Non-communicable diseases Diseases of Excess

Non-communicable unsoundnesss sicknesss of ExcessNon- catching complaints often referred to as Diseases of Excess or Diseases of Affluence ar change magnitude in some(prenominal)(prenominal) rich and suffering countries. What reckons ar add to this trend? What are the implications for public wellness form _or_ system of presidential term?wellness is a state of complete physiological, mental and social public assistance and not merely the absence of disease or infirmity (WHO, 1948) where as Disease is a condition where any deviation from or abeyance of the normal structure or function of any body part, organ, or system that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be kn avow or unknown (Dorlands medical Dictionary, 2007). Disease cigaret be divided broadly into devil categories as Communicable and Non Communicable Diseases (on the prat of its pass on). Communicable disease is a disease whi ch wad spread from unrivaled individual to early(a) through any carrier/ existence (Malaria, HIV/AIDS, etc). It is in addition known as Infectious or contagious disease. There are umteen factors responsible for the cause of communicable diseases interchangeable social, environmental, sanitation and education. Non Communicable disease is a disease which is not communicated from virtuoso individual from another (Hypertension, crabmeat, etc). It is also known as Chronic diseases because these diseases takes push-down list of time to show the sign and symptoms at bottom an individual. The study(ip) causes for NCDs are aliveness style, habits interchangeable fume and inebriantic drink, inadequate go outt and physical innatural process.Communicable diseases was reported to be the major cause of closing in earlier time where as Non Communicable diseases(NCDs) are of major threat in current come on except in some countries the handle Africa where still masses run suffering out of infections. In some countries like USA, the leading cause of death in 1900s was tuberculosis and pneumonia where as these diseases are secondary nowadays and their browses are acquired by the cardiovascular diseases on the top and malignant neoplastic disease being the second. The principal(prenominal) reason for the reduction in communicable diseases are the improvement in diagnosis, treatment, sanitation, nutrition, housing, working conditions, preventive measures much(prenominal) as immunization, evolution of life economic system drugs like antibiotics and sulpha drugs.Non-Communicable diseases or Non-Infectious diseases are caused by factors primarily behavioural, life style and heredity and which cannot be transmitted to other individual. It is also caused as the Disease of Affluence or the Disease of Excess as it is caused collectible to failure or disturbance caused in the normal routine lifestyle which is generally embed in the upper class of the s ociety where thither is more(prenominal) chances of misbalance between aliment and work can be seen. Few of the examples which turn tail along under non communicable diseases are sum of money diseases, Stroke, Obesity, Diabetes, Cancer, etc. Acc. to WHOs statistics in 2008, Heart Stroke has become the leading cause of death planetaryly going behind the infectious diseases like HIV/AIDS, TB, Malaria, etc.In 2003, there was an estimated 56 jillion death orbiculately, out of which 60% death was suppositious to be delinquent to non-communicable diseases (WHO, 2003). Among NCDs, 16 gazillion deaths impressioned from cardiovascular disease (CVD), particularly Coronary Heart Disease (CHD) and Stroke 7 million from Cancer 35 million from Chronic Respiratory Disease and more or less 1 million from Diabetes (Ibid). Apart from these, mental wellness problems are also the leading contri notwithstandingors to the freight of disease in many countries nowadays and revivify a maj or mapping in contributing to the severity and relative incidence of other NCDs.NCDs are now considered to be the major threat contributing 59% of death in 2000 and predicted to account for 73% by 2020 (WHO, 2002). NCDs are also termed as a Disease of Affluence due to incidence and prevalence mainly in the developed countries (Anand K et al, 2007). But gibe to them, this seems to be a misleading term as the NCD trend is add at a mel wretchededer rate in middle and abject income countries leaving them in a double commove of Communicable diseases as intimately as NCDs. It can more fittingly be tagged as Disease of Urbanisation (Ibid). Several studies done by them fox proved that the NCDs and its endangerment factors are found in last schooler molestonize among urban universe than rural nation. Their involve shows that urban population has increase during past decade due to migration where as urban harvesting is modify at 3%. Contrary to it, the urban slum growth localise has doubled which has make the situation worse as these migrated ridiculous mint living in urban areas allow for adopt the NCD lifestyle but forget not be in a condition to assenting the wellness wish well due to their poor purchasing ability. Study shows a towering prevalence of NCDs jeopardy factor in the urban slums of Haryana, India. The population residing in the slums is at high peril than the urban population due to poor access as well as no social and wellness co-occurrence system for them. This fills an urgent treatment which can work at national, connection as well as local level. A role model of the insurance policy is required at national level which has tobacco and alcohol let got measures, promotion of good diet and involvement of proper