Unit 4 of Global Health

What are non-communicable diseases (NCDs)?

Chronic diseases that are not spread from person or vector to person; they tend to be long in duration and often progress slowly over months or years.

What are other names for NCDs?

Chronic diseases or chronic illnesses.

What are the main types of NCDs?

Cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes.

What are examples of cardiovascular diseases?

Heart disease, heart attacks, and stroke.

What are examples of chronic respiratory diseases?

Chronic obstructive pulmonary disease (COPD) and asthma.

What are other conditions identified as NCDs in the Unit 4 study guide?

Mental health disorders.

What factors contribute to the development of NCDs?

A combination of genetic, physiological, environmental, behavioural, and sociodemographic factors.

Why are NCD risk factors important in public health?

Identifying, reducing, and managing risk factors can help prevent NCDs; they are major public health challenges and targets of health policies.

Why is a comprehensive approach needed to address NCDs?

NCDs are influenced by multiple factors, so prevention and control require collaboration across sectors.

How many people died from NCDs in 2021?

At least 43 million people, equivalent to 75% of non-pandemic-related deaths globally.

How many people died prematurely from NCDs in 2021?

Approximately 18 million people died from an NCD before age 70.

What proportion of premature NCD deaths occur in low- and middle-income countries?

Approximately 82%.

What proportion of all NCD deaths occur in low- and middle-income countries?

Approximately 73%, or nearly three quarters; the WHO overview reports approximately 32 million deaths in these countries.

Which NCD group caused the most deaths in 2021?

Cardiovascular diseases, accounting for at least 19 million deaths.

How many deaths from cancer were reported in 2021?

Approximately 10 million.

How many deaths from chronic respiratory diseases were reported in 2021?

Approximately 4 million.

How many deaths were attributed to diabetes in 2021, including kidney disease deaths caused by diabetes?

More than 2 million.

What proportion of premature NCD deaths are caused by cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes combined?

These four disease groups account for 80% of all premature NCD deaths.

Do NCDs affect only older adults?

No. People of all ages, regions, and countries are affected, including children and younger adults.

How do NCDs affect people aged under 70?

NCDs cause more deaths in this age group than all other causes of death combined, according to the provided WHO overview.

What does premature NCD mortality mean in the Byass (2019) article?

NCD deaths among people aged 30–69 years.

Which age range does SDG Target 3.4 use to measure premature NCD mortality?

People aged 30–69 years.

What is SDG Target 3.4?

Reduce premature mortality from non-communicable diseases by one third through prevention and treatment by 2030.

What is the difference between NCD mortality and premature NCD mortality?

NCD mortality includes deaths from NCDs across age groups; premature NCD mortality specifically measures deaths among people aged 30–69.

What are the four major behavioural risk factors for NCDs?

Tobacco use, unhealthy diets, harmful use of alcohol, and insufficient physical activity.

How does tobacco use contribute to NCD risk?

Tobacco use, including exposure to second-hand smoke, increases the risk of dying from an NCD.

What dietary factors increase NCD risk?

Unhealthy diets, including excess salt, sugar, and fats.

How does harmful alcohol use affect NCD risk?

It is a behavioural risk factor that increases the risk of NCDs.

How does insufficient physical activity affect NCD risk?

It increases the risk of NCDs and contributes to unhealthy metabolic changes.

What environmental factors help drive unhealthy behaviours?

The social environment, commercial environment, and physical environment.

What are the four key metabolic risk factors for NCDs?

Raised blood pressure, overweight or obesity, high blood glucose, and abnormal blood lipids.

What is hypertension?

Raised blood pressure; it is a metabolic risk factor for NCDs.

What is a metabolic risk factor?

A measurable bodily change that increases the risk of developing an NCD, such as raised blood pressure, high blood glucose, overweight or obesity, or abnormal blood lipids.

What metabolic changes can result from unhealthy diets and insufficient physical activity?

Raised blood pressure, increased blood glucose, elevated blood lipids, and obesity.

What is the leading metabolic risk factor globally in terms of attributable deaths?

Elevated blood pressure.

What proportion of global NCD deaths is attributed to elevated blood pressure in the provided WHO material?

Approximately 25%.

Which metabolic risk factors follow elevated blood pressure in the provided WHO overview?

Raised blood glucose, followed by overweight and obesity.

What are examples of genetic risk factors for NCDs?

Family disease history, genetic inheritance, epigenetic changes, environmental exposure-based changes, and toxic material-based mutations.

What are examples of environmental risk factors listed in the Unit 4 study guide?

