Non-Communicable Diseases – A Global Killer. Are there any Effective Prevention Strategies?


Non-communicable diseases (NCDs) are a group of diseases which are not transmitted through infectious agents or passed on from one person to another. In fact, they are commonly known as chronic diseases because they have a long duration and progress slowly. These diseases occur due to a complex interaction of genetic, physiological, behavioural and environmental factors. NCDs have become a global burden meaning they are responsible for killing nearly 41 million people each year, this is equivalent to 74% of all deaths globally (1). Of these deaths, there are 17 million premature deaths from an NCD (before the age of 70), and 86% of these deaths occur in low and middle income countries (1). In 2019, 88.8% of deaths in England were attributable to NCDs, demonstrating the large role of NCDs in the burden of mortality across our population (2). There are modifiable risk factors associated with NCDs which need to be highlighted in the prevention and control of NCDs.

What are the types of NCDs?

There are 4 major categories of non-communicable diseases and they are responsible for more than 80% of deaths, these include: cardiovascular diseases, diabetes, chronic respiratory diseases and cancer (3). Others include mental health disorders, chronic kidney disease, musculoskeletal disease and sensory disorders (4,5). A 2019 Public Health England publication, stated that in 2017, cardiovascular diseases, cancer and respiratory diseases were the leading cause of mortality in people between 59 to 79 years of age across both male and female genders (2). These premature deaths occurring before the age of 70 are preventable if appropriate knowledge is given at a population level regarding the modifiable risk factors of NCDs and making initiatives to provide regular health checks to the population.

Who is affected by NCDs?

All age groups can be affected by NCDs, but it is more common in the elderly population because of the accumulation of risk factors of co-existing diseases which weaken their immune systems through time. Furthermore, there is an inverse relationship between the socioeconomic status and the mortality rate from NCDs (3). Poverty has a higher chance of exposing individuals to the risk factors of NCDs contributing to the overall higher mortality rate compared to high socioeconomic status (4). Most of the NCDs occur in low and middle income countries and cause considerable disability as well. They have a significant economic impact due to the healthcare and medication costs and also limit a person’s ability to work (3). It is estimated that by 2030, deaths from NCDs will increase to 52 million a year (6). This is due to population growth, rise in the ageing population, globalisation and changes in behavioural, occupational and environmental risk factors (6).

What are the Risk factors of NCDs

There are two types of risk factors that contribute to the development of NCDs: non-modifiable and modifiable risk factors. Non-modifiable are factors that cannot be changed by an individual, these include: age, sex and genetic makeup (3). Modifiable risk factors on the other hand can be changed by an individual, these include: smoking, physical inactivity, poor nutrition, and harmful use of alcohol (3). The 4 modifiable risk factors are also known as behavioural risk factors and they could lead to the worsening of metabolic factors such as: high blood pressure, high lipid levels, increased glucose and obesity (3). The increasing metabolic factors are also associated with increasing morbidity levels. Morbidity levels are measured by the ‘Years Lived with Disability’ (YLD) index and it was found that in 2017 the top 3 risk factors for YLD for England were high body mass index, smoking and high fasting plasma glucose (2). It is also important to note that the exposure to these modifiable risk factors can happen over a life course. For example, it could be during childhood, adolescence, adulthood, midlife or even in-utero. Different risk factors can gradually accumulate and can cause an impact in later life (6). Therefore, the more risk factors a person is exposed to the higher likelihood there is of developing a NCD (5). This highlights the importance of taking action to tackle the risk factors of NCDs across all age groups so that more lives could be saved and overall improve quality of life.

What can we do to prevent NCDs?
In order to prevent and control NCDs, it is important to focus on reducing the risk factors. An effective public health strategy to address NCDs at a population level is to focus on the most common risk factors; tobacco use, physical inactivity, poor nutrition, and harmful alcohol consumption. For each of the modifiable risk factors there are proven cost-effective strategies that can be implemented. For example, to tackle the smoking risk factor, some possible strategies such as education, smoking cessation programmes, bans on smoking, and increasing prices of tobacco products, could be used. In order to promote physical activity, media campaigns, community educational programmes, and emphasising the importance of physical activity in primary health care during routine appointments could be further developed. NCDs such as cardiovascular diseases and diabetes can be particularly prevented if physical activity is more thoroughly promoted to the population. With regards to poor nutrition, it is important to promote a healthy diet through actions such as reducing salt intake, eliminating trans-fats and raising taxes on sugar, sweets and beverages (4). To reduce the harmful use of alcohol, more effective strategies to put bans on advertising alcohol, limiting access to alcohol, enforcing drink-driving laws, and interventions for alcohol abuse need to be implemented more strongly to the population. Over the years, interventions carried out to modify the behaviours in adulthood had variable results, meaning there was no consistent end result. Therefore, in addition to these preventative actions, it is vital to provide access to early diagnosis, treatment and care of children or adolescents with NCDs because in this way it will have a direct impact on the reduction of preventable death and disability (7). Early and regular screening, effective management of the disease, and managing complications relating to cardiovascular diseases, diabetes, respiratory disorders, and cancer will need a more thorough emphasis in the prevention and control model of NCDs.

What is the Red Drop Initiative?
With an overstretched NHS, it is vital for regular health checks to be implemented at a population level. It is estimated that 40% of the burden placed on the NHS may be preventable if appropriate action is taken to avoid the risk factors of chronic conditions such as NCDs. Our services here at Red Drop can benefit you as we provide tailored early and regular health screening, home-based blood testing and medical advice regarding NCDs. Early and regular screening and taking blood tests from the comfort of your home will be beneficial for early recognition and treatment of chronic conditions and will therefore allow us to effectively respond to the NCDs burden. Using a combination of strategies to tackle the early diagnosis and modifiable risk factors of NCDs, we believe that we will be able to make an effective contribution to overall improve the populational health.


References:

  1. Non communicable diseases (2022) World Health Organization. World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases (Accessed: December 29, 2022).
  2. Annex C: Data on the distribution, determinants and burden of non-communicable diseases in England (2021) GOV.UK. Available at: https://www.gov.uk/government/publications/nhs-health-check-programme-review/annex-c-data-on-the-distribution-determinants-and-burden-of-non-communicable-diseases-in-england#the-burden-of-non-communicable-disease (Accessed: December 29, 2022).
  3. Appuhamy, R. (2022) A global killer- Non Communicable Diseases- An Introduction, YouTube. YouTube- Lets Learn Public Health. Available at: https://www.youtube.com/watch?v=BWolWB3tSEU (Accessed: December 28, 2022).
  4. Noncommunicable Diseases (2022) World Health Organization. World Health Organization. Available at: https://www.who.int/health-topics/noncommunicable-diseases#tab=tab_1 (Accessed: December 30, 2022).
  5. Global noncommunicable diseases (2021) Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/globalhealth/healthprotection/ncd/index.html (Accessed: December 29, 2022).
  6. Competence centre on foresight (2022) Noncommunicable Diseases – NCDs | Knowledge for policy. Available at: https://knowledge4policy.ec.europa.eu/foresight/topic/shifting-health-challenges/non-communicable-diseases-ncds_en# (Accessed: December 29, 2022).
  7. Homepage (2015) NCD Alliance. Available at: https://ncdalliance.org/ (Accessed: December 30, 2022).