Non-Communicable Diseases and Injuries (PDF)

NON-COMMUNICABLE DISEASE AND INJURY What do people die from in Canada? (World Health Organization, 2014; http://www.who.int/nmh/countries/can_en.pdf) What is a non-communicable disease? ▪ Non-communicable diseases are ▪ Not infectious ▪ Not transmissible ▪ Include most chronic disea...

NON-COMMUNICABLE DISEASE AND INJURY What do people die from in Canada? (World Health Organization, 2014; http://www.who.int/nmh/countries/can_en.pdf) What is a non-communicable disease? ▪ Non-communicable diseases are ▪ Not infectious ▪ Not transmissible ▪ Include most chronic diseases, but not all ▪ AIDS is considered a chronic disease, but is transmissible as HIV ▪ Can be familial/genetic or the result of environmental/lifestyle factors Examples of non-communicable diseases Genetic Diseases Environmental Diseases Albinism Appendicitis Colour blindness Atherosclerosis Cystic fibrosis Asthma Down syndrome Carpal tunnel syndrome Fragile X syndrome Chronic obstructive pulmonary disease Hemophilia Fetal alcohol syndrome Muscular dystrophy Glaucoma Sickle-cell disease Hyper/Hypothyroidism Tay-Sachs disease Liver cirrhosis Triple X syndrome Osteoporosis Usher syndrome Sudden infant death syndrome Many more… Many more… Causes of non-communicable diseases ▪ Familial/genetic non-communicable diseases ▪ Result from genetic anomalies that occur during reproduction ▪ DNA sequences are changed away from the normal sequence – mutation ▪ Can occur in one gene (monogenic disorder) ▪ Sickle cell disease, cystic fibrosis, Huntington’s disease ▪ Can occur in multiple genes (multifactorial inheritance disorder) and in combination with environmental factors ▪ Have been implicated in many cancers, heart disease, and diabetes ▪ Can occur from changes to entire chromosomes (chromosome disorders) ▪ Down syndrome (extra copy of chromosome 21) ▪ Prader-Willi syndrome (absence of a group of genes on chromosome 15) ▪ Angelman syndrome (absence of a group of genes on chromosome 15) ▪ Chronic myeloid leukemia (exchange of genes between chromosome 9 and 22) Causes of non-communicable diseases ▪ Environmental and lifestyle factors are major causes of non-communicable disease in Canada ▪ Social determinants of health ▪ Cancer, diabetes, cardiovascular disease, and chronic respiratory disease all linked to physical inactivity, unhealthy eating, smoking, and misuse of alcohol Who is at risk of developing chronic non-communicable disease? ▪ People living with poor socioeconomic status (poor social determinants of health) ▪ Low access to nutritious foods ▪ Reduced rates of exercise ▪ Increased rates of smoking ▪ Increased rates of alcohol consumption ▪ Indigenous people are at heightened risk ▪ Lower socio-economic status (poor social determinants of health) creates increased risk of unfavourable lifestyle factors that lead to chronic disease ▪ Elevated rates of hypertension and type 2 diabetes ▪ As age increases, so does the risk of developing chronic disease Who is at risk of developing chronic non-communicable disease? (Stats Can, 2009; http://www.statcan.gc.ca/pub/82-003-x/2010003/article/11289/tbl/tbl1-eng.htm) Who is at risk of developing chronic non-communicable disease? ▪ Prevalence of diabetes increases with age (2011) (Public Health Agency of Canada, 2011; http://www.phac-aspc.gc.ca/cd-mc/publications/diabetes-diabete/facts-figures-faits-chiffres-2011/chap1- eng.php) How to prevent non-communicable diseases ▪ Best way is to improve the social determinants of health ▪ Increase physical activity ▪ Improve nutrition ▪ Reduce smoking ▪ Reduce alcohol consumption ▪ Improve all of the other factors related to the above factors ▪ Improve education ▪ Improve income ▪ Improve housing ▪ Improve social relations Injuries ▪ Proportionally, injuries do not kill very many people in Canada (World Health Organization, 2014; http://www.who.int/nmh/countries/can_en.pdf) Injuries ▪ However, injuries are extremely important in the healthcare system ▪ 15% (4.27 million) of Canadians 12 years or older were injured severely enough to limit their usual actives in 2009-2010 ▪ Injuries cost $19.8 billion dollars in 2004 due to direct healthcare costs and indirect costs due to reduced productivity ▪ Leading cause of death for Canadian youth aged 1-34 ▪ Second leading cause of death for those aged 35-44 ▪ Third leading cause of death for those aged 45-64 Who gets injured? ▪ Young people at highest risk of debilitating injury (aged 12-19) ▪ 27% risk – twice as high as the other age groups (13%) ▪ Males at highest risk of debilitating injury ▪ Especially young males aged 12-19 ▪ 30% risk Where do people get injured? ▪ People are most often injured playing sports or exercising ▪ 66% of injuries for those aged 12-19 were due to sports ▪ However, those 65 years and older are most often injured while walking (28%) or doing chores (27%) Concussions (Minor Traumatic Brain Injury) ▪ Concussions occur when the brain impacts the skull ▪ The head is bumped, hit, or jolted – causes brain to move rapidly back and forth ▪ Most common in children and older adults ▪ Often the result of, but not limited to, sports injuries ▪ Symptoms are often multifaceted, but mild ▪ Physical: headache, nausea, dizziness, sensitivity to light or noise, balance problems ▪ Emotional: irritability, anxiety, sadness, exaggerated emotions ▪ Cognitive: difficulty thinking, concentrating, and remembering new information ▪ Sleep: sleeping more than usual, sleeping less than usual, troubles falling asleep ▪ Recovery can last from days to months ▪ Require sleep at night and rest during the day, avoid physical activity, avoid drugs and alcohol ▪ One concussion increases the risk for subsequent concussions or major TBI ▪ Repeated concussions and TBI can lead to chronic traumatic encephalopathy (CTE) (CDC; https://www.cdc.gov/traumaticbraininjury/pdf/fact_sheet_concusstbi-a.pdf) Concussions (Minor Traumatic Brain Injury) ▪ Vox; https://www.youtube.com/watch?v=tnAmddi52Y8 (Vox; https://www.youtube.com/watch?v=tnAmddi52Y8) Concussions (Minor Traumatic Brain Injury) ▪ Return to play guidelines ▪ Step 1: No physical/sporting activity ▪ Step 2: Light aerobic exercise ▪ Step 3: Sport specific exercise with no contact ▪ Step 4: Begin drills without body contact ▪ Step 5: “On field” practice with body contact, once cleared by a doctor ▪ Step 6: Return to regular game play ▪ If symptoms are experienced at any level, return to the previous stage for at least one day ▪ If no symptoms are experienced, move up to the next step the next day ▪ These are the guidelines used by doctors across Canada (Parachute; https://parachute.ca/wp-content/uploads/2019/06/Return-to-Sport-Strategy.pdf) How do people get injured? ▪ Most injuries are the result of falls ▪ 50% of injuries sustained by those aged 12-19 ▪ 63% of injuries sustained by those aged 65 and older The importance of falls ▪ Falls account for 85% of senior’s injury related hospitalizations ▪ Leading cause of injury-related admissions for seniors ▪ Seniors on average stay in hospital 10 days longer for falls than any other cause ▪ Falls account for one third of admissions to long-term care facilities after being discharged from hospital ▪ Cost of falls among seniors is approximately $2 billion annually from direct healthcare costs ▪ After sustaining a fall, seniors may become overly cautious ▪ Reduce physical activity ▪ Lose strength and flexibility ▪ Increase risk for further falls ▪ Increase risk for other chronic diseases The importance of falls QUESTIONS?