PHSSR Policy Roadmaps for Acting Early on NCDs Synthesis Report 2025

Morbidity While mortality data reveals the ultimate impact of NCDs, Disability-Adjusted Life Years (DALYs) provide a more comprehensive picture by capturing both years of life lost to premature death and years lived with disability. This metric is particularly crucial for understanding NCDs, which often involve prolonged periods of morbidity that substantially impact quality of life and healthcare resource utilisation before causing death. Throughout this analysis, we report both unadjusted and age-adjusted DALY rates to reveal different dimensions of the NCD challenge. Unadjusted rates reflect the actual burden on health systems: the real service demand and resource needs. Age-adjusted rates reveal whether countries are successfully reducing risks at given ages. This distinction is diagnostic: when adjusted rates fall while unadjusted rates rise (as with CVD and cancer), it signals progress in risk reduction that population ageing renders invisible. When both rise (as with diabetes), it reveals systemic failure in prevention across all ages. Figure 5 shows IHME data on age-standardised DALY rates from NCDs. The divergence between unadjusted and age-adjusted DALY trends reveals a critical insight about the nature of the NCD burden. Between 2011 and 2021, unadjusted NCD DALYs increased in all eight countries, yet age- adjusted rates decreased universally. This pattern is most extreme in Japan where age-adjusted DALYs are approximately 51% of unadjusted in 2021. While biological aging is inevitable, much of the NCD burden reflects modifiable risks accumulated across the life course. The high NCD prevalence in older populations reflects decades of missed prevention opportunities earlier in life, underscoring the critical need for early intervention. Figure 5: All NCDs – DAL Ys (per 100,000), all ages and age-standardised, 2011, 2016 and 2021 Source: IHME, 2023. 24 Acting early on NCDs The Partnership for Health System Sustainability and Resilience 4.9% 0.7%0.3%11.0% 4.1% 8.1%5.1% 5.7% 05,00010,00015,00020,00025,00030,000 Canada France Germany Greece Italy Japan Poland Spain All ages: Age standardised % change (all ages) 2011 2016 2021