NCDs: Prevention, Impact & Statistics

• Non-communicable diseases (NCDs) are not passed from person to person
• NCDs are also known as chronic diseases
• NCDs are of long duration and generally slow progression
• Chronic conditions do not result from an acute infectious process.
• Are "not communicable”
• Chronic conditions cause premature morbidity, dysfunction, and reduced quality of life.
• Chronic conditions usually develop and progress over long periods
• Chronic conditions are often initially insidious, with a protracted period of impaired health.
• In 2013, for a UN high-level meeting, the World Health Organization (WHO) proposed restricting the term NCDs to four major disease groups.
• The four major disease groups restricted by the WHO are cardiovascular diseases (CVDs) which includes stroke, diabetes, cancers, and chronic respiratory diseases such as asthma, emphysema, and chronic bronchitis.
• The four major disease groups, though different in their clinical profile, are linked by common risk factors
• Some scholars find the term 'NCDs' unsatisfactory
• Some cancers (e.g., cervix, liver, and stomach) and some heart diseases (e.g. rheumatic heart disease) link to viral or bacterial infections
• NCDs kill 41 million people yearly, equivalent to 70% of all deaths globally.
• 85% of these "premature" deaths occur in low & middle-income countries
• NCDs are responsible for 74% of all deaths in Thailand
• Cardiovascular disease accounts for the majority of NCD related deaths at 23%
• The epidemic of NCDs poses devastating health consequences for individuals, families and communities and threatens to overwhelm health systems.
• The socioeconomic costs associated with NCDs make the prevention and control of these diseases a major development imperative for the 21st century
• The WHO's mission is to provide leadership and the evidence base for international action on surveillance, prevention and control of NCDs.
• Urgent government action is needed to meet global targets to reduce the burden of NCDs.
• Cardiovascular diseases (CVDs) are the leading cause of death globally, resulting in an estimated 17.9 million deaths each year.
• CVDs include coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions.
• Risk of CVD may manifest as increased blood pressure, glucose, and lipids, with being overweight or obese posing added risk.
• A considerable proportion of heart attacks and strokes can be prevented by controlling major risk factors through lifestyle interventions and/or medication.
• Diabetes occurs when the pancreas does not produce enough insulin or the body cannot effectively use it.
• Insulin regulates blood sugar, which. when raised is known as Hyperglycaemia.
• Hyperglycaemiais a common outcome of uncontrolled diabetes and with time leads to serious damage to many of the body's systems,
• 1.6 million deaths were directly caused by diabetes in 2016 with a further 2.2 million deaths attributable to high blood glucose in 2012
• Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation
• Cancer can affect virtually any organ or tissue within the body when abnormal cells grow uncontrollably and spread to other organs
• Cancer is the second leading cause of death globally.
• In 2018, 9.6 million people globally died due to cancer
• Cancers are incurable however screening and early diagnosis, especially with earlier treatment, can improve prognosis
• Between 30% and 50% of cancer deaths can be prevented by modifying or avoiding key risk factors
• Chronic respiratory diseases (CRDs) are diseases of the airways and other structures of the lung.
• Some of the most common CRDs are chronic obstructive pulmonary disease (COPD), asthma, occupational lung diseases and pulmonary hypertension
• CRD risk factors include tobacco smoke, air pollution, occupational chemicals and dusts
• 3 million people die each year from COPD, with an estimated 6% of all deaths worldwide
• Risk factors involve personal behaviour or lifestyle, environmental exposure, or individual hereditary characteristics which increase the occurrence of a disease, injury, or health condition.
• Risk factors can be biological, behavioural, socioeconomic, or sociocultural.
• Non-modifiable risk factors cannot reduced or controlled
• Examples of non modifiable risk factors include ethnicity, age, gender, and family history

Modifiable Risk Factors

• Modifiable risk factors are those that can be intervened on
• According to WHO the four prioritized modifiable risk factors include physical inactivity, tobacco use, alcohol use and unhealthy diets
• The four main diseases and the modifiable risk factors are:
  • Cardiovascular diseases - tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol
  • Diabetes - tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol
  • Cancer - tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol
  • Chronic Respiratory Diseases - tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol
• Complex aetiology (cause) because or the variable combination of many risk factors
• It's difficult to say which are the main cause(s) in any individual with an NCD
• In terms of tobacco use, risk factors include the inclusive of cigarettes, cigars, shisha, vaping and passive smoking.
• In terms of unhealthy diet, risk factors are excessive sugar consumption, excessive consumption of saturated fats and excessive portion size and highly calorific meals.
• Physical inactivity or sedentary behaviour is also a risk factor.
• Physically inactivity involves not doing enough physical activity.
• Sedentary behaviour: Sitting or lying down for prolonged periods
• Sedentary behaviour does not necessarily mean an individual is insufficiently active as they may have periods of physical activity
• Other risk factors include air pollution, socioeconomic status, geographic or environmental factors, social and cultural influences
• One of the most crucial ways of reducing global deaths from NCDs is to control unhealthy lifestyle choices that lead to their development.
• Crucial ways of reducing global deaths from NCDs include reducing the use of tobacco and the harmful use of alcohol, maintaining an active lifestyle and developing a healthy diet
• Promotional activities towards these goals are low-cost ways for countries to reduce the number of NCD deaths
• Tackling these risk factors can not only save lives, but also provide a huge
• Aside from prevention methods, the management of NCDs is critical.
• This includes detection, screening and treatment of the diseases, as well as palliative care for those who require it
• The vast majority of premature deaths from NCDs occur in low- and middle-income countries, where universal health coverage or access to health care services is often limited
• The development and promotion of universal health coverage is thus critical in addressing NCDs and working to reduce the number of
• Reducing the major risk factors of NDCs - primarily tobacco use, an unhealthy diet, harmful use of alcohol and physical inactivity – is the focus of WHO's Department for the Prevention of NCDs
• In 2013, WHO developed the Global action plan for the prevention and control of NCDs 2013-2020
• This Global action plan included 9 global targets with the greatest impact towards prevention and management of NCDs.
• Top fiscal interventions to raise funds for healthcare include raising taxes.
  • 87% of countries have tobacco taxation
  • 80% of countries have alcohol taxation
  • Only 18% of countries have sugar sweetened beverages taxation
  • only 89% of countries have Food taxation of foods high in fat, sugar, or salt
• Cardiovascular disease, diabetes, cancer and chronic respiratory diseases are the four main NCDs.
• Their prevalence continues to increase, they present a global burden both on individuals' health and longevity and health systems from an economic and capacity perspective.
• Addressing common risk factors is a critical target for all countries to reduce the prevalence of NCDs by 2030 as per WHO targets
• Further improved management of existing NCDs and appropriate palliative care would require more continued development and improvement.

Explore the global development imperative of preventing and controlling Noncommunicable Diseases (NCDs). Understand the risk factors, mortality rates, and the impact of diseases like diabetes, cardiovascular diseases, and cancer. Review key statistics on NCD-related deaths globally and in Thailand.