India’s (Not So) Silent Epidemic: Reviewing Apollo’s 'Health of the Nation 2025' Report
What 2.5M Screenings Reveal About India’s Next Health Infrastructure Play
The Apollo Hospitals' "Health of the Nation 2025" report offers a rare, data-heavy look into the state of non-communicable diseases (NCDs) in India. Drawing from 2.5 million health screenings across 2024, the findings reveal a growing burden of metabolic dysfunction, lifestyle diseases, and undiagnosed chronic conditions particularly among populations that could be asymptomatic, younger, or female.
But I think we need to look beyond this data. The key findings are hardly surprising for many of us who are working at the forefront of healthcare today. There are signals in this report that can help us understand where fault lines of Indian healthcare are forming, and where public health, private innovation, and systems design need urgent recalibration.
Key Findings
PS: These findings are specific to Indian populations and they highlight the need for South-Asian-first medical research. Most global studies still rely on Western cohorts, overlooking genetic, dietary, and lifestyle differences that shape how diseases show up in our bodies.
Prevalence of Metabolic Diseases
28% of the population screened in Apollo’s report showed signs of obesity or being overweight.
19% of college students were identified as pre-hypertensive, a concerning early indicator of long-term cardiovascular risk.
40% of women in the study showed signs of post-menopausal diabetes, underlining a critical gap in women’s health management as they transition through menopause.
70% of post-menopausal women also displayed evidence of fatty liver disease, a significant concern that is underdiagnosed and underreported.
Asymptomatic Health Risks
The report reveals that 40-60% of individuals screened were asymptomatic, yet presented early markers of hypertension, diabetes, and hyperlipidemia. This checks out with emerging longevity science that suggests metabolic and cardiovascular diseases are ‘slow diseases’ that develop silently over years before symptoms may emerge. Read: Outlive by Peter Attia.
This group—largely undiagnosed—represents a key opportunity for early intervention, particularly in women and younger populations who may not exhibit traditional symptoms but face long-term risks.
Gender and Age Disparities
Women, particularly those in their 30s-40s, are disproportionately affected by undiagnosed metabolic diseases, with 40% of women presenting signs of obesity and post-menopausal health issues.
Younger individuals (under 40) are often asymptomatic but show significant risk factors for cardiovascular and metabolic conditions, with nearly 30% of them exhibiting early-stage hypertension or diabetes.
Geographic and Demographic Disparities
Urban populations showed a higher prevalence of obesity, hypertension, and hyperlipidemia, whereas rural populations reported lower rates. This could be due to limited access to screening and healthcare infrastructure, but also lower incidences of these slow, lifestyle diseases.
The report indicates that Indian cities with higher socioeconomic status had greater incidences of lifestyle diseases, despite a preferential disparity in access to care, nutrition, and preventive health.
Increased Burden of Chronic Conditions
Chronic diseases like diabetes and hypertension are rising sharply across all age groups, with 33% of screened individuals showing signs of diabetes, and 25% of the population having hypertension. These rates are only expected to grow unless there is a shift toward preventive health and better diagnostic infrastructure.
40% of adults above 40 years are at risk of developing diabetes, and over 50% of adults aged 45 and above suffer from undiagnosed hypertension, which worsens over time.
Underdiagnosed Conditions
Diseases like fatty liver and sleep apnea are frequently undiagnosed due to a lack of accessible testing or public awareness. Up to 60% of the population with metabolic risk factors like fatty liver disease remains undiagnosed early (with 85% of these individuals being non-alcoholic!)
Mental health issues (especially stress-related disorders) were significantly underreported and underscreened. The report highlights a need for the integration of mental health into physical health screening frameworks, as stress plays a significant role in the onset of lifestyle diseases.
Impact of Lifestyle and Nutrition
Lifestyle factors like poor diet and physical inactivity were identified as major contributors to these conditions, with 60% of individuals failing to meet the recommended guidelines for physical activity, and nearly 50% reporting inadequate fruit and vegetable intake.
The report noted low vitamin D levels among 45% of the screened population, particularly in urban areas with high indoor activity and limited sunlight exposure.
Women’s Health Crisis
The report revealed that women aged 35 and above were the most vulnerable demographic, with higher rates of obesity, diabetes, and metabolic dysfunction compared to men. This aligns with the increasing burden of lifestyle diseases in women due to hormonal changes, inadequate access to menopause care, and general underrepresentation in health research.
Challenges in Early Detection and Diagnosis
60% of the population remains unaware of their health risks until later stages, primarily because of a lack of regular screening programs and health awareness campaigns.
Community screening and diagnostic solutions are still underdeveloped, with only 15% of individuals accessing regular health check-ups or screening in rural areas.
Healthcare System Gaps
There is a significant gap in access to preventive care and early diagnostics, especially in Tier 2 and Tier 3 cities. Only 30% of individuals in rural and semi-urban regions report having access to basic diagnostic tools like blood tests, cholesterol monitoring, or blood pressure checks.
