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1.
Adv Exp Med Biol ; 1121: 1-6, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31392647

RESUMO

Non communicable diseases (NCDs) become symptomatic in adulthood, but they mainly origin from early life. As NCDs are the major cause of mortality both in developed and developing countries, global actions are necessary for their life course prevention and control. The main preventable risk factors of NCDs include tobacco use, unhealthy diet, and physical inactivity. These risk factors track from childhood to adulthood; it is well documented that healthy lifestyles play an important role for primordial and primary prevention of NCDs. Sedentary lifestyle, especially prolonged screen time, is a main underlying factor for NCDs. Regarding dietary intake, lower consumption of fruits, vegetables and fibers, as well as higher consumption of fatty and salty foods (fast foods, junk food), and carbonated soft drinks are of most usual habits correlated with increased risk of NCDs.Strategic action areas for the prevention and control of NCDs are health promotion, risk reduction, health systems strengthening for early detection and management of NCD risk factors. Low-cost solutions for reduction the common modifiable risk factors including unhealthy life-cycle are important for guiding policy and priorities of governments and for decreasing the prevalence of NCDs.


Assuntos
Dieta , Doenças não Transmissíveis , Adolescente , Adulto , Criança , Promoção da Saúde , Humanos , Doenças não Transmissíveis/prevenção & controle , Prevenção Primária , Fatores de Risco , Adulto Jovem
2.
Adv Exp Med Biol ; 1121: 7-20, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31392648

RESUMO

Common Non communicable diseases (NCDs), such as cardiovascular disease, cancer, schizophrenia, and diabetes, have become the major cause of death in the world. They result from an interaction between genetics, lifestyle and environmental factors. The prevalence of NCDs are increasing, and researchers hopes to find efficient strategies to predict, prevent and treat them. Given the role of epigenome in the etiology of NCDs, insight into epigenetic mechanisms may offer opportunities to predict, detect, and prevent disease long before its clinical onset.Epigenetic alterations are exerted through several mechanisms including: chromatin modification, DNA methylation and controlling gene expression by non-coding RNAs (ncRNAs). In this chapter, we will discuss about NCDs, with focus on cancer, diabetes and schizophrenia. Different epigenetic mechanisms, categorized into two main groups DNA methylation and chromatin modifications and non-coding RNAs, will be separately discussed for these NCDs.


Assuntos
Epigênese Genética , Doenças não Transmissíveis , Metilação de DNA , Diabetes Mellitus Tipo 2/genética , Humanos , Neoplasias/genética , Esquizofrenia/genética
3.
Adv Exp Med Biol ; 1121: 21-31, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31392649

RESUMO

The increasing prevalence of non communicable diseases (NCDs) poses main challenges to global public health. Various environmental exposures to different chemicals and pollutants might interact with genetic and epigenetic mechanisms resulting in the development of NCDs. Among these environmental exposures, endocrine disrupting chemicals (EDCs) consist of a group of compounds with potential adverse health effects and the interference with the endocrine system. They are mostly used in food constituents, packaging industries and pesticides. Growing number of in vitro, in vivo, and epidemiological studies documented the link of EDC exposure with obesity, diabetes, and metabolic syndrome, which are the underlying factors for development of NCDs. Prevention of exposure to EDCs and reduction of their production should be underscored in strategies for primordial prevention of NCDs.


Assuntos
Disruptores Endócrinos , Exposição Ambiental , Poluentes Ambientais , Doenças não Transmissíveis , Disruptores Endócrinos/toxicidade , Exposição Ambiental/prevenção & controle , Poluentes Ambientais/toxicidade , Humanos , Praguicidas/toxicidade
4.
Adv Exp Med Biol ; 1121: 33-40, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31392650

RESUMO

The origin of some non communicable disease (NCDs) is in early life. Evidence has shown that early life nutrition is associated with the risk of developing chronic non communicable diseases. Pregnancy and infancy are the most critical stages that influence the risks of NCDs in childhood and adult life. Prenatal maternal undernutrition and low birth weight lead to obesity and increase the risk factors of cardiovascular disease and diabetes later in life. Nutrition is one of the easily modifiable environmental factors that may affect outcome of pregnancy, trajectory of growth, and immune system of the fetus and infant. Healthy eating behaviors associate with prevention of weight disorders in pediatric, non communicable diseases, and deficiencies of micronutrient.