Air pollution, weather changes, sunlight or ultraviolet radiation, and environmental exposures such as radiation.

What are examples of sociodemographic risk factors listed in the study guide?

Age, gender, race, ethnicity, education, and income.

What are examples of lifestyle or health-related risk factors listed in the study guide?

Tobacco use, alcohol use, physical activity level, weight, nutrition, dental health care, and stress reduction.

What medical conditions or health factors are listed as NCD risk factors in the study guide?

Medications, high blood pressure, lipids or high cholesterol, glucose, viruses, obesity or increased abdominal girth, stress, and high blood sugar.

What is the largest environmental risk factor for NCDs in the provided WHO overview?

Air pollution, both indoor and outdoor.

How many global deaths are attributed to air pollution in the provided WHO material?

Approximately 6.7 million deaths globally.

How many air-pollution-related deaths are estimated to be due to NCDs?

Approximately 5.6 million.

Which NCDs are associated with air pollution in the provided WHO overview?

Stroke, ischaemic heart disease, chronic obstructive pulmonary disease, and lung cancer.

How does poverty relate to NCDs?

NCDs can increase household health-care costs and impede poverty reduction, while people experiencing social and economic disadvantage may become sick and die sooner.

Why are socially disadvantaged populations especially affected by NCDs?

They may have limited access to health services and face greater exposure to risks and barriers to prevention and treatment.

How can NCDs affect progress toward sustainable development?

They can impede poverty reduction and progress toward the 2030 Agenda for Sustainable Development.

What is needed to reduce inequities in NCD outcomes?

Governments must invest in health systems that respond to users’ expectations and needs.

What is one important strategy for controlling NCDs?

Reduce the risk factors associated with these diseases.

Are there low-cost ways to reduce common modifiable NCD risk factors?

Yes. The WHO overview states that low-cost solutions exist for governments and other stakeholders.

Why is monitoring NCDs and their risk factors important?

It helps guide policies and priorities and allows progress and trends to be assessed.

Why must NCD prevention involve sectors beyond health care?

Sectors such as finance, transport, education, agriculture, and planning can influence risk factors and support prevention and control.

What does a multisectoral approach to NCDs mean?

Different sectors collaborate to reduce NCD risks and promote interventions to prevent and control disease.

What are key components of NCD management?

Detection, screening, treatment, and access to palliative care for people who need it.

Why is early detection and timely treatment of NCDs important?

Early interventions can reduce the need for more expensive treatment later.

How can essential NCD interventions be delivered?

Through a primary health-care approach that strengthens early detection and timely treatment.

Why is universal health-care coverage important for NCD control?

Countries with inadequate health-care coverage are unlikely to provide universal access to essential NCD interventions.

Why does the WHO describe essential NCD interventions as good economic investments?

Providing interventions early can reduce the need for more expensive treatment.

What role does palliative care play in the NCD response?

It provides care for people with NCDs who need it and is part of comprehensive NCD management.

What is the WHO's role in the global response to NCDs?

The WHO provides leadership, coordination, and promotion of the global effort to prevent and control NCDs and achieve SDG Target 3.4.

What did heads of state and government commit to under SDG Target 3.4?

Develop ambitious national responses to reduce premature NCD mortality by one third by 2030 through prevention and treatment.

What happened to the WHO Global Action Plan for NCD prevention and control in 2019?

The World Health Assembly extended the plan from 2013–2020 to 2030.

What is the WHO Implementation Roadmap 2023–2030 intended to do?

Accelerate progress on preventing and controlling NCDs and support action toward nine global targets.

What was the purpose of the WHO Global Action Plan for NCDs 2013–2020, according to the Unit 4 study guide?

Provide UN member states, international partners, and the WHO with a roadmap of policy options to help achieve nine global NCD targets for 2025.

What burden of disease did the WHO Global Action Plan aim to reduce?

The preventable and avoidable burden of morbidity, mortality, and disability caused by NCDs.

What principles underpin the WHO Global Action Plan described in the study guide?

Evidence-based action, multisectoral collaboration, regional, national, and global cooperation, and placing people at the forefront of decisions.

How did COVID-19 disrupt progress on NCDs, according to the study guide?

Health-care disruption, delayed diagnosis and treatment, COVID-related complications, and more sedentary lifestyles and behavioural changes contributed to increased NCD burdens.

What is RTI International's connection to NCDs in the study guide?

It is an independent, non-profit organization committed to the UN SDGs and SDG 3, including reducing premature NCD mortality by one third by 2030.

