Steps to reduce leading causes of death

WHO outlines steps to reduce leading

causes of death

By Madison Park, CNN

updated 5:33 PM EST, Sun September 18, 2011

Deaths from noninfectious diseases are increasing, especially for low- and middle-income countries.

STORY HIGHLIGHTS

• WHO: Countries should tax tobacco and alcohol, discourage smoking, salt and trans fats
• They should also emphasize good diet, physical activity, health organization report says
• Recommendations were released to cut heart disease, cancer, lung disease, diabetes
• Not implementing interventions could cost countries $7 trillion in 15 years, study says

(CNN) -- To decrease deaths from noninfectious diseases, countries should pass excise taxes on tobacco and alcohol, encourage smoke-free public places, reduce salt and trans fat in foods, and increase awareness of diet and physical activity, according to a World Health Organization report.

The report, released Sunday, warned that people in rich and poor countries continue getting noninfectious diseases related to lifestyle and the use of tobacco and alcohol.

These diseases -- heart disease, cancer, lung disease and diabetes -- are not only the leading killers in the world, with 36 million deaths a year, their economic toll can be devastating.

If these noncommunicable diseases flourish at their current rate, low- and middle-income nations could lose about $7 trillion from 2011 to 2025. These estimates are results from a World Economic Forum and Harvard School of Public Health study also released Sunday.

A 2009 survey of business leaders by the World Economic Forum called chronic disease one of the leading threats to global economic growth.

For only the second time in its history, the United Nations General Assembly, which is meeting this week, has put a health issue on its agenda. Nations will meet Monday and Tuesday to develop an international plan for preventing and controlling noncommunicable diseases.

The need for action is urgent, said Dr. Ala Alwan, assistant director-general for noncommunicable diseases and mental health at the WHO.

"The world is now recognizing the enormous health impact of noncommunicable diseases, particularly the four major groups: cardiovascular disease, cancer, chronic lung disease, diabetes. This is now emerging as a major social-economic problem as well," he said.

Deaths from noninfectious diseases are increasing, especially for low- and middle-income countries, some of which are grappling with other health issues such as malnourishment and infectious diseases.

"We know there are 100 million people who are pushed into poverty every year, because they have to pay directly for health care," Alwan said. "Most of the health care requirements are for noncommunicable diseases: cardiovascular disease, stroke, lung disease, diabetes or cancer."

These illnesses hurt household income for the affected individuals and their families, but also translate to loss of productivity and physical disability.

"When much of the work force is sick and dies in their productive years, national economies lose billions of dollars in output. And millions of families are pushed into poverty," Jean Pierre Rosso, managing director at the World Economic Forum, said in a news release.

The diseases also affect the United States, which spends $2 trillion a year on health expenses, according to the WHO report.

CNNMoney: Health care's big money wasters

WHO grouped heart disease, cancer, lung disease and diabetes because these account for 80% of the deaths from noncommunicable diseases, and they share common risk factors. These include tobacco use, harmful use of alcohol, physical inactivity and an unhealthy diet.

It recommended several public health steps to help countries take action such as discouraging smoking, reducing salt in foods and encouraging healthier habits.

The WHO studied 48 low- and middle-income countries all over the world over 10 years. The countries, such as Sri Lanka, Ukraine and Kenya, implemented measures such as salt reduction campaigns and tobacco control.

The measures resulted in a "considerable reduction" in the incidence of noncommunicable disease and death, Alwan said. He called these steps "best buys," because they cost little money and have the potential to "save literally millions of lives over the next 15 years."

These recommendations also include screening people who are at risk for heart disease, cervical cancer screenings and hepatitis B immunization to prevent liver cancer.

The cost of adopting these interventions in all low- and middle-income countries would be $12 billion per year. Inaction would result in about $7 trillion in losses over the next 15 years for these nations.

Unlike infectious diseases, these chronic diseases have been slow to get attention. The U.N'.s focus on the topic is much needed, said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations think tank.

"It's a difficult thing to do, to frame it as something sexy that mobilized policy makers or society groups," he said. The pervasive thought is that, "this is a lifestyle disease. It's because of the lack of exercise, too much high-fat food, you deserve it. It's your problem."

Beating Obesity - By 2015, four out of 10 Americans may be obese

Beating Obesity - by Marc Ambinder - The Atlantic

"By 2015, four out of 10 Americans may be obese....

