CHIANG RAI, In the mist-covered hills of the north, where rice terraces once stood for wealth and wellbeing, a different picture is taking shape. Thailand’s rapid urban growth and lifestyle shifts are fuelling a surge in NCDs (non-communicable diseases), putting immense strain on families, communities, and public services.
A new nationwide survey signals a sharp rise in risk, with heart disease, stroke, cancer, and diabetes increasingly affecting younger people. NCDs already account for 74% of deaths, more than 400,000 lives each year, and the new figures show the situation is worsening.
Chiang Rai, known for its strong community ties and lively markets, reflects the national pattern. Local clinics report a 20% rise in high blood pressure among working-age adults in the past year, linked to office work, long commutes, and fast food. The wider data is even more troubling.
New National Survey Shows Steep Increases
A major study carried out from August 2024 to April 2025 by the Thai Health Promotion Foundation and the Health Systems Research Institute (HSRI) highlights the growing threat.
Using a large sample of 30,057 people from cities and rural areas, researchers examined four key NCD risks: obesity, hypertension, high total cholesterol, and diabetes. Dr Wichai Aekplakorn, head of Community Medicine at Mahidol University’s Ramathibodi Hospital, presented the results as a serious warning.
Compared with data from about 20 years ago, the jumps are stark. Obesity, defined as a BMI of 25 or higher for Asian populations, rose from 28.6% to 45%. Hypertension increased from 22% to 29.5%.
High total cholesterol went up from 16.5% to 19.8%. Diabetes climbed from 6.6% to 10.6%. In real terms, that means an estimated 6.1 million people in Thailand are living with diabetes, 17.5 million have hypertension, and 5.7 million are on the verge of diabetes.
The hidden burden is severe. Around 27% of diabetes cases are undiagnosed, and almost half of those with high blood pressure do not know they have it. Metabolic syndrome, a cluster of linked risks, now affects 28.4% of the population and is rising across all ages.
In Chiang Rai, where farm work once kept bodies active, obesity is now highest among 15 to 34-year-olds. Dr Aekplakorn points to long hours on screens and processed snacks reaching even far-flung villages.
Lifestyle Pressures and Social Change Drive the Rise
The survey highlights a mix of modern pressures. Migration to cities has replaced home-cooked meals with high-sugar, high-salt street food. Sedentary jobs and gridlocked traffic cut daily movement. Alcohol and tobacco still carry weight.
Cigarette smoking fell from 25.3% in 2004 to 18.5%, yet vaping has tripled since 2020 to 2.8% nationwide. That includes about 60,000 users aged 10 to 14 and 840,000 in their twenties. “These are not harmless habits, they open the door to NCDs,” said Dr Roengrudee Patanavanich, an epidemiologist at Ramathibodi involved in the study.
Money pressures heighten the risk. In the north, where tourism grows but pay lags behind, families with lower incomes struggle to buy fresh food or access fitness options. The 2021 Health Behaviour Survey, backed by recent HSRI work, finds higher obesity rates in poorer groups, driven by cheap, energy-dense foods.
Women face sharp increases in abdominal obesity, a fat pattern tied to insulin resistance. High cholesterol is most common among people aged 45 to 59, the core of the labour force, raising the risk of early exits from work and lost productivity.
The World Health Organization warns that Thailand’s path mirrors many middle-income countries. Without action, NCDs could claim 310,000 more lives over the next 15 years. At home, the economic hit is massive, an estimated 1.6 trillion baht each year in care costs and lost work, or about 9.7% of GDP.
In hill tribe areas around Chiang Rai, traditional remedies often sit alongside limited access to screening, and undiagnosed disease turns treatable conditions into family crises.
A Growing Threat: What the Next Two Decades Could Bring
If current trends continue, the toll will grow. ThaiHealth projects diabetes cases will rise from 4.8 million in 2023 to 5.3 million by 2040, and adult obesity could pass 50%. Premature deaths before age 70 from NCDs could increase by 25% by 2030, putting the Sustainable Development Goals at risk.
Northern Thailand is especially exposed, with ageing farmers and young workers moving to towns and cities. Ministry of Public Health figures show stroke rates are already higher in the north than in the south.
The survey highlights clear gaps. Rural communities in the north have less access to screening, and only 40% of people at risk receive yearly check-ups. E-cigarettes, often brought across porous borders, are aimed at young people in towns such as Mae Sai.
Mental health pressures add to the load. ThaiHealth’s 2025 watchlist reports that the number of psychiatric patients doubled to 2.9 million between 2015 and 2023, and stress-related eating links closely linked with NCD risk.
There is room for progress if action is swift. The Ministry of Public Health’s 2025 plan lists seven priorities, including cutting NCDs. Measures include tighter rules on e-cigarettes, lower sodium in foods, and tax breaks for healthy choices.
The WHO has praised Thailand’s whole-of-society approach, with healthier school meals, workplace wellness policies, and community gardens in places such as Doi Tung in Chiang Rai. United Nations estimates suggest that investing 211 billion baht in prevention could save 310,000 lives and return 430 billion baht to the economy by 2040.
Local voices back the shift. In Chiang Rai’s markets, Noi, 52, who lives with hypertension, supports cheaper vegetables and community walking groups. “We cannot wait for policy from Bangkok,” she says. Experts advise scaling HSRI’s model, yearly risk checks, telemedicine with AI support for remote areas, and taxes on ultra-processed foods.
Thailand is at a turning point. This survey is not a final verdict; it is a clear signal to act. By tackling obesity, hypertension, high cholesterol, and diabetes through education, policy, and community effort, the country can slow the surge. The north has a proud tradition of grit and teamwork. That same spirit can help restore health if we move before this crisis deepens.
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