Non-Communicable (Chronic) and Communicable Diseases
Prevalence of Diseases
The prevalence of non-communicable disease (NCD) related death varies from country to country based on the efficacy of the available measures for responding to the diseases. A comparison was conducted across four countries namely Guatemala, Indonesia, the United States of America, and France. From the results, it was established that the percentage of deaths occurring in developed countries as a result of the NCDs was higher than those that occurred in the developing countries. In Guatemala, only 47% of the deaths were from NCDs; in Indonesia, 71% of deaths resulted from NCDs; the percentage was 87 and 88 for France and the USA respectively. Contrarily, there were fewer deaths resulting from communicable diseases in the developed countries compared to developing countries. In France and the USA, the rates of communicable disease-related deaths were 6% and 6% respectively. On the other hand, 34% of deaths resulted from communicable diseases in Guatemala, while Indonesia had 22% of deaths from communicable diseases.
Besides the death rates, there were slight differences between the countries in terms of trends in various health indicators including blood pressure, body mass index (BMI), cholesterol levels, and blood glucose levels. These indicators are related. For instance, the rates of diabetes as indicated in the report can be used as an indicator of cholesterol levels. Across the four countries, the rates of cholesterol, therefore, increased slightly over the years under consideration. The percentage of deaths from diabetes-related conditions was higher in the developing countries than in the developed countries with France recording the least values. The trends in risk factors for the various conditions also point to the probability of non-communicable disease-related deaths. For instance, the rates of high blood pressure, smoking, alcohol consumption, and obesity were significant in 2008, particularly in the developed countries. The levels of obesity indicate the BMI averages in the respective countries. The rate of obesity was highest in the USA in 2008 and has been increasing as indicated by the deaths related to cardiovascular diseases. Guatemala and Indonesia had average rates of obesity while France had the lowest, indicating the lowest average BMI among the four countries.
The most probable reason for the differences in NCD rates across the four countries is the differences in the infrastructures available for responding to NCDs. The developed countries seem to have taken greater care to ensure communicable diseases are prevented. Among the four countries, the U.S has the best infrastructure, followed by Indonesia, then Guatemala, and lastly France. The key metrics used in the evaluation include the availability of a monitoring and surveillance system that can be used to report NCD prevalence against the nine global targets; availability of an operational NCD department within the health ministry; availability of a multi-sectoral policy that integrates NCD management with other health sectors; and operational plans to reduce tobacco consumption among others.
Key Messages from the Data
From the data examined, various lessons can be adopted and probably applied to healthcare management in developing countries. One of the key messages is that NCDs are manageable. The prevalence of NCD-related deaths in developing countries indicates that with significant efforts, NCDs can be managed through effective lifestyle change. Practices such as smoking cessation campaigns, alcohol consumption reduction campaigns, and efforts by governments to put up requisite infrastructures can help to manage chronic diseases across all countries (Gutierrez, Alloubani, Mari, & Alzaatreh, 2018). Juma and Wisdom (2018) pointed out that the different non-communicable diseases share common risk factors.
While addressing the concern around non-communicable diseases is important, it is also necessary to address the menace of communicable diseases. The evidence from developed countries shows that effective strategies can be put in place to help curb communicable diseases across populations. Preventing communicable diseases requires more intensive care. Detailed information on the principles of controlling communicable diseases needs to be shared by healthcare organizations through nurses. Recommended practices include rapid assessment during emergency situations, identification of communicable disease threats, hygiene in the physical environment, and availability of working surveillance and early warning system for communicable diseases (Edemekong & Huang, 2019). Furthermore, healthcare practitioners need to invest in adequate outbreak preparedness and rapid response to emergencies. Additionally, prompt diagnosis and treatment is required in such emergency situations.
While the common perception is that NCDs are a developed world problem, the study has shown that the impacts of NCDs are universal. Developing countries have many deaths resulting from chronic diseases, almost similar to the experiences in some developed countries such as France. Preventive and management measures for NCDs should, therefore, consider the role of the healthcare professionals in managing chronic diseases even in developing countries. According to Toebes, Hesselman, Van Djik, and Herman (2017), the prevalence of NCDs in developing and developed countries indicates the need for research on the link between health, science, international relations, and environmental management. Similarly, the management of communicable diseases requires the adoption of a multidisciplinary approach to healthcare, through which the various needs of communities can be identified and addressed.
The health data on communicable and non-communicable diseases in the four countries is an indication that there is need for a proactive approach to improving the quality of lives of people in both the developing and the developed countries. Various interventions have and can be put in place to reduce the impacts of the different types of diseases on populations. For instance, a meeting on the prevention of avoidable early exposure of children to environmental factors that could promote the prevalence of non-communicable diseases was conducted by the WHO (2019) in a bid to identify and explore interventions that could be useful in the improvement of health outcomes. The interventions suggested are applicable in the developing and the developed world as well, and have been implemented to a certain degree, mostly under the stewardship of the WHO.