In 1960, when President-elect John F. Kennedy fretted about fitness in an essay for Sports Illustrated titled “The Soft American,” roughly 45 percent of adults were considered overweight, including 13 percent who were counted as obese; for younger Americans, ages 6 to 17, the rate was 4 percent. Obesity rates remained relatively stable for the next 20 years, but then, from 1980 to 2000, they doubled. In 2001, the U.S. surgeon general announced that obesity had reached “epidemic” proportions. Seven years later, as the obesity rate continued to rise, 68 percent of American adults were overweight, and 34 percent were obese; roughly one in three children and adolescents was overweight, and nearly one in five was obese. Americans now consume 2,700 calories a day, about 500 calories more than 40 years ago. In 2010, we still rank as the world’s fattest developed nation, with an obesity rate more than double that of many European nations.

For that dubious distinction, we pay a high price. The obese are more likely to be depressed, to miss school or work, to feel suicidal, to earn less, and to find it difficult to marry. And their health care costs a lot. Obese Americans spend about 42 percent more than healthy-weight people on medical care each year. Improper weight and diet strongly correlate with chronic diseases, which account for three-fourths of all health-care spending. Type 2 diabetes is one of the leading drivers of rising costs for Medicare patients, and 60 percent of cases result directly from weight gain. In short, even as the nation is convulsed by a political struggle to “reform” health care, no effort to contain its costs is likely to succeed if we can’t beat obesity....

The bad news is that no one knows exactly why. And the debate on how to deal with obesity remains frozen. On one side are the proponents of individual responsibility, who believe that fat people suffer from a surplus of self-indulgence and a shortage of willpower. On the other are people who believe that Americans are getting fatter because of powerful environmental factors like cheap corn, fast food, and unscrupulous advertising....

The people most vulnerable to obesity, however, do not have access to healthy food, to role models, to solid health-care and community infrastructures, to accurate information, to effective treatments, and even to the time necessary to change their relationship with food. And if that is true for fat adults, it is even more true for fat children, many of whose choices are made for them. Their vulnerability to obesity is much more the result of societal inequalities than of any character flaw....

“But if you go with the flow in America today, you will end up overweight or obese,” Thomas Frieden, the director of the Centers for Disease Control and Prevention, told me when I met him at an obesity conference in Washington last summer. “This does not absolve individuals of the responsibility of trying to get more exercise and eat healthier. But it suggests a synergy between policy intervention and personal efforts to lose weight.” Frieden’s tenure as New York City’s health commissioner from 2002 to 2009 was intensely productive and attention-getting: under his direction, the city banned trans fats from restaurants....

The rise in obesity is associated with a rogue’s gallery of individual, social, and technological factors. The “Big Two,” as scientists call the leading factors, are reduced exercise and increased food consumption: Americans are ingesting more and more calories than they’re burning. But underlying that simple energy-in, energy-out equation is a complex, and so far inexorable, interplay between powerful physiological and societal forces....

But why did the obesity rate accelerate in the United States beginning in the 1980s, setting us apart from our peers in other developed countries?....

The average American spends half of his or her food budget outside the home....

This jumble of circumstances and effects is what Thomas Frieden means when he says that just being an American can naturally lead you to be obese: obesity is an almost inevitable consequence of living with our cultural norms, our history of agricultural production and subsidies, our long-standing socioeconomic inequalities, and the impact of technology on our behavior and bodies....

[T]he Robert Wood Johnson Foundation, the largest philanthropy dedicated to improving health care in America...its nationwide campaign against childhood obesity and become the “connective tissue of the movement,” as the director of the childhood-obesity project, Dwayne Proctor, told me....

States and cities have come up with some of the best structural initiatives. In Pennsylvania, for example, the state has partnered with nonprofits and supermarkets to open high-quality food stores in underserved areas. In Louisville, Kentucky, housing projects, including the one where Cassius Clay grew up, have been redesigned with a focus on health. In one, wide sidewalks ring the perimeter so families and kids can walk in groups with less fear of crime. Near the boxer’s childhood home, the local sanitation department has cleaned the soil of toxins for the creation of a community garden. And there is a farmers’ market at a school across the street every Saturday. With the strong leadership of the mayor, the blue-collar city of Somerville, Massachusetts, lowered the rate of obesity in its elementary schools by promoting exercise in schools, smaller portions in restaurants, health counseling, and biking and walking to school. (The Robert Wood Johnson Foundation supported all three of these initiatives.)...

Michelle Obama went public on February 9 with her campaign against childhood obesity. Almost a year earlier, she had decided to make fighting obesity her principal cause: working largely in secret, over a period of about six months in 2009, the first lady’s staff and the White House Domestic Policy Council began to draft a truly comprehensive anti-obesity strategy.... The proposals that Raben and his group pondered have a place in the framework: state and local cooperation, nutrition-labeling standards, money to promote programs to bring healthy food to poor communities, and reforms to the school-lunch program. The goal is to end the epidemic of childhood obesity within a generation...."