Lecture 29 Non communicable diseases Flashcards
What is an epidemiological transition?
characteristic shift in the composition of causes of death and disability from communicable to noncommunicable diseases
What are key factors influencing risk burden?
How strong the causal association is and how common the exposure is to this risk
What is a risk transition?
Changes in risk factor profiles as countries shift from low to higher income countries, where common risks for perinatal and communicable diseases (eg. unhygienic water) are replaced by risks for non-communicable diseases (eg. tobacco)
What is risk transition?
As countries transition from low to high income, there is a shift in the risk factors. Common risks for perinatal and communicable diseases are replaced by risks for non communicable diseases
What is the double burden of disease?
Previously common risks for perinatal and communicable diseases coexist with increasing risks for non-communicable diseases, in many middle-income countries. This is a major challenges for healthy policy becase limited resources are needed to target two different types of disease
What are the myths related to non communicable diseases?
- They affect mostly high income countries (more than 80% of non communicable diseases are seen in low and middle income countries)
- Affects mostly rich (concentrated among poor)
- LMICs should control infectious diseases first (Double burden requires double response)
- Primarily affects old people (50% affected are younger than 70)
- Chronic diseases can’t be affected (Significant proportions of premature heart disease, strokes, cancer and diabetes can be prevented)
What are the population groups most affected by NCDs
populations living in poverty and those living in lower middle income countries
What are are changes in smoking prevalence for NZ?
For all age groups and ethnicities, there has been a decrease in smoking. socioeconomic gradient (more likely to be smoking if in low socioeconomic)
Why are lower socioeconomic groups more at risk to smoking?
Due to the commercial sector. e.g even with the same amount of alcohol consumption, the probability of an event occurring is higher for those at a lower economic position due to starting point.
How does the commercial create inequities?
Creates an uneven distribution of risks leading to an unequal NCD epidemic
How have commercially driven epidemics come to be in terms of social norms?
Social norms have changed as smoking became popular among other social groups. Started by marketing to vulnerable targets and by changing physical (where outlets are concentrated) and social environment (influencing public policy development)
How have commercially driven epidemics come to be in terms of downstream strategies?
They place a greater emphasis on downstream determinants, exploiting difficulties with behavior changes.
- Frames education as the most effective solution
- Offers choice and pleasure
- Emphasis on moderation
What are strategies used by the industry
shaping the evidence, employing narratives and framing techniques, constituency building, policy substitution, development and implementation, opposition to policy development, big money behind harmful products, public image and social media attacks
Why do industries target school children
so they have lifelong customers
What is the government doing about commercial sector?
weak governance systems/political timidity (they are unwilling to battle large companies)
conflicts of interest (people who have worked with lobbyists becoming politicians)
belief in education approaches and marketing solutions
lack of demand for policies
