People falling next to human anatomy

A Vicious Circle: Poverty and Noncommunicable Diseases

The interplay of poverty and NCDs in low- and middle-income countries.

By Patrick Smith • Illustration by Dung Hoang

Once considered afflictions of the affluent, noncommunicable diseases like cancer and diabetes are increasingly allied with poverty. 

NCDs can drive people into poverty. And poverty can make it more likely that a person will die or suffer a disability from an NCD. 

“Lack of access to health care and a lack of disease-prevention efforts put people in [LMICs] at higher risk of dying from a communicable disease such as tuberculosis as well as a noncommunicable disease like lung cancer,” says David Peters, MD, DrPH ’93, MPH ’89, Edgar Berman Chair and Professor in International Health.  

NCD risk factors like tobacco use are greater among lower socio-economic groups, notes Diwakar Mohan, MD, DrPH ’15, MPH ’08, a coauthor of a Lancet study last year with Peters and others that explored the relationships between poverty and NCDs in LMICs. Poor people are also less likely to be screened or receive early care for conditions like hypertension and diabetes. This can lead to complications like stroke, “which are likely to kill the poorest more often,” Mohan says.

The results are far-reaching burdens on poor families. Peters points to a study from Bangladesh showing that “when a family member in Bangladesh dies early because of an NCD, the family easily falls into a poverty trap …. They also change behaviors, and their daughters are more likely to have an early marriage or leave school early and enter the labor force.”