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tuberculosis in KiribatiKiribati is one of the world’s smallest countries, located in the middle of the Pacific Ocean. The 30 plus islands that together form Kiribati may be small and house a population of a little more than 100,000 people, but Kiribati is modernizing every day. The country only became fully independent in 1979 after a history of colonialism, and it joined the U.N. in 1999. Today, one of the biggest threats it faces is tuberculosis (TB). Of all the neighboring pacific island countries, Kiribati has the highest incidence of tuberculosis with a report of 349 incidents per 100,000 in 2018. While tuberculosis is endemic in Kiribati, the situation is far from hopeless. New scientific approaches to diagnosing and treating tuberculosis are making it possible to eradicate the disease in the future.

Tuberculosis and Overcrowding

Tuberculosis is directly related to overcrowding. While there are 33 total islands of Kiribati, only 20 of these islands are inhabited. Moreover, almost all of these islands are very sparsely inhabited, with around 64,000 inhabitants living on the main atoll, Tarawa. Though the nation does not boast a large overall population, the population density of the country is one of the highest in the world. Tarawa has a population density on par with major cities, like Tokyo and Hong Kong. This high population density means that most households in Kiribati are vastly overcrowded, creating a greater likelihood of spreading tuberculosis. Oftentimes, the housing lacks proper construction or proper ventilation, which also impacts the spread of TB. On average, households in Tarawa have between eight and nine people in them.

Tuberculosis and Diabetes

Tuberculosis and diabetes are often co-morbid illnesses causing major concern in Kiribati, which has one of the top 10 highest rates of diabetes in the world. In Kiribati, between one fourth and one-third of adults have diabetes, so the likelihood of having tuberculosis and diabetes is quite high. In fact, one-third of citizens with tuberculosis are also diagnosed with diabetes. This is so prevalent because diabetes can impact the treatment of tuberculosis. As a result, most of the citizens with both diabetes and TB have the infectious form of TB. This means that they pose a greater risk of spreading the illness to other members of the community.

New Methods for Catching and Eliminating TB

While tuberculosis is a serious concern to citizens of Kiribati, there are groundbreaking efforts to speedily diagnose and treat tuberculosis. Addressing TB is one of the country’s top priorities. In conjunction with organizations like the Global Fund to Fight Aids, Tuberculosis and Malaria, Kiribati has managed to acquire modern diagnostic tools like portable X-ray machines. In recent years, another strategy that targets specific “hotspot” areas has proved incredibly useful in diagnosing TB in the early stages. This process focuses on areas known to have the greatest likelihood of TB by using patterns from past years to locate the most at-risk communities. After locating these communities, citizens of the area participate in screening for TB. In 2019, during a hotspot case study, healthcare workers screened 3,891 people for tuberculosis in less than two weeks. Over the course of the 11 days, they diagnosed seven new cases.

A More Positive Future

In the past few years, the general fear of tuberculosis in Kiribati has greatly diminished. With the new systems in place to screen, diagnose and treat TB, citizens have become more aware of how to prevent the spread of disease. The new systems also allow more citizens who may be living in poverty or isolated areas to access treatment. Healthcare workers go directly into the villages within each hotspot, allowing citizens to easily walk to clinics for screening. At these clinics, they receive prevention tips, pamphlets and a better understanding of how to care for themselves and those around them.

Despite overcrowding and comorbidity with diabetes, the future of tuberculosis in Kiribati is looking up. With only 323 cases in 2018 after 745 new cases in 2007, the numbers are slowly decreasing. With increased awareness and prevention tactics, along with modern technology and hotspot screening, it is hoped that this trend will continue.

