Risk, lifestyle and non-communicable diseases of poverty (original) (raw)
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Background: Historically, the international development community has often held the view that those living in extreme poverty (at less than $1.90/day) are likely to have a low prevalence of cardiovascular disease (CVD) risk factors due to calorie scarcity, a largely plant-based diet, and physical labor. Evidence on CVD risk factor prevalence among adults living below the World Bank's international line for extreme poverty globally is sparse because studies have used measures of socioeconomic status that are not comparable across study populations and countries. For adults living in extreme poverty, this study aimed to determine i) the prevalence of each of five key CVD risk factors, ii) how the prevalence of these CVD risk factors varies across and within countries, and iii) the level of treatment coverage with statin, antihypertensive, and diabetes therapy. Methods: We pooled individual-level data from 105 nationally representative household surveys with physical measurements ...
Eighty percent of the global 17 million deaths due to cardiovascular disease (CVD) occur in low and middle income countries (LMICs). The burden of CVD and other noncommunicable diseases (NCDs) is expected to markedly increase because of the global aging of the population and increasing exposure to detrimental lifestylerelated risk in LMICs. Interventions to reduce four main risks related to modifiable behaviors (tobacco use, unhealthy diet, low physical activity and excess alcohol consumption) are key elements for effective primary prevention of the four main NCDs (CVD, cancer, diabetes and chronic pulmonary disease). These behaviors are best improved through structural interventions (e.g., clean air policy, taxes on cigarettes, new recipes for processed foods with reduced salt and fat, urban shaping to improve mobility, etc.). In addition, health systems in LMICs should be reoriented to deliver integrated cost-effective treatment to persons at high risk at the primary health care level. The full implementation of a small number of highly cost effective, affordable and scalable interventions ("best buys") is likely to be the necessary and sufficient ingredient for curbing NCDs in LMICs. NCDs are both a cause and a consequence of poverty. It is therefore important to frame NCD prevention and control within the broader context of social determinants and development agenda. The recent emphasis on NCDs at a number of health and economic forums (including the September 2011 High Level Meeting on NCDs at the United Nations) provides a new opportunity to move the NCD agenda forward in LMICs.
Journal of Diabetes, Metabolic Disorders & Control, 2014
Background Chronic non-communicable diseases are a major health concern and have been rising in prevalence over the last decades. These diseases commonly include obesity, diabetes, cardiovascular diseases, dyslipidemia, high blood pressure and asthma and lead to costly complications and diminish the quality of life of those who suffer from them. These diseases, particularly obesity, have traditionally been associated with socioeconomic privileges; nevertheless, recent studies have associated non-communicable diseases (NCDs) with disadvantaged conditions such as food insecurity, low income, poverty, inadequate living conditions and unemployment. 1 Eighty percent of the deaths caused by NCDs have been reported to occur in low and middle income countries and have been responsible for 44% of deaths globally. Combined with infectious diseases (including HIV, tuberculosis and malaria), poor maternal and perinatal conditions and nutritional deficits, these diseases double the death rate 1 and will have important economic losses. Over the next 10years, China, India and the United Kingdom will lose close to 558billion,558billion, 558billion,237billion and $33billion, respectively, as a result of cardiovascular diseases, stroke and diabetes. These loses will be partly due to the reduced economic activity caused by occupational absenteeism induced by NCDs complications. Social inequities have been emerging as a risk factor for NCDs together with increased physical inactivity, use of tobacco, alcohol and changes in food consumption patterns. 2 Social disparities contribute to the vicious cycle of poverty, which is difficult to break, particularly for those vulnerable groups whose lives are at risk because of issues such as personal insecurity and poor health status. Government interventions are needed in order to promote good quality of life conditions, provide access to adequate nutrition and income through employment, all of which may enhance individuals potential. 1,3 Poverty has many faces and can be analyzed from different perspectives. As an example, poverty in Latin America, from a historical perspective, has been a mixture of three types of poverty across the centuries since the American continent was discovered by Christopher Columbus. First, aboriginals lived in poverty; second, those who arrived with the colonizers were impoverished and excluded for many reasons. Third, those individuals who came from Africa were even more impoverished. Thus, poverty in the Latin American continent results from an incomplete process of ethnic, cultural and biological-genetic differences, and these differences should be approached from a more integrated perspective in order to propose adequate solutions. 4 In the United States, the highest obesity rates have reportedly occurred among population groups with the highest poverty index and lowest education, and an inverse relationship between energy density and energy cost has been shown. In addition, an association exists between poverty and food insecurity on the one hand and lower energy expenditures, low fruit and vegetable consumption and lower quality of diets on the other. The affordability of high energy dense foods versus a diet based on fish, lean meats, fruits and veggies has also been reinforced by the palatability of sugar and fat. 5 Thus, it is easy to understand why NCDs, particularly those associated with
2021
Cardiovascular diseases (CVDs), ranked top non-communicable diseases (NCDs), are the second leading cause of mortality in Africa, especially in sub-Saharan Africa (SSA) where they account for 73•4% global deaths and 80% of all premature deaths yearly. The ill-health due to CVDs in SSA is equivalent to the combined burden due to communicable, maternal, neonatal and nutritional diseases. Un-addressed, it is extrapolated that the Sustainable Development Goal 3.4 which targets NCDs will not be achieved. The preponderance of CVDs in SSA is due to determinants such as the epidemiological transition of diseases, aging, stress, illiteracy, poor health systems and poverty. This is quite worrisome for SSA dubbed "one of the most poverty stricken region on the globe". As such, poverty in Africa may adversely affect CVDs, but this has been less examined. This chapter explores the impact of poverty on CVDs and healthcare systems related to CVDs in Africa.
