As most of the world sees improvement in lowering the risk of dying from non-communicable diseases by age 80, India is moving in the opposite direction, particularly among women and in middle age.

A new Lancet analysis has sounded the alarm: while most countries are seeing a decline in mortality from chronic non-communicable diseases (NCDs), India is witnessing an increase – especially among women. The study, covering the period 2010 to 2019, finds that in India deaths from heart disease, cancer, diabetes and related conditions have moved in the opposite direction of global trends.

According to the study, India’s recent trajectory on non-communicable disease mortality marks a departure from the broader global pattern. As most of the world sees improvement in lowering the risk of dying from non-communicable diseases by age 80, India is moving in the opposite direction, particularly among women and in middle age. Addressing this will require urgent, focused action on prevention, gender equity in healthcare, early screening, and health system strengthening.

Without decisive policy shifts, the costs – in lives, health, and economic burden – will only grow larger, the study warns.

Globally, according to the paper “Benchmarking progress in non-communicable diseases: a global analysis of cause-specific mortality from 2001 to 2019” published in The Lancet, for the years 2010-19 the probability of dying from an NCD between birth and age 80 declined in about 82 per cent of 185 countries for females, and in slightly fewer countries for males.

India, however, is one of the outliers: rather than seeing continued declines, India experienced an increase in that probability over the decade.

The report identifies ischaemic heart disease and diabetes (including chronic kidney disease arising from diabetes) as leading contributors to this rise. Other chronic diseases, like certain cancers, strokes, and chronic respiratory diseases, show mixed trends. While some forms of NCDs decreased in death rates (for example, cirrhosis of the liver, and in some cases stroke or COPD), the increases in heart disease and diabetes more than offset those gains for India overall.

Gender differences: women disproportionately affected

One especially concerning dimension is the gender gap. The study reports:

• The increase in probability of dying from an NCD (between birth and age 80) was larger for Indian females than for males.
• For males, the increase over that period was only about 0.1 percentage points, while for females it was higher.
• For females, most of the increased risk comes from deaths in age groups above 40 years, whereas for males the critical age is above 55 years. That means women are seeing elevated risk quite earlier in life than men relative to baseline.

Why is India seeing this reversal?

The report and Indian health experts point to several converging causes:

1. Lifestyle shift: Rapid urbanisation, dietary changes (more processed foods, less whole grains/vegetables), reduced physical activity, rising obesity, higher stress, and other modern risk factors are widely cited.
2. Diabetes and heart disease burden: Ischaemic heart disease and diabetes (including related kidney disease) are the major causes pulling up mortality. These are often harder to prevent, detect early, or manage in many Indian settings.
3. Ageing population & delayed detection: As more people survive into older age, chronic health issues accumulate. However, detection and effective treatment may lag, especially for women, who may have less access to care, or may present later. The data show risk rises earlier for women (above 40) than for men.
4. Health system & policy gaps: Preventive care, screening, and early management of conditions like hypertension, pre-diabetes, early heart disease and cancers may not be universally available or prioritized. This includes gender‐specific screening for women (e.g. breast, cervical cancer) and awareness of cardiovascular risk in women. Some experts believe that policies are catching up, but not fast enough.

Other trends: what is improving, and what is still worrisome

While heart disease and diabetes are rising, the study does show that some chronic disease categories are improving:

• Mortality from cirrhosis of the liver has declined in India for both sexes.
• Improvements in other residual categories of non-communicable disease (NCDs other than the big ones) are seen. For example, for males there are declines or slower increases in stroke, COPD, some cancers, etc.

Yet, these gains are overshadowed by the rising mortality from NCDs that are more difficult or costly to manage (heart disease, cancers, diabetes) and by the fact that generational shifts in risk are making these diseases appear earlier. The increase in risk among age 40+ for women is especially troubling.

What needs to be done: policy implications

Health experts, drawing on the Lancet findings, propose several urgent priorities:

• Strengthening prevention: Promote healthy diets, physical activity, reducing tobacco and alcohol use, tackling obesity. Public awareness campaigns, improved urban planning to encourage walking/biking, regulation of unhealthy food advertising etc., are key.
• Early detection & screening, especially for women. Better screening for diabetes, heart disease risk factors (blood pressure, cholesterol), cancers (breast, cervical), etc., with special attention to reaching women in middle age.
• Ensure access to treatment and care across geographies, sexes, socioeconomic groups. This includes diagnostic services, affordable medication, follow-ups, rehabilitative services.
• Data improvement: Better quality mortality data, especially cause-of-death registration and surveillance, to reduce uncertainty in estimates and help target interventions. The Lancet paper notes limitations in Indian mortality data – quality is “very low” in many settings.
• Gender-sensitive health policy: Recognising that women are facing rising risk at younger ages and possibly facing inequities in access and treatment. Health systems should design interventions that are accessible and appropriate for women, including considering social determinants (education, economic status, mobility, etc.).

Why it matters: the human cost

The rising mortality from NCDs in India implies not just more deaths, but years of life lost, disability, economic burden for families, increased demands on health infrastructure. Moreover, earlier mortality (or morbidity) means loss of productive years, often among those who are still relatively young (40-60), with effects on households and communities.

For women, who already typically face multiple social barriers in accessing care, the rising risk above age 40 means that many may not receive adequate preventive care, may delay diagnosis, and may suffer complications that could have been mitigated.

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