– Lucia Kenig-Ziesler
Photo: Flickr

Heart Diseases in the CaribbeanHeart disease and related illnesses like hypertension, diabetes, and stroke, are devastating illnesses that according to World Health Organization (WHO) are on the rise. According to the WHO, 17.9 million people die of cardiovascular-related deaths each year and over 75 percent of these deaths occur in developing countries. A UN report in 2017 stated that Pacific and Caribbean regions had 14 of the top 25 obese countries in the world. “The Panorama” a report put out by the Food and Agricultural Organization of the UN cited that malnutrition and obesity heavily affect low-income families, women, indigenous communities, rural communities and people of African Descent. Studies have for decades indicated that people of Afro Caribbean descent are more likely to experience high blood pressure. However, recently heart disease in the Caribbean continues to rise at a fast pace.

Factors Contributing to Heart Disease

There are several risk factors that contribute to heart disease. According to the World Health Organization, reducing salt intake, reducing alcohol intake, avoiding tobacco, eating fruits and vegetables and getting physically active consistently can reduce cardiovascular disease. Low-income families are at risk because of a lack of proper health-care. The WHO stated that opportunities for early intervention are often missed because primary health care programs aren’t always available to low-income families. Late detections of cardiovascular diseases more often than not mean early deaths.

The Financial Impact of Cardiovascular Disease on Families

Caring for someone with cardiovascular disease can be time and energy-consuming, and without sufficient healthcare, paying for the bills out of pocket heavily impacts families. According to the WHO, cardiovascular diseases further contribute to poverty. According to a Harvard study, by 2020 the Global cost of Heart Diseases will rise by 22 percent. The current global cost of cardiovascular diseases is $863 billion. As cardiovascular diseases rise countries must spend money on screening, primary and secondary prevention, hospital care, and lost productivity due to premature deaths.

Jamaica and Barbados Hit by The Risk of Heart Disease

Countries like Barbados and Jamaica demonstrate that heart disease in the Caribbean is becoming more prevalent. In 2015 Barbados reported spending $64 million treating cardiovascular diseases and diabetes, and an economic loss of $145 million dollars. Surveys done in schools in Barbados found that 18 percent of students eat fast food more than twice a week and nearly three-quarters of students drink soda more than once a day.

Jamaica is also experiencing an alarming rise in cardiovascular-related diseases. In early 2018, a report found that in 2017 30,000 children in Jamaica between the ages of 10 and 19 had been diagnosed with hypertension. In Trinidad and Tobago, the situation is similar to one out of every four deaths being caused by a noncommunicable disease with heart disease as the leading cause.

The Reason Behind Cardiovascular Disease

The rise in heart disease in the Caribbean over the years is concerning. In Barbados, Sir Trevor Hassell, the President of the Healthy Caribbean Coalition believes that an increase in processed foods and a decrease in “locally grown indigenous staples” are to blame. The director of George Alleyne Chronic Disease Research Centre at the University of the West Indies (UWI) Cave Hill, Barbados, Professor Alafia Samuels said, “We do not eat the way our grandmothers used to eat. In the Caribbean, we have been importing more and more food and some of the main things that we are importing are the things that are leading to some of the challenges.”

Looking to the Future

Despite these harrowing statistics, there is hope. Expansive efforts to tackle cardiovascular disease in the Caribbean have been taken. In 2017 The Healthy Caribbean Coalition enacted the Civil Society Action Plan 2017-2021: Preventing Childhood Obesity in the Caribbean.The plan aims to bring the rising trend of obesity to a complete 360-turn by 2025. By collaborating with governments, civil society organizations, and other international partners, the HCC will tackle childhood obesity on a number of different levels. Some of the HCC’s top priorities are Trade and fiscal policies, nutrition literacy, early childhood nutrition, marketing of healthy and unhealthy foods and beverages to children, school-and-community based interventions, and resource mobilization. Upon providing assistance and education to the citizens and their governments alike, the HCC will positively impact the health conditions of the people in the Caribbean.