The WHO is working in collaboration with the department of health in various countries to implement interventions such as advocacy and awareness training; promotion of collaborative research between developing and developed countries; use of emerging technologies and tools in healthcare to promote long distance study and intervention implementation and translation of scientific findings into simple languages that can be understood by the masses (WHO, 2019). In the U.S in particular, there have been policy and healthcare interventions especially for the prevention of NCDs. For instance, policy interventions on tax and prices of foods and drink products that have been identified as risk promoting, have been implemented. Other interventions include creation of awareness about substitution of trans fats with unsaturated fats, alcohol consumption reduction and smoking cessation among others (Pan American Health Organization, 2011). While the WHO reports that such interventions work, there is no clear evidence to support this assertion given that the effectiveness of most of these interventions depend on the responses to them by the recipients. From past studies, it has been established that the response to such interventions is stronger in developing countries than in developed countries, which explains the disparities in the prevalence of NCDs across the two classes of countries.
For communicable diseases on the other hand, effective intervention requires the availability and utilization of resources to create awareness and to promote health. Most developing countries have insufficient infrastructure and resources for the prevention of communicable diseases, while the developed countries have robust healthcare systems with sufficient resources to prevent communicable diseases. Needless to say, the healthcare data indicates a higher prevalence of communicable diseases in developing countries relative to developed countries. For a country like the United States however, failure to utilize these resources due to factors such as lack of affordability and access to them can result in the observed high child mortality rates. The U.S and other developed countries should therefore learn from developing countries about the working strategies for intervention, and also the best implementation practices to avoid resource underutilization.
From the discussions provided by various organizations on the prevention of communicable and non-communicable diseases, environmental factors play a significant role in the health quality. Where one lives, plays and work determines the range of pathogens he/ she gets in contact with, and the probability of infection. For instance, NCDs are attributed to factors such as lifestyle choices, including exposure to cigarette smoke either directly through smoking or via second hand smoke (Pan American Health Organization, 2011). Pollution is also a significant factor in the spread of both communicable and non-communicable diseases. Through air and water pollution, pathogens can be spread from one person to another, resulting in adverse health outcomes. Factors such as high sodium intake through water, low physical activity, household air pollution, and ambient air pollution, have been mentioned as contributing factors to NCDs (Pruss-Ustun et al., 2019).
The Role of Nursing in Interventions
Prevention of communicable and non-communicable diseases is a prerogative of the healthcare sector in collaboration with major policy makers in the country. According to DeCola, Benton, Peterson, and Matebeni (2012), nurses in particular have a significant role in promoting the prevention of both communicable and non-communicable diseases. The interventions provided particularly for the prevention of NCDs require stringent implementation and follow up. Educating the masses about risky health behaviors such as smoking and alcohol consumption is the mandate of nurses who interact with patients and healthy people on a day to day basis. Promoting healthy environments for mother to be and follow-up on healthy behaviors during pregnancy is one of the roles that nurses can actively be involved in towards NCDs and communicable disease intervention. Furthermore, nurses have the capacity to promote collaboration among healthcare providers with the objective of enhancing multi-disciplinary awareness creation and intervention promotion.
Nurses comprise the largest population among healthcare providers, and their engagement in intervention measures can help to foster the prevention of NCDs as well as communicable diseases. Nurses can use their knowledge and skills to administer disease management programs for those who are already affected, for enabling self care and for promoting behavior change among the intervention target populations (DeCola et al., 2012). In all these, availability of time resources for engagement in intervention is a crucial determinant of the nurses’ participation in interventions.
DeCola, P., Benton, D., Peterson, C., & Matebeni, D. (2012). Nurse’ potential to lead in non-communicable disease global crisis. International Nursing Review, 59(3), 321-330. Retrieved from www.ncbi.nlm.nih.gov/pubmed/22897182
Edemekong, P.F., & Huang, B. (2019). Epidemiology of prevention of communicable diseases. Treasure Island, FL: StatPearls Publishing. Retrieved from www.ncbi.nlm.nih.gov/books/NBK470303/
Gutierrez, J., Alloubani, A., Mari, M., & Alzaatreh, M. (2018). Cardiovascular disease risk factors: Hypertension, diabetes mellitus and obesity among Tabuk citizens in Saudi Arabia. The Open Cardiovascular Medicine Journal, 12, 41-49. Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC5925866/pdf/TOCMJ-12-41.pdf
Juma, P.A., & Wisdom, J. (2018). Introduction: Non-communicable disease prevention policies in six African countries. BMC Public Health, 1, 955-956. Retrieved from bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-018-5824-8
Pan American Health Organization (2011). Non-communicable diseases in the Americas: Cost-effective interventions for prevention and control. Issue Brief on Non-Communicable Disease. Retrieved from www.paho.org/hq/dmdocuments/2011/paho-policy-brief-4-En-web1.pdf
Pruss-Ustun, A., van Deventer, E., Mudu, P., Campbell-Lendrum, D., Vickers, C., Ivanov, I., et al. (2019). Environmental risks and non-communicable diseases. British Medical Journal, 364. Retrieved from www.bmj.com/content/364/bmj.l265
Toebes, B., Hesselman, M., Van Djik, J.P., & Herman, J. (2017). Curbing the lifestyle disease pandemic: Making progress on an interdisciplinary research agenda for law and policy interventions. BMC International Health and Human Rights, 17(25). Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC5604365/pdf/12914_2017_Article_131.pdf
WHO. (2019). Early life opportunities for the prevention of non-communicable disease in developing countries. World Health Organization. Retrieved from www.who.int/ceh/risks/early_life/en/