Primary healthcare infrastructure is limited, with only 20% of primary healthcare centres in India offering full diagnostic services, making early detection difficult.
Purpose & Positionality: Who Is This For?
Apollo’s report carefully balances public health advocacy and private sector signalling. Positioned as corporate thought leadership, it speaks fluently to policymakers, healthcare entrepreneurs, insurers, and providers, essentially anyone invested in the future of India’s healthcare economy.
I can clearly see the intent to shift the paradigm from reactive to preventative care. The report also makes a case for expanding diagnostic services, wellness packages, and subscription-based health management models. Looking at this report as a diagnosis of India’s health crises is limiting the opportunity. I think there is a business case for long-term engagement and rethinking care models.
Opportunity: There is room for newer, more relevant, and long-term health systems and startups to respond with tech and diagnostics to start with, and build solutions that unlock trust, community support, and primary care.
Language & Framing: What Kind of Health Future Is Being Imagined?
The report leans heavily on systems-level data, but the framing still privileges the hospital as the centre of care. Terms like “asymptomatic individuals” and “screening ecosystems” are used often yet patient experience, social determinants, and lived realities are notably absent.
Health is largely framed as something that must be discovered by technology, rather than cultivated by communities or supported through policy. Fertility, menopause, mental health, and obesity are spoken of in clinical, deficit-oriented terms.
One of the biggest learnings building and advising in healthcare has been the importance of including community, lifestyle, and agency into the caregiving experience. We need to start thinking of patients as human beings first, with their own fears, preferences, limitations, and comforts.
Opportunity: Reports like these need balancing language: ones that humanize risk without pathologizing it, and see patients as agents, not just recipients. There’s also a missed opportunity to elevate community health workers, midwives, or local data systems as part of the solution.
Data & Evidence: Comprehensive, But Not Always Contextual
The dataset is robust: 2.5M screenings, with insights across demographics, age, gender, and geography. However, what’s absent is intersectionality. There’s minimal focus on segmentation by urban/rural, caste, income, or access to care.
The correlation between obesity, diabetes, and hypertension is well covered but what about dietary patterns, work-related stress, environmental exposures, or sedentary schooling systems? These upstream determinants remain unexamined.
Opportunity: Public health researchers, digital health startups, and foundations could extend this data into more granular, place-based insights especially as India shapes its Ayushman Bharat Digital Mission (ABDM) and National Health Stack.
What’s Missing: Silences in the System
No mention of reproductive autonomy, access to contraception, or abortion services (critical for a holistic view of women’s health)
Mental health is treated as a screening issue, with no deeper dive into causation, infrastructure, or interventions
Sleep disorders and lifestyle diseases are noted, but no reflection on work culture, shift jobs, or urban design
Nothing on pricing transparency, insurance uptake, or provider incentives, elements that often determine whether someone gets care at all
Opportunity: Policy labs, healthtech firms, and investors can use these silences as signals. Where a corporate hospital leaves gaps, new models like rural telemedicine, cooperative care, and value-based insurance could consider stepping in.
Integration Points: What Could This Report Inspire?
Menopause Clinics: With post-menopausal diabetes at 40% and fatty liver at 70%, there’s a clear need for longitudinal care pathways.
Decentralized Diagnostics: Fatty liver disease is underdiagnosed, even when blood tests are normal. Community-based ultrasound or AI-based imaging tools could be deployed earlier and more affordably.
School Health Programs: The report shows that 28% of college students are obese, and 19% are pre-hypertensive. This is a policy gap and a market opportunity for the future of our nation.
Vitamin D and B12 supplementation programs: Especially for indoor workers, urban adolescents, and perimenopausal women. These are low-cost, high-impact interventions.
Strategic Takeaways
The future of diagnostics is predictive, not just preventive. Apollo’s ProHealth model shows behavioral nudging works but it’s most effective when it’s real-time, personalized, and longitudinal.
India’s healthcare opportunity lies in infrastructure between the hospital and the home. Think decentralized diagnostics, digitally enabled health coaches, and school and workplace wellness networks.
Data alone is not transformation. Unless reports like these evolve their worldview, they will replicate the same hospital-first logic that created the gaps in the first place.
Women’s health, especially midlife and metabolic health, is still underserved. This is a public health emergency not just a consumer category.
The biggest risks are hidden and structural. Sleep disorders, silent heart disease, fatty liver, and micronutrient deficiencies are not individual failures. They are systemic symptoms.
Apollo’s report should act as a wake-up call (that’s hopefully not snoozed like the many other reports we’ve been seeing over the years). But it’s also an invitation for investors to rethink what constitutes health infrastructure, for policymakers to update screening and insurance frameworks, and for entrepreneurs to build with empathy, not just efficiency.
This is the next frontier of healthcare in India.
Lovely summary and perspective. Thanks a ton!