exercise. Simultaneously, reorientation and beef up of the goernments health system is needed to face the challenge of NCDs friendship level efforts to create an environment which promotes adoption of hea lthy behaviors. To overcome this situation, government has started the Integrated Disease Surveillance Programme (IDSP) which offer ups a rational basis for decision making and implementing public health disturbances and also ensures involving the slums as well (Ibid).A survey was being conducted by Anand et al in urban areas slums of Faridabad District, Haryana, India, in February 2003 to June 2004 for checking out the prevalence of NCDs in urban poor people. Their study watch outed the STEPS approach of WHO where questions related to tobacco use, alcohol intake, diet, physical activity were take ond and history of treatment for high blood pressure, diabetes, physical values like height, weight, stem circumference and blood pressure were also measured. They surveyed 1260 men and 1304 women of get on 15-64. The result came out of this survey was very alarming. The rate of smoking and alcohol drinkers were high among urban slums male population. Almost one third of the popula tion had at least one danger factor. Alcohol consumption among younger population indicates gradually falling economy of the sphere in the coming future.The dodge 1 (Appendix) shows that NCDs are the leading cause for the death in both(prenominal) developed and develop countries except some countries like Africa where still today, there is more yield of death due to communicable diseases than NCDs. In 2003, 28 million CVD deaths occur in china and 26 million in India. NCDs contributed substantially to adult mortality with central and easterly Europe having the highest rates (WHO, 2003).The Table 2 (Appendix) shows that the developed countries claim cardinal NCDs out of ten leading risk factors which are contributing to the world(prenominal) burden of disease, where as six and lead out of ten with low and high rates of mortality respectively, in the ontogenesis countries. These NCD risk factors are increase at a higher rate in the development countries and assumed to conti nue in the same manner for the next two decades.Chronic diseases attribute to the 46% of the world(a) burden of the disease, Cardio Vascular Diseases (CVDs), in particular. Although some of the communicable diseases are still prominent in the some parts of the Africa, Asia and Latin America, deaths mainly due to chronic diseases were reported in quint out of the six WHO regions (Africa, America, South east Asia, Eastern Mediterranean, western Pacific and Europe). In ontogenesis countries also, 79% of the deaths are reported due to the chronic diseases. Incidence and prevalence of obesity, diabetes, crab louses, respiratory diseases and other NCDs are increasing all over the world (Murray and Lopaz, 1996). Developing country like chinaware has experienced an epidemiological novelty shifting from the infectious to the chronic diseases in much shorter time than many other countries. The pace and spread of behavioral changes, including changing diets, ebbd physical activity, high rates of male smoking, and other high risk behaviors, has accelerated to an unprecedented degree. As a result, the burden of chronic diseases, preventable morbidity and mortality, and associated health-care tolls could now increase substantially. China already has 177 million adults with high blood pressure furthermore, 303 million adults smoke, which is a third of the worlds contribute number of smokers, and 530 million people in China are passively exposed to second-hand smoke. The prevalence of overweight people and obesity is increasing in Chinese adults and children, because of dietary changes and cut down physical activity. Emergence of chronic diseases presents exceptional challenges for Chinas ongoing reform of health care, given the large numbers who require curative treatment and the narrow window of opportunity for timely legal profession of disease (Gonghuan Y et al, 2008).Common Non-Communicable Diseasescardiovascular diseases include all the pith diseases like hypertension, blow, atherosclerosis, etc. yearlyly, 17 million deaths are reported mainly due to the CVDs globally out of which 80% are reported in low and middle income countries with a continuous increasing trend (Reddy and Yusuf, 1998). Acc. to Lenfant, CVD forget be the leading cause of the death by 2010 in the developing countries due to changes brought about by urbanization and industrialization. Due to costly and prolonged treatment cost of CVDs, developing countries are at greater prevalence for the risk factors, higher incidence of disease and higher mortality (Reddy, 2002).Diabetes is increase in blood dinero level in a person. international Diabetes Federation has released the statistics in 2003, according to which diabetes patients will going to increase from 194 million in 2003 to 330 million in 2030 and at that time every 3 out of 4 living person will be diabetic. The age of diabetic patients in developing countries is comparatively more than developed countries. The crusades found in developing countries are above the age of retirement which may lead to conditions like blindness, amputations, kidney failure and titty diseases (Boutayeb and Twizell, 2004).Cancer and its type are increasing at an alarming rate worldwide. It is known to be the major cause for the mortality and morbidity. More than 10 million new cases and over 7 million deaths from crabby person occurred in 2000 (Shibuya et al., 2002). Developing countries contributed by 53% in incidence and 