 Desiree Nestor
Photo: Flickr

 

Common Diseases in AndorraAndorra is one of the smallest countries in Europe, residing between the French and Spanish borders. In recent years, Andorra has become a tourist destination, drawing in more than eight million visitors every year. This tourism is due to the country’s winter sports, a summer climate and an international commercial center for shopping. For the people who live in Andorra, preventable disease acts as one of their leading causes of death. Below are some of the most common diseases in Andorra:

Ischemic Heart Disease
One of the most common diseases in Andorra is ischemic heart disease (IHD). IHD occurs when blood flow is restricted in the body and arteries in the heart become narrowed. When heart arteries are narrowed, the victims of this disease have less blood transported to the heart and can ultimately lead to a heart attack.

About 22 percent of Andorrans suffer from IHD, and it is the leading preventable cause of death in Andorra. The disease has become more prevalent in recent years due to increased economic prosperity, allowing people to live a more sedentary lifestyle. In fact, there has been a 43 percent increase in the past twenty years of the occurrence of IHD.

Lung Cancer
Lung cancer is the third most common disease in Andorra. The disease is an uncontrolled growth of abnormal cells that start off in the lungs and has the potential to spread to other regions of the body. This spread can compromise other organs in the body, leading to death. Currently, six percent of Andorrans suffer from lung cancer, which is a 36 percent increase from when it was last measured in 1990.

Andorra suffers from this disease due to preventable actions. About 44 percent of males and 28 percent of females in Andorra smoke tobacco products on a regular basis, which is one of the leading causes of lung cancer. Even though the knowledge about the dangers of this disease are well-documented and known throughout the country, many individuals do not take the proper actions to avoid lung cancer.

Diabetes
Due to the economic prosperity of Andorra, food is easily available in the country, often leading to diabetes. Diabetes is a disease that affects a person’s ability to produce or use insulin. This inability to use insulin can cause a surplus of blood sugar in the body. Prolonged exposure to increased levels of blood sugar causes a person suffering from diabetes to risk getting kidney disease, heart disease and blindness.

Currently, three percent of Andorrans suffer from diabetes. Similarly to lung cancer, although many know of the risks associated with diabetes, many individuals do not take the proper actions to avoid the disease.

The most common diseases in Andorra are also the most preventable ones. Proper diet, exercise and the avoidance of intoxicants are one method that an individual can avoid a higher chance of getting any of the above illnesses. Although the information on these diseases is well known, many in Andorra have not taken steps to avoid them.

Nicholas Beauchamp

Photo: Flickr

Common Diseases in Trinidad and TobagoThe Republic of Trinidad and Tobago is a twin island country bordering the Caribbean. Trinidad and Tobago is the third richest country by GDP in the Americas. As a developed country, the most common diseases in Trinidad and Tobago are noncommunicable diseases (NCDs), medical conditions not caused by infectious agents.

Heart Disease
Heart disease is the leading cause of death in Trinidad and Tobago, accounting for 32 percent of all deaths in 2014.

Uncontrolled hypertension (high blood pressure) is the main cause of heart attack and stroke and can also lead to blindness, kidney failure and other health problems. The prevalence of hypertension in Trinidad and Tobago is high; approximately 29.8 percent of males and 23.1 percent of females are affected.

In 2013, The Ministry of Health in Trinidad and Tobago started a campaign aiming to reduce the risk factors of heart disease among the population. The “Fight the Fat” campaign focuses on reducing obesity, physical inactivity and unhealthy diets. For the World Health Campaign, the Ministry of Health launched “Know Your Numbers; Get Screened.” Initiatives included raising awareness about hypertension and creating opportunities for adults to check their blood pressure.

Cancer
According to a report released by the Pan American Health Organization (PAHO) in 2013, Trinidad and Tobago has the highest cancer mortality rate in the Americas. Among men, the majority of cancer deaths are due to prostate cancer and, among women, breast cancer. The high number of deaths from breast and cervical cancer has led to calls for better access to screening and treatment services, given that cervical cancer is very preventable, and breast cancer can be detected and treated early.

Diabetes
Diabetes is another one of the most common diseases in Trinidad and Tobago and is responsible for about 14 percent of all deaths. As of 2016, 10.9 percent of men and 14.1 percent of women in the country are living with diabetes.

