As the world progresses towards the third millennium the major issue of non communicable diseases is darkening the world, taking the form of a thick cloud of poor healthcare systems and a lack of information available. In particular, in developing countries one of the major causes of death is because of suffering from non communicable diseases.
The prevention of non communicable diseases is corollary to tackling associated risk factors and, one of the major causes of the mayhem as well. This is largely because of ill-facilitated resources in the developing countries. The resources present not being harnessed at par, leading to depreciation of 'life value' of the common.
Focussing on various non communicable diseases - cardiovascular diseases, diabetes, cancer and chronic pulmonary diseases are the leaders. Although these diseases are prevailent worldwide, the major concerns and interests of organizations, such as the WHO (World Health Organization), remains in contexts of developing nations.
Due to the prevalent nature of these diseases in developing countries (shown by various research data from national registries and international organisations) the burden of infective diseases has doubled. And undoubtedly due to the present situation of the low quality healthcare systems in these developing countries does not help the prevention of these diseases let aside the thoughts about a cure.
There is a need to take urgent preventive action against these diseases and invention of efficient strategies to deal seriously with the connected risk factors, so that the world can be made a better place to live.
Introduction
In this essay we will be discussing about the conditions related to non-communicable diseases and the consequences to the European region of World Health Organization (WHO). First of all we describe about what exactly is meant by non-communicable diseases (NCDs) and the various classification of diseases. Then in the following section we talk about the situation of Europe and the effects of non-communicable diseases on the population. Further to which we discuss the root causes of non-communicable diseases. The second last section described the role of organizations regarding non-communicable diseases. Finally the last section is the conclusion.
Non- communicable diseases and cardiovascular diseases (CVD) together are the biggest burden on the developing countries or the industrialized countries and are troubling their present healthcare systems (Puska, 2002). Studies show that many deaths in developed countries, precisely three out of four deaths are because of cardiovascular diseases, cancer, accidents and various other violent causes. When considering the global statistics, cardiovascular diseases (CVD) are the cause of every third death, alongside coronary heart diseases (CHD) which are also equally responsible for the overall number of deaths around the globe.
For the past few decades researchers have been working to learn and understand the major causes and mechanisms related to non communicable diseases. These researchers included large epidemiological studies confined to certain population masses, basic biochemical and animal studies, intervention trials and large - scale community based studies for prevention. Although nothing was limited to the above, there was much more work and investigation done into understanding the root causes (Puska, 2002).
These studies closing down to the nearest decade showed that cardiovascular diseases or situations leading to them originate from unhealthy lifestyles of the common residents, also including adverse physical and social environments. These include factors such as unhealthy nutrition, smoking, physical inactivity, excessive consumption of alcohol on an everyday basis, and psychosocial stress. If taken in to account carefully everything can be seen as major lifestyle issues and to be the root cause of cardiovascular diseases (Puska, 2002).
As society advances, aspects would become clear by extensive research being carried out; still, we do have enough knowledgebase at present to start working towards the prevention of these diseases. We do have more access to information everyday regarding non communicable diseases (NCD) that the question here is not "What should be done?" , but "How should it be done?". The most important issue is to how to use existing knowledge and research in real life for taking preventive measures towards these diseases (Puska, 2002).
What are non-communicable diseases (NCDs)?
Clarification of non-communicable diseases clarifies the common myths:
Non-communicable diseases are not ordinary diseases which are an inevitable consequence of ageing or the result of affluence that is difficult to control and less important than communicable diseases. Do heart attacks, strokes, diabetes, chronic lung diseases come as life goes on? Probably not, because non-communicable diseases are not related to facts of life (Fact Sheet - Euro, 2006/2004)
Non-communicable diseases are not inevitable, basically very much preventable. The biggest challenge to public health in the World Health Organization (WHO) European Region is the same at present and for the foreseeable future. 86% of the deaths in this Region and 77% of the disease burden were because of non-communicable diseases. This is increasing the everyday burden on people and the related healthcare systems. Non-communicable diseases (NCDs) are also a major hurdle in economic and social development. The European Region of all the World Health Organization (WHO) regions is the most affected one.
