NCDs are chronic diseases that are not passed from person to person. They are of long duration and generally slow progression. The main types of NCDs—cardiovascular diseases (e.g., heart attack and stroke), cancer, chronic respiratory disease (e.g., chronic obstructed pulmonary disease and asthma), and diabetes—have an enormous impact on people, health systems, and societies around the world.
Characteristics of NCDs
• Complex etiology (causes)
• Multiple risk factors
• Long latency period
• Non-contagious origin (non-communicable)
• Prolonged course of illness
• Functional impairment or disability
Risk Factors for Non-Communicable Diseases
A risk factor is a condition or behaviour that increases the chances of developing a particular disease. Here are some examples of risky behaviours that can cause diseases.
Modifiable Risk Factors
These are risk factors that can be changed by specific action. The harmful effect can be reduced with changes in lifestyle and treatment. Risk factors may affect the individual such as unhealthy diets, lack of physical activity, tobacco and alcohol consumption. Population level risk factors include poverty, poor living and working conditions and environmental factors like pollution from factory smoke, cars and even cooking stove in home, can increase the risk of many NCDs.
At the individual level, some modifiable risk factors can be changed if the person changes her/his individual behaviours. However, some factors also require changes at the level of laws and government action, e.g. government should provide smokeless chulhas (stove) to reduce indoor pollutions or reduce air pollution by imposing fine on industries setup in residential areas. Also, there is a law against selling of tobacco products near schools and colleges so that children do not start smoking early.
Non-Modifiable Risk Factors
These risk factors are inherent to an individual and cannot be changed, such as age, family history and sex.
Age: With increasing age, our body undergoes changes. As we grow older, there is an increase in the risk of developing high blood pressure, (Hypertension), high blood sugar levels, (Diabetes), high levels of body fat and blood fats. These conditions can lead to Non-Communicable Diseases like heart and blood vessel diseases (stroke), diabetes, cancer, respiratory problems, etc.
Sex: Both women and men are at risk of developing Non-Communicable Diseases. Men are at a higher risk of developing Non-Communicable Diseases. However, women who have reached menopause are more likely to suffer from heart attacks than pre-menopausal women. Some risk factors for developing Non-Communicable Diseases such as high blood pressure or high blood glucose can affect women even during pregnancy.
Family history: The chances of getting some NCDs are higher if a close family member – parents, siblings also have the disease. This is called Family History. If a person has a family history of NCDs she/he has a high chance of getting the disease.
Metabolic Risk Factors
“Metabolic” refers to the biochemical processes involved in the body’s normal functioning. Behaviors (modifiable risk factors) can lead to metabolic/physiologic changes. WHO has prioritized the following four metabolic risk factors:
• Raised blood pressure
• Raised total cholesterol
• Elevated glucose
• Overweight and obesity
Hypertension occurs when the blood moves through the blood vessels at a higher pressure than normal. This requires the heart to work harder to push blood through the blood vessels. This increases the load on the heart.
Hypertension is also referred to as “silent killer”. This is because it can exist without causing any warning signs or symptoms. That is why it is important to screen all individuals at least above the age of 30 years for blood pressure at least once annually.
High blood pressure, if not controlled, may lead to damage of blood vessels, heart and other organs, such as the brain, kidneys and eyes. Constant high blood pressure can cause life – threatening conditions, such as heart diseases and stroke, diabetes, kidney diseases, etc. Reducing blood pressure to even a small extent can help lower the risk of these conditions.
All food that we eat is broken down into a sugar called glucose. Glucose is carried by the blood to all the parts of the body to give energy. The hormone which helps glucose move from the blood into the cells, is called INSULIN.
Insulin helps to keep the blood sugar levels normal. In diabetes, the body does not produce insulin or cannot use the insulin properly. The glucose builds up in the blood, resulting in high blood glucose levels.
Diabetes is classified into three types namely Type 1, Type 2 and Gestational Diabetes.
Type 1 diabetes: Body does not produce insulin at all. People with this form of diabetes require daily injections of insulin in order to control the levels of glucose in their blood.
Type 2 diabetes: This is the most common type of diabetes. The body produces some insulin, but not enough. This type of diabetes used to be seen only in adults but it is now also occurring increasingly in children and adolescents. It is seen in those with a family history of diabetes, excess body weight, lack of physical activity, and as people grow older.
Gestational diabetes: Diabetes which occurs among women during pregnancy. Has a risk of complications during pregnancy and delivery. The children of women with Gestational Diabetes are at an increased risk of type 2 diabetes in the future.
Cancer is a disease caused by uncontrolled division of cells in any part of the body. This causes abnormal growth of that part of the body. The cancer may also spread to more distant parts of the body through the blood. There are various kinds of cancers that are prevalent in our country. In this module, we are specifically going to address only the three most commonly occurring cancers in India – cancer of the cervix and breast among women and oral cancers in women and men.
These three are commonly occurring cancers in India. Together, they account for approximately 34% of all cancers in India. If these cancers are diagnosed early and treated appropriately, chances of survival are good. Thus, regular screening programmes which can diagnose cancers at early stages are an important preventive health programme.