Since 1980, there has been a 350 percent increase in the number of people in Trinidad and Tobago living with diabetes. The Ministry of Health attributes this rise to unhealthy lifestyle choices among the population, such as poor diet and physical inactivity. In its fight against diabetes, the Ministry of Health is establishing more accessible screening programs, educating medical professionals about treatment and expanding programs to promote healthy lifestyles.

Like most other developed countries, the most common diseases in Trinidad and Tobago are noncommunicable. Though genetics can play a role in an individual’s development of an NCD, many are at risk because of unhealthy choices. This can be seen by statistics provided by the World Health Organization: 30 percent of the population is obese, with sedentary lifestyles and diets high in sugar, salt and fat to blame.

The Ministry of Health has taken a stance on personal responsibility, in a statement that reads: “The Ministry of Health will do its party with the strengthening of primary health care interventions, but the population of Trinidad and Tobago has a role to play in making better dietary choices and increasing physical exercise.” However, the Ministry of Health also has a role to play in helping Trinidad and Tobago make these changes. It is unlikely that everyone in the country is actively deciding to be unhealthy – there may be issues of accessibility and education at play, too.

Hannah Seitz

Photo: Google

Common Diseases in HondurasHonduras is a country with fairly poor healthcare available to its citizens. This means that patients who cannot afford care suffer unnecessarily from curable diseases. However, the CDC is helping the country strengthen their healthcare systems by increasing the technical skills of doctors in the region. A few common diseases in Honduras can turn rather serious without the appropriate care to get better.

According to the World Bank, Honduras currently has just over 9 million people. The per capita income is $3,710, and the life expectancy is 76 years for the women and 71 years for the men.

One of the major problems in Honduras is the childbirth complications, and many mothers have issues with their pregnancies and some could lead to infant deaths. In fact, 16 percent of deaths in Honduras come from perinatal conditions. This may not be a disease, but it is a problem that needs to be addressed. The CDC can clean up some conditions and help the doctors address the issues that are causing so many deaths in the birthing process.

Diabetes is a major problem in Honduras, as well. In 2010, it was the second leading cause of death in Honduras, sitting at just under seven percent. Some of the major risk factors leading to the presence of diabetes includes physical inactivity and obesity. The problem exists in Honduras because the only capability they have are blood glucose measurement.

Many other medicines, such as insulin and metformin, and procedures available elsewhere around the world are not available in Honduras. They also don’t possess many of the procedures and policies such as a registry, national guidelines, etc. These are vital to helping the people that need insulin and other procedures to help relieve them of the problems that they face with diabetes.

Some of the other common diseases in Honduras include heart disease, lower respiratory disease, diarrhea and other lower respiratory and common infectious diseases, and HIV/AIDS and other sexually transmitted diseases.

HIV/AIDS has an estimated prevalence in Honduras between one and just over three percent within adults ages 15-49. The estimated number of people living with either HIV or AIDS in Honduras is between 35,000 and 110,000 people.

There needs to be more awareness and testing available to the people in Honduras. In addition, only about a third of HIV/AIDS patients were receiving the therapy they needed in 2005. That proportion has no doubt increased in the past decade, but new technology will be able to assist people in need. The CDC’s involvement in the country is definitely a good thing for those with HIV and AIDS to make sure they are treated for.

Honduras needs better healthcare in place to help their citizens. There is help from the CDC, who has been there in recent years, to attempt to help them improve their care for the common diseases in Honduras. The look toward the future is brighter with the CDC’s involvement than the past.

Brendin Axtman

Photo: Flickr

Most Common Diseases in QatarEven the richest country in the world has diseases that do not seem to be going away. Qatar a Middle Eastern nation that borders Saudi Arabia. This prosperous country had a gross domestic product (GDP) per capita of $66,415.30 in 2016. For comparison, the United States had a GDP per capita of $52,194.90. Even so, there are still health concerns that are not diminishing. Here are five of the most common diseases in Qatar.

