NCDs are sickness of poverty not of affluence


According to the World Health Organization (WHO), non-communicable diseases (NCDs) are the leading cause of deaths worldwide. In 2008, of the 57 million deaths, 36 million people died due to NCDs. Deaths were attributed to cardiovascular diseases (48%), cancers (21%), chronic respiratory diseases (12%), and diabetes (3%).

The WHO global status report (GSR) on NCDs for 2011 revealed that poorer countries are more susceptible to NCDs. High-income countries have 13% prevalence, upper-middle-income countries have 25% prevalence, while lower-middle-income countries like the Philippines have 28% prevalence. Low-income countries have 41% prevalence of premature deaths among citizens below 60 years of age. This is three times higher than the proportion of the high-income countries.

Dr. Antonio Dans, professor at the College of Medicine, University of the Philippines Manila (UPM) stressed that NCDs are not diseases of affluence but diseases of poverty.

Dr. Dans presented the report on non-communicable diseases of the Lancet Southeast Asia series during the 12th National Health Research Forum for Action held at the Pan Pacific Hotel Manila last 14-15 November 2011. He said that Southeast Asia is facing the epidemic of chronic non-communicable diseases. Based on 2008 figures, 60% of all deaths in Southeast Asia are attributed to NCDs.

In the Philippines, about 200,000 Filipinos die annually because of NCDs. “This is larger than any epidemic we have ever seen in the country,” said Dr. Dans.

Traditionally, NCDs are viewed as the diseases of the elderly, “therefore unavoidable.” However, based on studies, NCDs are now affecting even the productive age group from 15 to 59 years old. “Sixty percent of the disability causes in this age group are NCDs. This situation is greatly affecting the productivity and economy of countries,” said Dr. Dans.

“While death or disability results to productivity and income losses, it also brings expenditures for medical care on families affected, leading to serious consequences, not only at the household level, but at the national level as well,” added Dr. Dans.

Risk factors of NCDs

The leading risk factors globally for non-communicable diseases are raised blood pressure, tobacco use, raised blood sugar, physical inactivity as well as overweight and obesity.

“The prevailing risk factors varied among a country’s income groups,” said Dr. Dans. Physical inactivity among women is the prevailing risk factor in high-income countries, while smoking or tobacco use is the prevailing NCD risk factor among middle-income group countries like the Philippines.

Dr. Dans also challenged the paradigm that lifestyle is a choice. “It is not, because we live according to what the environment provides us.” He cited the strong connection between poverty and NCDs as an example. “People in the lower socio-economic class have less access to disease prevention. Therefore, they have unhealthy lifestyles and have higher risk factors. They have no access to treatment when they have heart diseases, lung cancer and other NCDs.” Likewise, poor families do not have the money to finance treatments which leads to higher mortality rates.

Dr. Dans proposed several measures to promote healthy lifestyle: 1) legislative advocacy on proper food labeling (emphasizing food health risks and benefits), 2) implementation of sin taxes, and 3) legislation on healthy urbanization or creating infrastructure for healthy lifestyle in school, in workplace and the community.

“No matter how much we shout at patient’s ears about exercise and healthy lifestyle, they will not listen because we live according to what the environment provides us. Even the doctors who have mountains of information necessary to live healthy, they still smoke, they don’t eat healthy, and they don’t exercise. Rather than begging individuals to live healthy, we should level-up our agenda towards a healthy environment and help promote healthy lifestyle in our society,” concluded Dr. Dans. (Edmon Agron/PCHRD-DOST)


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