Lifestyle Diseases 21: NCDs Alarmism vs. Rising Lifespan

From the WHO website, this update on NCDs is shown:

Noncommunicable diseases

Fact sheet
Updated March 2013

Key facts

•  Noncommunicable diseases (NCDs) kill more than 36 million people each year.
•  Nearly 80% of NCD deaths - 29 million - occur in low- and middle-income countries.
•  More than nine million of all deaths attributed to NCDs occur before the age of 60; 90% of these "premature" deaths occurred in low- and middle-income countries.
•  Cardiovascular diseases account for most NCD deaths, or 17.3 million people annually, followed by cancers (7.6 million), respiratory diseases (4.2 million), and diabetes (1.3 million¹).
• These four groups of diseases account for around 80% of all NCD deaths.
• They share four risk factors: tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets.

The alarm bells about NCDs have been sounded by the WHO for several years now. The message is something like "Let us reduce deaths from NCDs, pour more public money into the problem."

So the Department of Health (DOH), PhilHealth and local governments have been pouring more money on reducing or preventing diseases and death from NCDs. PhilHealth for instance reported of Rising Claims for NCD. If PhilHealth will raise further spending for NCDs, the reserve fund can  evaporate soon, or PhilHealth will ask for higher monthly premium from members, especially those employed in the formal sector. Why?

People with NCDs are sort of "patients forever". Unlike treating infectious diseases like dengue or malaria, once the disease inside a patient's body is killed, the patient gets well and will not need medication or hospitalization for the next few years or ever decades. For patients with NCDs though, they have to visit a physician monthly or even more frequently. For instance, a hypertension patient, according to a physician or pharmacist who spoke during the MeTA forum at the AIM last April said will need a combination of 2-3 medicines per day.

The WHO I think is pulling health alarmism here, the same way they alarmed the world with the dangers of HIV/AIDS in the 90s. It turned out that the warning was exaggerated because if their projections were true, the population of Africa by now should be less than its population in the 90s, but this did not happen.

If an average Filipino dies of stroke or cancer or hypertension or other NCDs at age 75 or 80 or older, is it a problem?

WHO and DOH say Yes, because about 2/3 of deaths in the Philippines and worldwide now are due to NCDs.

For me it is not a problem. We will all die. If not of NCDs, we can die of infectious diseases or accidents or some crime.

The average lifespan of Filipinos now is 70 years old; 67 for men, 73 for women, so average of 70. If a person dies at 75 or older due to NCDs, there should be NO cause for alarm except alarmism itself. Ala "man-made warming" alarmism.

Even if death from NCDs rise from 66 to 80 percent, or even 90 percent of all deaths, but life expectancy has increased from 70 to 80 or 90 years old, then it is not a problem.

Perhaps the WHO and various government health agencies want people to die at 100 or 200 years old on average, so they play God to keep prolonging average life span? Which means governments will tax-tax-tax the rest of us further so it will have more money to play and act like a God.

I think governments should focus more on reducing morbidity and mortality from infectious and communicable diseases. Give more vaccines to children for instance to limit deaths from preventable diseases.

For adult NCDs, governments should step back and allow people to buy private health insurance, to augment existing government health insurance programs. As the WHO pointed out above, NCDs are closely related with unhealthy lifestyle, like people who over-eat, over-sit, over-drink and over-smoke. I know of some people who are fat and irritable, they don't even want to admit that they are fat, and yet all they want to do is sit down and eat, rest and sleep or watch TV for hours.

It will be a criminal act of the government to over-tax people who take care of their body more responsibly, so that government will have more money to subsidize the deteriorating health of this type of people. NCDs are essentially lifestyle related, with a minor factor due to genetics.

Meanwhile, Reiner Gloor of PHAP made a good discussion about NCDs in his article last week, below.
------------

http://www.bworldonline.com/weekender/content.php?id=70310

Posted on 05:16 PM, May 16, 2013

Medicine Cabinet -- Reiner W. Gloor

The global burden of NCDs

(First of a series)

EACH DAY, about 100,000 people around the world die from major non-communicable diseases (NCDs) namely cardiovascular disease, diabetes, asthma, chronic respiratory infections and cancers.

An estimated 36 million people succumb to these diseases each year, or some two out of three deaths globally. About nine million of these were people under the age of 60.

