- More than 80 million people in the Association of Southeast Asian Nations (ASEAN) have mental disorders, a 70% increase from 1990, burdening children, the elderly, and women the most.
- 37 million people in the region suffer from cardiovascular disease and 1.7 million die from it, making it one of the fastest growing non-communicable diseases and the leading cause of death.
- The number of smokers has increased in every ASEAN country and by 63% to 137 million regionally, which is 12% of the total number of global smokers.
- Some 35 million people across the region are injured every year from various kinds of accidents and incidents, and road injuries is the top cause of death in this category, making it a public health priority.
SEATTLE, Wash., May 27, 2025 – The Association of Southeast Asian Nations (ASEAN) is seeing double-digit increases in some of the leading causes of mortality and morbidity, according to the first of its kind research published today in a series of scientific papers in The Lancet Public Health. The articles showcase the region's public health crisis from mental disorders , cardiovascular disease , smoking , and injuries .
Researchers at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine in Seattle and the National University of Singapore's (NUS) Yong Loo Lin School of Medicine analyzed the data from 1990 to 2021 by age, sex, and location across all ASEAN countries: Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Vietnam.
"Without immediate action from each of the countries, these preventable health conditions will worsen causing more death and disability across ASEAN," said lead author Dr. Marie Ng , Affiliate Associate Professor at IHME and Associate Professor at NUS. "Additionally, the region's rapid economic growth and aging population are increasing the burden from non-communicable diseases and the strain on health systems. We must revisit current policies to protect people's well-being and ensure proper resource allocation to address the evolving health care demands."
"ASEAN countries have made significant progress in improving health outcomes in recent decades, but progress has been hindered by a combination of long-standing and newly emerging risk factors, particularly in some areas," said Dr. Xiaochen Dai, a first author and Lead Research Scientist at IHME. "The member states must work together to align on the best strategies to improve policies at the national and regional level and set the region back on track."
Mental disorders
Mental disorders were among the top 10 causes of disease burden in every ASEAN nation except Myanmar, and anxiety disorders were the region's most common mental disorder. In 2021, more than 80 million people suffered from one of the 10 mental disorders studied, surging 70% higher than in 1990. That translates to an age-standardized prevalence of 12%, representing a 7% increase from 1990 and with Malaysia experiencing the highest prevalence, which is a 13% rise. The increase in mental disorders is taking a heavier toll on children, adolescents, the elderly, and women than other demographic groups. A closer look by age shows 15–19-year-olds had the steepest climb in prevalence at nearly 11%, while mental disorders accounted for more than a quarter of the total disease burden among 10–19-year-olds, mainly across high-income ASEAN countries and with Singapore having the greatest burden. Although the increase in prevalence was less than 3% among adults 70 and older, the number of cases increased 183%. See complete data for mental disorders by country, sex, age, and year .
Cardiovascular diseases
With 37 million people in the region suffering from cardiovascular disease (CVD) and 1.7 million deaths, it's now the leading cause of mortality and morbidity and one of the fastest growing non-communicable diseases in ASEAN. From 1990 to 2021, the total number of CVD cases increased by 148% whereas the prevalence increased about 3%, accounting for nearly 10% of the global CVD burden. CVD death rates were higher than the global average in Laos, Indonesia, Myanmar, Cambodia, the Philippines, Vietnam, and Malaysia. Men had a higher prevalence and mortality rate of CVD compared to women across the region. The top three CVDs with the highest prevalence rates were ischemic heart disease (IHD), lower extremity peripheral arterial disease, and stroke. The leading risk factors contributing to the CVD burden were high systolic blood pressure, dietary risks, air pollution, high low-density lipoprotein cholesterol, and tobacco use. High body mass index and high fasting plasma glucose have also been rapidly rising risks contributing to CVD burden since 1990. See complete data for CVD by country, sex, age, and year .
Smoking
Since 1990, the number of smokers has increased in every country in ASEAN and regionally by 63% to 137 million, which was about 12% of the total number of global smokers aged 15 and up in 2021. Although smoking prevalence has declined in ASEAN, it remains high at 48% among males 15 and older. In Indonesia, that figure was higher at 58%. In Malaysia, youth smoking is a growing concern, with an estimated 20% of male children aged 10–14 currently smoking. The prevalence of youths smoking has more than doubled in Cambodia and rose by 79% in Indonesia. Furthermore, some countries reported the average age at which smokers aged 20–24 first started smoking was 15. Compared to other parts of the world, the burden of smoking in ASEAN is also disproportionately high, with smoking as one of the leading risk factors that causes death and disability. In 2021, more than half a million people in the region died from smoking-related diseases, an increase of 231,000 deaths from 1990, with men dying at a rate 10 times higher than women. The region's highest number of smoking-related deaths were from IHD, stroke, and chronic obstructive pulmonary disease. The region's annual tobacco consumption of 556 billion units was also more than the global average. That's equivalent to 4,131 cigarettes per smoker aged 15 and older, or 11 cigarettes every day. See complete data for smoking by country, sex, age, and year.
Injuries
Injuries are largely preventable but are killing and harming people unnecessarily across ASEAN. While road injuries had the highest mortality and morbidity in most of the countries, falls were the most common cause of injuries and second-leading cause of injury mortality followed by self-harm, drownings, and interpersonal violence. Death and disability from road injuries were particularly severe in Thailand, which recorded 30 deaths per 100,000 population, primarily from motorcycle accidents. Malaysia reported 24 deaths per 100,000 population, mostly from motor vehicle accidents. Falls were the second-leading cause of injury-related mortality in Brunei, Cambodia, Indonesia, Myanmar, Singapore, and Viet Nam. Interpersonal violence was the leading cause of death from injuries in the Philippines and ranked second in Laos. Self-harm was the leading cause of injury-related mortality in Singapore and accounted for nearly half of all injury deaths in the country, mostly males 20–24 years old. Self-harm was also among the top three leading causes of death for injuries in Brunei, Malaysia, Thailand, and Viet Nam. Conflict and terrorism resulted in substantial mortality and morbidity in Myanmar, making it the fourth-leading cause of injury burden, with males 15-19 facing the highest burden. Drowning is a common cause of injury-related burden among children 5–9 years in Thailand, Cambodia, Laos, and Myanmar. When looking at the patterns by sex and age across the region, most of the total injury burden impacted males aged 15–19 years, which is consistent with global patterns. For females, it was highest among children aged 5–9 years. See complete data for injuries by country, sex, age, and year.
About ASEAN
ASEAN is a union with diverse socioeconomic, political, and cultural backgrounds. Established in 1967, the network has been promoting economic growth, political stability, and social progress for its 10 member states. Today, the region is the world's fifth largest economy with an annual gross domestic product growth of 4.5%, making it one of the fastest developing regions in the world. The network of countries has a population of 671 million, which is 1.5 times larger than that of the European Union and comprises almost 9% of the world's population. With demographics and economic status varying widely across countries, public health challenges and health care systems differ.
About the Global Burden of Disease
This research is part of the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021. The GBD is the most comprehensive assessment of health, which includes granular estimates of burden across all age groups, sexes, and locations, as well as risk factors for 204 countries and territories from 1990 to 2021. Access to GBD data is available via IHME's visualization tools, GBD Compare , and GBD Results .
