Lecture 23: NCD case study

Question 1

What is epidemiological transition

Answer 1

Characteristic shift in the common causes of death and disability from PERINATAL and CD to NCD

Question 2

What is risk transition

Answer 2

Changes in risk factor profiles as countries shift from low to higher incomes where common risks for Perinatal &CDs are replaced by risks for NCDs

Question 3

What is the double burden of disease

Answer 3

Middle income countries with previously common risks for perinatal and CDs coexist with increasing risks for NCDs. Therefore have major challenges for health policy.

Question 4

What is population attributable risk and how do you calculate it

Answer 4

To identify leading risk factors PAR is used to calculate the amount of extra disease burden attributable to a particular risk factor in a population. If this is casual association then this is the amount of disease we could theoretically prevent by removing the risk.
PAR = (total number of people with + outcome/total population) - ( number of people with disease+ but not exposed to risk factor (b/CG)

Question 5

What is the SES inequities related to NCDS

Answer 5

> 80% of NCDs in LIMIc, concentrated among the poor. (Not mostly rich problem.
Double burden requires double response rather than just CDs for MIc. almost 1/2 of people affected by NCDs are <70yr. Chronic diseases can be prevented

Question 6

Discuss the role that the commercial sector
(distal/upstream determinant) plays in (unequal)
NCD epidemics

Answer 6

The commercial sector creates uneven distribution of risks therefore leading to unequal distribution of disease and health inequities.
It does this by:
- marketing to vulnerable targets
- Changing physical and social environments
- Actively exploiting difficulties with behaviour change: framing choice, moderation and social responsibility.
-This promotes unhealthy consumption among vulnerable groups
-Therefore NCDS are higher in poor than rich.

Question 7

What is industrial epidemic

Answer 7

Diseases arising from the overconsumption of unhealthy commercial products.

Question 8

What is a R2Health approach for smoking

Answer 8

WHO MPOWER
M-monitor tobbaco use and prevention policies
P- protect people from tobbacco use (smoke free)
O- offer help to quit tobbaco use (downstream targetted programme)
W- warn about the dangers of tobacco
E- enforce bans on tobbacco advertising, promotion and sponsorship
R- raise taxes on tobbaco