Non-communicable diseases (NCDs) – diseases that are not passed from one person to another, such as diabetes, cancer and cardiovascular disease – represent arguably the biggest threat to health worldwide.
Often chronic, they are generally of long duration and slow progression. Of the 56M deaths reported in 2012, the World Health Organization (WHO) reports that NCDs were responsible for 38M (68%), and more than 40% of these were premature deaths under the age of 70 years. (1)
The big risk factors for NCDs include tobacco use, insufficient physical activity, poor diet and harmful alcohol consumption. While you might assume that victims of NCDs are the affluent, lazy, or elderly, this is not entirely correct. The social gradient, whereby populations of lower socio-economic status are more likely to experience poorer health outcomes than their wealthier counterparts, means that vulnerable population groups are doubly affected by poor access to preventative and promotive health services. Indeed, almost three-quarters of all NCD deaths worldwide occur in low and middle income countries (2). Almost 9% of the world’s population have diabetes, the focus of this year’s World Health Day, totalling about 422M people (3), a figure which is predicted to double by 2036, disproportionately affecting those in low- and middle-income countries.
Trends in globalisation, urbanisation and the global consumer market mean that in developing countries – where fragile and resource-poor health systems are faced with the already high burden of maternal and perinatal conditions, nutritional deficiency and infectious diseases – the emergence of NCDs as a health threat results in a crippling double burden of communicable and non-communicable diseases. Where access to care is more likely to be scarce or of poorer quality, NCDs contribute to poor health outcomes and premature deaths.
Yet there is reason to be optimistic. The 2015 UN Sustainable Development Goals (SDGs) make an explicit commitment to reduce premature deaths from NCDs by a third by 2030. This reflects a growing global commitment from the international community to tackle NCDs, which were overlooked in the preceding Millennium Development Goals.
Substance abuse, road traffic accidents, and tobacco control are all addressed as risk factors. Individual and collective health is the product of the interaction of broader political, economic, environmental and social factors, so collaboration from all sectors and at all levels of government and policy-making is vital.
The statistics mentioned above suggest that most people will know someone whose life is impacted by an NCD. World Health Day reminds us that we all have a role to play: individually, to replace unhealthy lifestyle choices with healthy ones; and collectively, to raise awareness of NCDs and to advocate for policies and regulations that support health-promoting behaviours.
1, 2: See Global Status Report on non-communicable diseases 2014
3: See World Health Organization fact sheet on diabetes.