Assuntos
Comportamento Alimentar , Doenças não Transmissíveis , Fenômenos Fisiológicos da Nutrição , Adulto , Doenças Cardiovasculares/prevenção & controle , Criança , Feminino , Humanos , Lactente , Obesidade/prevenção & controle , Gravidez
5.
Adv Exp Med Biol ; 1121: 61-66, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31392653

RESUMO

Childhood obesity is one of the major public health problems. Childhood obesity mostly remains in adulthood and lead to non communicable diseases like diabetes and cardiovascular diseases at a younger age. Therefore, childhood obesity prevention needs high priority. Several risk factors including genetic factor, unhealthy dietary habits, physical inactivity related to childhood obesity.Providing suitable strategies and novel interventions should be considered by the entire health care system for prevention and management of obesity.


Assuntos
Doenças não Transmissíveis , Obesidade Pediátrica , Adulto , Criança , Comportamento Alimentar , Humanos , Doenças não Transmissíveis/prevenção & controle , Obesidade Pediátrica/prevenção & controle , Fatores de Risco
6.
J Glob Health ; 9(2): 020409, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31448113

RESUMO

Background: Non-communicable diseases (NCDs) cause a large and growing burden of morbidity and mortality in sub-Saharan Africa. Prospective cohort studies are key to study multiple risk factors and chronic diseases and are crucial to our understanding of the burden, aetiology and prognosis of NCDs in SSA. We aimed to identify the level of research output on NCDs and their risk factors collected by cohorts in SSA. Methods: We conducted a scoping review to map the extent of current NCDs research in SSA by identifying studies published after the year 2000 using prospectively collected cohort data on any of the six NCDs (cardiovascular diseases, diabetes, obesity, chronic kidney disease, chronic respiratory diseases, and cancers), ≥1 major risk factor (other than age and sex), set only within SSA, enrolled ≥500 participants, and ≥12 months of follow-up with ≥2 data collection points (or with plans to). We performed a systematic search of databases, a manual search of references lists from included articles and the INDEPTH network website, and study investigators from SSA were contacted for further articles. Results: We identified 30 cohort studies from the 101 included articles. Eighteen countries distributed in West, Central, East and Southern Africa, were represented. The majority (27%) set in South Africa. There were three studies including children, twenty with adults, and seven with both. 53% of cohorts were sampled in general populations, 47% in clinical populations, and 1 occupational cohort study. Hypertension (n = 23) was most commonly reported, followed by obesity (n = 16), diabetes (n = 15), CKD (n = 6), COPD (n = 2), cervical cancer (n = 3), and breast cancer (n = 1). The majority (n = 22) reported data on at least one demographic/environmental, lifestyle, or physiological risk factor but these data varied greatly. Conclusions: Most studies collected data on a combination of hypertension, diabetes, and obesity and few studies collected data on respiratory diseases and cancer. Although most collected data on different risk factors the methodologies varied greatly. Several methodological limitations were found including low recruitment rate, low retention rate, and lack of validated and standardized data collection. Our results could guide potential collaborations and maximize impact to improve our global understanding of NCDs (and their risk factors) in SSA and also to inform future research, as well as policies.


Assuntos
Doenças não Transmissíveis/epidemiologia , África ao Sul do Saara/epidemiologia , Estudos de Coortes , Humanos , Fatores de Risco
7.
J Glob Health ; 9(2): 020413, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31448114