Many of the losses occur in low and middle-income nations to include the Philippines which had cardiovascular diseases as the number one cause of death among Filipinos, according to the Department of Health (DoH). With the sheer number of lives lost, major NCDs are no doubt the world’s biggest killer diseases.

NCDs place a heavy burden on individuals, families, and communities and public health systems that often rely on out-of-pocket payments.

The World Health Organization (WHO) said that out-of-pocket payments could cause households to incur catastrophic expenditures, which in turn push them into poverty. A WHO technical report, "Designing Health Financing Systems to Reduce Catastrophic Diseases," said that when people have to pay fees or co-payments for health care, the amount can be so high in relation to income that it results in "financial catastrophe" for the individual or the household.

PhilHealth 16: Financial Engineering to Subsidize NCDs Treatment

In a presentation during the MeTA Forum last April 10, 2013 at the Asian Institute of Management (AIM) in Makati, Dr. Rizza Herrera and Dr. Liezel Lagrada of PhilHealth showed some 50 slides about the Primary Care Benefit (PCB) packages, showing only some of those slides here. PCB are outpatient services for the poor, a form of preventive healthcare to minimize incidence of the poor going to hospitals more often. I support more preventive healthcare, but I do not support the view that it's the government that should provide it for all.

PCB1 is one year old now, started in April 2012.

These packages are the equivalent of annual medical check up for clients of private health insurance or health maintenance organizations (HMOs). They even include X-ray. The hypertensive are entitled to once a month check up even though their annual premium is the same (or slightly higher?) than those who have no hypertension and are entitled to only once a year BP measurement.

PhilHealth says they have veered away from rebate mentality to capitation as payment service.  The number of participating local government units (LGUs) have been rising.

PCB1 is not portable, each family is assigned to a specific PCB1 provider, extending it to other member sectors would entail a good tracking system, both from Philhealth and from the providers.

Despite the increase in the number of PCB1 providers, there is still a big gap in the patient : health personnel ratio which greatly affects the realization of quality health care.

Intermission -- some photos that afternoon, speakers and audience....

Then the expansion to PCB 2, mainly addressed to control NCDs. My earlier discussion on PhilHealth claims for NCDs is posted below, PhilHealth Watch 15.

Lifestyle Diseases 18: Addressing NCDs via Preventive Healthcare

Mainly lifestyle-related non-communicable diseases (NCDs) can be addressed via change in lifestyle and hence, preventive healthcare, not curative. Preventive approach shifts the burden of healthcare from the government to the individuals themselves, their households and civil society organizations (health and wellness groups, sports clubs, medical and nutrition associations, etc.). Whereas curative approach is mainly throwing more money, ie tax money, to problems that are more often than not, self-inflicted.

My cardiologist friend, Dr. Tony Leachon, has written several articles about NCDs posted in this blog. See for instance,

Lifestyle Diseases 11: Obesity and Cancer, January 08, 2012
Lifestyle Diseases 12: On Fat Filipinos, January 17, 2012
Lifestyle Diseases 13: Curbing and Preventing NCDs, January 17, 2012
Lifestyle Diseases 14: Transformative Education on Health, January 18, 2012 

Lifestyle Diseases 15: Preventing Metabolic Syndrome, January 27, 2012

Lifestyle Diseases 16: On Smoking and NCDs, February 16, 2012.

Below are some powerpoint slides he had made and presented in his talks. These are good supplementary materials and visuals to the DOH Presentation on smoking and tobacco tax hike, Tobacco Tax 7: DOH on NCDs and Tax Hike. A number of his slides were also used in the said DOH presentation.

I like the title, Shifting to Preventive Healthcare. The three risk factors are obviously lifestyle related -- high tobacco use, low intake of fruits and vegetables (more fried meat, etc.) and less physical activity (more couch potato in front of a computer or tv, etc.).

Many Asian economies are indeed getting wealthier. The rising problem of the people is that they are eating more expensive, more sweet and more fatty food and drinks like more soda, more ice cream. The result is more diabetes, more obesity. People work hard and they eat and party hard too.

