Health Affairs, 27, no. 4 (2008): 1051 doi: 10.1377/hlthaff.27.4.1051 © 2008 by Project HOPE	New Online   Rating Health IT Progress   Consumers And Health IT   Dutch Health System   HIV/AIDS In India, China

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Disease & Demography

PROLOGUE

Disease And Demography

But the other side of having a large population is that even modest upticks in disease prevalence translate into large burdens of disease for millions of people—producing economic and social costs that can threaten the pace of development. What’s more, wealth itself can set the stage for more disease, as the newly affluent in these countries adopt the same unhealthy diet and lifestyle choices of the richer nations. The result is that historically underresourced health systems in China and India are left to grapple not only with the usual suspects—infectious diseases like HIV, TB, and malaria—but also with an explosion in chronic disease.

The papers in this section offer insights into these changes in disease burden and demographics. First, Somnath Chatterji and colleagues (of the World Health Organization, RAND, and the National Institute on Aging) discuss the effects on health and development of one major driver of China and India’s growing chronic disease burden: rapidly aging populations. Next, Barry Popkin of the University of North Carolina at Chapel Hill explores how changes in China’s diet and nutrition profile, as well as shifts to a more sedentary lifestyle, contribute to increased morbidity, health-related absenteeism, and rising health care costs. Karen Siegel (MATRIX Public Health Solutions), Venkat Narayan (Emory University), and Sanjay Kinra (London School of Hygiene and Tropical Medicine) then report that India’s population of thirty-five million with diabetes could produce a $237 billion drag on the economy; they offer solutions for what policymakers might do to turn the tide. Finally, Mariam Claeson (World Bank) and Ashok Alexander (Avahan, India AIDS initiative) write that a downward revision in India’s HIV prevalence may indicate in part an epidemic coming under control, and they discuss the interventions that produced this apparent success.

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