Capitalizing on the Demographic Transition

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Figure 2.5 Age Structure in Maldives b. 2025 male

female

15

5 5 percentage

15

80–84 60–64 40–44 20–24 0–4

age group

80–84 60–64 40–44 20–24 0–4

male

15

5 5 percentage

age group

a. 2000 female

15

Source: U.S Census Bureau, http://www.census.gov/ipc/www/idb/ (accessed February 20, 2011).

In 2004, NCDs accounted for 77.4 percent of the total burden of forgone DALYs, with the remainder from communicable diseases and MCH issues. Of the total DALY burden, CVD accounts for 9.7 percent, mental health 18.7 percent, cancer 10.6 percent, respiratory diseases 2.7 percent, diabetes 2.4 percent, and injuries 14.6 percent. NCDs account for 74.5 percent of all deaths with CVD (26.1 percent) the leading cause followed by cancer (24.0 percent), respiratory diseases (6.4 percent), and diabetes (5.2 percent). Injuries account for 12.9 percent of total deaths. Key NCDs trends include the following: • CVD. This is the leading cause of mortality and contributed to 45 percent of all deaths in 2003. • Diabetes. Diabetes affects 7.1 percent of men and 6.8 percent of women. • Obesity. Approximately 13 percent are obese (body mass index >30 kg/m2) and its prevalence is twice as high in women (17 percent) as in men (9 percent). The prevalence of obesity increases with age: approximately 50 percent of women over 35 years old are overweight or obese. • Injuries. Among all injuries, road traffic injuries account for 2.3 percent of total deaths and 2.8 percent of total DALYs. • Thalassaemia. Thalassaemia is a major public health problem. One out of every six persons is a carrier for thalassaemia, and the country has the highest incidence of the disease in the world. • Smoking. Prevalence is among the highest in South Asia (males 45 percent, females 12 percent), while smoking prevalence among youth is lower than in most other countries (9 percent for boys, 3 percent for girls).

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Capitalizing on the Demographic Transition

Published on Aug 18, 2011

World Bank Publications

Increasing life expectancy in South Asia is resulting in a demographic transition that can, under the right circumstances, yield dividends through more favorable dependency ratios for a time. With aging, the disease burden shifts toward noncommunicable diseases (NCDs) which can threaten healthy aging. However, securing the gains expected from the demographic dividend—where developing countries’ working and nondependent population increases and per capita income thus rises— is both achievable and affordable through efficiently tacking NCDs with prevention and control efforts. This book looks primarily at cardiovascular disease (CVD) and tobacco use since they account for a disproportionate amount of the NCD burden—the focus is strategic, rather than comprehensive. The goal of this book is to encourage countries to develop, adopt, and implement effective and timely country and, where appropriate, regional responses that reduce both population-level risk factors and the NCD burden.