My beef about these analysis by Dr. Antonio Dans, DOH, WHO and other known health analysts is that there is little or zero mention about personal responsibility aspect of healthcare. It is very often easy to blame the tobacco companies, the soda/softdrink/beer companies, the junk food manufacturers, the fastfood shops, the heavy ads in tv of these products, and so on. But somehow we have to look inwards and see what we individuals, parents and guardians do, to prevent children not to get addicted to junk food, softdrinks and sedentary life too early.

Articles like these by Dr. Leachon and Dr. Dans, campaigns by the DOH and WHO, the various health professional organizations, are helpful in reminding people again and again, good healthcare rests first and foremost in their own hands, not in government. They do not need the DOH and WHO to realize that having a clean house, a clean environment, washing hands properly before eating, drinking plenty of water and other liquid, having more vegetables and/or fruits everyday, among others, are simple but highly effective steps towards better health. More than cheaper or free medicines, more than cheaper hospitalization and free PhilHealth card.

Cheaper or free medicines are effective for infectious and communicable diseases, for pediatric diseases, for genetic and hereditary diseases. And even if those cheaper medicines -- will the government abolish taxes on medicines please? -- are made available for these illnesses, preventive healthcare still play a big and important role, at least not to exacerbate existing diseases.
-------

See also:
Lifestyle Diseases 1: Obesity, February 04, 2011
Lifestyle Diseases 2: Killer diseases in the Philippines, March 16, 2011
Lifestyle Diseases 3: Causes of Mortality in the Philippines, August 10, 2011
Lifestyle Diseases 4: The UN on NCDs, September 24, 2011
Lifestyle Diseases 5: NCDs Global Picture, September 30, 2011

Lifestyle Diseases 17: On Cancer, COPD and NCD Risk Factors, March 05, 2012

Lifestyle Diseases 17: On Cancer, COPD and NCD Risk Factors

Cancer -- there are probably 200 types as listed in wiki -- will remain a major killer disease into the future. Aside from natural human biology that allows certain diseases to advance as we grow older, human lifestyle can either prevent or exacerbate such disease advances.

Related to the DOH presentation on non-communicable diseases (NCDs), smoking and tobacco tax hike below, and powerpoint slides from Doc Tony Leachon on NCDs which I will post shortly after this, I am posting three papers by Mr. Reiner Gloor of the Pharmaceutical and Healthcare Association of the Philippines (PHAP) related to NCDS.

The first is on cancer. My older brother, my sister in law, my mother's cousin, two of our wedding godmothers, have all died of cancer. That is why I am really hoping that "magic" medicines will soon be developed that can really kill various cancer cells, especially for younger people in their productive period. My brother died at age 52 only.


The second and third papers are on COPD or chronic respiratory diseases, and on the four risk factors of NCDs. Like cancer, Reiner says COPD is also preventable via change in lifestyle, aside from medication and other treatment.

See, more personal and parental/guardian responsibility in healthcare, more than government responsibility; more preventive rather than curative healthcare, can make a big difference. It's another story of course when we grow older. No matter how healthy is our lifestyle, human biology says that reaching 100 years or older is more of an outlier, more of exception, rather than the rule. Medicines, innovator and generics alike, will help humanity prolong their lives but only to a certain extent. But with endless improvement in the pharmaceutical, medical and biological sciences, human understanding of various diseases and how they expand will improve and hence, their treatment and control will also improve. 

----------

 

(1) Many cancers can be prevented and cured

August 19, 2011

Medicine Cabinet -- Reiner W. Gloor

Cancer is one of the major noncommunicable diseases (NCDs) that will be given global attention when the United Nations General Assembly convenes for a High-level Summit in September. It is a leading cause of death worldwide which claimed more than 7.5 million lives in 2008. It is projected that it will continue to rise with an estimated 12 million deaths in 2030, a situation which could be a crucial concern.

Cancer knows no boundaries. Rich or poor, young or old, men or women. However, the burden for low- and middle-income countries is growing with more than 70% of the reported deaths occurring in them in 2008. Low- and middle-income countries also stand to be hardest hit by consequences of other major NCDs such as chronic respiratory diseases, diabetes, and cardiovascular diseases. A UN report explained that in developing countries, noncommunicable diseases and their risk factors worsen poverty, while poverty results in rising rates of such diseases.

