vascular disease in China between 2000 and 2040 (Leeder et al., 2005). In addition, the rapid economic growth in these countries accompanied by rapid urbanization may also contribute to the increase of noncommunicable diseases. Urbanization is associated with unhealthy nutrition and physical inactivity, leading to obesity and increases in the prevalence of chronic diseases such as diabetes (Wang et al., 2005, 2007). The number of people with diabetes in China is estimated to be more than 92 million, with another 148 million pre-diabetic (Yang et al., 2010). India has the second largest estimated number of people with diabetes currently, at 51 million (International Diabetes Federation, 2009).
Mean life expectancies at birth and age 60 were higher in China (74 years and 20 years) than India (65 years and 17 years) in 2010, with the differences between the countries projected to shrink over the next two decades (see Table 17-1). The most recent healthy life expectancy (HALE) at birth estimates for China were 65.0 years for men and 67.8 years for women in 2007 (World Health Organization, 2008). At age 60, HALE is 13.7 years for Chinese men and 15.5 years for women. HALE at birth in India is 55.9 years for men and 56.7 years for women. The difference in HALE between the genders at age 60 in India is small, with years for men and 11.9 years for women. In comparison to HALE at 60 years for both sexes combined of 14.6 years in China and 11.5 years in India, older people living in Indonesia can expect 11.9 years of healthy life remaining at age 60; in the United States, 17.3 years; and in Japan, 20.2 years.
Recent Global Burden of Disease estimates show a higher age-standardized overall disease burden in India than China, but with a higher proportion of noncommunicable disease (NCD) burden to overall burden in China than India (Abegunde et al., 2007; World Health Organization, 2008) (see Figure 17-1). The composition of NCDs across the countries is also notable, with considerable differences in cerebrovascular and ischemic heart diseases and unipolar depressive disorders. It is estimated that 44% of the total burden of disease in China in 2004 was from adults aged 45 and older (Chatterji, 2008), which is expected to increase to more than 65% by 2030. In India, the figure was 26% in 2004, rising to 46% by 2030.
In light of the demographic and health changes occurring in China and India, and in response to conferences in 2010 and 2011 to address population aging in Asia hosted by five national science academies, including the Chinese Academy of Social Sciences and Indian National Science Academy, this chapter summarizes selected health results from the World Health Organization’s (WHO) Study on Global AGEing and Adult Health (SAGE) Wave 1 for the two nations with the largest numbers of older persons. Health state and chronic condition patterns are compared and contrasted across the two countries to further improve the understanding