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The Earth Institute at Columbia University
This project seeks to establish the macroeconomic significance of cardiovascular disease now and for the next forty years in low- and middle-income countries. Cardiovascular disease is the leading cause of death throughout the world. The diseases constituting its range of fatal expression diabetes, heart attack and stroke are also among the most important global causes of disability. In much of the developing world by 2020, the median age of the population will begin to approach that of the West. Recent work indicates that the death and disability attributable to cardiovascular disease in the labor-force-age groups in these populations may be much higher than was previously appreciated, and is certainly much higher than in comparable Western nations. Projections for the next two decades indicate that the existing disability rates attributable to these diseases will likely rise. Little attention has been paid to the chronic disease and disability profile of labor-force-aged populations in the developing world. Less has been paid to the economic implications of failing to stem current trends in the development and expression of these diseases. In many countries undergoing rapid urbanization, the next twenty years will be ones in which the effects of increased cardiovascular disease risks accumulate. Because of the way these populations are growing, aging with falling birth rates, they may not be the years of the highest disease expression of these risks. Hence, these two decades represent a small (but closing) aperture while child dependency is falling, elderly dependency has not risen, and chronic-disease risk, while real, can be subjected to aggressive systems of disease prevention and management.This project explores the significance of cardiovascular disease over the next forty years for low and middle-income countries. It does this from both epidemiological and economic perspectives, projecting what the likely burden of cardiovascular disease will be if current trends persist, and what the consequences of this burden will be in economic terms. In reconciling the epidemiologic projections with their likely economic consequences we address the macroeconomic question, what will be the likely cost of cardiovascular disease if we do nothing about it? Once this is established, alternate investment strategies can then be considered, and budgets determined for addressing the problem. Fortunately, in relation to cardiovascular disease, there are now demonstrably effective and frequently affordable medical and public-health measures that can be taken to halt its progress and prevent the expression of its most serious consequences such as recurrent heart attack and stroke. Because the cost of these interventions can be calculated, decisions about investment in these strategies can be taken in economic terms by considering these costs and the benefits of intervention versus the costs and savings of doing nothing. Assuming that these explorations favor investment in intervention, microeconomic choices then can be made—drug therapy or public health measures or a combination of both—using cost-effectiveness information.
Project Leader/Principal Investigator
Leeder, Stephen
Primary Contact
Leeder, Stephen
Location
United States of America
Department/Center
Center for Global Health and Economic Development (CGHED)
Funding Source
ICHealth
Additional Researchers
Dr Susan Raymond, economist
Dr Henry Greenberg, cardiologist
Dr Sarah Liu, research assistant
Collaborating Institutions
Australian Health Policy Institute and Institute for Interantional Health
Mailman School of Public Health
Faculty of Medicine
University of Sydney
Initiative for Cardiovascular Health Research in the Developing Countries (ICHealth),T-7, Green Park
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