Week 9- NCD Flashcards
What is a non-communicable disease (NCD)?
Diseases of long duration and generally slow
progression
• Also referred to as chronic diseases or long-term
health conditions
WHO: Non-communicable diseases (NCDs), also known as chronic
diseases, tend to be of long duration and are the result of a combination
of genetic, physiological, environmental and behavioural factors.
what are the five main types of non-communicable disease?
• Five main types:
• cardiovascular diseases (such as heart attacks and stroke)
• cancer
• chronic respiratory diseases (such as chronic obstructed
pulmonary disease and asthma) and
• diabetes
• mental health conditions
NCDs globally
The leading cause of death in the world, representing
71% of all annual deaths
• Kill more than 41 million people each year
• Some 80% of all NCD deaths occur in low- and middleincome countries
Around the world, NCDs affect women and men
almost equally
• Largely preventable
• Not only a health problem but a development
challenge as well
10 chronic conditions focussed on in Australia
Arthritis • Asthma • Back pain (and problems) • Cancer • Cardiovascular diseases • Chronic obstructive pulmonary disease (COPD) • Diabetes • Chronic kidney disease • Mental and behavioural conditions (A&D, dementia, mood) • Osteoporosis
Risk factors of NCD
• Tobacco
• Physical inactivity
• Poor diet (leading to obesity and related biomedical conditions)
• Air pollution
• Alcohol
• More prevalent in low SES areas, in regional and
remote areas
List some NCD
- Cancer
- Ischaemic heart disease
- Cerebrovascular disease
- Diabetes
- Chronic respiratory disease
- Injuries
- Mental health conditions
- Genetic disorders
RISK FACTORS
Behavioural determinants:
diet, physical activity,
smoking and alcohol. WHO 2014 www.who.int/beat-ncds
• Social determinants shape the distribution of the behavioural risk
factors. eg. socioeconomic status, employment, social exclusion
• Environmental determinants: pollution, access to parks and
recreation, injury prevention, etc
List the potential risk factors for each health problem:
• Catching a cold
- Breaking your hip
- Heart disease
- Catching a cold
- Being around others with colds
- Impaired immune system
- Breaking your hip
- Fragile bones
- Slippery steps
- Age
- Heart disease
- High cholesterol, blood pressure
- Smoking, stress;
- Genetics
DETERMINANTS OF HEALTH
A determinant of health is a factor or characteristic that brings
about change in health, either for the better of the worse.
• Biological eg. Age, sex, genetics
• Behavioural (lifestyle factors) eg. Healthy eating, physical
activity, tobacco smoking
• Social (inc. environmental, cultural, economic) eg.
socioeconomic status, employment, education, healthy environment
Bob is a 59yo male, with a family history of heart disease. He lives in an
area with few parks or green spaces and a significant amount of ambient air
pollution. Bob is a smoker, who has tried to quit without success. He works a
stressful office job with a long commute to work. As a result, he rarely has
time to cook nutritious meals. Though Bob would like to join a gym or fitness
center, his job pays minimum wage and he is unable to afford the fees.
§ Which determinants of health could be modified to
reduce Bob’s risk of cardiovascular disease?
– Biological determinants?
59yo male, and family history
Bob is a 59yo male, with a family history of heart disease. He lives in an
area with few parks or green spaces and a significant amount of ambient air
pollution. Bob is a smoker, who has tried to quit without success. He works a
stressful office job with a long commute to work. As a result, he rarely has
time to cook nutritious meals. Though Bob would like to join a gym or fitness
center, his job pays minimum wage and he is unable to afford the fees.
§ Which determinants of health could be modified to
reduce Bob’s risk of cardiovascular disease?
– Behavioural determinants?
smoker
cook nutritious meals.
join a gym or fitness
center,
Bob is a 59yo male, with a family history of heart disease. He lives in an
area with few parks or green spaces and a significant amount of ambient air
pollution. Bob is a smoker, who has tried to quit without success. He works a
stressful office job with a long commute to work. As a result, he rarely has
time to cook nutritious meals. Though Bob would like to join a gym or fitness
center, his job pays minimum wage and he is unable to afford the fees.