In the interest of space, this column will discuss cancer in general as there could be more than a hundred types of cancer. This is due to the fact that cancer, also referred to as malignant tumor or neoplasm, can affect any part of the body. It arises from a single cell but transforms and progresses into malignant tumors.

The Philippine Cancer Society explained that cells grow, divide, and produce more cells as needed to keep the body healthy and functioning properly. However, the process goes wrong sometimes and cells become abnormal, forming more cells in an uncontrolled way. The extra cells form a mass of tissue, called a growth or tumor, which can be benign or malignant, meaning cancerous.

The World Health Organization (WHO) noted that “metastasis” is a defining feature of cancer. It is a process referring to the rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the body and spread to other organs.

The WHO added that these changes are the result of the interaction between a person’s genetic factors and external agents such as physical carcinogens (ultraviolet and ionizing radiation); chemical carcinogens, such as asbestos, components of tobacco smoke, aflatoxin (a food contaminant) and arsenic (a drinking water contaminant); and biological carcinogens, such as infections from certain viruses, bacteria or parasites.

Aging is also a factor for the development of cancer. Other risk factors include smoking, alcohol, unhealthy diet, and chronic infections from hepatitis B virus, hepatitis C virus and some types of human papilloma virus (HPV).

According to the WHO, the main types of cancer are lung (1.4 million deaths); stomach (740,000 deaths); liver (700,000 deaths); colorectal (610,000 deaths); and breast (460,000 deaths).

The 2010 Philippine Cancer Facts and Estimates has provided a glimpse of the burden of the disease in the country.

According to the report, lung cancer is the most common cancer in men and the third most common in women. It added that four out of 100 men and one out of 100 women in the country would have had a likelihood of developing lung cancer before reaching the age 75. In 2010, the same report said that 6,987 men and 2,197 women succumbed to lung cancer.

Meanwhile, breast cancer is the leading cause of cancer deaths among Filipino women while cervical cancer ranked second. Colorectal cancers, on the other hand, is the third most common cancer in the Philippines.

On the brighter side, more than 30% of cancer can be prevented by avoiding risk factors such as tobacco use, obesity, unhealthy diet, low fruit and vegetable intake, physical inactivity, alcohol use, sexually transmitted HPV infection and air pollution, among others.

Tobacco Tax 7: DOH on NCDs and Tax Hike

The Department of Health, along with WHO, officially recognizes the increasing risks of non-communicable diseases (NCDs) and since many of these are directly or indirectly caused by smoking, it is naturally expected to support proposed legislations raising the taxes on tobacco. I also think that very few people in this country ever oppose such move. I support it myself 100 percent. I think the debate is limited only on the level and rate of increase that should be taken.

DOH Sec. Enrique Ona made a presentation at the House of Representatives' Committee on Ways and Means last February 21, 2012, about the proposed hike in tobacco taxes. Below are his slides.

Upper right: as societies develop, death from infectious diseases decline while death from lifestyle-related and NCDs increase. There is clear recognition that people's unhealthy lifestyle increases the risk factors for NCDs. I have no question with these data and observations.

Below, incidence of death due to NCDs is the same in South East Asia including the Philippines, as that of the global average -- around 60 percent of total deaths. I have no question with these data except this observation: "tobacco use, unhealthy diet and physical inactivity... Disadvantaged sector is most affected."

The poorer and disadvantaged sector is now smoking more, eating more healthy food, and becoming more physically inactive. Which may imply that (a) they are earning more but spending more money on smoking, (b) they are earning more and eating more, but the unhealthy food, and (c) earning more and can afford to be more physically inactive. There are contradictions here. But we proceed.

Below: diseases of the young Meaning more young people are fat if not obese, more young people are smokers. Poorer countries are more susceptible to NCDs. This implies that people in the developing world are more sedentary, more addicted to fatty food, more smokers, more drunkards, and so on.

Now look at bottom right slide: "Lifestyle related disease is not a disease of affluence... One reason for greater death rates in the poor is that the poor smoke much more than the rich." I think there is a contradiction here. The poor are victims of NCDs because they smoke more than the rich, so why are they victims? Did anyone put a gun on the heads of the poor telling them to smoke one or two packs a day or more, otherwise they will suffer physical beating, or their heads will be blown away? I'm sure there is none.