Definition
Non-communicable diseases (NCD) are comprised of various diseases which come under the same umbrella. These are the diseases which are not transmitted by the means of an infective agent or caused by injury. Out of all, the most prominent diseases share common grounds of risk factors, and hence some common preventive measures as well. Many diseases out of the group of non-communicable diseases (NCDs) take a chronic course, and therefore are very much amenable to some or the other common approaches to care and management (Fact Sheet - Euro, 2006/2004).
Table 1: Classification of diseases
Source: (World Health Report 2004 Changing History, 2004)
The above table shows clearly the various categories of diseases out of which the most broadly classified one are non-communicable diseases (NCDs). In the table it is clearly outlined the prevalent conditions which classify a disease as a non-communicable disease. Furthermore, it can be clearly inferred from the conditions that each condition can be understood, and once research is carried out to justify the cause of the same condition, preventive measures are easier to be applied.
Scope of Non-Communicable diseases (NCDs) in Europe
The European union (EU) is facing health challenges that require various immediate and significant actions to be taken soon. One of the most serious problems is high levels of adult premature mortality which is due to coronary heart diseases, cancer, and also to some extent injuries. To reduce the incidence of coronary heart diseases it is important to reduce smoking, change food habits and increase the level of physical activity (Leif Edvard Aaro, 2008). Also a decline in smoking prevalence would substantially reduce lung cancer mortality in the region. To reduce the incidence of injuries there is a high need to reduce the level of consumption of alcohol and to create a physical environment which would be safer.
There has been a dramatic societal change in the early 1990s which has shown signs of improvements in public health in almost all the countries of Europe, however not equally strong across all population segments (Leif Edvard Aaro, 2008). It can be clearly seen that the health and disease statistics are less encouraging for less well educated and low income groups. Various strategies are being developed towards strengthening public health actions and also health promotion in order to improve the health of masses of the common in the newly formed European Union.
"Leading epidemiologists and public health researchers have maintained that the only effective approaches to improving the health of general populations or large population segments are preventive strategies and health promotion (Rose, 1992; Tones & Green, 2004)." Various curative health services have also accounted for some reduction in diseases such as strong reduction of coronary heart diseases in various western countries during the last 30 years at least. British epidemiologist Richard Peto has, however, suggested that as much as two thirds of the reduction is caused by positive changes in health behaviour.
There is also a need to have a wide range of tools which must be utilized to improve health in whole population (Leif Edvard Aaro, 2008). Safer physical environments can be easily created through combining legislation and regulations, enforcement strategies, educational measures, and community programmes. Relying only on a single tool for example only health education has proven to be much less effective (Leif Edvard Aaro, 2008).
"In terms of mortality, the leading non-communicable diseases in the WHO European Region in 2002 were cardiovascular diseases (CVD), cancer, respiratory disorders, digestive disorders and neuropsychiatric disorders (Fact Sheet - Euro, 2006/2004). In terms of burden of disease, the chief contributions were estimated to come from CVD (23%) and neuropsychiatric disorders (20%), with cancer accounting for 11%. The burden of non-communicable diseases is unevenly distributed across the Region. When the countries in the region are placed in three groups (Eur-A1, Eur-B2, Eur-C3), according to their levels of mortality in children under 5 years of age and males aged 15-59 years, the relative contribution of non-communicable diseases to disease burden can be more clearly seen. Some parts of the WHO European Region have a double burden of disease: both an increasing burden from non-communicable disease and the persistent threat of communicable diseases." (Fact Sheet - Euro, 2006/2004)
3.1 Figure: Burden of disease in disability- adjusted life years (World Health Report 2004 Changing History, 2004)
What causes non-communicable diseases?
Non-communicable diseases (NCDs) are very largely preventable. In the WHO European Region, just eight risk factors are the main contributors to the burden of disease from NCDs and that is tobacco, alcohol, low fruit and vegetable intake, physical inactivity, high blood pressure, high cholesterol, overweight and obesity and raised blood sugar.
