Earlier this year, Oxfam proposed that if current financial trends persist, the richest 1% will earn more than the remaining 99% of the population1. Whilst staggering, to many of us this is just another meaningless statistic, easily ignored - forgotten. What we fail to realise is that this escalating inequity is having a huge impact on global health. Unbeknownst to many, our economic divide is a key contributor to our leading cause of death. Which begs the question, what is the biggest killer globally? Whilst Ebola, HIV and TB all immediately spring to mind, none of these have mortality rates comparable to NCDs1.
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| Available from http://visual.ly/wealth-distribution-around-world |
Non-Communicable Diseases (NCDs) kill 3 out of 5 people. Vastly more that HIV (1.4 million in 2013) or Ebola (3,800 in 2014). NDC’s include heart disease, cancer, diabetes, chronic lung disease and mental illness, all chronic diseases which, by definition, are not transmittable3. Notably whilst there is no apparent link between any of these diseases, they all arise from a combination of lifestyle and socio-economic factors including; poor diet, alcohol and tobacco use3,4.
Looking at the list above you may immediately assume that NCDs are diseases of the wealthy. This could not be further from the truth. Approximately 80% of NCD’s exist in middle to low socioeconomic groups. Due to their chronic nature, these diseases are extremely costly3,4,5. The WHO (World Health Organisation) reported that 100 million sufferers (per year) will be driven into poverty by the extraneous costs associated with these diseases.
So why do NCD’s have the greatest impact on those of low socioeconomic status? Two words, inequity and urbanisation. Whilst those in higher socioeconomic groups have naturally benefited from the economic boom, those within the middle and lower socioeconomic groups are suffering3,4,5. The resulting gross level of global inequity means that those in lower socioeconomic groups now have less control over their access to nutritious foods, education, quality healthcare, medication, and a safe working environment5,6. This means that the majority of those in middle and low income groups lead largely sedentary lifestyles, working long hours in high stress environments. Forced lifestyle choices are further exacerbated by the behaviours of exploitative global food production companies, manufacturing cheap, poor quality and nutritionally defunct foods targeted towards low socioeconomic groups3,5,6. Redirection of marketing by global tobacco companies has also increased the tobacco usage within these populations. In short, people from lower socioeconomic settings have limited access to healthcare due to both cost and location.
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| Total deaths based on income group, nationality and sex taken (2010)5. |
So why do NCD’s have the greatest impact on those of low socioeconomic status? Two words, inequity and urbanisation. Whilst those in higher socioeconomic groups have naturally benefited from the economic boom, those within the middle and lower socioeconomic groups are suffering3,4,5. The resulting gross level of global inequity means that those in lower socioeconomic groups now have less control over their access to nutritious foods, education, quality healthcare, medication, and a safe working environment5,6. This means that the majority of those in middle and low income groups lead largely sedentary lifestyles, working long hours in high stress environments. Forced lifestyle choices are further exacerbated by the behaviours of exploitative global food production companies, manufacturing cheap, poor quality and nutritionally defunct foods targeted towards low socioeconomic groups3,5,6. Redirection of marketing by global tobacco companies has also increased the tobacco usage within these populations. In short, people from lower socioeconomic settings have limited access to healthcare due to both cost and location.
This begs the question, what can be done? If urbanisation is the leading cause of these diseases, how do we overcome it? Recognition. To be fair this is easier said than done. Current developmental and social security agendas have been targeted towards combating starvation and infection disease within low-socioeconomic groups, leaving lifestyle factors contributing to NCDs largely unattended. All too often these factors are considered the individuals responsibility. It is assumed that people should be educated to the traps of globalised marketing companies and the outcomes of poor health and nutrition. Notably cross-national correlations conducted in developing countries have shown a strong inverse association between education level and cardiovascular risk2,3,5. Based on this data various educational campaigns have been established within developed countries to educate their populations as to causal factors of NCDs. Furthermore, in order to rectify these major over sites; in 2011, the WHO launched a global response, involving 190 countries in their Global Action Plan. From 2013, the WHO established 9 voluntary global targets in order to reduce premature deaths from NCDs by 25% before 20255,6.
Whilst this is a great start there is a lot more that can be done. In terms of education, its all about making information available to the general population – essentially that’s what this blog is trying to achieve. Any difference is a start.
References
1. Hardoon D.
Having it all and wanting more. Oxfam international; 2015. 12p
2. Crooks R. Wealth distribution around the world [Internet] 2011[updated 2011 May 20; cited 2015 Mar 6]. Available from http://visual.ly/wealth-distribution-around-world
3. Demanio A. The greatest health threat you've never heard of, but need to know about [Internet]. 2014[updated 2014 Oct 25; cited 2015 Mar5]. Available from http://blogs.plos.org/globalhealth/2014/10/greatest-health-threat-youve-never-heard-need-know/
4. Lim et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease study 2010. Lancet 2013;80(9859):2224-60.
5. World Health Organisation. Global status report of non-commutable disease. Geneva: WHO Press; 2011. 162p
6.AIWH. Australias Health. Canberra :AIWH:2004
2. Crooks R. Wealth distribution around the world [Internet] 2011[updated 2011 May 20; cited 2015 Mar 6]. Available from http://visual.ly/wealth-distribution-around-world
3. Demanio A. The greatest health threat you've never heard of, but need to know about [Internet]. 2014[updated 2014 Oct 25; cited 2015 Mar5]. Available from http://blogs.plos.org/globalhealth/2014/10/greatest-health-threat-youve-never-heard-need-know/
4. Lim et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease study 2010. Lancet 2013;80(9859):2224-60.
5. World Health Organisation. Global status report of non-commutable disease. Geneva: WHO Press; 2011. 162p
6.AIWH. Australias Health. Canberra :AIWH:2004
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