My main critique of such analysis is that it acquits the poor of having more personal responsibility in running their own lives. If they smoke more, if they drink more, if they eat more fatty food than vegetables and fruits, and so on, they are victims of some "external forces" and hence, government must bail them out from such irresponsibility.

If government will say to the people, "Don't worry much being irresponsible to your body, when you get sick, I will take care of you", then we will have more smokers, more gamblers, more fat people.

Below, the poor have little or no access to prevention due to their low education. Is this an acceptable reason or alibi to acquit people of being irresponsible about their body? Maybe, but maybe not.

Now look at bottom right slide: DOH budget is P40 billion, but smoking related expenditures is 10x that at P400 billion. If the problem is this big, then perhaps raising the tax on cigarettes is not the answer, but outright banning of cigarettes, to close down all tobacco manufacturing plants, to disallow the planting of tobacco, etc.

The DOH is aware that outright banning of smoking is impossible to implement. If the demand is there regardless of the prohibitions by the government, then supply will find its way towards the consumers. Thus, certain leeway must be allowed for people to smoke. It's their own lives. Like people who do risky sports (rock climbing, cliff jumping, race car/motorcycle drivers, etc.)

Below, a study done in 1999 estimating that tobacco-related expenses and loss of productivity from 4 out of 40 smoking-related diseases, was P46.4 billion a year. That was a big amount then.

A study on tobacco control program in Thailand.

Table below shows that Philippine cigarette taxes are not exactly low or "among the lowest in the region. Of the 9 S.E. Asian economies, Philippine taxes are 4th highest.

Again, I reiterate my support to a hike in tobacco taxes in the country. If a 1,000 to 10,000 percent increase can be fully implemented and cigarette smuggling can be fully stopped and controlled, I will support that move then. Being a non-smoker ever since, I have no love affair with cigarette or cigar. But I think the probability that the government can fully control cigarette smuggling is as high as the probability of an average Grade schooler passing an exam on partial and differential calculus.  Thus, higher tax rates can only mean higher incidence of smuggling.

Many smokers will not be comparing Philippine tobacco prices vs. Singapore or Malaysia prices. Rather, they willl be comparing cigarette prices before and after the tax hike.

I wish the DOH and other groups and individuals pushing for tobacco tax hike, to be successful in this campaign. I also support a unitary or single tax rate to apply to all cigarette products. But more than government intervention via higher taxation to reduce smoking incidence, it is more important to remind people over and over again, that healthcare is first and foremost their own personal responsibility, not government's, especially for lifestyle-related diseases. Thus, the need for the government to step back in subsidizing personal irresponsibility via higher budget for NCDs. Infectious diseases and pediatric diseases remain dangerous that claim many young lives until now. That's where the bulk of our tax money for health should go.

If people have the money to buy a pack or two of cigarettes a day, then they should have the money to buy private health insurance on top of their PhilHealth membership which will soon become more expanded. Or at least save money for their future costly healthcare.
--------

See also:
Tobacco Tax 1: Telecom and Medicine Taxes Too, September 15, 2009 
Tobacco Tax 2: Higher Tax + Corruption = Lower Revenue, June 06, 2010
Tobacco Tax 3: When Supply is Killed But Demand Persists, November 15, 2010
Tobacco Tax 4: Finding the Optimum, Not Maximum Cigarette Tax, May 26, 2011
Tobacco Tax 6: On Cigarette Smuggling, February 27, 2012.

IPR and Medicines 21: Tropical Diseases and Governments

Malaria, dengue, tuberculosis, schistosomiasis, river blindness, leptospirosis, lymphatic filariasis, sexually-transmitted diseases (STDs), these are among the known tropical diseases that affect Filipinos and other people living in the tropics yearly. Many of them are infectious and communicable, usually by mosquitos and other insects, parasites and bacteria, and have no treatment or vaccines yet. Hundreds, if not thousands, are dying in the Philippines alone each year because of these diseases.

Yet the attention of many governments and even the WHO are on the lifestyle-related non-communicable diseases (NCDs). Even the DOH website, http://www.doh.gov.ph/ has little discussion about tropical diseases, more on NCDs. While it is true that the latter are now the world's chief killers, their isolation and control are mostly internal, meaning based on personal responsibility or irresponsibility, on how people takes care of their body and that of their households. I have argued in the past that government should focus more on infectious and communicable diseases because these can affect entire communities, and they are relatively easier to control than NCDs.

