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Lancet. 1997 Jul 12; 350(9071):141.A recent comprehensive global burden of disease survey initiated by the World Bank and the World Health Organization (WHO) found ischemic heart disease and cerebrovascular disease to be the leading causes of death in the world, followed by other noncommunicable diseases, accidents, and injuries. In light of these findings, the journal's May 3 editorial argues that the WHO should consider changing its current policy stressing the eradication of infectious diseases in favor of higher priority for managing noncommunicable diseases. WHO's reluctance to shift its focus away from infectious diseases stems from its concern for equity and the health of the poor. The global burden survey gives equal importance to the health of the lower, middle, and upper classes. However, the noncommunicable diseases noted in the study findings are far less important for the poor than for the rich. Infectious diseases remain the most important and urgent concern for the world's poorest people. To accord highest priority now to noncommunicable diseases would be at the disadvantage of those most in need, to the benefit of individuals living in the wealthiest countries and the emerging middle and upper classes in the developing world.
NURSING JOURNAL OF INDIA. 1992 Apr; 83(4):82-90.Heart attacks and stroke kill about 12 million people each year or 25% of all deaths. No other single disease takes so many lives or disables so many people each year. Besides many of these dead are <65 years old resulting in considerable premature deaths. Heart attacks and stroke caused by life style choices even affect people living in developing countries as these countries reduce the prevalence of infectious diseases and develop socioeconomically with their concomitant increase in life expectancies. People in these countries still develop heart diseases that almost do not even exist in developed countries including rheumatic heart disease and heart disease caused by Chagas' disease. Crowded living conditions caused by poverty and limited medical services cause strep throat which left untreated can turn into rheumatic fever and then to heart disease. Yet treatment with penicillin protects against all 3 conditions. About 300,000 new rheumatic heart disease cases arise each year. Yearly deaths from rheumatic heart disease equals about 60,000. Poverty is also responsible for Chagas' disease of which about 17 million suffer in Latin America. In developing countries, the middle class is at highest risk of hypertension. Health promotion activities have resulted in a decline in cardiovascular diseases in developed countries in Western Europe, North America, Australia, and New Zealand. These activities include health education, diet changes, exercise, and no tobacco use. These activities also reduce the prevalence of other diseases thus keeping populations healthier longer. It is important that the healthy life styles begin when children are young. WHO dedicated World Health Day 1992 to heart health to promote heart healthy activities which can save 6 million lives yearly.
WORLD HEALTH STATISTICS QUARTERLY. RAPPORT TRIMESTRIEL DE STATISTIQUES SANITAIRES MONDIALES. 1988; 41(3-4):267-73.Because declining mortality from infectious diseases is accompanied by increasing mortality from noncommunicable diseases in both developed and developing countries, the World Health Organization (WHO) has initiated the Integrated Program for Community Health in Noncommunicable Diseases (Interhealth). Interhealth is based on the concepts that 1) noncommunicable diseases are related to a set of risk factors some of which can be controlled; 2) the entire community must be involved; 3) health promotion intervention strategies, such as population control, risk identification, screening and prevention strategies, must be integrated; 4) different categories of intervention (e.g., lifestyle changes, health care reorganization) must be coordinated; 5) social and environmental changes will be necessary; and 6) noncommunicable disease prevention and control strategies will be implemented through existing primary health care systems. The core program of Interhealth addresses heart diseases, stroke, diabetes, cancer, and respiratory diseases from the point of view of their common risk factors: diet, tobacco, physical activity, environment, oral hygiene, blood pressure, lipids, and glucose. The Interhealth program is being developed as a dynamic system, consisting of 4 main activities: experimental testing by means of demonstration projects (of which there are currently 18 in 15 countries); mathematical modeling of disease/risk factor interrelations; training; and research activities. These activities will be supported by organizational, financial and information activities at WHO headquarters and in the WHO Regional Offices.