The top diseases in Chile are primarily noncommunicable and reflect the development and increased urbanization of the country, currently at 89 percent.
One of the most concerning issues in Chile is the high level of income inequality. Chile is the only South American country in the Organization for Economic Cooperation and Development; however, nearly 15 percent of the population lives below the poverty line. Poverty is closely linked with noncommunicable diseases, and high levels of NCDs increase household healthcare costs and hinder efforts to reduce poverty levels. Those in poverty are more likely to use tobacco and have unhealthy diets. The long and expensive treatments associated with NCDs deplete household resources and those in poverty die at a much higher rate due to NCDs compared to their wealthier counterparts. Below are three of the of the top diseases in Chile:
- Ischemic Heart Disease
Ischemic heart disease, also known as coronary heart disease, is caused by reduced blood flow to the heart, often resulting in a heart attack. Some risk factors — such as being male and older — are hereditary. Others that are modifiable behaviors include tobacco use, high cholesterol, obesity, diabetes, high blood pressure and physical inactivity.In 2008, 30 percent of deaths in Chile were due to ischemic heart disease. Through initiatives like the Go Red for Women Campaign, heart disease-related deaths have declined to only eight percent in 2012, though it remains a leading cause of death in the country.
Combined with cardiac disease, diabetes is estimated to be responsible for half of all deaths in Chile. Diabetes causes the most death and disability combined of all diseases in the country and is therefore considered one of the top diseases in Chile to address.In 2003 only 4.2 percent of the population was diagnosed with diabetes; in 2015 that percentage rose to nearly 10 percent. Gestational diabetes has also increased from one percent in 2003 to five percent in 2015. Public health officials in Chile cite being overweight as a major contributor to the rise of diabetes. The cost per person for diabetes care is approximately $1,500. With high levels of income inequality and the disproportionate impact of NCDs on low-income populations, this high cost and rising prevalence are major concerns.
- Ischemic Stroke
Ischemic stroke occurs when a clot obstructs blood flow to the brain, a result of atherosclerosis — the hardening of the arteries due to fat deposits. The risk of stroke can be reduced through increased physical activity, improved diet, weight loss and stopping tobacco use. Deaths due to stroke in Chile are on the rise; as of 2012, they were the leading killer in Chile, accounting for nine percent of all deaths. While heart disease and diabetes are the focus of Chilean public health efforts currently, the rise of ischemic stroke cannot be ignored.
The most common risk factors for death and disability are dietary risks, high blood pressure, obesity and alcohol and drug use. All these risk factors are modifiable behaviors, and all are large contributors to the three top diseases in Chile. Additionally, almost 30 percent of the population is overweight. Of those individuals over 15 years of age, 76 percent are overweight or obese.
A positive note is that many of the leading causes of death and disability in Chile require similar lifestyle changes – reduction in tobacco usage, increased physical activity and healthier eating habits. Finding effective interventions that promote lifestyle modifications can contribute to the reduction of many of the top diseases in Chile. While Chile implements a tax on tobacco, the only country in the Americas to do so, 39 percent of the population still engages in tobacco use. A comprehensive tobacco law passed in 2013 bans all tobacco advertising, including at the point of sale, as well as requires tobacco prevention education at every level of schooling. The long-term impact of these laws in addition to the tax is to be determined.
To promote healthier eating habits, in 2016 Chile was the first country in the world to require that warning labels be placed on foods high in salt, fat, or sugar content. These labels are in the form of black stop signs, designed to make them more reader friendly. Additionally, items required to be labeled are not permitted to be sold to children under 14 years of age or sold with toy incentives. These items are also not allowed to be sold for purchase in or near schools.
To combat some of the top diseases in Chile, the country is focusing on broad public health measures, particularly those that target the younger population. The country is clearly thinking far ahead, focusing not just on treating diseases currently affecting the adult population, but also attempting to prevent the rise of NCDs as the younger population ages.
– Nicole Toomey