Why are NCDs no longer considered mainly a burden of wealthier countries?

NCDs are also a major issue in low- and middle-income countries.

Which global changes are linked to the growing NCD burden in lower-income countries in the study guide?

Globalization of food marketing and distribution, wider availability of energy-dense foods, population ageing, urbanization, growth in service industries, mechanization of work, and improved living standards.

What is an energy-dense food?

In the context of the study guide, it refers to food whose wider availability is discussed as one factor associated with changing NCD burdens; the guide does not provide a more detailed definition.

What is the central public-health lesson of the Unit 4 NCD overview?

NCDs affect every country, and prevention requires action at every level of prevention and across sectors.

What is the focus of Bonita et al. (2013), “Country actions to meet UN commitments on non-communicable diseases: a stepwise approach”?

The article discusses interventions for NCDs, with a focus on low- and middle-income countries.

What does the Unit 4 study guide ask students to do with Bonita et al. (2013)?

Summarize the article’s nine panels.

What limitation applies to studying the nine panels of Bonita et al. (2013) from the materials currently available?

The available Bonita file contains citation metadata rather than the full article, so the individual panel contents cannot be reliably summarized from that file alone.

Which article discusses embedding NCDs in the post-2015 development agenda?

Alleyne et al. (2013), “Embedding NCDs in the post-2015 development agenda.”

Which Alleyne et al. (2013) reading sections are specified in the Unit 4 study guide?

Page 568, Panel 2: “Anticipating non-communicable diseases in Rwanda,” and pages 568–571 on human development, sustainability, and NCDs in the sustainable human development agenda.

What questions does the Unit 4 study guide ask about the SDGs and health?

Whether the SDGs made human health the central theme and whether the goals represent NCDs and the social determinants of health that lead to NCDs.

What are social determinants of health in relation to the Unit 4 discussion question?

The study guide asks students to consider social conditions that contribute to NCDs; it does not provide a complete definition in the supplied text.

What are the main global mental health goals described in the Unit 4 study guide?

Reduce the prevalence of mental illness, increase access to mental health services, and integrate mental health care into primary health-care systems.

Why is cultural and social context important in global mental health?

It is important for understanding mental health and designing culturally sensitive interventions.

Why is a commission needed for mental health?

The study guide poses this as a critical-thinking question but does not supply a specific answer; the assigned video or commission material is needed to answer it accurately.

What losses can occur when mental health care is not sought?

The study guide poses this as a critical-thinking question but does not provide a specific list of losses; the assigned video or reading is needed to answer it accurately.

What are the three unique guiding principles of the mental health commission mentioned in the study guide?

The study guide asks this question but does not name the principles; the assigned video or commission material is needed to identify them.

What factors are described as contributing to adult mental health struggles in some parts of the world?

Conflict and childhood trauma.

What mental health resource challenge is highlighted in Zimbabwe in the study guide?

The material states that Zimbabwe had seven mental health workers in the entire country, making it challenging to establish or maintain mental health care.

What comparison does the study guide make between mental health workers in Zimbabwe and Canada?

It states that Zimbabwe had seven mental health workers, compared with over 650,000 in Canada.

What is the purpose of the WHO initiative mentioned for Zimbabwe?

To support improvements in Zimbabwe’s mental health programming and support.

How can physical activity relate to mental health?

The study guide highlights campaigns promoting physical activity and a video connecting sport with mental well-being.

How can environmental conditions relate to mental health?

The study guide notes that access to nature and green spaces can reduce stress, improve mood, support cognitive function, and promote well-being.

What are examples of nature-based activities that may benefit mental health?

Spending time outdoors, gardening, and engaging in other nature-based activities.

How can lack of access to green spaces affect people?

It can limit access to the mental-health benefits associated with parks and natural environments.

How can environmental degradation contribute to mental-health inequities?

It can exacerbate social inequalities and affect marginalized communities that already face environmental injustices and unequal access to resources and services.

What is an integrated approach to mental health and planetary health?

An approach that recognizes the links between mental health, environmental sustainability, social justice, community engagement, resilience, and environmental stewardship.

What three categories of social problems can occur during emergencies?

Pre-existing social problems, emergency-induced social problems, and humanitarian-response-induced social problems.

What are examples of pre-existing social problems during emergencies?

Low income and discrimination against disadvantaged groups.

What are examples of emergency-induced social problems?

Family separation, lack of safety, loss of livelihoods, disrupted social networks, and low trust and resources.

What are examples of humanitarian-response-induced social problems?

Overcrowding, lack of privacy, and undermining of community or traditional support.