Common Chronic Diseases in india
Chronic diseases like diabetes, cancer (breast, lung and cervical cancer), cardiovascular diseases (stroke, coronary heart disease), mental disorders (schizophrenia, depression) and injuries (vehicle acccidents and suicides) are the most commonly seen in all over india and are the leading cause of deaths especially among poor and rural population. The wider range of preventive strategies are available in India however their coverage is insignificant among poor and rural population. Mostly the preventive strategies are implemented in private sectors and are expensive hence poor population cannot afford or adopt these preventive strategies. To understand this issue we need to understand what are the reasons for chronic illnesses and what can be the effective preventive intervention.
In 2004 approximately 10.3 millions deaths were occured out of which 1.1 millions death were due to injuries and 5.2 millions died due to chronic diseases. In 2004, the survey showed that overall mortality rates for chronic diseases were higher that high income countries. Heart diseases are major cause of death rates in India. Indians are more likely to develop heart diseases at earlier age than the high income countries. WHO also estimated that more than 200000 deaths are due to road traffic accidents and 190000 suicides occured in India in 2004. Why Indians are more likely to suffer from such chronic diseases and what are the reasons or risk factors for these?
Causes
1) Health Behavior
Health behavior means the lifestyle adopted by the people. More than 20% of indian population smoke cigarettes daily. People in urban areas are more likely to have low physical activity than rural areas which is the main reason for obesity and related diseases like cardiovascular diseases, cancer and diabetes. The greatest use of tobacco and alcohol among high school and and young adults increases the risk of lung cancer and lung diseases and mental disorders.
2) Social determinant
Social determinant means the condition where people live, work and grow. Rapid development of socioeconomic conditions are seen in India which can be easily linked with the health behaviors. High socioeconomic conditions has lead to reduction in physical activity, increase consumption of fatty food and low consumption of nutritious food which is the main cause for chronic diseases; driving above the speed limit with excess intake of alcohol leading to road accidents. These are some of reasons which either directly or indirectly affect the health of people.
Cost-Effective Interventions
1) Population-wide intervention
It includes prevention and control the use of tobacco and alcohol by reducing the availability and increasing the taxes and reduction in dietary use of salt would help to reduce the cardiovascular diseases like stroke, diabetes, heart attacks and high blood pressure. Enforcement of laws like seat belt and helmets use and speed limit check would help to prevent road traffic accidents.
2) Primary care intervention
Government must provide cost-effective treatment for high blood pressure and high cholesterol. Control in blood pressure and cholesterol levels would prevent the cardiovascular diseases. Effective smoking and alcohol cessation programs would more likely reduce the risk of lung cancer and mental diseases. Misuse of alcohol leads to psychological disorders hence by increasing the taxes and reducing the alcohol production would help to prevent mental disorders. Vaccination programs would also help to prevent the seasonal diseases like swine flu.
3) Secondary and tertiary care intervention
It includes the cost-effective care and interventions for chronic diseases like cancer. Low budget treatment for stage 1 cancers of breast and lung. Extensive breast cancer program would create awareness among the women and early screening would prevent the deaths from cancer. Regular screening for breast cancer in women more than 60 years would be effective too.
Programmes and Policies
India has made substantial progress in terms of developing the intervention programs however they are either poorly funded or not properly managed or implemented. For Instance, National mental Health Program was poorly funded and covered only few districts of India. Hence it is necessary that government take legal action and supervise each programmes and make sure that every needy person is benefitted by the program.
Looking at the above issues it is important for the policy makers to move forward and create an efficient resources. Also once the policy or program is implemented it is important to monitor and inspect the ongoing work so that large popluation is benefitted.
References:
Chronic diseases and injuries in India, Lancet 2011
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