How will the main risk factors contribute to the burden of non-communicable diseases under different scenarios by 2050? A modelling study

PLoS One. 2020 Apr 29;15(4):e0231725. doi: 10.1371/journal.pone.0231725. eCollection 2020.

Abstract

Background: The future burden of non-communicable diseases (NCDs) depends on numerous factors such as population ageing, evolution of societal trends, behavioural and physiological risk factors of individuals (e.g. smoking, alcohol use, obesity, physical inactivity, and hypertension). This study aims to assess the burden of NCDs in Europe by 2050 under alternative scenarios.

Methods: This study combines qualitative and quantitative forecasting techniques to examine how population health in Europe may evolve from 2015 to 2050, taking into account future societal trends. Four scenarios were developed (one business-as-usual scenario, two response scenarios and one pessimistic scenario) and assessed against 'best' and 'worst'-case scenarios. This study provides quantitative estimates of both diseases and mortality outcomes, using a microsimulation model incorporating international survey data.

Findings: Each scenario is associated with a different risk factor prevalence rate across Europe during the period 2015-2050. The prevalence and incidence of NCDs consistently increase during the analysed time period, mainly driven by population ageing. In more optimistic scenarios, diseases will appear in later ages, while in the pessimistic scenarios, NCDs will impair working-age people. Life expectancy is expected to grow in all scenarios, but with differences by up to 4 years across scenarios and population groups. Premature mortality from NCDs will be reduced in more optimistic scenarios but stagnate in the worst-case scenario.

Interpretation: Population ageing will have a greater impact on the spread of NCDs by 2050 compared to risk factors. Nevertheless, risk factors, which are influenced by living environments, are an important factor for determining future life expectancy in Europe.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Computer Simulation
  • Europe / epidemiology
  • Female
  • Forecasting*
  • Global Burden of Disease / trends*
  • Humans
  • Life Expectancy / trends
  • Male
  • Middle Aged
  • Models, Statistical*
  • Mortality, Premature / trends*
  • Noncommunicable Diseases / epidemiology*
  • Noncommunicable Diseases / prevention & control
  • Population Dynamics / trends*
  • Risk Factors

Grants and funding

FRESHER (“FoResight and Modelling for European Health policy and Regulation”) is an interdisciplinary research project funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement No 643576 for a duration of 36 months (2015-2018). The European Commission provided support in the form of salaries for GG, SB, SG, AR, FR, DC, and BV. The Austrian Institute of Technology provided support in the form of salaries for SG. The OECD programme of work on the economics of public health is supported by a number of voluntary contributions by Ministries of Health or other national government institutions of OECD member countries or key partners, including grants from the European Commission (DG Santé). The funders did not play a role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript and only provided financial support in the form of authors' salaries. The specific roles of these authors are articulated in the ‘author contributions’ section. The opinions expressed herein are solely those of the authors and do not necessarily reflect the official views of the OECD or its member countries.