56% in deaths. By 2020, there will be an increase of around 29% cases in developed countries and 73% in developing countries (Mathers et al., 1999). Lung, breast, stomach, colorectal and liver cancer are the most frequent in developing countries. Cancer and its related types can be treated on a preventative basis. Early detection and control of risk factors like tobacco and alcohol can be express to be the cornerstones in this process because it is estimated that over one third of the cancer types are preventable and around one third are potential differencely curable if they are detected early (Alwan, 1997).Other NCDs includes chronic respiratory diseases like asthma and chronic obstructive pulmonary diseases, mental and depressive disorders, osteoarthritis, auditory sense loss and disorder of vision (WHO, 2003). They all contribute mainly to the burden of disease in developing countries. Conditions such as obesity and high blood pressure also has a double doctor, either as a disease or as a risk factor for other NCDs (WHO, 2004).Risk FactorsThe life expectancy at birth has change magnitude since 1970 in all the high, middle and low income countries (UNDP, 2005). Due to this factor, longer life span has resulted in the predominance of the chronic diseases in the population. The epidemiological musical passage has resulted in the higher proportion of the adults population due to decline in profusion rates and the infant mortality rates. The behavioural risk factors like smoking and nutritional transition towards diet having high fat, high sugar with low carbohydrates and fruits along with the physical inactivity and increase in alcohol consumption have become the greatest health challenge in the 21st century (Magnusson, 2007). The environmental causes are also responsible for the outcome of NCD as an pandemic. These factors have brought up the nutrition transition by industrialisation of the food business, expansion of the market economies in the developing countries, the growth of the complex supply chain management at a global level, fast growth of supermarket in the developing world and the growing concentration of global food manufacturers (Ibid). Some other key factors like rising incomes, production of cheap and low energy-dense foods, growing urbanisation and increase in growth in demand for pre-packed food are also the major risk factors for NCDs (Ibid).The evolution of NCDs has put up a double burden on low and middle in come countries. Diabetes and lung cancer are also reflecting rise in the rate of smoking and obesity which are called to be the major risk factors for the NCDs (Leeder, 2004). In the year 2001, 17 million people died due to stub diseases where as 3 million people died due to AIDS (Ibid). During this year, heart disease and stroke were the leading cause of death in both high income and low-middle income countries, accounting for 27 and 21% population respectively. Out of all, 83% of death occurred in the developing countries (Ibid). Evidence has shown that CVD occurs at an early age in developing countries, consuming their productive years of life. world(prenominal)ly, obese people are also increasing at a higher pace with a far higher number overall in developing countries. Due to this, diabetic patients are also increasing with more number falling in the 45-65 age group (Ibid). tobacco causes 4.8 million previous(p) deaths in the year 2000, half of which were in the developing wo rld (Ezzati and Lopez, 2003). Since 1975, hindquarters consumption has decreased sharply in the developed countries, but it is perpetually rising in developing countries due to the rapid increase in population. More than 1 meg smokers lives in the developing counties out of 1.3 cardinal smokers globally which indicates that forthcoming threat of tobacco related epidemic will impact the developing world. Even after non smoking awareness syllabus through out the world, there will be around 1.45 billion smokers in 2025 (Guindon and Boisclair, 2003). Tragically, half to two third of the chronic smokers will die out of their habit (Jamison et al, 2006). Peto and lopez has estimated that if this trend continues, 10 million people will die every year because of tobacco where 7 out of 10 will be from the developing countries resulting in around 150 million death till 2025.The ageing of populations, mainly due to falling fertility rates and increasing child survival, are an underlying d eterminant of non-communicable disease epidemics. Additionally, global trade and marketing developments are driving the nutrition transition towards diets with a high proportion of saturated fat and sugars. This diet, in faction with tobacco use and little physical activity, leads to population-wide atherosclerosis and the widespread scattering of non-communicable disease. Globally, many of the risk factors for heart disease, diabetes, cancer and pulmonary diseases are due to lifestyle and can be prevented. Physical inactivity, Western diet, alcohol and smoking are prominent causes for the NCDs and its risk factors.Tobacco is number one opponent of public health (WHO, 2000). It is the most important established cause of cancer but also responsible in CVDs and chronic respiratory disease. In the twentieth century, approximately 100 million people died worldwide from tobacco-associated diseases such as cancer, chronic lung disease, diabetes and CVDs. Half of the 5 million deaths at tributed to smoking in 2000 occurred in developing countries where smoking prevalence among men is nearly 50%. Today, 80% of the 1.2 billion smokers in the world live in poorer countries and, magic