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Noncommunicable diseases (NCDs) are responsible for the greatest disease burden worldwide, killing more people than all other causes of death combined and resulting in a devastating impact on health and enormous human suffering. Beyond their health implications, NCDs have a negative social and economic impact and represent a major challenge to sustainable development.
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NCDs cover a wide range of conditions. This chapter focuses on the main types responsible for the highest burden, namely cardiovascular diseases (CVDs), diabetes, cancer, chronic respiratory diseases, as well as mental, neurological, and substance (MNS) use disorders.
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Despite the progressively increasing magnitude and inequitable distribution, much of the adverse human and social impact caused by NCDs can be averted by applying high-impact, cost-effective prevention, and control strategies implemented through a whole of government approach. The last two decades witnessed a great increase in awareness among policy makers on the pressing need to reduce the NCD burden and a global vision and a road map has been recommended for countries to consider. This chapter reviews the global burden of NCDs and their risk factors, and outlines prevention and control strategies based on evidence and international experience.
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BURDEN: MORTALITY, MORBIDITY, AND RISK FACTORS
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The prevalence and disease burden of chronic NCDs are steadily increasing worldwide, driven by population growth, ageing, changes in lifestyles and risk factors, alongside achievements in communicable disease control and progress in reducing maternal and child mortality. In 1998, NCDs were estimated by the World Health Organization (WHO) to cause 31.7 million deaths, representing 60% of global mortality. This increased to 38 million (68%) in 2012, and 41 million (71%) in 2016.1–3 Table 24-1 shows the mortality estimates for 2016.3 Furthermore, a large proportion of people with NCDs die too young. Almost a quarter of NCD deaths occur prematurely below the age of 60 years, and more than 40% below the age of 70 years.
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Over 80% of deaths due to NCDs are caused by CVDs, diabetes, cancer, and chronic respiratory diseases. Of all NCD deaths in 2016, 17.9 million (45%) were due to CVDs, 9 million (22%) to cancer, 3.9 million (9.5%) to chronic respiratory disease, and 1.6 million (3.9%) to diabetes.4 An estimated 2.8 million were due to MNS-use disorders.5 Among CVDs, heart disease and stroke are the main causes, and remain the ...