RESUMO

Background: Past studies have demonstrated how single non-communicable diseases (NCDs) affect health care utilisation and quality of life (QoL), but not how different NCD combinations interact to affect these. Our study aims to investigate the prevalence of NCD dyad and triad combinations, and the implications of different NCD dyad combinations on health care utilisation and QoL. Methods: Our study utilised cross-sectional data from the WHO SAGE study to examine the most prevalent NCD combinations in six large middle-income countries (MICs). Subjects were mostly aged 50 years and above, with a smaller proportion aged 18 to 49 years. Multivariable linear regression was applied to investigate which NCD dyads increased or decreased health care utilisation and QoL, compared with subjects with only one NCD. Results: The study included 41 557 subjects. Most prevalent NCD combinations differed by subgroups, including age, gender, income, and residence (urban vs rural). Diabetes, stroke, and depression had the largest effect on increasing mean number of outpatient visits, increasing mean number of hospitalisation days, and decreasing mean QoL scores, respectively. Out of the 36 NCD dyads in our study, thirteen, four, and five dyad combinations were associated with higher or lower mean number of outpatient visits, mean number of hospitalisations, or mean QoL scores, respectively, compared with treating separate patients with one NCD each. Dyads of depression were associated with fewer mean outpatient visits, more hospitalisations, and lower mean QoL scores, compared to patients with one NCD. Dyads of hypertension and diabetes were also associated with a reduced mean number of outpatient visits. Conclusions: Certain NCD combinations increase or decrease health care utilisation and QoL substantially more than treating separate patients with one NCD each. Health systems should consider the needs of patients with different multimorbidity patterns to effectively respond to the demands on health care utilisation and to mitigate adverse effects on QoL.


Assuntos
Países em Desenvolvimento , Multimorbidade/tendências , Doenças não Transmissíveis/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Qualidade de Vida , Adolescente , Adulto , Idoso , China/epidemiologia , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Índia/epidemiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Federação Russa/epidemiologia , África do Sul/epidemiologia , Adulto Jovem
11.
J Glob Health ; 9(1): 010428, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31293781

RESUMO

Background: The "greying of AIDS" - the aging of the population living with HIV who benefit from antiretroviral treatment (ART) and the emergence of age-related non-communicable diseases (NCDs) - has been well documented. The emerging health systems challenges - eg, the implications of HIV on the disease burden from NCDs on the population level, and the evolving role of HIV as a co-morbidity or co-existing disease of various NCDs - are less well understood. The paper elucidates these challenges by providing a quantitative analysis of HIV-NCD interactions for Botswana. Methods: We projected the prevalence of HIV and of selected NCDs in Botswana using demographic and HIV-specific estimates building on data on the state and the dynamics of the HIV epidemic, using the Spectrum modelling software, and extrapolating on estimates of the prevalence of NCDs from the 2015 global burden of disease (GBD). Results: HIV has slowed down overall population aging and thus has attenuated the growing burden of many NCDs so far, because cohorts reaching old age have been decimated by AIDS-related mortality in the 1990s and early 2000s. Aging and the rise in the prevalence of NCDs, however, will accelerate rapidly from about 2030 because of reduced attrition of cohorts living with HIV since the start of the ART scale-up in Botswana. While HIV prevalence will decline over time, the health needs of people living with HIV will become more complex. HIV prevalence among the growing populations affected by various important NCDs will not decline for decades, because of the aging of the population living with HIV and interactions between HIV, ART and NCDs. Conclusions: Even though HIV prevalence is projected to decline steeply to 2030 because of reduced HIV incidence, the prevalence of HIV among people affected by many of the most important NCDs will increase or barely change. While the health care needs of people living with HIV will increase and become more complex, HIV will also emerge as a key factor complicating the management of the growing burden of NCDs. Health systems will need to prepare for the challenge of large numbers of patients living with both HIV and NCDs.


Assuntos
Epidemias , Infecções por HIV/epidemiologia , Doenças não Transmissíveis/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Botsuana/epidemiologia , Criança , Pré-Escolar , Comorbidade , Simulação por Computador , Feminino , Infecções por HIV/terapia , Necessidades e Demandas de Serviços de Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Doenças não Transmissíveis/terapia , Prevalência , Adulto Jovem
12.
Med Lav ; 110(3): 168-190, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31268425

RESUMO

Non-communicable diseases (NCDs) are chronic diseases that are by far the leading cause of death in the world. Many occupational hazards, together with social, economic and demographic factors, have been associated to NCDs development. Genetic susceptibility or environmental exposures alone are not usually sufficient to explain the pathogenesis of NCDs, but can be integrated in a more complex scenario that can result in pathological phenotypes. Epigenetics is a crucial component of this scenario, as its changes are related to specific exposures, therefore potentially able to display the effects of environment on the genome, filling the gap between genetic asset and environment in explaining disease development. To date, the most promising biomarkers have been assessed in occupational cohorts as well as in case/control studies and include DNA methylation, histone modifications, microRNA expression, extracellular vesicles, telomere length, and mitochondrial alterations.


