Overview

1. Key messages

Non-communicable diseases are conditions that are not transmitted by an infectious agent and that are often chronic in nature.
More than one in four Belgians report living with a chronic disease. There is a clear association with age, with more than half of the population 75+ reporting to live with a chronic disease.
The five most commonly reported non-communicable diseases are low back problems, high blood pressure, high blood cholesterol, osteoarthritis, and allergy. The prevalence of non-communicable disease has increased over time, and is generally higher among individuals with a lower educational level.

2. Background

Non-communicable diseases (NCDs) are medical conditions or diseases that are not caused by infectious agents. While sometimes referred to as synonymous with "chronic diseases", NCDs are distinguished only by their non-infectious cause, not necessarily by their duration, though some chronic diseases of long duration may be caused by infections.

NCDs are by far the leading causes of (premature) mortality. In addition, they are also one of the most relevant health problems with a potential impact on the for health-related quality of life, especially for the elderly, and are one of the main reasons for the use of health care services. Information on the prevalence of NCDs is therefore an important indicator of the level of (ill) health in the population.

The Belgian health interview survey (HIS) is one of the sources in Belgium to get information on the prevalence of NCDs at the population level. The advantage of this source is that it also takes into account people who rarely or never make use of health care facilities. It is therefore a valuable tool to obtain representative information on NCD prevalence at the level of the country or a region, and to monitor the NCD prevalence over time. However, the results must be interpreted with caution because the information is self-reported.

In the HIS 2013, questions were asked on the presence of a chronic disease, condition or handicap in general (henceforth referred to as “chronic disease”) and on the presence of 36 specific NCDs.

3. Prevalence of chronic disease

In 2013, more than one person in four (29%) reported suffering from at least one chronic disease. The percentage of people with a chronic disease increases considerably with age, going up from 9.6% for young people aged 15-24, to 53% for the 75 or older age group.

Self-reported prevalence of chronic disease by age and sex, Belgium, 2013
Source: Health Interview Survey, Sciensano, 2013 [1]

Between 1997 and 2013 the percentage of people reporting to suffer from a chronic disease fluctuated, but overall an increasing trend was observed. Compared with 2004, the percentage of people with a chronic disease increased from 27% to 29%. This increase is mainly due to the ageing of the population, as evidenced by the age-adjusted prevalence estimates, which even tend to decrease. In the Brussels and Walloon region, the percentage of people with a chronic disease is higher than in the Flemish region.

  • Crude
  • Age-adjusted

Crude self-reported prevalence of chronic disease in Belgium and its regions, 1997-2013
Source: Health Interview Survey, Sciensano, 1997-2013 [1]

Age-adjusted self-reported prevalence of chronic disease in Belgium and its regions, 1997-2013
Source: Own calculations based on Health Interview Survey, Sciensano, 1997-2013 [1]

The percentage of people reporting to suffer from a chronic disease increases as their educational level decreases.

Self-reported prevalence of chronic disease by educational level, Belgium, 2013
Source: Own calculations based on Health Interview Survey, Sciensano, 2013 [1]

4. Multimorbidity

Multimorbidity refers to the simultaneous presence of multiple NCDs in the same individual. The HIS measured multimorbidity as the simultaneous presence of at least two out of the following six major NCDs: heart disease, chronic lung disease, diabetes, cancer, arthritis and/or arthrosis, and hypertension.

Overall, multimorbidity is present in 13.5% of the Belgian population aged 15 years and over. Multimorbidity is strongly associated with age, reaching a prevalence of 39% in the population 75+, and is more common in women than in men, also after correction for age.

Prevalence of multimorbidity by age and sex, Belgium, 2013
Source: Health Interview Survey, Sciensano, 2013 [1]

Multimorbidity shows a negative association with educational level, but no significant differences across regions.

5. Major non-communicable diseases

The top five of the most commonly reported NCDs is the same for men and women, although the order differs. The top five comprises two problems of the musculoskeletal system (low back problems and osteoarthritis), two cardiovascular risk factors (high blood pressure and high cholesterol levels in the blood) and allergy.

Prevalence of 20 most commonly reported non-communicable diseases among men and women, Belgium, 2013
Source: Health Interview Survey, Sciensano, 2013 [1]
prev slopegraph 2013

The evolution of the prevalence of NCDs in the general population differs by the type of disease. NCDs that have significantly increased in prevalence between 1997 and 2013 include high blood pressure, diabetes, osteoarthritis and thyroid disease. This increase may in part be explained by the aging of the population; however, even after adjustment for age, the increase remains significant. On the other hand, the prevalence of a number of other NCDs has decreased, including coronary heart disease, chronic bronchitis, severe bowel disease, chronic cystitis, severe headache and migraine, and severe or chronic skin diseases.

  • Crude
  • Age-adjusted
Crude prevalence of selected chronic diseases, Belgium, 1997-2013
Age-adjusted prevalence of selected chronic diseases, Belgium, 1997-2013
Source: Own calculations based on Health Interview Survey, Sciensano, 1997-2013 [1]

Regional differences in the prevalence of the included NCDs are generally quite limited, although thyroid disorders are more commonly reported in the Walloon region.

Socio-economic status, proxied in this report by the educational level, is one of the most significant determinant of NCDs. The majority of the 36 NCDs included in the HIS occurs more frequently in people with lower educational levels. This applies in particular to serious NCDs such as cardiovascular pathologies, diabetes, and chronic lung diseases. One notable exception is allergy, which occurs more frequently with increasing educational levels.

6. Read more

View the metadata for this indicator

HISIA: Interactive Analysis of the Belgian Health Interview Survey

Definitions

Chronic disease
In the Belgian Health Interview Survey, a global question is asked on the presence of one or more chronic diseases, chronic conditions or handicaps, without specifying the nature of the disease, condition or handicap. For the sake of simplicity, this indicator is referred to in this report as the presence of “chronic disease”.
Non-communicable diseases
Non-communicable diseases (NCDs) are medical conditions or diseases that are not caused by infectious agents. While sometimes referred to as synonymous with "chronic diseases", NCDs are distinguished only by their non-infectious cause, not necessarily by their duration, though some chronic diseases of long duration may be caused by infections.

References

  1. Health Interview Survey, Sciensano, 1997-2013. https://his.wiv-isp.be/