scholarly journals The household economic burden of non-communicable diseases in 18 countries

2020 ◽  
Vol 5 (2) ◽  
pp. e002040 ◽  
Author(s):  
Adrianna Murphy ◽  
Benjamin Palafox ◽  
Marjan Walli-Attaei ◽  
Timothy Powell-Jackson ◽  
Sumathy Rangarajan ◽  
...  
Keyword(s):  
Low Income ◽  
Healthcare Costs ◽  
Health Expenditure ◽  
Communicable Diseases ◽  
The Philippines ◽  
Low Income Countries ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries ◽  
Catastrophic Spending

BackgroundNon-communicable diseases (NCDs) are the leading cause of death globally. In 2014, the United Nations committed to reducing premature mortality from NCDs, including by reducing the burden of healthcare costs. Since 2014, the Prospective Urban and Rural Epidemiology (PURE) Study has been collecting health expenditure data from households with NCDs in 18 countries.MethodsUsing data from the PURE Study, we estimated risk of catastrophic health spending and impoverishment among households with at least one person with NCDs (cardiovascular disease, diabetes, kidney disease, cancer and respiratory diseases; n=17 435), with hypertension only (a leading risk factor for NCDs; n=11 831) or with neither (n=22 654) by country income group: high-income countries (Canada and Sweden), upper middle income countries (UMICs: Brazil, Chile, Malaysia, Poland, South Africa and Turkey), lower middle income countries (LMICs: the Philippines, Colombia, India, Iran and the Occupied Palestinian Territory) and low-income countries (LICs: Bangladesh, Pakistan, Zimbabwe and Tanzania) and China.ResultsThe prevalence of catastrophic spending and impoverishment is highest among households with NCDs in LMICs and China. After adjusting for covariates that might drive health expenditure, the absolute risk of catastrophic spending is higher in households with NCDs compared with no NCDs in LMICs (risk difference=1.71%; 95% CI 0.75 to 2.67), UMICs (0.82%; 95% CI 0.37 to 1.27) and China (7.52%; 95% CI 5.88 to 9.16). A similar pattern is observed in UMICs and China for impoverishment. A high proportion of those with NCDs in LICs, especially women (38.7% compared with 12.6% in men), reported not taking medication due to costs.ConclusionsOur findings show that financial protection from healthcare costs for people with NCDs is inadequate, particularly in LMICs and China. While the burden of NCD care may appear greatest in LMICs and China, the burden in LICs may be masked by care foregone due to costs. The high proportion of women reporting foregone care due to cost may in part explain gender inequality in treatment of NCDs.

Physical inactivity and non-communicable disease burden in low-income, middle-income and high-income countries

2021 ◽  
pp. bjsports-2020-103640
Author(s):  
Peter T Katzmarzyk ◽  
Christine Friedenreich ◽  
Eric J Shiroma ◽  
I-Min Lee
Keyword(s):  
Cardiovascular Disease ◽  
Low Income ◽  
Physical Inactivity ◽  
Communicable Diseases ◽  
High Income ◽  
Asia Pacific ◽  
Global Burden ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries

ObjectivesPhysical inactivity is a risk factor for premature mortality and several non-communicable diseases. The purpose of this study was to estimate the global burden associated with physical inactivity, and to examine differences by country income and region.MethodsPopulation-level, prevalence-based population attributable risks (PAR) were calculated for 168 countries to estimate how much disease could be averted if physical inactivity were eliminated. We calculated PARs (percentage of cases attributable to inactivity) for all-cause mortality, cardiovascular disease mortality and non-communicable diseases including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers of the bladder, breast, colon, endometrium, oesophagus, stomach and kidney.ResultsGlobally, 7.2% and 7.6% of all-cause and cardiovascular disease deaths, respectively, are attributable to physical inactivity. The proportions of non-communicable diseases attributable to physical inactivity range from 1.6% for hypertension to 8.1% for dementia. There was an increasing gradient across income groups; PARs were more than double in high-income compared with low-income countries. However, 69% of total deaths and 74% of cardiovascular disease deaths associated with physical inactivity are occurring in middle-income countries, given their population size. Regional differences were also observed, with the PARs occurring in Latin America/Caribbean and high-income Western and Asia-Pacific countries, and the lowest burden occurring in Oceania and East/Southeast Asia.ConclusionThe global burden associated with physical inactivity is substantial. The relative burden is greatest in high-income countries; however, the greatest number of people (absolute burden) affected by physical inactivity are living in middle-income countries given the size of their populations.