spell tobacco consumption is falling in most developed countries, it is increasing in developing countries by about 3.4% per annum. However, albeit these striking facts, the majority of developing countries which signed the Framework Convention on Tobacco Control (FCTC) (Joossens, 2000) ride out passive about the control of smoking.Obesity and dietary habits represent potential risk factors for CVDs (Kenchaiah et al., 2002), type 2 diabetes (Drewnowski and Specter, 2004), and some types of cancer (Key, 2002), especially in absence of physical activity (Derouich and Boutayeb, 2002 and WHO, 2003b). Fish is considered to be a usable food intake to prevent CVDs and reduction of CVD associated deaths (Stampfer, 2000). Similarly, intake of an adequate amount of money of fresh fruit and vege tables is recommended to wait on reduce the risk of coronary disease, stroke and high blood pressure (WHO, 2002). But, developing countries finds it more fruitful to export most of the quality fruits and vegetable production in exchange of the abroad currency.Alcohol causes more than 2 million deaths every year in the world. It is particularly associated with liver disease and esophageal cancer. The increase in alcohol consumption in developing countries will add other hazards caused by violence and road accidents to the burden of disease.Public health policy and its implicationsLee, Fustukian and Buse provide a helpful framework for disentangling four dimensions of global health political (Lee et al, 2002) as-* form _or_ system of government Actors They are the power (political) who can drive the policy and decision making at a global level. In case of NCDs, United Nations, WHO, FAO, WTO, World bank, codex Alimentarius Commission, etc.* form _or_ system of government mould Process through which policy is developed and implemented. Interactions and relationship between policy actors.* Policy Context For NCDs, its global.* Policy Content Effective strategy should address universal prevention , selective or primary prevention for high risk group and targeted or secondary prevention and treatment for those with existing conditions.It is fairly clear that NCDs has its roots in unhealthy lifestyles or adverse physical and social environments. Risk factors like unhealthy nutrition over a prolonged period, smoking, physical inactivity, excessive use of alcohol, and psychosocial stress are among the major lifestyle issues. Now to our understanding, it is known that what has to be done so we have to work more on how to do it (Aulikki et al, 2001). Well planned lodge architectural plans can be a successful step towards this process. Several factors like cultural, psychological, political and economical factors has created a gap between what needs to be do ne and day to day happening in the developing countries because of which major health challenges cannot be achieved. So, a corporation architectural plan will help in bridging this gap and also helps in changing the NCD related lifestyles (Ibid). .The policies make at an international level also require global processes which can help to achieve a stable policy change at a country level, thus reducing the long term harm associated with it. International practice of law is an example for this type of process. Multilateral agreements contain lawfully binding obligations, such as the WHOs Framework Convention on Tobacco Control (FCTC). FCTC includes hard law conventions. FCTC is an evidence-based treaty that identifies core areas of agreement over regulatory measures that involved countries are leally required to implement within their own domestic systems (WHO, 2005). Apart from FCTC, there are some soft law resolutions and declarations too, like United Millennium Declaration and WHOs Global Strategy on Diet, Physical employment and wellness (GSDPAH). WHO also worked in the area of chronic, lifestyle related diseases through Global Strategy on Diet, Physical activity and health (GSDPAH, 2004). It flora on a strategy which builds on the role of tobacco, unhealthy diet and physical inactivity in the most NCDs. GSDPAH works in close relation with the UN agencies, the WTO, World Bank, other Development banks, Codex Airentarius Commission (WHO, 2004). One of the most significant health development programs within the United Nations system is the Millennium Development Goals (MDGs). The MDGs are a global partnership embracing ambitious goals to be achieved collectively within 15 years timeframe from 2000-2015 (Magnusson, 2007, p 6). The MDGs and FCTC serve as helpful models when considering ways of strengthening the global response to non-communicable diseases.The ideal step for developing countries to overcome the NCD epidemic and they have to plan and implem ent accordingly to control NCDs. Each community based prevention programmes require the same principles to be followed. As an example, The newton Karelia Project in least developed areas of Finland which was based on low cost lifestyle modifications and community participation (Puska P et al, 1981). The reason to follow the general principle can be the collaboration between countries and several(predicate) international organizations working on the similar fields and upchucks like WHOs nationwide Integrated Non Communicable Disease Intervention (CINDI, 1985). Even these sort of unified programmes like CINDI were implemented in developed countries they are now followed by the developing countries too. Many of these programmes are carried out in conjunction with the WHO coordinated programmes, which was started in 1986. After the success of CINDI programme, American regional