PAHO Rep. Highlights Chilling Effects of Non-Communicable Diseases

Non-communicable diseases are the leading cause of functionary impairment and deaths worldwide. Sixty per cent of the world’s population die from chronic or non-communicable diseases, 30 per cent from communicable diseases and 10 per cent from injuries.
This alarming revelation was made by the Washington Representative of the Pan American Health Organization (PAHO), Dr. Alafia Samuels, in her presentation, ‘Regional Perspective on Chronic Disease/Port- of-Spain NCD Summit Declaration’, at a recent National Policy Dialogue on Non-Communicable Diseases (NCD) workshop, at the Hilton, Kingston Hotel.
She says that while the incidence of communicable diseases and injuries has been declining over time, non-communicable/chronic diseases (NCDs) have remained relatively steady. Even more frightening she says, is the fact that the leading cause of death in the Caribbean is heart disease and that most of these deaths are in people under 70 years. Yet, she informs, these are mostly preventable deaths.
Dr. Samuels dispels the myth that chronic diseases are for the elderly. “There is the view that chronic diseases are inevitable, that you have to age and that the body must eventually degenerate. However, the problem is that almost half of the deaths from chronic diseases are in people below age 70,” she explains, adding that, “anything that does not allow you to get to three score and ten is a problem, which is why we have to deal with chronic diseases.”
Generally, these conditions or diseases result from prolonged exposure to causative agents, many associated with personal behaviours and environmental factors she says, adding that after these diseases manifest, there may be a protracted period of impaired health. So, for the indifferent who will say, “oh, but I have to die from something, so what’s the stress,” Dr. Samuels warns: “The stress is, you may not actually die; you may get a stroke and be deformed for 20 or so years or have diabetes and lose your legs, or go blind.”
Between 1980 and 2000, the number of diabetics doubled. Even more startling is the revelation that the treatment of diabetes and hypertension is costing the Jamaican Government approximately six percent of its Gross Domestic Product (GDP), said Dr. Samuels.
These statistics are more than enough to awaken a sense of urgency within Jamaicans and by extension the world; to ignite in people that need to tackle the risk factors for these diseases and ultimately stem the high incidence of deaths caused by them.
Non-communicable/chronic diseases are conditions that do not result from an acute infectious process, as in the case of communicable diseases, such as malaria, typhoid and other vector borne and venereal diseases. They can cause death, dysfunction, or impairment in the quality of life, and usually develop over relatively long periods; first without causing symptoms. The non-communicable diseases mentioned by Dr. Samuels as those mostly affecting the region are “cardiovascular diseases, heart attack, stroke, diabetes, cancer and chronic respiratory diseases, particularly asthma.”
“Preventing chronic diseases is a very important investment for a country to make,” she notes. This is especially so when close to six per cent of the country’s Gross Domestic Product (GDP), is being lost because of high blood pressure and diabetes. “That’s a lot of money, and we can do better in preventing them,” Dr. Samuels emphasises. High blood pressure, she reports, is causing about 22 per cent of deaths in Jamaica.
Because most chronic diseases take years to develop, with clear manifestations occurring mostly in middle to late adult life, Dr. Samuels believes that there is considerable potential for early identification and modification of risk during the early years – childhood, adolescence and early adulthood – through changes in personal health behaviours and the environment, for example, increased access to exercise facilities.
To stem this unrelenting trend in the incidence of chronic diseases, Dr. Samuels advises that Jamaica must concentrate on implementing preventive measures to curb the risk factors that cause these killer diseases.
The number one risk factor for death in the region and in the world is high blood pressure, followed closely by obesity, alcohol, tobacco, low fruit and vegetable intake, physical inactivity and unsafe sex. “These are our major risk factors for deaths and disabilities in the region and this is where our targets need to be if we seriously want to prevent these diseases, because treatment is not going to do it for us. We need also to prevent it as well as to control it,” she explains.
Dr. Samuels points out that the higher a person’s blood pressure, the greater the chance of a heart attack, heart failure, stroke or kidney disease. The risk for high blood pressure starts at 115/75. Anything above this, she says, confers increased risk.
She also suggests that a small improvement in the health of the entire population can lead to a large reduction in chronic diseases. She points to Poland as an example of countries implementing measures to reduce the incidence of deaths caused by NCDs. Poland removed subsidies on butter, sold cheaper vegetable oil, increased their fruit intake and decreased consumption of tobacco.
Accompanying this population type approach, she mentions, should be intervention for individuals who are high risk. These interventions require lifestyle changes to ward off these debilitating lifestyle diseases.
It is imperative for high risk individuals and by extension the Jamaican population to significantly cut back on salt intake to mitigate the effects of salt as a major risk factor for high blood pressure. “Salt is a major problem. A significant reduction in salt can lead to half the number of people needing treatment, a 22 per cent reduction in stroke and a 16 per cent reduction in coronary heart disease,” Dr. Samuels says. She urges the Government and the population to adopt drastic measures to begin to save lives.
Though often convenient and a quick fix for hunger pangs, fast foods are high in calories and low in nutrients. These sugary, salty or oily foods are highly addictive and contribute to the high incidence of deaths from chronic diseases. “Excess sugar leads to obesity, excess fat leads to high blood pressure and obesity, stroke or kidney disease,” she notes.
Junk and fast foods all have one major ingredient called Trans Fat. This, Dr. Samuels states, is “the worst kind of fat,” due to its overall contribution to the onset of chronic diseases, such as high blood pressure and diabetes. Trans Fat, she says, raises the bad cholesterol (Low density lipo protein) and lowers the good cholesterol (High density lipo protein). “Each two per cent of fat from Trans fat is associated with a 23 per cent increase in heart disease,” she reveals.
This sentiment is echoed by Medical Dietician at the Spanish Town Hospital, Cordell Dallas. “The more Trans Fat we take in, increases the bad cholesterol in our bodies, if you have too much cholesterol in your blood it will clog the arteries and make the passage for the flow of blood smaller. This leads to heart attack or chest pains, indicating that one may be pending,” she tells JIS News in an interview.
The Government and by extension other regional Governments have been undertaking a number of initiatives to improve the quality of life of its various populations.
In September last year, Prime Minister Bruce Golding led a delegation to the Chronic Disease Summit in Trinidad. From this Summit came the Declaration of Port-of-Spain, as well as an agreement to implement a Caribbean Wellness Day, which will be observed on September 13.
The National Policy Dialogue on Non-Communicable Disease Prevention and Control, where Dr. Alafia Samuels made her presentation, was also an initiative of the Trinidad Summit.
Minister of Health and Environment, Rudyard Spencer, also announced in his June 2008 Sectoral Debate presentation that, “we will undertake certain specific interventions to safeguard the health and well being of our people.”
He spoke of plans to strengthen existing initiatives, such as the Healthy Zone Project, the Workplace Wellness Programme and other projects of the Healthy Lifestyle Project of the Ministry of Health, as part of Government’s overall mission, to increase preventive measures against chronic diseases and for overall better health care.