Download Slide 1

BK FOUNDATION HEALTH
AWARENESS - CHRONIC DISEASES
JOSEPH ANA
CHAIRMAN BOARD OF TRUSTEES
BK EDUCATION FOUNDATION
OBJECTIVE
PARTICIPANTS TO HAVE AN INCREASED
AWARENESS OF CHRONIC DISEASES AND
THEIR PREVENTION AND AVOIDANCE
WHAT IS KILLING PEOPLE IN THE
WORLD
Global Causes of Death (2006)
CHRONIC DISEASES:
INFECTIOUS DISEASES:
-
Heart disease 30.2%
-HIV/AIDS 4.9%
-
Cancer 15.7%
-TB 2.4%
-
Diabetes mellitus 1.9%
-Malaria 1.5%
-
Others 15.7%
-Other inf. Dses 20.9%
-Injuries 9.3%
The total number of people dying from chronic (58 MILLION) is double
that of all infectious diseases including HIV/AIDS, tuberculosis and
malaria
(Nature, 2007).
DOUBLE WHAMMY OF KILLER- DISEASES
IN NIGERIA
• Infections
• Chronic disease
Maternal death
630 per 100,
1000
Under 5
mortality 124
per 1000
IN NIGERIA 2012
Infant
mortality 78
per 1000
Children under
5 stunted
growth 36%
Burden of
disease in
Nigeria
High Blood
Pressure
Diabetes
Stroke
Asthma
CHRONIC
Cancer
DISEASES
ADD
MENTAL ILLNESS!
Did you know??
35 000 000
people died from
chronic diseases
in 2005
COMMON DENOMINATORS
•
•
•
•
smoking
Lack of exercise
Food abuse
Alcohol abuse
10 widespread misunderstandings about
chronic disease - and the reality
• Chronic disease epidemic is rapidly evolving
• Global recognition and response has not kept
pace
• Misunderstandings can be dispelled by the
strongest evidence
Reality: 80% of chronic disease deaths
occur in low & middle income countries
Reality:
double burden = double response
Reality: chronic diseases are concentrated
among the poor and chronic disease is one
of the main reasons that families are
pitched into poverty
Facing illness
and deepening
poverty
Reality:
poor and children have limited choice
The next
generation
Reality: 80% of premature heart disease,
stroke and type 2 diabetes is preventable,
40% of cancer is preventable
20%
80%
Heart disease
20%
20%
80%
80%
Stroke
Type 2 diabetes
60% 40
%
Cancer
preventable
not preventable
Reality: inexpensive and
cost-effective interventions exist
Reality: these people are the rare
exceptions
Reality: death is inevitable but
it does not need to be slow,
painful or premature
Dying slowly,
painfully and
prematurely
Three risk factors
• Three risk factors cause four chronic diseases
that cause over half of deaths worldwide.
• The risk factors are:
Tobacco use
Lack of physical activity
Unhealthy diet
ADDITIONALS
• ALCOHOL ABUSE – complex
• OBESITY - complex
Old and new agendas for global health
acute childhood infections
maternal deaths
Simple technologies
Rapid impact
Controlled by health services
Within the remit of the health
campus and the health
department
chronic, life long infectious and
non-infectious diseases
Complex interventions
Decades before impacts
Main levers outside health
service control
Takes a whole university and all
government!
What works?
Comprehensive
and integrated
action is the means
to prevent and
control chronic
diseases
Multiple interventions are effective
Cigarette smoking is influenced by
•
•
•
•
•
•
•
•
•
Fiscal measures – high taxation
Advertising bans
Prohibiting smoking in public places
No vending machines available
Health campaigns to stop smoking
Transport smoking bans
Campaign groups
Health warnings on packets
Medical advice repeatedly
Diet – changing what we eat
Nutrition transition
• Worldwide, there is an accelerating move
towards a diet high in saturated fats, sugar
and refined foods, but low in fibre.
• Average food consumption per person is likely
to increase from 2,680 kcal in 1997–1999 to
almost 3,000 kcal by 2030.
Source:
UN FAO, 2004
Diet – changing what we eat
What is driving the nutrition transition?