Assuntos
Epigênese Genética , Doenças não Transmissíveis , Exposição Ocupacional , Biomarcadores , Metilação de DNA , Humanos
13.
Stud Health Technol Inform ; 262: 288-291, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349324

RESUMO

Noncommunicable diseases (NCDs) are incurable disease, which causes by the risk factors. This study aimed to determine the prevalence and distribution of the risk factors associated according to gender. A cross-sectional survey on Health dataset between October 2013 and April 2017 of people, age 13 years and older about 1,245,462 people, using the high technology and the STEPS approach questionnaire by the WHO. The questions included demographic, behaviour and metabolic. The results found that the prevalence of the risk NCDs were 611,099 people (49.07%) Most risk factors was tobacco use in men (p-value<001), waist in women (p-value<001), having diabetes mellitus family in men (p-value<001), having hypertension family in men (p-value<001), alcohol consumption in men (p-value<001), blood pressure in women (p-value<001), blood sugar level in women (p-value<001), BMI in women (p-value<001), and cholesterol level in women (p-value<001). This data indicates that the prevalence of behaviour needs to be concerning and decision-making to prevention.


Assuntos
Tomada de Decisões Assistida por Computador , Hipertensão , Informática Médica , Doenças não Transmissíveis , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças não Transmissíveis/prevenção & controle , Prevalência , Fatores de Risco , Fumar , Tailândia , Adulto Jovem
14.
Global Health ; 15(1): 43, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31262312

RESUMO

BACKGROUND: Non-communicable diseases (NCDs)-chronic human health problems such as cardiovascular diseases linked to poor diets-are significant challenges for sustainable development and human health. The international livestock trade increases accessibility to cheap animal products that may expand diet-related NCDs worldwide. However, it is not well understood how the complex interconnections among livestock production, trade, and consumption affect NCD risks around the world. METHOD: Our global dataset included 33 livestock products (meat, offal, and animal fats) in 156 countries from 1992 to 2011. We employed path analysis to uncover how livestock trade contributes to diet-related NCDs and identify underlying environmental and socioeconomic factors of livestock trade. Then we performed trend analyses to investigate long-term changes in livestock production and trade at a country level. RESULTS: We found that livestock consumption through livestock import increased diet-related NCD risks. This was especially true in developing countries, which in general were not well prepared in terms of policies for NCD risk reduction, and where there was a lack of funding to implement the policies. Population size and income level were the main factors affecting global livestock import activities. CONCLUSIONS: Our results suggest that new governance structures to incorporate separate international efforts, improved national policies, and bolstering individual efforts are needed to decrease NCD risks, particularly in developing countries.


Assuntos
Comércio , Internacionalidade , Gado , Doenças não Transmissíveis/epidemiologia , Animais , Doenças Cardiovasculares/epidemiologia , Países em Desenvolvimento , Dieta/efeitos adversos , Humanos , Fatores Socioeconômicos
15.
Global Health ; 15(1): 46, 2019 07 11.
Artigo em Inglês | MEDLINE | ID: mdl-31296242

RESUMO

Non-communicable diseases in general and cardiovascular diseases in particular are a leading cause of death globally. Trans-fat consumption is a significant risk factor for cardiovascular diseases. The World Health Organization's 'REPLACE' action package of 2018 aims to eliminate it completely in the global food supply by 2023. Legislative and other regulatory actions (i.e., banning trans-fat) are considered as effective means to achieve such a goal. Both wealthier and poorer countries are taking or considering action, as shown by the United States food regulations and Cambodian draft food legislation discussed in this paper. This paper reviews these actions and examines public and private stakeholders' incentives to increase health-protecting or health-promoting standards and regulations at home and abroad, setting the ground for further research on the topic. It focuses on the potential of trade incentives as a potential driver of a 'race to the top'. While it has been documented that powerful countries use international trade instruments to weaken other countries' national regulations, at times these powerful countries may also be interested in more stringent regulations abroad to protect their exports from competition from third countries with less stringent regulations. This article explores practical and principled considerations on how such a dynamic may spread trans-fat restrictions globally. It argues that trade dynamics and public health considerations within powerful countries may help to promote anti-trans-fat regulation globally but will not be sufficient and is ethically questionable. True international regulatory cooperation is needed and could be facilitated by the World Health Organization. Nevertheless, the paper highlights that international trade and investment law offers opportunities for anti-trans-fat policy diffusion globally.


