Non communicable disease are best controlled by individual
behavior change
Behavior change counseling (BCC) that is integrated into routine health care has
been shown to be effective in helping patients modify risk behaviors for non-
communicable disease (NCD), improve self-management of chronic conditions, as
well as produce clinically meaningful improvements in biological outcomes
(Murphy et al., 2016), but is this the only effective way to control NCDs globally? In
this essay we are going to look over this debate and conclude our understandings.
Non-communicable diseases (NCDs) are medical conditions or diseases that are by
definition non-infectious and non-transmissible among people (Kim and Oh, 2013).
NCDs are an emerging public health problem that kill 41 million people each year
which accounts for 71% of all deaths globally. Among all non-communicable
diseases (NCDs), cardiovascular diseases, chronic pulmonary diseases, cancer, and
diabetes are the most important which account for over 80% of all premature NCD
deaths. According to World Health Organization report, cardiovascular diseases are
responsible for most NCD deaths (17.9 million annually), followed by cancer,
chronic respiratory diseases, and diabetes each killing 9 million, 3.8 million and 1.6
million respectively. Of these premature deaths, more than 85% are estimated to
occur in low and middle income countries (WHO, 2018b).
Non-communicable disease can affect all people at all ages, countries, and regions
but often old age groups are more prone to these diseases. Nevertheless, 15 million
of all NCD attributed deaths occur between the age group of 30 to 69 year. The
global probability of dying from one of the four main NCDs in 2016 was 18%, with
a slightly higher risk for males (22%) than for females (15%) (WHO, 2018a).
In 2010 the estimated expenditure on NCDs was 6.3 trillion US dollars and it is
projected to increase to 13 trillion US dollars in 2010. Countries around the world
recognize that something must urgently be done to alter the current state and
future outlook of NCDs (Arena et al., 2015).
Taking this into account and considering the utmost importance of NCDs in the
global health arena, the United Nations General Assembly conducted a high-level
meeting on prevention and control of NCDs in 2011, resulting in a declaration and
, voluntary country commitments. In 2012 the World Health Organization (WHO) set
the goal of “25 by 25” which meant to reduce the global NCD mortalities by 25% in
2025 among adults (WHO, 2013 - 2020)
Generally, unplanned urbanization, industrialization, globalization, unhealthy
lifestyle, population aging and the most important thing epidemiologic transition
are tend to be the force which make the NCDs a global health issue in 21st century.
It is commonly believed by public health experts that NCDs could be better
controlled through health promotion intervention especially individual behavior
change programs while on the other hand, some may believe that behavior change
itself is a long and difficult process and needs deep understanding of nature of
people which may not be the only effective way to control non-communicable
diseases.
The causes of the main NCDs are well established and well recognized. World
Health Organization (WHO) divided risk factors of non-communicable disease into
two categories of modifiable risk factors (tobacco use, alcohol consumption,
physical inactivity, and unhealthy diet) and Metabolic Risk factors (Raised blood
pressure, overweight, hyperglycemia, and hyperlipidemia).
Studies show that smoking is markedly associated with multiple cancer (particularly
lung cancer), heart disease, stroke and chronic obstructive pulmonary disease
(COPD). Similarly, incidence of lip, tongue, and mouth cancers are found to be
higher in those who are chewing tobacco compared to those who do not (Dobe,
2012).
According to a study published in 2011, alcohol is causally linked (to varying
degrees) to eight different cancers, risk increasing with the volume consumed.
Similarly, alcohol use is detrimentally related to many cardiovascular outcomes,
including hypertension, hemorrhagic stroke and atrial fibrillation (Parry et al.,
2011). Some studies show that the proportion of alcohol-attributed disease in
developing countries is between 2.6 and 9.8% of total burden for men and between
0.5 and 2% of the total burden for women (Dobe, 2012).
Furthermore, pieces of evidence show that those people who regularly do up to 30
min moderately intense physical activity per day have 20 to 30% less risk of all-
cause mortality compared to those who are physically inactive. Physical inactivity
