In the third series paper, an international team led by Professor Majid Ezzati from Imperial College London, UK show that efforts to tackle NCDs will only succeed with a focus on both the health of the most disadvantaged people within societies, who disproportionately contribute to the overall burden of NCDs, and the poorest nations where deaths from NCDs and many NCD risk factors are highest.
“The persistence of NCD inequalities is a political and technical failure”, says Ezzati. “Reduction in NCDs in disadvantaged groups is necessary to achieve substantial decreases in the total NCD burden, making them mutually reinforcing aims.”
If adults in all regions of the world had the same mortality from cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes as those in high-income regions, worldwide deaths from these diseases would be lowered by more than 25% in both men and women, surpassing the global NCD goal of a 25% reduction in mortality.
Social inequalities in conventional risk factors such as unhealthy diet, smoking, high blood pressure and obesity, and excessive alcohol use account for more than half of inequalities in major NCDs.
But, explain the authors, NCD inequalities are also often the result of broader social and economic inequalities between rich and poor such as a poor start in life, lack of education, poor living and working conditions, and lack of affordable and high-quality health care.
They emphasise that to reduce or eliminate these inequalities will require actions and policies across the social, economic, and health sectors.
Ezzati and colleagues propose several key actions to reduce NCD inequalities, both between countries and within them, including: investment in early child development and high-quality education; removal of barriers to secure employment for disadvantaged groups; improved access to high-quality primary health care for early detection and treatment; and universal health insurance or other mechanisms to remove financial barriers to health care.
Source: Lancet
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