Objectives:
To evaluate country-level time trends (1994-2011) in premature (30-69 years) mortality from non-communicable, chronic diseases (NCDs), including cardiovascular diseases, and to create forward projections to 2025 to evaluate the WHO’s goal of reducing the risk of premature mortality from NCDs by 25% by 2025.
Methods:
Using publicly available data from the WHO Mortality Database, we created annual estimates of risk of premature (30-69 years) NCD mortality (1994-2011). The sample included data from all countries reporting NCD mortality data from ≥2 years (n=116) and all countries reporting population estimates over the same years (n=135). We matched these datasets by country, year, division, administrative grouping and sex to reach a final sample of 60 countries (193 WHO Member States, 2011). We used ordinary least squares and log-linear Poisson regression models stratified by sex to evaluate the annual change in risk of premature mortality. We then created forward projections through 2025 using log-linear models. We used extrapolated premature mortality risk at 2025 and compared risk to 2010, with projected United Nations age- and sex-specific population estimates, to evaluate trends.
Results:
Among all included countries, the average (SD) risk of premature mortality from NCDs based on log-linear models in 1994 was 6.8 (4.2) and 3.9 (2.1) per 1,000 persons in men and women, respectively (Table 1). In 2010, men in lower-middle income countries had the highest rates of premature NCD mortality (7.2 [1.8] per 1,000), and women from high-income OECD countries had the lowest rates (2.0 [0.5] per 1,000). If recent trends continue, the median risk of premature mortality from NCDs will decrease by 25.1% (IQR 16.4, 37.0) by 2025.
Conclusions:
Among included countries, if recent trends in risk of premature death from NCDs continue to 2025, 50% of countries will achieve the WHO’s 25 x 25 goal. However, data are disproportionately missing from low- and middle-income countries, which appear less likely overall to achieve this goal.