Assuntos
Comércio/legislação & jurisprudência , Saúde Global , Direito Internacional , Doenças não Transmissíveis/prevenção & controle , Ácidos Graxos Trans/efeitos adversos , Humanos , Doenças não Transmissíveis/epidemiologia
17.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(6): 726-730, 2019 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-31238627

RESUMO

Objective: To assess the follow-up situstion and changes of policies related to the prevention and control on chronic non-communicable diseases (NCDs), in various provinces from 2011 to 2017. Methods: Three national assessment programs on the prevention and control capacity of NCDs were carried out from September 2012 to March 2013, September 2014 to March 2015, and July to November 2018 respectively. Data related to the capacity on policy implementation among the 31 provinces, autonomous regions, municipality directly under the central government and Xinjiang Production and Construction Corps, were collected through online surveys. Results: The rate of data collection in all the provinces reached 100%, for all three surveys. In 2011, 2013, and 2017, the capacity for policy development special funding was distributed for prevention and control NCDs under the provincial fiscal revenue by 27 provinces (84.4%), 26 provinces (81.3%) and 25 provinces (78.1%), and the numbers of provincial governments leaders attended the local activities related to prevention and control NCDs was 15 (46.9%), 13 (40.6%) and 19(59.4%), respectively. From 2009 to 2011, 14 (43.8%) proposals related to the topics on prevention and control of NCDs, were raised at the provincial People's Congress and Political Consultative Conference, while from 2011 to 2013 and2014 to 2017, 13 (40.6%) and 12 (37.5%) were respectively raised. In terms of capacity for policy development, numbers of provincial comprehensive plan which targeting prevention and control of NCDs reached 6 (18.8%), 20 (62.5%) and 27 (84.4%) in 2011, 2013, and 2017 respectively. In 2011, 2013 and 2017, numbers of provincial special plans that targeting on NCDs or the risk factors of NCDs prevention and control were 0, 1, and 3, respectively. Conclusions: Under the continuous introduction of international and national policies related to prevention and control on NCDs, capacity for policy formulation in various provinces has been greatly improved. However, a slight progress has been made in the capacity for policy making. The increase of capacity building on policy making regarding prevention and control of NCDs, at the provincial government level, has become a key issue.


Assuntos
Doença Crônica/prevenção & controle , Serviços de Saúde Comunitária/organização & administração , Organizações de Planejamento em Saúde/organização & administração , Política de Saúde , Doenças não Transmissíveis/prevenção & controle , Recursos Humanos/tendências , China , Humanos , Fatores de Risco , Inquéritos e Questionários
18.
Artigo em Russo | MEDLINE | ID: mdl-31251866

RESUMO

Reducing mortality of working-age population is a potential reserve for preserving Russia's population and its labor force. In addition, the task of analyzing health of economically active citizens of our country is inextricably linked with the challenge of developing strategy of development of reproductive potential at the regional level. As reproductive or generative woman's age is defined precisely enough, and such unambiguous definition for men is lacking, the study used mortality rates, calculated for men and women of working age (16 - 59 years and 16 - 54 years respectively) and officially published by the Russian Federal State Statistics Service (Rosstat) as characteristics of reproductive health. The analysis of mortality rate for working age men and women in the Republic of Chuvashia as well as the structure of main causes of death are presented for 2002-2016 in comparison with average indicators for the Russian Federation. The mortality rate of the mentioned population category in Republic of Chuvashia since 2002 has decreased by 17.5% in all age groups except women aged 30-39 years. At this, the rate of mortality decreased in men during the analyzed period is higher than in women i.e. 20.5% and 19.3% respectively. As compared with 2002, the percentage of circulatory system diseases, neoplasms, digestive system diseases increased with a simultaneous decrease in the proportion of "external" causes in mortality structure of able-bodied population of the Republic of Chuvashia in 2016. Throughout the analyzed period relative mortality rates of able-bodied men are four times and higher than those of women. The analysis of dynamics characteristics in mortality level and structure among working age women and men as well as risk factors that contribute to its growth, can become the basis for developing an organizational improvement program of rendering medical care to economically active population as a component of regional strategy of increasing the level of reproductive potential.