Diabetes

In 2013, the Action on Diabetes (AOD) initiative provided people in Qatar with a free diabetes test. There was a concern about high blood sugar in the adult population, and the speculations were justified. The tests found that about 16 percent of the adult population has diabetes. This common disease is an issue that demands action. In the AOD test, 86 percent of the people who discovered they had diabetes were unaware of their blood-sugar problem, according to the Gulf Times.

Ischemic Heart Disease

Ischemic heart disease was the number one killer of people in 2005, but it has since moved to the number two spot. Science Daily explains that “ischaemia means a ‘reduced blood supply,’” so this heart disease occurs when the blood supply to the heart is low. This common disease in Qatar can be prevented by regular exercise, a healthy diet and monitoring cholesterol and blood pressure.

Diarrhea

Although diarrheal diseases have been decreasing since 1990, cases still occur and cause other issues, sometimes resulting in death. Intestinal issues can be caused by diarrhea, killing 1.4 out of 100,000 people annually. With the help of advanced medicine, awareness of eating healthy and improved water quality, the incidence of diarrhea will continue to drop.

Respiratory Problems

In Doha, the capital of Qatar, there is very poor air quality, which is causing respiratory issues. Difficulty breathing and coughing, lung infection and other respiratory diseases are prominent in the city. Although not many people have been fatally affected by the air pollution thus far, Doha News estimates that more people will contract diseases and die,if the air quality is not addressed. Even natives are “unclear [as to] why Qatar’s high pollution levels don’t correlate to high levels of early death and/or disease.”

Cancer

Similar to the United States, cancer is a big threat to residents. The three most common types of cancer are cancer of the respiratory system, breast cancer and liver cancer. These three diseases “[make] up 36.4% of all deaths from cancer in Qatar.” Researchers and organizations in Qatar are working hard to promote cancer awareness and prevention for the future. The National Cancer Strategy has laid out a plan for awareness and hopefully advances in medicine so less patients have to travel abroad for treatment. Many people are working to eliminate cancer from among the most common diseases in Qatar.

A wealthy nation is not a perfect one, and Qatar is an example of a developed nation with its own struggles. However, with enough medical research, health education and environmental consciousness, these diseases in Qatar will continue to become less common.

Sydney Missigman

Common Diseases in GreeceGreece is a small nation in the south of Europe, full of history and culture. A large portion of the tradition in Greece resides in the food they make for their family and friends and spending time together. While these activities are common to the Mediterranean country, many of these people’s habits are also what cause their most common illnesses. Here are the top five common diseases in Greece:

1. Cardiovascular Disease

The number one cause of death in Greece in 2014, cardiovascular diseases (CVDs) affect millions of people annually, worldwide. CVDs are common killers in low- and middle-income countries, such as Greece. These diseases come in many forms. Some examples include eart disease, heart failure, arrhythmia and heart valve problems. The causes of CVDs vary, but they often connect to lifestyle choices such as an unhealthy diet, lack of physical exercise, tobacco use and harmful use of alcohol.

2. Cancer

While cancer comes in many forms and affects Grecians differently, the most prevalent among them is lung cancer. Lung cancer has become the leading cause of cancer-related deaths for men and women around the world, often being found once it is in a very developed stage. In recent years, doctors have begun to develop early screenings for people who they believe are at a high risk of developing the cancer. Lung cancer is one of the more preventable cancers, often caused by large amounts of exposure to smoke.

3. Alzheimer’s and other Dementias

In 2013, 1.77 percent of the Greek population suffered from dementia. Additionally, Alzheimer’s disease is the most common form of dementia. Dementia is a disease that affects memory loss and other cognitive abilities, which make everyday living difficult. Dementia is not a normal part of aging, but it can reveal itself as people start to reach 65 years of age or older. While there is currently no cure for the disease, there are medicines and treatments that help with symptoms.

4. Chronic Respiratory Diseases

Another one of the common diseases in Greece, chronic respiratory diseases affect thousands of people every year. The disease can come in many forms, such as chronic obstructive pulmonary disease, asthma and occupational lung diseases. These diseases are often due to behavioral or environmental forces such as tobacco smoke, air pollution, occupational chemicals and dust.

