It is far easier to quantify morbidity and mortality from chronic diseases than it is to hang a dollar sign around the economic effects of cancer, heart disease, stroke and diabetes.
But economists say the financial cost to a country makes prevention of noncommunicable diseases critical for the developing world.
"The cost of chronic diseases ... is significant and sizable, ranging from 0.02 percent to 6.77 percent of a country's gross domestic product," according to a the recent Oxford Health Alliance report Chronic disease: an economic perspective, one of whose authors was Dr. Rachel Nugent, a former Fogarty program officer and now director of health and economics at the Population Reference Bureau.
Photo by Harvey Nelson,
Disease-conscious street vendors in
Halong, Vietnam, wear face masks to
block air pollution.
"Overall, a fair amount of evidence exists to conclude that there are important economic consequences of chronic disease—important for the individual and his/her family but also potentially important for the economy at large," the report said.
"At the same time, there are severe gaps in the evidence that call for more research into the economic consequences of chronic disease, in particular for developing countries."
The long-held idea that it affects mainly the most prosperous countries, "may be partly responsible for the lack of research into the economic implications and public policy relevance of chronic disease," the authors said, noting the "significant burden on both the poor—across countries and within countries—and those of working age."
But it is not only low-income countries that need to factor in chronic diseases as an economic drag, the authors say. "To the extent that ... evidence points to future impacts in developing countries, it may function as a reminder to policymakers to act now to stem the growing burden of disease ... as a means to promote economic development."
"Because there is little economic incentive for the private sector to conduct such research, it could be an excellent investment for the public sector as the burden of chronic diseases grows with aging populations and the factors contributing to many chronic chronic diseases spread around the world."
The strongest link between chronic diseases and human behavior is in smoking, particularly in low- and middle-income countries where the poor smoke more and in female obesity, also associated with poverty.
The report found that tobacco-cessation programs, taxes on tobacco, public information campaigns and pharmacological interventions can be cost effective.