usual hours worked, compared to women without chronic lung disease. Men with heart disease have a 3.2% increased absenteeism compared to men without.
Combining these effects, the labour force output of OECD and EU countries loses the equivalent of 18 million and 5 million full-time workers to NCDs, respectively (Figure 3.4).
Reduction in workforce output due to NCDs, including employment (combining unemployment and part-time work), absenteeism, presenteeism, and early retirement, full-time equivalents (FTE) per 100 000 working age population, average over 2026‑2050
Note: the results compare the effective size of the workforce in a business-as-usual scenario to one in which there are no NCD. In this figure, EU, OECD and G20 averages are reported as simple (i.e. unweighted) means across member countries.
Source: OECD SPHeP NCDs model, 2025.
At the macroeconomic level, the combined effects of premature mortality and lower productivity weaken economic growth and the gross domestic product (GDP). It is estimated that, on average across the OECD and the EU, the annual GDP will be nearly 4% lower due to the consequences of NCDs (Figure 3.5). All four NCDs have a considerable impact on GDP, each accounting for about a quarter of the impact.
The reduction in annual GDP due to NCDs, as a percentage of GDP, on average over 2026‑2050
Note: The results compare the GDP in a business-as-usual scenario to one in which the four NCDs are eliminated, and reflect the change in the annual GDP, averaged over 2026-2050. In this figure, EU, OECD and G20 averages are reported as simple (i.e. unweighted) means across member countries.
Source: OECD SPHeP NCDs model, 2025.
References
[6] 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.
[2] Global Burden of Disease Collaborative Network (2024), Global Burden of Disease Study 2023 Results, https://vizhub.healthdata.org/gbd-results/. (accessed on 17 October 2025).
[4] IHME (2025), GBD Results Tool, http://ghdx.healthdata.org/gbd-results-tool (accessed on 4 September 2025).
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[3] OECD/Eurostat (2022), Avoidable mortality: OECD/Eurostat lists of preventable and treatable causes of death (January 2022 version), https://www.oecd.org/health/health-systems/Avoidable-mortality-2019-Joint-OECD-Eurostat-List-preventable-treatable-causes-of-death.pdf?_ga=2.68722321.1471485303.1679671412-417290248.1637500244 (accessed on 24 March 2023).
[5] WHO (2025), WHO Global Health Observatory, World Health Organization, https://www.who.int/data/gho.