scholarly journals The global non-communicable diseases epidemic and association between dietary factors and non-communicable diseases by income levels

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Hyunjung Lim ◽  
Do-Yeon Kim ◽  
Ju Hyun Park ◽  
Hyunjung Lim
Keyword(s):  
Risk Factors ◽  
Blood Glucose ◽  
Low Income ◽  
Fasting Blood Glucose ◽  
Communicable Diseases ◽  
Dietary Factors ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Income Levels ◽  
Middle Income Countries

AbstractNon-communicable diseases (NCDs) share common risk factors as poor dietary intakes, especially among low-income populations worldwide. However, the diet-related health burden by country income levels remains unclear. We assessed the current prevalence of NCDs and the association between selected dietary factors and NCDs by income levels. Data were obtained from the World Health Organization, Food and Agriculture Organization, and World Bank, and 151 countries were included in the analysis weighted by the total population size. Linear regression was used to find the association between metabolic risk factors and health-related behaviors by income levels. The prevalence of raised fasting blood glucose and total cholesterol, overweight, and obesity were lowest in lower and middle income countries, but prevalence of raised blood pressure and NCD deaths under age 70 were highest in lower and middle income countries (p for trend < 0.001). The proportion of carbohydrates and alcohol consumer were highest, and vegetable, milk supply, insufficient activity were lowest in lower and middle income countries. In high income countries, raised fasting blood glucose level were negatively associated with vegetable consumption (β = -0⋅05 CI [-0⋅08, -0⋅02]), and alcohol consumption, fat intake (7⋅94 [1⋅82, 14⋅06]), and sugar and sweetener supply (0⋅04 [0⋅01, 0⋅07]) were associated with overweight. In low income countries, overweight was associated with vegetable oil (0⋅03 [0⋅00, 0⋅05]),. In this study, different relationship between diets and NCDs trends were found across country income levels. Appropriate health policies for each group of countries by income are needed to solve the increasing challenges of NCDs.This work was carried out with the support of “Cooperative Research Program for Agriculture Science and Technology Development (Project No. PJ PJ01317001)” Rural Development Administration, Republic of Korea.

scholarly journals Are WHO “best buys” for non-communicable diseases effective in low-income and lower-middle-income countries? A systematic review

2017 ◽  
Vol 5 ◽  
pp. S17 ◽  
Author(s):  
Luke N Allen ◽  
Jessie Pullar ◽  
Kremlin Wickramasinghe ◽  
Julianne Williams ◽  
Charlie Foster ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Income ◽  
Communicable Diseases ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries

scholarly journals Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2439
Author(s):  
Brendon Stubbs ◽  
Kamran Siddiqi ◽  
Helen Elsey ◽  
Najma Siddiqi ◽  
Ruimin Ma ◽  
...  
Keyword(s):  
Health Survey ◽  
Low Income ◽  
World Health ◽  
Low Income Countries ◽  
Multivariable Logistic Regression Analysis ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

scholarly journals Breast Cancer in Low- and Middle-Income Countries: An Emerging and Challenging Epidemic

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Arafat Tfayli ◽  
Sally Temraz ◽  
Rachel Abou Mrad ◽  
Ali Shamseddine
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Low Income ◽  
Therapeutic Interventions ◽  
Low Income Countries ◽  
Middle Income ◽  
Major Health ◽  
Middle Income Countries ◽  
Low And Middle Income

Breast cancer is a major health care problem that affects more than one million women yearly. While it is traditionally thought of as a disease of the industrialized world, around 45% of breast cancer cases and 55% of breast cancer deaths occur in low and middle income countries. Managing breast cancer in low income countries poses a different set of challenges including access to screening, stage at presentation, adequacy of management and availability of therapeutic interventions. In this paper, we will review the challenges faced in the management of breast cancer in low and middle income countries.

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