Global rise of noncommunicable diseases, associated with poor preventable lifestyle choices

ncd2Health transition is a dynamic process that every society experiences as it evolves on the scale of socioeconomic development. The remarkable pace of global health transition, however, has been most marked over the last half century, resulting in a recast of public health challenges and a reordering of health system priorities across all regions of the world. Addressing health priorities is no longer differentiated by a country’s specific health indicators.

Over the course of the 20th century, infectious and nutritional deficiency disorders have yielded place to noncommunicable diseases (NCDs) as the foremost cause of death and disability globally. While this was most evident in high income countries, the low income and middle income countries are also presently experiencing escalating epidemics of NCDs such as cardiovascular diseases, cancers, diabetes, obesity, chronic respiratory disorders and mental illness, even as they are still combating the unconquered threats of infectious diseases and endangered maternal and child health. The 4 main types of noncommunicable diseases are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma) and diabetes.

The World Health Organization estimates that NCDs results in 38 million deaths each year, accounting for 63% of the global death toll. Low income and middle income countries contributed to 80% of the global NCD deaths and to 90% of the 9 million NCD deaths that occurred below 60 years of age. The consequences of such premature mortality can be catastrophic for global economy, national development and the financial stability of affected individuals and families.

The world is witnessing shifts in dietary patterns and levels of physical activity, with increasing overweight and obesity and a rising burden of NCDs. Social determinants lead to unhealthy personal behaviors, which in turn cause cause metabolic problems ultimately leading to disease.

Cardiovascular diseases account for most NCD deaths, or 17.5 million people annually, followed by cancers (8.2 million), respiratory diseases (4 million), and diabetes (1.5 million). Four specific preventable risk conditions contribute to 82% of all NCD deaths and include tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets.

All age groups and all regions are affected by NCDs. NCDs are often associated with older age groups, but evidence shows that 16 million of all deaths attributed to noncommunicable diseases (NCDs) occur before the age of 70. Of these “premature” deaths, 82% occurred in low- and middle-income countries. Children, adults and the elderly are all vulnerable to the risk factors that contribute to noncommunicable diseases, whether from unhealthy diets, physical inactivity, exposure to tobacco smoke or the effects of the harmful use of alcohol.

These diseases are driven by forces that include ageing, rapid unplanned urbanization, and the globalization of unhealthy lifestyles. For example, globalization of unhealthy lifestyles like unhealthy diets may show up in individuals as raised blood pressure, increased blood glucose, elevated blood lipids, and obesity. These are called ‘intermediate risk factors’ which can lead to cardiovascular disease, a NCD.

The statistics reflect that about 3.2 million deaths annually can be attributed to insufficient physical activity.
More than half of the 3.3 million annual deaths from harmful drinking are from NCDs.
In 2010, 1.7 million annual deaths from cardiovascular causes have been attributed to excess salt/sodium intake.

In low-resource settings, health-care costs for cardiovascular diseases, cancers, diabetes or chronic lung diseases can quickly drain household resources, driving families into poverty. The exorbitant costs of NCDs, including often lengthy and expensive treatment and loss of breadwinners, are forcing millions of people into poverty annually, stifling development.

In many countries, harmful drinking and unhealthy diet and lifestyles occur both in higher and lower income groups. However, high-income groups can access services and products that protect them from the greatest risks while lower-income groups can often not afford such products and services.


World Health Organization

Global status report on alcohol and health 2014

Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2012; 380(9859):2224-2260.

Mozaffarian D, Fahimi S, Singh GM, Micha R, Khatibzadeh S, Engell RE, Lim S et al.; Global Burden of Diseases Nutrition and Chronic Diseases Expert Group. Global sodium consumption and death from cardiovascular causes. N Engl J Med. 2014;371(7):624−34. doi:10.1056/NEJMoa1304127.

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