Wednesday, August 10, 2011

Lifestyle Diseases 3: Causes of Mortality in the Philippines

The Department of Health (DOH) posted in their twitter account two tables, the leading causes of morbidity (diseases) and mortality (deaths) in the Philippines. These are old data actually, average for 2000-04 and 2005. The National Statistics Office (NSO) released its Death Statistics 2007 early this year. Check my earlier paper, Lifestyle Diseases 2: Killer diseases in the Philippines, March 16, 2011.

Nonetheless, these data are still useful. The top 3 killer diseases in 2005 here are similar with NSO's killer diseases in 2007. Numbers 4, 5 and 6 are Pneumonia, Accidents and Tuborcolosis. In the NSO data, #s 4, 5 and 6 are Pneumonia, Tubercolosis and Chronic lower respiratory diseases. I do not know the reason for the discrepancy in ranking here.

And here are the main causes of sickness in the Philippines until 2005. The top 5 are: Acute Lower Respiratory Tract Infection and Pneumonia, Bronchitis, Diarrhea, Influenza and Hypertension.

Many of the diseases here are preventable if proper and healthy lifestyle are observed. Like having a clean house and surrounding, not over-drinking, over-smoking and over-eating.

Prevention of dengue and other mosquito-born diseases can be helped by the DOH and local government units through mass fogging and spraying of insecticides in a wide area of communities. But it is still personal responsibility that can ward off mosquitos away from our houses, schools and offices. Like taking out stagnant water where mosquitos can breed.

On December 16, 2009 I wrote this:

Healthcare is personal responsibility

I got this chart somewhere, I forgot to take down the exact source and web links, but the author of this chart is Dr. Indur Goklany, an Indian intellectual who wrote the book, "The improving state of the world" published a few years ago.

This chart supports my personal view, that healthcare is first and foremost, personal and parental responsibility. Government responsibility in healthcare is a far second.

Of the top 12 global health risk factors in 2004 in the above chart, 9 are related to personal and parental irresponsibility:

1. unsafe sex
2. alcohol use
3. unsafe water, hygiene
4. high blood pressure
5. tobacco use
6. high blood glucose
7. overweight and obesity
8. physical inactivity
9. high cholesterol

and only 3 are socio-economic, or health risks mainly due to poverty:

1. underweight (malnutrition)
2. sub-optimal breastfeeding
3. indoor smoke from solid fuels (due to lack or absence of LPG, electricity, etc.)

A few weeks ago, I heard a talk by the Medical Director of a pharmaceutical company here in the Philippines. He said that 7 of the top 10 causes of mortality in the country are directly or indirectly related to smoking.

The Top 10 Leading Causes of Mortality, 2000 to 2005 (and probably until now) are:

1. Diseases of the heart
2. Diseases of the vascular system
3. Malignant neoplasm
4. Pneumonia
5. Accidents
6. Tubercolosis, all forms
7. Chronic lower respiratory diseases
8. Diabetis militus
9. Conditions from perinatal period
10. Nephritis, nephritic syndrome

Only #s 5 and 9 above seem to be external or not related to smoking. I don't know which is the 3rd disease above that is not related to smoking.

Anyway, if most people are dying because of over-smoking, and almost related, due to over-drinking, over-eating fatty food, over-sitting in sedentary lifestyle, etc., then those people really have no right to demand that "healthcare is a basic right" and the government should provide it to them at the lowest cost possible, if not free.

In this case, government therefore, has no justification to declare drug price control, or issue IPR-confiscation policies like compulsory licensing (CL) to have "cheaper medicines" by blaming the multinational pharma companies as the main cause of lack of access to good healthcare by the peope.

The best healthcare is preventive, not curative. Hence, the importance of personal hygiene, healthy lifestyle, vaccines, competitive health insurance system, and economic growth that lift people from poverty.

By focusing on the curative aspect of healthcare, the government and some activist health NGOs are deliberately losing sight of the personal responsibility aspect of healthcare, and the distortionary effects of government multiple taxation of medicines, vaccines and healthcare.

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