I talked to these two women when I was in Bolivia.

And then they're sitting and, and selling things primarily potatoes,

greens, and a few of the food stuffs.

And as I talked to them I realized that they both had one thing in common,

they both had hypertension.

Which lead to me to talk now about non-communicable diseases.

What are non-communicable diseases?

Why are they important in global health?

And why do they seem to be on the rise?

Let's start with a definition.

You know, a noncommunicable disease is a disease that

that's not spread via pathogens, right, or agents.

But rather it's primarily caused by lifestyle or other daily exposures,

including to human social networks, and I say human social networks.

Because we tend to do what our social network does.

And that can produce good health outcomes, neutral health outcomes, or

bad health outcomes.

Non-communicable diseases tend to be of delayed onset,

they don't occur immediately.

They're chronic, and long-term.

They tend to impair daily function and can lead to premature death.

Now I've just differentiated, I realized infectious and non-communicable

diseases but let me just problematize that for a second because some.

Non-communicable disease such as cancers might

actually originate from an infectious disease.

Take for example cancer of the cervix, which frequently recur, can frequently

occur frequent, most common cause is HPV, human papilloma virus.

But that's actually a virus that's been

transmitted through through through sex.

In fact, we're probably going to see eventually that at least 40%

of cancers have an origin in an infectious agent.

Nonetheless, the final result, we're going to cause a non-communicable dis,

it's called a non-communicable disease.

Let me give you a little mini-med school here before we go on,

I think it will be important.

When we're talking about non-communicable diseases there are quite a few

terms that we use.

Hyper, meaning excess.

Hypo, meaning deficient.

Emia, relating to blood.

Tension, relating to blood pressure.

Lipid, relating to fat.

Glyc, relating to sugar.

So, if someone has high blood sugar, we would say that they have hyperglycemia.

Right, high sugar in the blood.

This will be useful as you read and study more about global health.

There's a very interesting distribution of non-communicable diseases in the world

among different regions.

Globally, a little over half of DALYs are caused by noncommunicable disease,

but in the global north, it is well over 80%.

In the global south, it is about, about, about half.

If you look at the regions, however,

you see if you look even among regions you see some very interesting things, but

if you look within regions you also see that there are many differences.

India, 48% of DALY is non-communicable diseases.

South Korea, 83% of DALYs, right?

Again, well we are in one region SEARO, we're also looking at

countries that wold be developing, such as India.

Or developed, highly developed and

industrialized such as South Korea.

Now, while in lower-middle income countries we find that DALYs responsible

for about half.

Of that, that that non-communicable disease are responsible for

about half the DALYs they are responsible for

80% of deaths in lower and middle income countries.

They're the leading global cause of death.

Over half of the NCD mortality is from two things alone.

Heart disease and diabetes.

We're expecting mortality from NCDs to increase at least 15% by 2020.

And we think we're going to see the greatest,

absolute increase of NCDs in southeast Asian, Asia, and western Pacific region.

Now while people think about things like heart disease as primarily being.

Men the fact is, for men the fact is that overall NCDs including heart disease,

ultimately affect men and women about equally.

There are many risks of NCDs.

You see me, I am in Tokyo, looking at this image of mister hot dog.

Poor diet, high blood pressure, smoking.

Indoor and outdoor pollution, substance abuse, too much alcohol.

Having a body mass index that's too high,

in other words, for your for your weight and height, having too much fat.

High blood sugar, not getting enough exercise, poor cholesterol profile.

Cultural beliefs can play a role, what should or should not be eaten.

For example, whether one should or should not exercise.

How much fat one should have in one's body?

We also know there's correlation with education, socioeconomic status.

There's actually some evidence that race and ethnicity can predispose

some groups to greater risk of particular types of NCD's.

For example, one example is the possibility amongst South Asians,

there might be a greater propensity towards diabetes.

But the research is still out.

Now, you might ask, why are these NCDs on the rise?

Well, there are lots of reasons for them and

a lot of it has to do with the transitions, right?

Epidemiological transition as we have fewer infectious disease, people live

longer, more likely they're going to get get an NCD.

Remember, ultimately, we all die of something, right?

The demographic transition, aging population,

older people who have survived the most common infectious diseases of childhood

are more likely to get non-communicable diseases, or to get sick from that.

Structural violence meaning poverty, lack of access, to things like good food

sources or supermarkets can lead to poor nutrition.

Epigenetics, the impact of our the, the, the, the impact of our

environment can play a role in having causing genetic genetic changes in us.

Which can then predispose us towards particularly noncommunicable diseases.

The impact of globalization understanding about genomics, these genetic changes,

and even the bile.

The bacteria that live inside us, right, in our intestines in particular.

That makeup of bacteria which produces vitamins produces some

neurotransmitters can have an impact on our metabolism can all play a role.

There's no one reason, it's all of these factors together.

What are Non-Communicable Diseases and Why are They on the Rise?

The Challenges of Global Health

Meet the Instructors