I am posting here two of the most recent articles by Mr. Reiner Gloor on "neglected tropical diseases" (NTDs). Reiner is the Executive Director of the Pharmaceutical and Healthcare Association of the Philippines (PHAP, www.phap.org.ph). This is the organization of mostly innovator pharma companies, enterprises that are often demonized by certain sectors over patents and other intellectual property rights (IPR) issues, and they fail to recognize the value of medicine innovation and the high cost, high risks of such undertaking. These groups are so focused on "cheaper medicines" and curative healthcare, than more powerful, more disease-killer drugs and vaccines.

Reiner did not mention the policy bias of governments towards NCDs in his two articles below, I only made that observation myself. Here are the papers, enjoy.
------------

(1) http://www.bworldonline.com/weekender/content.php?id=46457

Posted on 05:34 PM, February 09, 2012

Medicine Cabinet -- Reiner W. Gloor

Global collaboration vs tropical diseases

THE WORLD Health Organization (WHO) has set a new target that would control, eliminate and eradicate a group of diseases that affects about one billion people living in poor tropical and subtropical countries.

By year 2020, the WHO announced its vision to end the misery caused by neglected tropical diseases (NTDs) that kill or disable millions of adult and children worldwide.

Since these illnesses affect poor countries, they likewise remain a contributor to a vicious cycle of poverty.

NTDs often lead to stigmatization and prevent children from developing to their fullest potential. Given their impact on patients, NTDs can no longer be ignored.

Lifestyle Diseases 16: On Smoking and NCDs

Here's another paper from a cardiologist friend, Doc Tony Leachon. After his article, an article from Inquirer columnist Rina David, where she quoted Tony.
----------

Things You didn't know about Smoking and Lifestyle-Related diseases

Anthony C. Leachon, MD

1. Consultant of the Department of Health on Noncommunicable or Lifestyle Diseases
2. Regent, Philippine College of Physicians
3. Cardiologist Internist, Department of Medicine, Manila Doctors Hospital

According to the World Health Organization (WHO), non-communicable diseases (NCDs) or lifestyle diseases are the leading cause of deaths worldwide. In 2008, of the 57 million deaths, 36 million people died due to NCDs. Deaths were attributed to cardiovascular diseases (48%), cancers (21%), chronic respiratory diseases (12%), and diabetes (3%).

1. Lifestyle - related disease is not a disease of affluence.The WHO Global Status Report (GSR) on NCDs for 2011 revealed that poorer countries are more susceptible to NCDs. High-income countries have 13% prevalence, upper-middle-income countries have 25% prevalence, while lower-middle-income countries like the Philippines have 28% prevalence. Low-income countries have 41% prevalence of premature deaths among citizens below 60 years of age. This is three times higher than the proportion of the high-income countries. Death rates from stroke, heart disease, COPD and cancer) is highest among poorer countries in the ASEAN region (Dans et al , Lancet 2010). One reason for greater death rate in the poor is that the poor smoke much for than the rich. The study likewise shows that smoking rates are highest among the poor in the ASEAN region including the Philippines, Malaysia, Vietnam,Laos, and Myanmar while rich countries like Singapore and Brunei have lower NCD death rate.

Prof Antonio Dans of the University of the Philippines College of Medicine said that Southeast Asia is facing the epidemic of chronic non-communicable diseases. Based on 2008 figures, 60% of all deaths in Southeast Asia are attributed to NCDs. Dr. Dans stressed that NCDs are not diseases of affluence but diseases of poverty.

In the Philippines, about 200,000 Filipinos die annually because of NCDs. “This is larger than any epidemic we have ever seen in the country,” said Dr. Dans.

2. Traditionally, NCDs are viewed as the diseases of the elderly, “therefore unavoidable.” However, based on studies, NCDs are now affecting even the productive age group from 15 to 59 years old. “Sixty percent of the disability causes in this age group are NCDs. This situation is greatly affecting the productivity and economy of countries,” said Dr. Dans. He further stressed that this figure is projected to increase to 75 % by 2030 if nothing is done.

While death or disability results to productivity and income losses, it also brings expenditures for medical care on families affected, leading to serious consequences, not only at the household level, but at the national level as well.