§ Which determinants of health could be modified to
reduce Bob’s risk of cardiovascular disease?
– Social and environmental determinants?
few parks or green spaces ambient air pollution stressful office job long commute minimum wage
what is health promotion ?
Health promotion is the process of enabling people to
increase control over, and to improve, their health. It moves beyond a focus on individualm behaviour towards a wide range of social and environmental interventions
History of Health Promotion
1947 WHO definition of health: a state of complete physical,
mental and social well-being and not merely the absence of
disease and infirmity
1978 WHO-UNICEF Alma Ata Declaration, promoted Primary
Health Care based on social equity, intersectoral action, social
investments, participation, reorientation of health services
Social determinants of health
The social determinants of health are the circumstances in
which people are born, grow up, live, work and age, and the
systems put in place to deal with illness. These circumstances
are in turn shaped by a wider set of forces: economics, social
policies, and politics.
Downstream factors
Downstream factors: those biological factors at the micro level,
including treatment systems, disease management, investment in
clinical research.
Upstream factors:
–Upstream factors: the social factors at the macro level including
government policies, population health, healthy environments
Midstream factors
–Midstream factors: the behavioural factors intermediate level
including lifestyle, behavioural and individual prevention.
Primary prevention
– healthy protection – FOCUS ON HEALTHY DISEASE FREE POPULATIONS
implementing programs and services to
prevent disease from occurring
Secondary prevention
– at risk populations – early diagnosis
early diagnosis at pre symptomatic stage;
early effective treatment to stop progress and shorten duration of
disease; prevent complications from the existing disease process
Tertiary prevention
= Treatment and management of people with disease
: stabilising the disease process; preventing
after effects of long-term impairments/disabilities; restoring,
maintaining optimal functioning – functional rehabilitation
Infrastructure and systems change
Taxation
Example: Tobacco tax, proposed sugar tax!
Legislation & policy
Example: Gun control, seat belts, smoke free public places, advertising bans &
restrictions (plain packaging, media)
Urban planning
Example: Green spaces
Organisational change
Example: Advocacy around gender diversity within workplaces
What stage(s) of prevention do you think public health campaigns are generally directed at and why?
• Primary or secondary.
• Aim to reach a broad section of the population – so message must be
relevant to most people.
• Most people either do not have a disease, or are asymptomatic.
list some primary prevention
Asbestos legislation Seat belts Bike helmets Health education (eating well, exercising, not smoking) Immunization for infectious disease Food safety regulations Publicity campaigns (lifestyle changes) Controlling potential hazards (home and workplace) Adequate housing Dental check ups Insect nets in the tropic
list some secondary prevention
Mammogram Modified work (injured work can return) Daily low-dose aspirin Exercise programs Blood pressure Screening for hepatitis patients with history injecting drug use Pap smear screening Prostate tests Administering medication to prevent heart failure Blood lipid screening Nutrition and physical activity programs for overweight children
List some Tertiary Prevention
Rehabilitation programs (chronic disease, addiction, vocational) Support groups Chronic pain management programs Speech, Physio and OT therapy after an brain haemorrhage Treatment, such as diabetes management, HIV management, arthritis management Specialised feeding clinics for children with special needs
What is health policy ?
what does it include?
Health policy = public policy, decisions of society
• Framework for health promoting actions.
• Covers the social, economic, environmental determinants of health.
• Health policy includes things outside what you might consider to be “health”
• Agricultural policies: Availability, price, quality of meat/dairy.
• Advertising/fiscal policies: Price, availability of cigarettes, healthy foods.
• Transport policies: Urban air pollution, risk of traffic crashes
• Industrial production, corporate management
• Taxation (e.g. Tobacco)