5. Diabetes

Approximately 7.5 percent of Greece’s population suffers from diabetes. The disease can come in two forms, type one and type two. Type 1 diabetes is normally diagnosed in childhood, whereas type 2 is diagnosed later on in adulthood. Type two diabetes is the most common form of diabetes found in those afflicted and is often the result of behavioral choices, such as eating habits.

These common diseases in Greece are just some of the many illnesses that the population deals with. While many of these afflictions often lead to fatality, they are often preventable by living a healthy and active lifestyle.

Olivia Hayes

Photo: Flickr

Top 3 Diseases in Israel
While Israel has been able to lower the number of deaths caused by diseases, many conditions in Israel are still prevalent. The death rates from certain diseases in Israel have declined by 80 percent since the 1970s, but there is always room for improvement. Here are the top three diseases in Israel.

Top Three Diseases in Israel

  1. Cancer: Cancer, the major killer in Israel, caused almost one-quarter of total deaths in Israel in 2011. Even though the cancer rate is relatively low compared to other countries, cancer is still a primary cause of death. The most common cancer among Israeli men is lung cancer, which is primarily caused by tobacco smoking. The most common cancer among Israeli women is breast cancer. About 4,500 Israeli women are diagnosed with breast cancer each year, and 900 dying from it. However, according to the Israel Cancer Association, the number of women surviving breast cancer is steadily on the rise thanks to research and technology able to detect early signs. It has also been reported that the lung cancer rate among men is lower than most countries.
  2. Coronary Heart Disease: Coronary Heart Disease is the second most prevalent cause of death in Israel. Together, cancers and heart disease account for 40 percent of deaths. However, like cancer, heart disease in Israel is being contained. The death rate from heart disease in Israel has dropped by 50 percent since 1998, partly due to declines in smoking and national campaigns against obesity, diabetes and hypertension. The people of Israel have been willing to change their lifestyles to prevent heart disease. There are also reliable ambulance services in Israel to respond to any emergency.
  3. Diabetes: Diabetes is the next leading cause of death after cancer and heart disease. Compared to other countries, deaths from diabetes are high in Israel. But the country has tried a number of ways to defeat diabetes including using an artificial pancreas, medical smartphones and glucose-sensing enzymes. Researchers have also been looking for a cure with the help of the Juvenile Diabetes Research Foundation and the Israel Science Foundation. Scientists are also working on an antibody to block killer cells that destroy helpful cells in the pancreas.- Emma MajewskiPhoto: Flickr


Diabetes is a serious chronic disease that occurs due to the body’s inability to produce insulin, which regulates sugar levels in the body (Type 1), or when the body cannot effectively use the insulin it produces (Type 2). A recent report by the World Health Organization (WHO) found that the global prevalence of diabetes has nearly doubled since 1980, rising from 4.7 percent to 8.5 percent. This trend is particularly troubling, as diabetes prevalence has risen faster in low and middle-income countries. In many of these countries, diabetes is an added burden to states already struggling to deal with weak economies, weak health systems and significant infectious disease burdens. This is especially true for African countries. Here are six facts about diabetes in Africa:

  1. The prevalence of diabetes in African adults has more than doubled since the 1980s. The International Diabetes Federation estimates that more than 14 million people in Africa live with the disease and if trends continue this figure could grow to 34 million by 2040.
  2. The increase in diabetes (Type 2) cases in Africa is largely attributed to changing lifestyles. A large percentage of people with diabetes (58 percent) live in cities. Traditional diets are changing to more high-calorie refined carbohydrates and fats which are more readily accessible and affordable than healthier options. Occupational patterns are also changing, leading to physical inactivity and a more sedentary lifestyle.
  3. Most African countries have healthcare systems already struggling to keep up with other illnesses like HIV, tuberculosis, malaria and diarrheal diseases, all of which seem more pressing than diabetes. As a result, Africa has the highest percentage of undiagnosed people (an estimated two-thirds) who are at a higher risk of developing harmful and costly complications. These complications include heart disease, strokes, damage to eyesight, kidney failure and loss of limbs.
  4. Awareness is one of the biggest issues when it comes to diabetes in Africa. Limited awareness about the disease among both healthcare professionals and the general public contributes to the high number of neglected cases or misdiagnosis. Better education about the importance of healthy diets and physical activity is necessary.
  5. Access to affordable insulin is another challenge faced by many diabetics in African countries. Almost a third of diabetics need insulin to treat their disease. While many African countries have health programs that provide more affordable insulin at public clinics, the supply can be erratic, or patients have to travel far to a clinic with supplies. If public healthcare providers do not have insulin, patients are forced to buy more expensive private sector insulin or go without. This is one of the leading causes of the 321,000 diabetes-related deaths every year in Africa.
  6. Insulin is not the only expense. Access to blood glucose meters, test strips and syringes are also essential for diabetes treatment. The high cost of these medical devices, coupled with the treatment of complications due to the disease, increases the burden of disease on patients and healthcare systems.

While the current facts about diabetes in Africa are dire, efforts are being taken to address this challenging disease. Diabetes awareness and treatment programs are being developed by states, civil society and the private sector. For instance, one of the three main manufacturers of insulin, Novo Nordisk, has programs in several African countries to improve awareness about diabetes and to improve the availability and affordability of treatments.

Helena Kamper

Photo: Flickr

Lifestyle Diseases in India
India, a third world country by economic profile, has morphed its morbidity profile to that of a first world nation. Lifestyle diseases in India are cropping up increasingly under the scanner making it a ticking time bomb with an alarming rise in cardiovascular disease, diabetes, hypertension, asthma and respiratory diseases as well as cancers.

Termed non-communicable diseases (NDC), many of these are found to be equally prevalent among the poor. In fact, ongoing studies prove they are increasing among the poorest. Sixty-six percent of the disease burden is borne by lifestyle diseases consequently cutting into the most productive asset of contemporary India- its people.

India has the highest number of diabetics at 50.8 million per the WHO, though only 11 percent of the population has health insurance. This figure, set to increase to 73.5 million by 2025, will include many of the poorest since India has one of the largest populations of the poor. Twenty-five million suffer from cardiovascular disease, 60 percent of the global total.

According to national diabetes expert Dr. Anoop Misra, diabetes is on the rise because the poor make bad and cheaper nutritional choices based on high fat and carbohydrates intake in their diet leading to malnutrition. They forego vitamins, proteins, and micronutrients as carbohydrates push up their insulin resistance and increase sugars. Diabetes is the forerunner to many opportunistic infections- fatty livers, high cholesterol leading to coronary heart disease and organ failures. Overcrowding and bad living conditions also increase stress leading to coronary heart diseases, asthma and cancers. Urbanization makes for a sedentary life leading to greater obesity. Mass migration from rural to urban areas has made it likely that nearly 60 percent of India will be urban by 2030.

One of the biggest problems with lifestyle diseases in India is that a large part of treatment is through self-monitoring and self-reporting. The high level of ignorance and lack of education about the ramifications of food and lifestyle choices amongst the urban poor leads to these diseases having the worst impact on them. Data collection in India is negligible and there is a large quantum of underreporting and underestimation among poorer patients.

India spends 4.2 percent of its GDP on health for its population of over a billion people. In comparison, Germany spends 11.3 percent for its relatively small population. Per capita spending on health amounts to 34 euros per person whereas in Germany it is over 4000 euros. Eighty percent of health care in India is dominated by the private sector. As a result, the poor become almost invisible for health care providers, leading to undetected and untreated morbidity.

Lifestyle diseases in India require prolonged treatment for a lifetime, including lasting changes in lifestyle. Without better and more consistent healthcare services being provided for the poor, NCDs could be the next big epidemic wiping out large parts of the Indian population.

Mallika Khanna

Photo: Flickr