Lancet (London, England), 2018
Five Sustainable Development Goals (SDGs) set targets that relate to the reduction of health inequalities nationally and worldwide. These targets are poverty reduction, health and wellbeing for all, equitable education, gender equality, and reduction of inequalities within and between countries. The interaction between inequalities and health is complex: better economic and educational outcomes for households enhance health, low socioeconomic status leads to chronic ill health, and non-communicable diseases (NCDs) reduce income status of households. NCDs account for most causes of early death and disability worldwide, so it is alarming that strong scientific evidence suggests an increase in the clustering of non-communicable conditions with low socioeconomic status in low-income and middle-income countries since 2000, as previously seen in high-income settings. These conditions include tobacco use, obesity, hypertension, cancer, and diabetes. Strong evidence from 283 studies overwhe...
Poverty and Cardiovascular Diseases in Sub-Saharan Africa
Lifestyle and Epidemiology - Poverty and Cardiovascular Diseases a Double Burden in African Populations [Working Title], 2021
There is a rise in cardiovascular diseases (CVDs) in sub-Saharan Africa (SSA). Even though SSA is home to 14% world’s inhabitants, it is home to more than half of the global poor. The objective of this chapter is to evaluate the interconnection between CVD and poverty in SSA. We found that the relationship between poverty and CVD is bidirectional. The intersection between poverty and CVD cuts through primordial, primary prevention and secondary prevention interventions. In the context of poverty in SSA, CVD prevention is a challenge due to competing demands to address the never conquered infectious diseases exacerbated by the current COVID-19 pandemic. With a weak healthcare system and out of pocket payment for the costs of CVD care, a significant proportion of individuals with CVD and their households are consequently impoverished. Besides, CVD affects a younger and productive population in SSA than in the rest of the world. Thus, CVD-related loss of productivity progressively push...
Feast and famine: Socioeconomic disparities in global nutrition and health
Public Health Nutrition, 1998
To review current information on under- and over-malnutrition and the consequences of socioeconomic disparities on global nutrition and health. Malnutrition, both under and over, can no longer be addressed without considering global food insecurity, socioeconomic disparity, both globally and nationally, and global cultural, social and epidemiological transitions. The economic gap between the more and less affluent nations is growing. At the same time income disparity is growing within most countries, both developed and developing. Concurrently, epidemiological, demographic and nutrition transitions are taking place in many countries. Fully one-third of young children in the world's low-income countries are stunted because of malnutrition. One-half of all deaths among young children are, in part, a consequence of malnutrition. Forty percent of women in the developing world suffer from iron deficiency anaemia, a major cause of maternal mortality and low birth weight infants. Despite such worrying trends, there have been significant increases in life expectancy in nearly all countries of the world, and continuing improvements in infant mortality rates. The proportion of children malnourished has generally decreased, although actual numbers have not in sub-Saharan Africa and south Asia. Inequalities are increasing between the richest developed countries and the poorest developing countries. Social inequality is an important factor in differential mortality in both developed and developing countries. Many countries have significant pockets of malnutrition and increased mortality of children, while obesity and non-communicable diseases (NCDs) prevalences are increasing. Not infrequently it is the poor and relatively disadvantaged sectors of the population who are suffering both. In the industrialized countries, cardiovascular disease incidence has declined, but less so in the poorer socioeconomic strata. The apparent contradictions found represent a particular point in time (population responses generally lag behind social and environmental transitions). They do also show encouraging evidence that interventions can have a positive impact, sometimes despite disadvantageous circumstances. However, it seems increasingly unlikely that food production will continue to keep up with population growth. It is also unlikely present goals for reducing protein-energy malnutrition prevalence will be reached. The coexistence of diseases of undernutrition and NCDs will have an impact on allocation of resources. Action needs to be continued and maintained at the international, national and individual level.