How will the main risk factors contribute to the burden of non-communicable diseases under different scenarios by 2050? A modelling study

Abstract

BackgroundThe future burden of non-communicable diseases (NCDs) depends on numerous factors such as population ageing, evolution of societal trends, behavioural and physiological risk factors of individuals (e.g. smoking, alcohol use, obesity, physical inactivity, and hypertension). This study aims to assess the burden of NCDs in Europe by 2050 under alternative scenarios. MethodsThis study combines qualitative and quantitative forecasting techniques to examine how population health in Europe may evolve from 2015 to 2050, taking into account future societal trends. Four scenarios were developed (one business-as-usual scenario, two response scenarios and one pessimistic scenario) and assessed against 'best' and 'worst'-case scenarios. This study provides quantitative estimates of both diseases and mortality outcomes, using a microsimulation model incorporating international survey data. FindingsEach scenario is associated with a different risk factor prevalence rate across Europe during the period 2015-2050. The prevalence and incidence of NCDs consistently increase during the analysed time period, mainly driven by population ageing. In more optimistic scenarios, diseases will appear in later ages, while in the pessimistic scenarios, NCDs will impair working-age people. Life expectancy is expected to grow in all scenarios, but with differences by up to 4 years across scenarios and population groups. Premature mortality from NCDs will be reduced in more optimistic scenarios but stagnate in the worst-case scenario.

Assessing the future medical cost burden for the European health systems under alternative exposure-to-risks scenarios

“…As the data availability and modelling capacity improve, there is a growing interest in forecasting future trends in health outcomes and projecting health expenditures. For example, Devaux et al [16] used qualitative and quantitative foresight techniques to project how future societal https://doi.org/10.1371/journal.pone.0238565.g004 Table 3. Contribution of the 10 NCDs as % of total healthcare spending, by region and scenario (over 2014-2050).…”

“…The model also uses prevalence-based direct cost estimates as an input into the model to forecast incidence-based health expenditures associated with various scenarios/policy interventions, from the health system perspective. More detailed information on data and the modelling assumptions can be found at a technical report posted online [14,15], the accompanying paper [16], as well as in the S6 Appendix in S1 File.…”

“…We compare the outcomes under three scenarios for the evolution of the following key risk factors: smoking; obesity rates; alcohol use; physical inactivity and high blood pressure. Our BAU scenario is identical with the "the rich get healthier" scenario described in more detail in the accompanying paper [16]. Briefly, a group of 90 health experts were asked to predict the future evolution of five key risk factors based on the narrative description of four different scenarios of the future, previously identified after consulting a large number of experts on societal trends likely to impact the future evolution of NCDs.…”

“…For example, if the average obesity rate in Europe in 2015 was 20%, and the highest observed obesity rate that year was 30%, then we assume that every country will see its obesity rate linearly increase so that in 2050 it's greater by 10 percentage points than its current rate. This approach was implemented to ensure comparability with the other scenarios described in the accompanying paper [16]. Table 1 presents the average risk factor prevalence in 2015, as well as their evolution under the three scenarios.…”

Wholegrain Consumption and Risk Factors for Cardiorenal Metabolic Diseases in Chile: A Cross-Sectional Analysis of 2016–2017 Health National Survey

“…Non-communicable diseases are one of the major causes of overall mortality, from which cardiovascular diseases are the leading cause of death worldwide [ 1 ]. Cardiovascular, renal, and metabolic diseases (CRMD) share several risk factors and simulation studies have showed that policies and interventions promoting a healthy lifestyle, including a healthy diet, may significantly reduce the incidence rates of CRMD in the years to come [ 2 ].…”