Nine million people in England will be living with major illnesses such as dementia, diabetes, cancer, depression and kidney disease by 2040, according to projections health leaders called “catastrophic”.
In a rapidly ageing population, the number living with serious diseases will rise from almost one in six of the adult population in 2019, to nearly one in five by 2040, with huge implications for the NHS, social care and the public finances.
An extra 2.5 million people will be living with major illnesses, up 37% to 9.1 million compared with 2019, according to the report by the Health Foundation.
Cases of dementia are expected to rise 45% by 2040, heart failure by 92%, cancer by 31%, diabetes by 49%, chronic pain by 32% and anxiety or depression by 16%.
By the age of 70, people will have an average of three long-term conditions, rising to more than five by the age of 85, researchers said.
Four-fifths of the rise in major illnesses will be driven by an ageing population, with longer lifespans meaning people are more likely to encounter – and live with – ill health. About 80% (2 million people) of the projected increase in people living with major illnesses will be among the over-70s.
Some positive health steps, like fewer people smoking and lower cholesterol rates, will be offset by obesity as many people who have been overweight for decades reach old age.
Anita Charlesworth, from the Health Foundation, said that over the last 30 years obesity levels in the adult population had broadly doubled. And while the data focused on adults, there were “really concerning obesity rates” among children, which would have a big future impact on the NHS.
The report said: “There is no silver bullet to reduce the growth in the number of people living with major illness. A long-term plan is needed to reform, modernise and invest in the NHS, alongside a bold new approach to investing in the nation’s health and wellbeing.”
Researchers used health and death records to look at the 20 health conditions that account for 65% of the burden of illness in England. Average life expectancy by 2040 was projected to rise to 83.1 years, they noted.
Only one of the 20 conditions listed – coronary heart disease – was expected to drop due to declining smoking rates and the use of medications such as statins.
Charlesworth said: “The growth in major illness will place additional demand on all parts of the NHS, particularly primary care, where services are already under extreme pressure.
“But with one in five people projected to be living with major illness in less than two decades’ time, the impact will extend well beyond the health service and has significant implications for other public services, the labour market and the public finances.”
Dr Sarah Clarke, the president of the Royal College of Physicians, said: “The projections laid out in the Health Foundation’s report will quite frankly be catastrophic – for people and their families, for the health of the NHS and its workforce, and for the prosperity of the nation.
“We know that much of this illness is avoidable – it’s caused by smoking, poor housing, unemployment, poor food and air quality, and obesity. We need a strategy that pulls at every policy lever available in order to build a healthier society and economy.”