The major risk factors which accumulate through the life course are those such as socio-economic, political, behavioural, and environmental. These factors basically interact in many different ways with other determinates of health to form the attributes of the disease. Many parts of the population which are from a low socioeconomic groups have two times more risk of getting serious illness and premature death of those in high socioeconomic groups. Once the gap between these groups can be narrowed the potential for reducing the mortality and susceptibility to various non-communicable diseases can be highly reduced as well.
The approach to tackle non-communicable disease has to be designed in a way to combine integrated action on the risk factors and also determinants spread wide across sectors along with putting in efforts to strengthen the health systems. This would then lead to improved prevention and control. Gaining health: the European strategy for the prevention and control of non-communicable diseases has provided the members with an opportunity so that they can bring together various relevant strategies and action plans within a mutually reinforcing framework. (WHO - Non-Communicable diseases - Risk Factors, 2010)
Role of organizations
Various effective interventions already exist to prevent and treat non-communicable diseases and also to reduce their impact and the resulting disability. Like cardiac failures have fallen 50% in people who stop smoking, the risk of getting CVD has also reduced. This includes acute myocardial infarction, stroke and peripheral vascular disease. Increase of the prices by 10% on a packet of cigarettes would reduce the consumption by 4% (Fact Sheet - Euro, 2006/2004).
Further, the North Karelia project reduced mortality from coronary heart disease in Finland by 73% over 25 years, through community-based activity that encouraged a healthier diet and that was supported by national policies on risk factors. Combining population-based cholesterol-reduction strategies with interventions to reduce salt intake in the population is very cost-effective in reducing hypertension and cholesterol (Fact Sheet - Euro, 2006/2004). Primary preventive strategies that focus on unhealthy diet, physical inactivity, tobacco use and harmful alcohol use in an integrated way are likely to have the greatest impact over time on the leading conditions. While primary prevention is a more long-term strategy, real short-term gains can be made in treating people at high risk, such as those with established coronary heart disease. More needs to be done to ensure that people who would benefit from drug treatment receive the support they need. Drugs such as beta-blockers, acetylsalicylic acid and lipid-lowering agents can be highly effective in reducing risks of CVD morbidity and mortality (Fact Sheet - Euro, 2006/2004).
A combination of measures, aimed simultaneously at the entire population and at individuals at high risk of developing diseases, is also cost-effective. For example, population interventions to reduce salt intake, lower cholesterol and reduce weight, alongside the implementation of an absolute risk approach to managing CVD risks, have received positive evaluations.
Intervention is worthwhile throughout the life-course. The foundations of adult health are laid in early childhood and even before birth. Further, the adoption of healthy lifestyles in older age can prevent disease and functional decline, extend longevity and increase the quality of life.
Non-communicable diseases need to be high on the agenda of other sectors than health. Issues such as diet and physical activity require multi-sectoral responses. Non-health sectors have more control over the determinants of health, and in facilitating supportive environments. For example, effective promotion of physical activity as a part of everyday life requires the involvement of urban and transport planners.
Although much is known about the causes of non-communicable diseases and effective interventions, much still needs to be done to ensure that this knowledge is put into practice, so that the entire society benefits and so that these benefits spread across the whole WHO European Region.
Conclusion
Finally, it can be clearly seen that organizations like World Health Organization (WHO) plays a vital role in strategically planning health scenario in various countries of the world, including those in Europe. In Europe non-communicable diseases is a major cause of mayhem, which is not related to ageing of the human body. Rather than that, non-communicable diseases (NCDs) are usually caused by various addictive habits such as smoking, excessive alcohol consumption etc. With all the statistics and discussions done in the above presented matter, it can be concluded that prevention of these non-communicable diseases is an important step towards welfare of the countries in Europe as well as to improve the social lifestyle and physical environments of the population. As it is well said - "Prevention is better than cure".
Search Strategy
I started off looking for articles on Google Scholar and PubMed. Google Sholar was of good use. I focused on key words such as non-communicable diseases, non-communicable diseases in Europe, differences between non-communicable and communicable diseases and common risk factors of non-communicable diseases. I also visited websites of the World Health Organisation(WHO) and United Nation, I focused on the same key words as before. I payed more attention to articles from year 2000 and so on.
