Over the past few decades, the world has experienced an epidemiological transition marked by increasing burden of Non Communicable Diseases (NCDs), also known as chronic or lifestyle diseases. These are non-infectious health conditions that cannot be spread from person to person, but result from a combination of genetic, physiological, environmental and behavioral factors. They are of long duration in nature, generally developing and progressing over many years or several decades
These ailments are heavily linked to various lifestyle factors and choices with their origin being primarily based on the day to day habits of people. Their course of illness is often progressive and takes years before substantial manifestation that would force a patient to opt for intervention. In the long run, they give rise to circumstances that may make it difficult for the patients to lead a normal active and quality life.
The four major types include cardiovascular diseases (e.g. heart attack, stroke), cancers, chronic respiratory diseases (e.g. COPD, asthma) and diabetes. Other types of non-communicable diseases which contribute to the high incidence of disability around the world are musculoskeletal (e.g. osteoarthritis, osteoporosis), neuromuscular (e.g. Parkinson’s disease, multiple sclerosis), and mental health (e.g. dementia, schizophrenia).
Four modifiable risky behaviors have been identified to be commonly in link with these conditions. They include excessive alcohol use, long-term use of tobacco products, physical inactivity and unhealthy diet that is characterized by consumption of foods high in sugar, salt, fat and a low in fibre, fruit and vegetable intake.
Diseases of affluence?
Initially referred to as diseases of affluence, one would reserve NCDs and their trouble for the affluent few, or at least for the developed and high income countries as historically perceived. On the contrary, recent trends and current statistics show that it is an increasing challenge across all socio-economic classes. In fact, it seems to be more devastating for the not-rich. According to the World Health Organization, lifestyle diseases kill about 41 million people annually (71% of all deaths globally), of which 78% occur in low and middle-income countries.
The 2017 Global Burden of Disease study shows that disability-adjusted life-years (DALYs) caused by lifestyle diseases in Africa for instance, is almost equivalent to the combined DALYs from communicable, maternal, neonatal, and nutritional (CMNN) conditions, and is projected to exceed deaths due to these conditions by 2030. In Kenya, a 2015 survey for lifestyle diseases’ risk factors revealed that over 55 percent of hospital deaths and more than 50 percent of all hospital admissions were due to NCDs.
Over 55 percent of hospital deaths and more than 50 percent of all hospital admissions in Kenya are due to diseases of lifestyle.2015 STEPS survey of NCDs Risk Factors, Kenya.
Diseases of old age?
Though commonly associated with older age group, NCDs actually affect people of all ages and all age groups are vulnerable to their risk factors. They basically manifest after decades of exposure to risk factors which do accumulate throughout the life course – from infancy to adulthood. Evidence show that 15 million of all deaths attributed to NCDs are between the age of 30 and 69 years, over 85% of these occurring in low and middle income countries. Most of these premature deaths are caused by the four major NCDs, i.e. cardiovascular, chronic respiratory diseases, cancers and diabetes.
The burden of lifestyle diseases is growing, afflicting an increasing number of people, families and communities. The lengthy and high health-care costs associated with these conditions quickly drain household resources, not to mention disability and deaths of family breadwinners, all of which cause poverty. This led to NCDs’ inclusion in the Sustainable Development Goals (SDGs), with a target of reducing by one-third, relative to their 2015 levels, premature mortality from NCDs and promoting mental health and well-being by 2030.
Currently, global strategic action areas for NCDs prevention and control are health promotion, risk reduction, health systems strengthening for early detection and management. Kenya has had an NCD burden reduction strategy that aims at reducing the preventable burden, avoidable morbidity, mortality, risk factors and related costs.
What can I do?
It is well documented that healthy lifestyles play an important role for primordial and primary prevention of NCDs. Because their genesis is early in life, prevention is most effective when it targets problem at its roots. Taking early, appropriate, timely, and collective action is important if we are to control this. This is a responsibility we can take as individuals, families or households.
As governments employ multisectorial approaches in this fight, we must play our individual roles. First is to recognize the fact that the major risk factors driving these diseases are modifiable behaviors embedded in our day to day habits and choices. Every lifestyle choice we make at every stage of our life is thus an opportunity to control our behavior and reduce the probability these diseases later in life.
Much important also is our health seeking behavior. Make an effort to monitor your wellbeing and take necessary action. When last did you check your blood pressure and/or sugar levels? Early screening and diagnosis of NCDs and their risk factors allows for early intervention which is associated with better outcomes. In low resource settings, it is common for people to cope with early symptoms of a chronic illness until later when they are eventually overwhelmed, or even incapacitated. Advanced illness coupled with poor accessibility of care normally has no good outcomes. Primary prevention of NCDs and their risk factors is the most cost-effective control of the epidemic of lifestyle diseases and its adverse socio-economic effects. It is possible, affordable, and sustainable.