3. Based on National Nutrition and Health Survey ( NNHes) 2008, smoking does not just cause cancer and lung diseases, it is also the number one cause of stroke and heart attack ( 50,000 deaths per year). In fact, smoking causes more stroke and heart attack than diabetes, hypertension , obesity and high cholesterol.

“The prevailing risk factors varied among a country’s income groups,” said Dr. Dans. Physical inactivity among women is the prevailing risk factor in high-income countries, while smoking or tobacco use is the prevailing NCD risk factor among middle-income group countries like the Philippines.

4. We are challenging that lifestyle is a choice. “It is not, because we live according to what the environment provides us.” The medical profession has been unsuccessful in improving lifestyle despite decades of trying. Even medical professionals , with all their knowledge , find it hard to live a healthy lifestyle. Lifestyle is shaped by the environment. If food is expensive , people will eat unhealthy cheap food. If tobacco is cheap, people will smoke.

Prof Dans cited the strong connection between poverty and NCDs as an example. “

1. People in the lower socio-economic class have less access to disease prevention. Therefore, they have unhealthy lifestyles and have higher risk factors.

2. They have no access to treatment when they have heart diseases, lung cancer and other NCDs.”

3. Likewise, poor families do not have the money to finance treatments which leads to higher mortality rates.

Dr. Dans proposed several measures to promote healthy lifestyle: 1) legislative advocacy on proper food labeling (emphasizing food health risks and benefits), 2) implementation of sin taxes, and 3) legislation on healthy urbanization or creating infrastructure for healthy lifestyle in school, in workplace and the community.

Rather than begging individuals to live healthy, we should level-up our agenda towards a healthy environment and help promote healthy lifestyle in our society.

We make our goals in life. We define our own successes. We don't get to choose where we start in life ; however, we do get to choose the kind of people we become.
-----

http://opinion.inquirer.net/22431/breaking-out-of-denial

Breaking out of denial

By: Rina Jimenez-David
Philippine Daily Inquirer

9:52 pm | Saturday, February 4th, 2012

0share2321

While the Department of Health currently operates on an annual budget of P40 billion, the total annual expenditure for smoking-related illnesses (cancers, lung diseases and cardio-vascular complications, not to mention lower productivity, absenteeism and fires caused by cigarettes) total P400 billion.

Should Congress pass the “sin taxes” law, which would impose higher taxes on cigarettes, among other things, the government would be able to raise an additional P60 billion in revenues, money which could go a long way towards battling smoking-related ailments.

As they say: “You do the math.”

Dr. Tony Leachon, a consultant on non-communicable diseases (NCDs) with the DOH, presents these figures as part of his advocacy to raise awareness about the need to move from a mentality of “treatment and cure” to one of “prevention,” which in the long run is cheaper and more effective.

“We are currently facing an epidemic of NCDs, with six out of every 10 deaths in the country attributable to stroke, cardiac arrest, chronic respiratory disease, Type 2 diabetes and cancer,” Leachon said, speaking at the conclusion of “Moving as One,” a conference billed as “A Global Call to Action for a Public-Private Partnership for Cancer Care and Control.”

NCD’s are also called “lifestyle diseases,” and apart from an unhealthy diet and lack of exercise, Leachon singles out smoking as a culprit. Science has already determined the link between smoking and a number of diseases, but as Leachon points out: “We know it’s bad for our health and yet smokers allow themselves to suffer and die prematurely – this is really absurd.”

The sin taxes would, in theory, impose higher taxes on cigarettes and make them more expensive, putting tobacco out of reach of the young and the poor, the population most vulnerable to NCDs in both the short and long term. Another pending piece of legislation, which would require the use of “graphic” warnings on the health risks of smoking in cigarette packs – already in place in neighboring countries – could also help bring down the number of smokers and prevent more young people from taking up smoking....

---------

See also:

Lifestyle Diseases 11: Obesity and Cancer, January 08, 2012
Lifestyle Diseases 12: On Fat Filipinos, January 17, 2012
Lifestyle Diseases 13: Curbing and Preventing NCDs, January 17, 2012
Lifestyle Diseases 14: Transformative Education on Health, January 18, 2012 

Lifestyle Diseases 15: Preventing Metabolic Syndrome, January 27, 2012