bk foundation health awareness - chronic diseases joseph ana chairman board of trustees bk education...
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BK FOUNDATION HEALTH AWARENESS - CHRONIC DISEASES
JOSEPH ANACHAIRMAN BOARD OF TRUSTEES
BK EDUCATION FOUNDATION
OBJECTIVE
PARTICIPANTS TO HAVE AN INCREASED AWARENESS OF CHRONIC DISEASES AND THEIR PREVENTION AND AVOIDANCE
WHAT IS KILLING PEOPLE IN THE WORLD
Global Causes of Death (2006)CHRONIC DISEASES:
- Heart disease 30.2%
- Cancer 15.7%
- Diabetes mellitus 1.9%
- Others 15.7%
The total number of people dying from chronic (58 MILLION) is double
that of all infectious diseases including HIV/AIDS, tuberculosis and malaria (Nature, 2007).
INFECTIOUS DISEASES:
-HIV/AIDS 4.9%
-TB 2.4%
-Malaria 1.5%
-Other inf. Dses 20.9%
-Injuries 9.3%
DOUBLE WHAMMY OF KILLER- DISEASES IN NIGERIA
• Infections
• Chronic disease
IN NIGERIA 2012
CHRONIC DISEASES
ADD
MENTAL ILLNESS!
Did you know??
35 000 000people died fromchronic diseases
in 2005
COMMON DENOMINATORS
• smoking• Lack of exercise• Food abuse• Alcohol abuse
10 widespread misunderstandings about chronic disease - and the
reality
• Chronic disease epidemic is rapidly evolving• Global recognition and response has not kept
pace• Misunderstandings can be dispelled by the
strongest evidence
Reality: 80% of chronic disease deaths occur in low & middle income countries
Reality: double burden = double response
Reality: chronic diseases are concentrated among the poor and chronic disease is one of the main reasons that families are pitched
into poverty
Facing illness and deepening
poverty
Reality: poor and children have limited
choice
The nextgeneration
Reality: 80% of premature heart disease, stroke and type 2 diabetes
is preventable, 40% of cancer is preventable
Heart disease Stroke Type 2 diabetes Cancer
80%
20%
80% 80%40
%
20% 20%60%
preventable
not preventable
Reality: inexpensive and cost-effective interventions
exist
Reality: these people are the rare exceptions
Reality: death is inevitable but it does not need to be slow,
painful or premature
Dying slowly, painfully and prematurely
Three risk factors
• Three risk factors cause four chronic diseases that cause over half of deaths worldwide.
• The risk factors are:
Tobacco use
Lack of physical activity
Unhealthy diet
ADDITIONALS
• ALCOHOL ABUSE – complex
• OBESITY - complex
Old and new agendas for global health
acute childhood infections maternal deaths
Simple technologiesRapid impactControlled by health
services
Within the remit of the health campus and the health department
chronic, life long infectious and non-infectious diseases
Complex interventionsDecades before impactsMain levers outside health
service controlTakes a whole university
and all government!
What works?
Comprehensive and integrated action is the means to prevent and control chronic diseases
Multiple interventions are effective
Cigarette smoking is influenced by• Fiscal measures – high taxation• Advertising bans• Prohibiting smoking in public places• No vending machines available• Health campaigns to stop smoking• Transport smoking bans• Campaign groups• Health warnings on packets• Medical advice repeatedly
Diet – changing what we eat
Source: UN FAO, 2004
Nutrition transition• Worldwide, there is an accelerating move
towards a diet high in saturated fats, sugar and refined foods, but low in fibre.
• Average food consumption per person is likely to increase from 2,680 kcal in 1997–1999 to almost 3,000 kcal by 2030.
Diet – changing what we eat
Source: The Guardian, 25 April 2006
What is driving the nutrition transition?• The cost of industrial fat has fallen by 50% in
the last 50 years, whereas the cost of a healthy ingredient such as fruit has increased by one third.
• Salt provides flavour to cheap food at around $150 (£84) a tonne. Real spices cost up to $2,000 a tonne.
Diet
From this…
8oz 12oz 16oz 20oz 34oz
Diet
… to this!
16oz 32oz 44oz 52oz 64oz
50 tsp (200g) of sugar (Coca-Cola)
Source: Brownell, 2005
• There are 1,144 kcal in a McDonald’s quarter-pounder with cheese, small fries and a small chocolate milkshake
• This is approximately 70% of the recommended daily calorie intake of a 10-year-old girl
• To work off 1,144 kcal, a child weighing 87 lbs would have to walk at 3 mph for about six hours
Source:McDonalds; AAFP; The fitness calculator
A rough example
Physical activity transition
A transition in physical activity is occurring – we lead increasingly sedentary lives:
• desk jobs replace manual work• labour-saving devices make housework easier and
less time consuming• transportation options remove the need to walk or
cycle• safety fears keep children – and older people –
indoors.
Gender
Age
Beliefs
AbilitiesSelf-image
Knowledge/ education
Motivation
Motivating people/orgs
Motivating factors
Personal characteristics
Work/school
Home Environmental
Media
Employer
Media
Family
Community
Government
ColleaguesGovernment
Architects
Industry
Town planners
Health insurers
Health professionals
PE / lunchbreaks
Playing fields
Distance to work/school
Work gym
Stair access
Shop location
Safe streets
Bike paths
Pavements
Access to gym
Green space
Stairs
Housework
Active games
Sports equipment
Influences on physical activity
Changing facilities
Income
TimeMobility
Street layout
Pollution
Friends
Teachers
School governors
NGOs
Lack of physical activity
Source: ‘At least five a week’ – report from the CMO of England and Wales, 2004 and CDC 2002
• As a result of these trends…– UK: 69% of adults and 35% of children– US: 55% of adults and 31% of adolescents – - ? Data for Nigeria
• … do not reach the recommended levels of physical activity.
Recommended levels of physical activity
• For adults – – At least 30 minutes a day of moderate-intensity
physical activity on five or more days of the week. – The 30 minutes can be made up of bouts of
activity of 10 minutes or more.
• For children and young people – – At least 60 minutes of moderate-intensity physical
activity every day.
Benefits
Source: ‘At least five a week’ – report from the CMO of England and Wales, 2004
• Compared with people who do not reach the recommended levels of physical activity, active people have:– almost half the risk of dying from coronary heart disease– a 27% lower risk of stroke– a 33–50% lower risk of developing type 2 diabetes– 40–50% lower risk of colon cancer, and reduced risk of
other cancers, e.g. breast cancer.• Plus, benefits for musculoskeletal health and
mental health.
Increasing physical activity
• No magic bullet• Many interventions will be necessary• Redesigning the environment will be more
important than exhortation, doctors prescribing exercise, or gyms
TAKE THE STAIRS!
THANK YOU FOR LISTENING
A: BP<135 – reassess every 3 years 85 B: BP 135 -139 – high normal
values 85 – 89 - reassess yearlyC: 145 – 159 – Hypertension 90 – 99 (after at least three
readings) ↓Target organ damage No target organ damageCVD complications No CVD complicationsDiabetes No DiabetesTen year CHD risk > 15% Ten year CHD risk < 15% ↓ ↓ TREAT OBSERVE
(reassess yearly)
HYPERTENSION - MANAGEMENT- Non pharmacological therapy (for all)- Weight reduction\salt reduction/limit alcohol- Regular exercise- increase fruit & vegetable intake- Pharmacological therapy- Diuretic- Diuretic & B-blocker- Diuretic & ACE Inhibitors (except verapramil)- Calcium antagonist & B-blocker- Calcium antagonist & ACE In hibitor- A-blocker & B-blocker
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