Non-Communicable diseases, an economic and health burden for the Region
Washington, DC, December 19, 2002 (PAHO) -- In the next century, the Americas face the challenge of fighting against a dramatic rise in non-communicable diseases. According to information presented at the last Pan American Health Organization’s Sanitary Conference, these diseases, including diabetes, hypertension, and cancer, cause 44 percent of the deaths in the Region. Furthermore, the work force of the majority of the countries is affected by diseases and risk factors that, to a great extent, can be prevented.
According to a recent PAHO report on Public Health Response to Chronic Diseases, the most important of these in the Americas are, in order of importance: cardiovascular diseases, of which stroke and ischaemic heart disease are the most frequent in terms of mortality; cancer, particularly cervix, uterine and breast cancer among women, and stomach and lung cancer among men as well as prostate cancer in some populations; diabetes, which affects over 35 million people; and injuries, the leading cause of death among men, especially adolescents and young adults. These diseases share several common, related risk factors: hypercholesterolemia, obesity, impaired glucose tolerance and diabetes, which can be regarded both as disease and a risk factor for cardiovascular diseases; physical inactivity, smoking, and high fat consumption.
The importance of non-communicable diseases is evident in all ages and in both sexes. Studies reveal that the prevalence of hypertension ranges from 14 percent to 40 percent among those 35 to 64 years old. But almost half of them are not aware of their condition, and on average, only 27 percent control their blood pressure. Furthermore, among the 9 percent to 18 percent of people 35 to 64 years old living with diabetes, nearly 60 percent already have at least one microvascular complication when diagnosed. These complications that can be prevented lead to significant disabilities such as blindness, amputation, and chronic renal failure, the report notes.
Another impressive example is the almost 231,000 women who die every year because of cervical cancer. More than three fourths of those deaths occur in underdeveloped countries, making it one of the leading causes of death in women.
To fight against these problems, PAHO’s Program of Non-communicable Diseases is working to strengthen the capacity of the countries to formulate effective policies, strategies, and models to control non-communicable diseases, emphasizing cardiovascular diseases, cervical cancer, diabetes and injuries.
PAHO is promoting the creation of alliances and instruments to prevent and control intentional and unintentional injuries and violence. It advocates the establishment of a regional network of countries that use an integrated approach for non-communicable disease control and supports the creation and the improvement of national and regional surveillance of these diseases and their risk factors.
Together with support for epidemiological surveillance systems, PAHO has developed a series of strategies for an integrated approach to prevention emphasizing risk management at the population level, improvements in the environment, and the CARMEN initiative of actions for the multi-factorial reduction of non-communicable diseases, that identifies and fosters effective interventions to promote and maintain healthy lifestyles.
A demonstration area for the CARMEN program, in the city of Bucaramanga, Colombia, has been oriented to modify risk factors associated with non-communicable diseases, in particular encouraging physical activity. At the same time, it has facilitated effective social participation and development of cost-effective interventions in healthy public policies.
The CARMEN network, formed by Canada, Chile, Costa Rica, Cuba, and Puerto Rico, has been expanded. In Argentina, Brazil, Colombia, and the United States (in El Paso, Texas) community-based prevention strategies are underway. Knowledge of the distribution of the risk factors has improved and interventions that integrate health services with community organizations have advanced.
PAHO has also supported the reorientation of health services, mainly with respect to facilitating access to services and increasing user satisfaction. This was achieved through improvement of epidemiological surveillance systems, training of health workers, strengthening the capacity of services to work with the community, and the improvement of quality of health services.
Together with the National Heart, Lung, and Blood Institute of the National Institutes of Health of the United States, and within the framework of the Pan American Hypertension Initiative, a standard methodology was also prepared to measure blood pressure, so that it produces valid and reliable measurements that can be adopted in the studies of surveillance of hypertension.
All these measures aim at diminishing the incidence of risk factors for chronic diseases that, in many cases, are preventable with healthy habits or with changes in eating behavior.
PAHO, which was created in 1902, has been working for 100 years to improve the health and raise the living standards of the peoples of the Americas.
For more information, please contact: Daniel Epstein, Office of Public Information, (202) 974-3459, e-mail: epsteind@paho.org.
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