Quantifying the global distribution of premature mortality from non-communicable diseases

Background: Non-communicable diseases (NCDs) have slowly risen to the top of the global health agenda and the reduction of premature NCD mortality was recently enshrined in Target 3.4 of the UN Sustainable Development Goals. The unequal global distribution of NCDs is inadequately captured by the most commonly cited statistics. Methods: We analyzed ‘WHO Global Health Estimates’ mortality data to calculate the relative burden of NCDs for each World Bank income group, including the ‘risk of premature NCD death’ based on methods in the WHO Global Status Report. We included all deaths from cardiovascular disease, all cancers, respiratory diseases and diabetes in people aged 30–69 years. Results: Developing countries experience 82% of absolute global premature NCD mortality, but they also contain 82% of the world's population. Examining relative risk shows that individuals in developing countries face a 1.5 times higher risk of premature NCD death than people living in high-income countries. Premature NCD death rates are highest in lower middle-income countries. Conclusions: Although numbers of deaths are useful to describe the absolute burden of NCD mortality by country type, the inequitable distribution of premature NCD mortality for individuals is more appropriately conveyed with relative risk.