office had also launched CARMEN (AMRO) programme in 1990s. With the regional development experience, WHO has launched similar programme in Asian and African networks.In Latin America, Cuba is carrying out the NCD prevention programme from long time with the collaboration with the WHO activities where Havana and Cienfuegos as the main sites. cayenne pepper also participated in the Interhealth Programme CARMEN and was the first Latin American country to join this programme and many other countries followed it. Argentina has started PROPRIA heart health intervention as an active network at various certainty sites (Aulikki, 2001).Africa has started community based CVD prevention programme long time back. Nigeria, Mauritius and coupled republic of Tanzania participated in Interhealth Programme and gained the positive responses. Mauritius intervention programme put down considerable effect of nutrition policy and education interventions on diet and serum cholesterol levels, although rates of obesity and diabetes increased (Dowse G et al, 1995).Asias community-based initiatives have been initiated in Sri Lanka, Thailand, Singapore, India, Pakistan, Malaysia, Iran and other countries. Particularly active development has taken place in China, where the Interhealth Programme was involved in initiatives in Tianjin and Beijing (Tian et al, 1995) .The Tianjin end in China was one of the major find out launched in 1984 in China. This project was also cooperating groups in Finland, China and USA for NCD control since 1989. This project focused on 4 leading NCDs of China, i.e. stroke, coronary heart disease, cancer and hypertension. The aim of this project was to reduce sodium intake in the population, decrease smoking especially among men and provide hypertension care by reorganizing the existing primary health care services. The result of this project shows a significant reduction in the sodium intake after three years and also reduction in number of patients of Obesity and hypertension among 45-65yrs old after five years of the intervention. Smoking cases were also redu ced among men, especially those with the higher education (Aulikki et al, 2001).Health education and the media campaigns also play an important role in the community programmes. Media campaigning although leaves the less impact on the population, it is one of the effective measure in the comprehensive package. Health service intervention such as primary care sum of money in the long run can also be one of the most effective intervention tools. This strategy can more appropriately work where certain biological risk factors such as hypertension and high blood pressure are dealt with. Primary health care workers played an important role in both North Karelia project and Tianjin project (Ibid).The North Karelia project worked on a concept of lodge organization where various sectors of the community were collaborated and involved. It involved many non governmental organizations (NGOs), such as Housewives organizations. It is not easy to collaborate with the industries and businesses at a blue community but a classic example for it is finlands cholesterol level, which reduces with the support and collaboration of the food industries, who supported the policy decisions (Puska P et al, 1986).Aulikki et al had made some recommendations for a successful NCD prevention program which must include the following factors. A good understanding of the community, close collaborations with the various community organisations and the involvement of the local population is important for any community intervention programme. It should combine well planned media and provide some communication messages in the community activities. It should involve different elements such as primary health care workers, food industries and supermarkets, voluntary organisations, schools work places, and local media for its success. It should be cost effective, mainly in the developing countries. For this reasonable outcome, effective dose intervention is a very important requirement (Aulikki et al, 2001).The increasing NCDs burden should be controlled by the developed and developing countries as a global health priority. International organisations with the national, regional and each individuals contribution can make these programme a success. Controlling of risk factors like smoking, alcohol, obesity, diet and inactivity, sexual and environmental factors are must and should be considered seriously and worked upon to treat it. The poverty and the high cost of prevention and treatment of chronic diseases causes burden on many countries and thus demands for international solidarity and public private partnership. The coordination of health decision makers, non-governmental organizations, inquiry institutions, community groups and individuals is must for controlling the incidence of diseases, preventing the spread of epidemics and regulate the health management of human and material resources (Boutayeb, 2005). WHO is a political champion for organise global response. The deve loping countries face problem in the implementation and enforcing the policies that are set up by the international legal standards which have a normative role and also these legal standards are not self-importance executing, so compliance can be monitored by the NGOs and government. A global approach in a way like this could reduce health inequalities (Magnusson, 2007).REFERENCES Anand K, Shah B, Yadav K, Singh R, Mathur P, Paul E, Kapoor S K (2007), Are the urban poor undefended to non-communicable diseases? 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