• The cost of industrial fat has fallen by 50% in
the last 50 years, whereas the cost of a
healthy ingredient such as fruit has increased
by one third.
• Salt provides flavour to cheap food at around
$150 (£84) a tonne. Real spices cost up to
$2,000 a tonne.
Source: The Guardian, 25 April
2006
Diet
From this…
8oz
12oz
16oz
20oz
34oz
Diet
50 tsp (200g) of sugar (Coca-Cola)
… to this!
16oz
32oz
ource: Brownell, 2005
S
44oz
52oz
64oz
A rough example
• There are 1,144 kcal in a McDonald’s quarterpounder with cheese, small fries and a small
chocolate milkshake
• This is approximately 70% of the
recommended daily calorie intake of a 10year-old girl
• To work off 1,144 kcal, a child weighing 87 lbs
would have to walk at 3 mph for about six
hours
Source:McDonalds; AAFP; The fitness calculator
Physical activity transition
•
•
•
•
A transition in physical activity is occurring – we
lead increasingly sedentary lives:
desk jobs replace manual work
labour-saving devices make housework easier and
less time consuming
transportation options remove the need to walk or
cycle
safety fears keep children – and older people –
indoors.
Influences on physical activity
Personal characteristics
Work/school
Distance to
work/school
Playing fields
Changing
facilities
Stair access
School
governors
Active games
Motivating people/orgs
Work gym
PE / lunchbreaks
Employer
Colleagues
Media
Community
Age
Housework
Friends
Stairs
Access to gym
Teachers
Government
Family
Motivating factors
Green space
Motivation
Health insurers
Knowledge/
Beliefs
education
Income
Government
Self-image
Abilities
Gender
Town planners
Time
Mobility
Architects
Media
Health professionals
Bike paths
Shop location
Pollution
NGOs
Industry
Home
Safe streets
Street layout
Sports equipment
Pavements
Environmental
Lack of physical activity
• As a result of these trends…
– UK: 69% of adults and 35% of children
– US: 55% of adults and 31% of adolescents
– - ? Data for Nigeria
• … do not reach the recommended levels of
physical activity.
Source: ‘At least five a week’ – report from the CMO of England and Wales, 2004 and CDC 2002
Recommended levels of physical activity
• For adults –
– At least 30 minutes a day of moderate-intensity
physical activity on five or more days of the week.
– The 30 minutes can be made up of bouts of
activity of 10 minutes or more.
• For children and young people –
– At least 60 minutes of moderate-intensity physical
activity every day.
Benefits
• Compared with people who do not reach the
recommended levels of physical activity,
active people have:
–
–
–
–
almost half the risk of dying from coronary heart disease
a 27% lower risk of stroke
a 33–50% lower risk of developing type 2 diabetes
40–50% lower risk of colon cancer, and reduced risk of
other cancers, e.g. breast cancer.
• Plus, benefits for musculoskeletal health and
mental health.
Source: ‘At least five a week’ – report from the CMO of England and Wales, 2004
Increasing physical activity
• No magic bullet
• Many interventions will be necessary
• Redesigning the environment will be more
important than exhortation, doctors
prescribing exercise, or gyms
TAKE THE STAIRS!
THANK YOU FOR LISTENING
A:
B:
values
C:
readings)
BP<135 – reassess every 3 years
85
BP 135 -139 – high normal
85 – 89 - reassess yearly
145 – 159 – Hypertension
90 – 99 (after at least three
↓
Target organ damage
CVD complications
Diabetes
Ten year CHD risk > 15%
↓
TREAT
(reassess yearly)
No target organ damage
No CVD complications
No Diabetes
Ten year CHD risk < 15%
↓
OBSERVE
HYPERTENSION - MANAGEMENT
- Non pharmacological therapy (for all)
- Weight reduction\salt reduction/limit alcohol
- Regular exercise
- increase fruit & vegetable intake
-
Pharmacological therapy
Diuretic
Diuretic & B-blocker
Diuretic & ACE Inhibitors (except verapramil)
Calcium antagonist & B-blocker
Calcium antagonist & ACE In hibitor
A-blocker & B-blocker