A research group reviewed each country’s residents’ probability of dying from a non-communicable disease (including, but not limited to cancers; cardiovascular diseases; diabetes; endocrine, blood, and immune disorders; non-infectious respiratory, digestive, and genitourinary diseases; neurological conditions; mental and substance use disorders; congenital anomalies; and sense organ, skin, musculoskeletal, and oral or dental conditions) at 2001, 2010, and 2019. When looking at the probability of dying from a non-communicable disease between birth and age 80 in 2019, here are the top five performers by gender, along with America, Canada and England:
For females
- South Korea 15.4% (high data quality)
- Japan 15.7% (high)
- Singapore 18.5% (high)
- Spain 18.8% (high)
- France 19.5% (medium)
- Canada 24.5% (high)
- United Kingdom 27.0% (high)
- United States 31.5% (high)
For males
- Singapore 29.1% (high data quality)
- Switzerland 30.3% (high)
- Japan 30.7% (high)
- South Korea 31.1% (high)
- Iceland 31.4% (high)
- Canada 34.3% (high)
- United Kingdom 37.0% (high)
- United States 43.0% (high)
“the poor performance of the USA from 2010 to 2019 can be summarised as a rise in the probability of dying from neuropsychiatric conditions, which was not offset by the continued declines in cancers and circulatory diseases. Specifically, although mortality from most cancers, ischaemic heart disease, and chronic obstructive pulmonary disease (COPD) declined from 2010 to 2019, most of these declines were smaller than the preceding decade. Lung cancer and some other cancers and kidney diseases were among the few exceptions, and had larger declines from 2010 to 2019 than in the preceding decade, but did not compensate for the deterioration in changes over time for other causes of death. Mortality from some neuropsychiatric conditions (comprising Alzheimer disease and other dementias, alcohol use disorders, and the aggregate group of all other neuropsychiatric conditions [which include drug use disorders that were not analysed separately in this work]), diabetes and its kidney complications, liver cirrhosis, and liver and pancreatic cancers increased more from 2010 to 2019 than in the previous decade or deteriorated from a decrease to an increase. [..]
[from the article’s Discussion section] Although data for quantitative attribution are currently scarce, some countries provide case studies of pathways to good performance. For example, South Korea had the fifth largest decline in NCD mortality in the world for females and the third largest for males from 2001 to 2010 (and the single largest among countries with high-quality data) and continued impressive declines from 2010 to 2019 despite a slowdown. South Korea rolled out universal health insurance in the last part of the 20th century, and set up national programmes that not only translated knowledge and technologies related to disease aetiology, diagnosis, and treatment into clinical practice in primary and secondary health care but also ensured that these advances benefited the entire population. South Korea has the largest number of contacts with primary care providers among the Organisation for Economic Co-operation and Development countries, and a rigorously designed and evaluated nationwide programme for screening that increased the diagnosis of multiple conditions. This has made South Korea one of the leading countries in diagnosis and treatment of conditions such as hypertension and diabetes alongside good performance in cancer screening. South Korea also leveraged its rapid economic growth towards substantial broad-based improvements in education, housing, infrastructure, and early-life nutrition that addressed many of the environmental and nutritional determinants of NCDs. Finally, South Korea has lower health inequalities than some of its western counterparts, and has constrained or even lowered inequalities across its districts, in contrast to countries such as the UK and USA. These mechanisms exemplify those used by other countries with good performance in NCDs, such as hypertension or diabetes diagnosis and treatment in Costa Rica, Chile, Kazakhstan, and Finland, and cancer prevention, screening, and treatment in Denmark and Chile.
[..] few large-scale policy experiences have been rigorously evaluated and, of those that have, only a handful of the commonly recommended policies show a more-than-negligible effect on epidemiologically relevant and clinically relevant outcomes; beyond the aforementioned tobacco and alcohol control policies, those with stronger impacts are: air pollution regulations, comprehensive indoor smoking ban, tax on sugar sweetened beverages, trans fat bans, and comprehensive salt reduction programmes, all of which involve fiscal and regulatory components. [..] the shifting focus of health system discourse onto universal health coverage might have helped remove or lower the financial barriers to care, but has not been accompanied by sufficient emphasis on high-quality programmes that improve the coverage of evidence-based interventions for timely diagnosis and treatment of NCDs through guidelines, training, decision support, equipment, and procurement and distribution of medicines. Without such programmes, the effects of universal health coverage on uptake of NCD preventive interventions and treatment and their mortality benefits are limited, especially in low-income countries where the health systems and services have been largely focused on infectious diseases and maternal and child health.
[..] Our results and the experiences of countries with strong performance indicate that what is needed is investment or reinvestment in programmes that increase the coverage of efficacious diagnosis and treatment, and effective policies, such as those related to tobacco and alcohol control that are well established, or emerging ones such as those related to pricing and availability of healthy (e.g., fresh fruits and vegetables) or unhealthy (e.g., trans fat and sugar-sweetened beverages) foods. Crucially, these programmes should be designed to reach the people that account for the largest number of disease cases and deaths, yet are persistently and increasingly excluded from the benefits of health policies and programmes, as done for the aforementioned screening programme in South Korea, for example. At the same time, for finite health budgets to revive and exceed the progress seen around the turn of the millennium, the programmes and policies must be rigorously evaluated based on the relative size of the conditions they intend to address and their effectiveness in real-world implementation, and be amended or even discontinued when ineffective. Given the range, heterogeneity, and dynamics of NCDs, there is a need to adopt a learning health system approach, which systematically collects data on NCD interventions and outcomes, benchmarks performance across and within countries to detect and identify and learn from the reasons for differential performance, and uses explicit policy trials, natural experiments, and other evaluation techniques to provide insights on what programmes and policies work to reduce mortality and improve clinically relevant outcomes in the real world.”
The authors admit that their metric, probability of dying from a non-communicable disease between birth and age 80 does not consider morbidity and its effect on healthy life-years. Their definition also excludes deaths from injuries (e.g., psychiatric conditions increase the risk of suicide) or infectious disease (e.g., COPD can increase the risk of contracting tuberculosis)
Full article, NCD Countdown 2030 Collaborators, The Lancet, 2025.9.20