The cost of inaction: understanding the burden of CVD and diabetes

Abstract Cardiovascular diseases (CVDs) and diabetes mellitus (DM) represent major public health challenges in the EU Member States (MSs). Both exert a significant burden on individuals, healthcare systems, and economies. Based on the Global Burden of Disease Study data for the EU MSs, the prevalence of CVD is 15% and that of DM 9%. Furthermore, CVD causes 18% and DM 3% of total disease burden expressed as disability-adjusted life years (DALYs) with uneven distribution between population groups. The economic consequences are significant. CVD accounts for about 11% of the EU's health and long-term care costs, that is €155 billion annually, whereas the health care costs of DM are about €150 billion. Many of the risk factors contributing to CVD and DM are modifiable through lifestyle changes. By targeting unfavourable lifestyles such as tobacco use, unhealthy diet, physical inactivity, and excessive alcohol consumption through public health measures, biological risk factors can be reduced. Major biological risk factors include high systolic blood pressure for CVD (population attributable fraction, PAF 49%) and high body mass index for DM (PAF 54%). Through risk factor reduction, a significant proportion of the CVD and DM disease burden could be delayed or prevented, which would also lessen the economic burden. Population level monitoring of lifestyle determinants and biological risk factors is a requirement for evaluating the needs and effectiveness of public health measures. Currently, only lifestyle determinants are monitored systematically in all EU MSs through the European Health Interview Survey (EHIS). With aging populations and increasing rates of obesity and sedentary lifestyles, the burden of CVD and DM will increase. By prioritizing early detection of CVD and DM risk factors and promoting healthy lifestyles, policymakers and healthcare professionals can combat the impact of these conditions and strive towards securing sustainable healthcare systems.