by Maria Teresa L. Ungson
THE rapid rise of non-communicable diseases represents one of the major health challenges to global development in the coming century. This growing challenge threatens economic and social development as well as the lives and health of millions of people.
In 1998 alone, non-communicable diseases are estimated to have contributed to almost 60% of deaths in the world and 43% of the global burden of disease. Based on current trends, by the year 2020 these diseases are expected to account for 73% of deaths and 60% of the disease burden.
Low and middle income countries suffer the greatest impact of non-communicable diseases. The rapid increase in these diseases is sometimes seen disproportionately in poor and disadvantaged population and is contributing to widening health gaps between and within countries. For example, in 1998, of the total number of deaths attributable to non-communicable diseases, 77% occurred in developing countries, and the disease burden they represent, 85% was borne by low and middle income countries.
In the Philippines, increasing life expectancy, urbanization and lifestyle changes have brought about a considerable change on the health status of the country. Globalization and social change has influenced the spread of non-communicable or lifestyle/degenerative diseases by increasing exposure to risk. As the country’s per capita income increases, the social and economic conditions necessary for the widespread adoption of risky behaviors gradually emerge. This in turn has brought a considerable challenge to the country’s health policy and health system to address emerging lifestyle/degenerative diseases amidst the unfinished agenda of communicable health.
Recent statistics have sounded out the alarm. The life expectancy of Filipinos in 1999 has gone up to 69 years. The process of aging brings out myriad health problems which are degenerative by nature. Mortality statistics in 1997 shows that 7 out of 10 leading causes of deaths in the country are diseases which are lifestyle related (diseases of the heart and the vascular system, cancers, chronic obstructive pulmonary diseases, accidents, diabetes, kidney problems). Morbidity statistics show that diseases of the heart ranks 6th as the leading cause of illness in the country.
In a study by Tiglao et al, (2000) 32.2% are ever smokers or having smoked at one point in their lives. Current smokers are 23.5% (73.1% of the ever smokers) 78.5% are males while 21.4% are females. Among the current smokers 13.6% began smoking at the age of 6-14 years old; 51.4% began at the age of 15-19 years old; 19.6% 20-24 years; 6.8% 25-29 and 8.5% 30-70 years old. A study done by NDHS in 1998 revealed that 60% of the households nationwide have at least one smoker.
In the same study by Tiglao et al, 38.9% of the sample population are alcohol drinkers, with recorded age of initiation at 6 – 71 years old. Half of the drinkers (50.3%) started drinking at ages 15-19, the teenage years; while 8.5% started at less than 14 years. More than half (58.1%) are light drinkers, meaning they usually take less than four drinks; about 37% are moderate drinkers (4-12 drinks) while a small proportion (5.9%) are heavy drinkers (>12 drinks). Number of drinks is equivalent to 1 glass of wine, 1 shot of liquor, or 1 cocktail.
Again, in the same study, 79.1% of the respondents claim that they have some form of exercise or engage in some physical activities. More than half (54.4%) engages in low to moderate physical activities – walking, jogging, bending, stretching, yoga, exercise for pregnant women, weaving, sewing, gardening. Thirty one percent (31.1%) engages in sustained physical activity – household chores, peddling, farming, carpentry, fishing, serving. Only 14.6% participates in vigorous forms of physical activities – brisk walking, push up, weightlifting, PE class, taebo, sports. Most popular form of physical activity is walking followed by household chores.
Looking at the weekly consumption of fruits and vegetables, Tiglao et al’s study revealed that a big majority (81.3%) of the respondents claim to eat fruits and vegetables four or more times a week; 10.7% thrice a week; 3.9% twice a week; 3.4% once a week; while 0.7% admitted they don’t eat fruits and vegetables.
Four of the most prominent non-communicable diseases are linked by common preventable risk factors related to lifestyle. These are cardiovascular disease, cancer, chronic obstructive pulmonary disease and diabetes. The risk factors involved are tobacco use, unhealthy diet and physical inactivity. Action to prevent these diseases should therefore focus on controlling these in an integrated manner. Intervention at the level of family and community is essential for prevention because the causal risk factors are deeply entrenched in the social and cultural framework of the society. Addressing the major risk factors should be given the highest priority in the global strategy for the prevention and control of lifestyle related diseases.
The mandate of the Department of Health is to promote and protect health lifestyles. For common understanding, healthy lifestyle has been operationally defined as a way of life that promotes and protects health and well being. This would include practices that promotes health such as healthy diet and nutrition, regular and adequate physical activity and leisure, avoidance of substances that can be abused such as tobacco, alcohol and other addicting substances, adequate stress management and relaxation; and practices that offer protection from health risks such as safe sex and responsible parenthood.
DOH goal is to reduce the toll of morbidity, disability and premature deaths due to lifestyle related diseases. One of the components of the major strategies employed will be health promotion, across the life course and prevention of the emergence of the risk factors in the first place. This is where a serious campaign on healthy lifestyle would be most relevant. Thus the development and installation of the National Healthy Lifestyle Program in the Department of Health.
The National Healthy Lifestyle Program aims to reduce prevalence of major risk factors specifically smoking, physical inactivity and unhealthy diet and nutrition. Specifically, the program aims to: (1) develop the program components of the National Healthy Lifestyle Program, (2) launch a Comprehensive Healthy Lifestyle Advocacy and Health Promotion, (3) institutionalize the promotion of healthy lifestyle in local government units, and (4) quality assurance through Sentrong Sigla.
Program components of the Healthy Lifestyle Program include: a) Tobacco Control Program, b) Lifestyle Physical Activity Program, c) Healthy Diet and Weight Control Program, d) Stress Management Program and e) Control of Alcohol Use Program. These will all be further strengthened by the DOH. The key messages include: a) exercise regularly, b) eat a healthy diet everyday. c) watch your weight / weight control, d) don’t smoke, e) manage stress and f) have a regular health check-up.
The movement also highlighs periodically a year round thematic advocacy/IEC campaign on specific healthy lifestyle messages.
January – Regular health check up
February – Exercise regularly
May/June – Don’t smoke
July – Eat a healthy diet
October – manage stress
December – Watch your weight / Weight control
