Esha Bhat

High School Finalist, Grade 9
Sammamish, WA

“Ill-Fated Finances”: The Economic Cost of Non-Communicable Diseases in  rural India

Nineteen-year-old Poonam Gond says quietly, “I have never known zero pain”. She sits on the faded plastic chair, gripping the sides because standing is agonizing. Growing up in a rural agrarian family, Poonam’s sickle cell disease went unnoticed for years, her socioeconomic status blocking access to regular healthcare. Even now, medicines she desperately needs are out of reach (Ghosal, 2023). Her story reflects thousands of rural Indians diagnosed with non-communicable diseases. As an aspiring medical professional, I was shocked that NCD  treatment can consume a person’s life when hospitals are not accessible. That realization drives me to advocate for a solution so no one’s health depends on socioeconomic status. 

The Problem: Critical Diagnosis 

Non-communicable diseases (NCDs) are chronic illnesses due to lifestyle and environmental factors. The most common in India are cancer, diabetes, cardiovascular disease, and chronic respiratory disease. Each year, NCDs account for 63% of all deaths in India (UNDP, n.d.). Treating these conditions is arduous for people who live outside the bustling cities, since 65% of  India’s population resides in rural areas (WHO, n.d.). Numerous elements contribute to why treatment is challenging. 

India’s rural communities are highly susceptible to NCDs. These risk factors specifically impact low-income households, since they report higher tobacco and alcohol use, experience food insecurity, and limited access to proper physical activity. Severe air pollution and high-stress

environments without support increase the threat for households. This leaves families struggling mentally and financially with the outcome of an NCD diagnosis (Sharma et al., 2024). 

The Outcome: Strangling Expenses 

In villages far from cities, many travel up to 100 km to reach the nearest hospital, making early detection nearly impossible (Player, 2019). The long journey means losing potential wages,  while transportation, medical, and non-medical fees consume hard-earned savings. For many families, these costs trigger catastrophic health expenditures. This is financially critical for families, the economic weight pushing them below the poverty line. 

This impacts not only low-income households but the whole of India. NCDs can incapacitate workers, leading to productivity loss, and blocking socioeconomic development. With every 10% increase in NCDs, there is a 0.5% decrease in India’s annual economic growth (Sharma et al., 2024). Since NCDs strain India’s workforce, it can’t develop properly without focusing resources on this issue. 

India has been working towards programs like the AB-PM-JAY insurance scheme freeing low-income households of healthcare expenses or the telemedicine van which provides digital checkups and reminders to save money and time. While these solutions are helpful, the lack of medical or digital literacy, poor infrastructure, and a shortage of medical professionals in rural areas is an issue for effective use of these programs. Help from the US can provide new perspectives and resources for the issue.

The Solutions: US involvement 

Awareness: 

We cannot help without knowing the problem. Social media advocacy through videos, posts, and blogs using hashtags and tagging NCD-prevention organizations, such as the Arogya World, can spread awareness faster. Starting community awareness projects by posting engaging videos about NCDs every week and reaching out to different states to expand chapters of the program can give youth advocates positions of leadership and expand the events possible to raise awareness. Even telling your friends and family can get people thinking about how to help in  India. 

Prevention: 

Many Americans are fluent in various languages, and we can use that for prevention purposes!  Creating visual pamphlets that explain ways to prevent NCDs can reduce the need for treatment.  Examples include digital literacy (for telemedicine), healthier eating, reducing tobacco and alcohol, and ways to stay active. Visual aids and symbols can make it accessible to low-literacy communities. It can be shortened to make engaging activities that teachers can introduce to children to learn about healthy habits. Sharing these through ASHA workers and local NGOs can bring them to rural communities. 

Early Screening: 

Early screening can mitigate the irreversible body damage caused by NCDs. Funding AB  PM-JAY to create mobile health vans would help them cross the bad roads and act as mini-hospitals for early screening. Telemedicine can be combined with these vans to fix

electrical issues and make sure everyone has access to basic phones for the program to work.  These operations can be funded through government grants, nonprofit partnerships and donations, and community impact projects. Pre-recorded downloadable videos can train villagers to survey the locals and send reports back. 

Treatment: 

With the rise of AI, it’s important to incorporate these tools to enhance treatment. The community can create apps partnering with NCD-focused NGOs that build offline AI chatbots helping with non-communicable diseases. AI could ask basic questions when doctors aren’t available and give simple steps for how to relieve pain or what to do next. It is easily adaptable with text-to-speech features and the ability to speak in different languages. Hospitals with low staffing could use this tool for repetitive tasks such as filling in data and charting incoming patients,  so the staff can focus on what really matters. 

Call to action 

The real facts about how NCDs impact households are heartbreaking. They steal what workers achieve. If there is any hope for Poonam to be able to stand up from that faded plastic chair, we need to act now. I refuse to believe that your network should determine your treatment process.  The resources and knowledge are out there; now all that is needed is us.