How to prevent chronic diseases that kill 41 million people a year?

Author: Zhang Fengguang, epidemiology expert, chair of the UCLA Department of Epidemiology, visiting professor of Fudan University

Chronic diseases, according to the definition of the World Health Organization, are called chronic non-communicable diseases. Unlike COVID-19, they are not transmitted by viruses or bacteria. They are characterized by a long course of disease and generally slow progression, and their impact on people's health is also more serious.

So what causes chronic diseases? Of course there are many factors, including genetic factors, physiological factors, environmental factors, and behavioral factors. It is the result of the combined effects of these factors.

How serious is chronic disease in the world? Of the total number of deaths in the world of 55.4 million, 41 million are caused by chronic diseases, accounting for 74% of all deaths. That is, 3/4 of deaths are caused by chronic diseases. At the same time, about 77% of deaths from chronic diseases occur in low-income countries, so the impact on poor countries is relatively large.

What are the main types of chronic diseases?

What are the common chronic non-communicable diseases?

The most important one is cardiovascular disease. Cardiovascular disease kills about 17.9 million people worldwide each year, so it is the most important cause of death. Cardiovascular disease includes coronary heart disease, stroke, and many vascular diseases, so it is the most serious chronic disease.

The second largest chronic disease is tumor, which is what we often call malignant tumor or cancer. It causes 9.3 million deaths each year and ranks second in the death rate among chronic diseases.

The third type of chronic disease is what we often call chronic respiratory disease, or sometimes we call it chronic bronchitis, which causes 4.1 million deaths each year.

The fourth type is diabetes, which is relatively common nowadays. Diabetes kills about 2 million people every year. These four types of chronic non-communicable diseases together account for about 80% of all chronic diseases.

So if we can effectively control these four types of diseases, chronic diseases will be reduced by 80%.

What are the risk factors for chronic diseases?

What causes chronic diseases?

There are many factors that can cause chronic diseases, as we mentioned before, including genetics, physiology, dangerous environment, and lifestyle. What are these comprehensive risk factors for chronic non-communicable diseases?

The first category is called modifiable behavioral factors, which can be changed.

(1) Tobacco. Smoking is a huge problem in China. Smoking causes 8 million deaths worldwide, including deaths caused by secondhand smoke.

(2) Salt intake: eating too much salt. Salt intake can cause 1.8 million deaths. Salt intake can not only cause high blood pressure, but also cause stomach cancer, which is the most common tumor among Chinese people.

(3) Harmful drinking. Harmful drinking means drinking in large quantities, which causes great harm. Every year, about 3 million people die from drinking, of which about half are caused by chronic non-communicable diseases.

(4) Lack of exercise. Lack of exercise is mainly due to more sitting time and less exercise time, which has caused 830,000 deaths. So these four factors are behavioral factors that can be changed. If these four factors are controlled, many deaths can be controlled.

The second type of risk factors is called metabolic risk factors, which include the most common high blood pressure, overweight and obesity, high blood sugar and high blood lipids among Chinese people. We call them metabolic syndrome or metabolic risk factors, which can cause chronic non-communicable diseases.

The third is environmental factors, which are more obvious, including air pollution, land pollution, and biological pollution. For example, air pollution can cause 6.7 million deaths, most of which are related to chronic diseases.

The fourth is the socioeconomic factors we mentioned, such as poverty. Poverty is one of the most important factors causing chronic diseases. It not only causes an increase in chronic diseases, but also a large increase in deaths caused by the disease.

What impact do chronic diseases have on society and families?

What impact do chronic non-communicable diseases have on our health, our society and our families?

Chronic non-communicable diseases are the world's largest cause of death and long-term consequences, causing great impact on human health.

In terms of medical expenditure, chronic diseases put a great burden on our medical service system, because many people suffer from chronic diseases and the course of illness is relatively long, which puts a lot of pressure on hospitals and medical services. At the same time, the impact on public health is also relatively large, because we need to prevent 3/4 of deaths, the pressure on public health is also very large, and public health expenditures will increase accordingly.

At the same time, for the whole society, productivity will be greatly reduced, and it will also cause certain economic losses. For example, chronic diseases can lead to premature death of many people, that is, death before the age of 70, which we define as premature death. It may also cause premature withdrawal from the labor force, absenteeism, and a decline in people's labor capacity, so overall it will affect the development of social economy.

From the perspective of individual and family situations, it will also cause great financial expenditures for the family, including out-of-pocket medical expenses and a decrease in family income due to illness. This will cause financial risks for many families and will also cause many families with people suffering from chronic diseases to become poor.

Therefore, the impact of chronic diseases is not only on health, but also has a great impact on society, economy, and family.

In general, most chronic diseases are controllable. As long as we take these comprehensive factors into consideration, deaths from chronic diseases will drop significantly.

This article is a work supported by the Science Popularization China Creation Cultivation Program

Team/Author: Deep Science - Zhang Zuofeng

Reviewer: Bai Yamin, Deputy Director of Health Promotion and Behavior Intervention Office, Chronic Disease Center, Chinese Center for Disease Control and Prevention

Researcher, Master's Supervisor

Produced by: China Association for Science and Technology Department of Science Popularization

Producer: China Science and Technology Press Co., Ltd., Beijing Zhongke Xinghe Culture Media Co., Ltd.