The number of people in Bangladesh dying from chronic diseases such as cancer, diabetes and hypertension—long considered diseases of the wealthy because the poor didn’t tend to live long enough to develop them — increased dramatically among the nation’s poorest households over a 24-year period, suggests new research from the Johns Hopkins Bloomberg School of Public Health.
The study, published October 13 in the International Journal of Epidemiology, found that the rate of people dying from chronic conditions between 1982 and 2005 fell among the richest 20 percent while rising dramatically among the poorest 20 percent. The shift underscores how chronic diseases, once referred to as “diseases of affluence,” have become diseases of poverty, as lower-income people live longer but often lack the resources to prevent and treat these illnesses.
This research, believed to be the first long-term study of its kind, also finds that chronic disease can worsen poverty, underscoring the importance of including chronic disease prevention and management in strategies to alleviate poverty. Instead of dying from infectious diseases at a young age or dying soon after birth, many more children are instead living far longer than before. As life expectancy increases around the world, other countries will likely experience a shifting burden of chronic diseases, with poorer households spending a disproportionate amount of their income on health care costs than better-off households.
“Our study is the first moving picture of the epidemiologic transition that is occurring in low- and middle-income countries. Instead of a single snapshot, we were able to track the changes in the same population over the course of two decades,” says study leader Dr. David Peters, professor and chair of the department of international health at the Bloomberg School. “While the proportions of people dying from chronic diseases are rising across all groups, the poor are suffering disproportionately.”