Non-communicable diseases Flashcards
What are NCDs and what is the importance of NCDs?
NCDs are chronic diseases that cannot pass from one person to another. They develop slowly over time, and generally progress slowly.
Non-communicable diseases (NCDs) are the leading cause of preventable ill health, related disability and premature death in the world today.
The major groups of NCDs are:
*cardiovascular diseases
*non-hereditary cancers
*chronic respiratory disease
*diabetes
*mental health conditions
NCDs are associated with a high level of social and economic burden. This includes:
*reduced quality of life (often for many years)
*reduced productivity - affecting economic and social wellbeing for the individual, their family and community
*increased burden of health care for the individual, the family and society
What is the global impact of NCDs?
Non-communicable diseases (NCDs) kill 41 million people each year, equivalent to 71% of all deaths globally.
Premature death
*Each year, more than 15 million people die from a NCD between the ages of 30 and 69 years;
*85% of these “premature” deaths occur in low- and middle-income countries.
In Aus= low Socio-economic situations, regiognal and remote areas
These four groups of diseases account for over 80% of all premature NCD deaths.
*Cardiovascular diseases (17.9 million people annually),
*Cancers (9.3 million),
*Respiratory diseases (4.1 million),
*Diabetes (1.5 million).
Note: mental health not on WHO list.
Tobacco use, physical inactivity, harmful use of alcohol, unhealthy diets → increased risk of dying from a NCD.
*Tobacco accounts for >7.2 million deaths every year
* Excess salt/sodium intake→ 4.1 million annual deaths
*>50% of the 3.3 million annual deaths attributable to alcohol use are from NCDs, including cancer.
*insufficient physical activity → 1.6 million annual deaths
*Detection, screening & treatment of NCDs, as well as palliative care, are key components of the response to NCDs.
Metabolic risk factors contribute to four key metabolic changes that increase the risk of NCDs:
*raised blood pressure; ^[biggest]
*overweight/obesity;
*hyperglycemia (high blood glucose levels); and
*hyperlipidemia (high levels of fat in the blood).
The leading metabolic risk factor globally (→ death) is elevated BP, followed by overweight & obesity, and raised blood glucose.
What is the impact of NCDs in Australia?
- The five disease groups: cancer, MSK, CVD, mental health and SUDs and neurological conditions (instead of respiratory)
- vary in fatality (MSK not too much)- Mostly chronic and long-lasting conditions
- Cancer contributes most burden, and is very fatal
- NCDs = 90% deaths ^[2011]
- Disease burden, or DALYs, is not equally shared: NT, remote and very remote areas, and lowest socioeconomic group
Discuss trends in NCDs in rural and remote Australia
A clear trend of greater burden rates with increasing remoteness for:
*coronary heart disease
*chronic kidney disease
*chronic obstructive pulmonary disease (COPD)
*lung cancer
*stroke
*suicide
*self-inflicted injuries
*type 2 diabetes.
In contrast, anxiety disorders, dementia and depressive disorders showed lower rates of burden in more remote areas (AIHW 2019a).
Health inequalities in rural and remote areas may be due to factors, including:
*challenges in accessing health care or health professionals, such as specialists, allied health
*social determinants such as income, education and employment opportunities
*higher rates of risky behaviours such as tobacco smoking and alcohol use
*higher rates of occupational and physical risk, for example from farming or mining work and transport-related accidents.
Health risk factors are attributes, characteristics or exposures that increase the likelihood of a person developing a disease or health disorder.
Modifiable risk factors such as:
*tobacco smoking (people outside major cities had higher rates of current daily smoking)
*poor eating patterns
*risky alcohol consumption
*not getting enough exercise.
Note: prevalence of health risk factors increases with remoteness.
Note 2: median age of death decreases with remoteness
Discuss the intersection of Indigenous health and remoteness
Remoteness and Indigenous people
- in very remote areas, 47% of the population are Indigenous
- remote areas = 18%
- 1.7% in major cities (however most Indigenous people live in cities, or inner regional areas)
Central Australian statistics
*Life expectancy of Aboriginal people 20 years less than for non-Aboriginal Australians.
*considerably worse than other comparable indigenous populations, eg the first nation peoples of USA and Canada, and the Maōri of Aotearoa.
*Aboriginal boys born today have 45% chance of living to age 65 (81% for non-Aboriginal boys); Aboriginal girls have 54% chance of living to age 65 (89% for non-Aboriginal girls).
*Age standardised death rates for Aboriginal males are 2.8 times those for non-Aboriginal males; Age standardised death rates for Aboriginal females are 3.3 times those for non-Aboriginal females.
Note: potentially avoidable deaths
- 17% of all deaths in Australia
- rate increases with remoteness for both males and females (more in females?)
Discuss some key challenges in public health and care in managing NCDs in rural and remote settings
The way people in rural and remote areas access primary health care often differs to those in metropolitan areas.
*facilities are generally smaller, have less infrastructure, less capacity i.e. for testing and provide a broader range of services to a more widely distributed population.
*Rural and remote populations also rely more on general practitioners (GPs) to provide health care services, due to less availability of local specialist services (Department of Health 2016).
Note: NT nurse dependent
“Australians living in Remote and Very remote areas experience health workforce shortages, despite having a greater need for medical services and practitioners with a broader scope of practice” (AMA 2017).
*health professionals per 100,000 population generally decreased with remoteness
*rate of allied health professionals, dentists and pharmacists was lower in regional areas and lowest in Remote and Very remote areas
*rate of specialists substantially declined with increasing remoteness
*Full time nurses and midwives were highest out of all health professionals in rural and remote
GP supply was also unequally distributed as remoteness increased. Data indicate that the rate of GPs in 2017 increased with extreme remoteness, however, care should be taken in interpreting the data as work arrangements in these areas have the potential to be more complicated (NRHA 2017) e.g. part-time, no after hours.
A demonstration of the inverse care law.
when answering questions hink of, mgmt vs prevention, non-drug.med,profs