Assuntos
Emprego , Mortalidade , Neoplasias , Doenças não Transmissíveis , Adolescente , Adulto , Doenças Cardiovasculares/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Neoplasias/mortalidade , Doenças não Transmissíveis/mortalidade , Dinâmica Populacional , Grupos Populacionais , Fatores de Risco , Federação Russa , Adulto Jovem
19.
BMC Health Serv Res ; 19(1): 347, 2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31151451

RESUMO

BACKGROUND: In life time, nearly each person succumbs to some sort of chronic disease and many develop complicated chronic diseases. It is critical to focus on preventive services with a relatively high health impact and favorable cost effectiveness. During routine health facility visits, it is advisable to evaluate both symptomatic and asymptomatic patients for their needs of health promotion and disease prevention services. This necessitates the development of an integrated health service (IHS) approach that incorporates health promotion, disease prevention and curative services. METHODS: There were two phases for the study. The first phase explored the degree of promotive and preventive health care delivery at the health centers and hospitals. Phase two, utilizing the Delphi strategy, centered on looking for agreement on the finding from phase 1 and on IHS approach. Delphi questions were created based on the results of phase 1, and the reply choices were tied to a five point Likert scale. Consensus was considered come to when 75% of the experts concurred on an issue. From that point, advance clarification and agreement was looked for by implies of a second-round assessment for scores between 50 and 75%. Agreement on proposed IHS model, application of case finding and Periodic Health Examination (PHE) approaches were also sought. This study focuses on finding from phase 2. RESULT: Of the twenty experts, 90% (n = 18) agreed that the IHS framework shows the causal relationship of diseases and included plausible intervention approaches. Experts reached consensus (90%;n = 18) that case finding testing,screening patients for conditions other than the medical care they sought at a particular time, can be performed at health facilities. All experts (100%; n = 20) recommended conducting periodic health examinations in selected diseases for patients who are apparently not sick. CONCLUSION: The Integrated Health Service (IHS) framework was agreed by experts to be a plausible method in describing the causal relationship of chronic non-communicable, communicable, and nutrition-related diseases. The framework can play a vital role by preventing the acquiring, progression, suffering or dying from diseases through restraining the vicious cycle of chronic diseases.


Assuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Doenças não Transmissíveis/prevenção & controle , Adulto , Consenso , Análise Custo-Benefício , Etiópia , Feminino , Promoção da Saúde/organização & administração , Humanos , Masculino , Pessoa de Meia-Idade , Serviços Preventivos de Saúde/organização & administração
20.
Artigo em Inglês | PAHO-IRIS | ID: phr-51069

RESUMO

[ABSTRACT]. Caribbean countries are experiencing social, epidemiological, and demographic transitions shaped by the growing elderly population and the rise of noncommunicable diseases (NCDs)—now responsible for 78% of all deaths. These circumstances demand rethinking the model of care to improve health outcomes and build more sustainable health systems with new orientations in policy, service delivery, organization, training, technology, and financing. Policy must be aimed towards healthy living, leveraging interventions that ensure healthy aging. The health system must proactively structure interventions to reduce the incidence of new NCD cases and to prevent related complications. Interventions should be focused on optimizing the individual’s capacity, functional ability, and autonomy within adapted environments, as well as with the necessary preventive, long-term care, self-care, community care, and health system support.


[RESUMEN]. Los países del Caribe están experimentando transiciones sociales, epidemiológicas y demográficas como resultado del envejecimiento de la población y el aumento de la prevalencia de las enfermedades no transmisibles (ENT), que en la actualidad causan el 78% de todas las defunciones. Estas circunstancias exigen replantear el modelo de atención para mejorar los resultados de salud y establecer sistemas de salud más sostenibles mediante nuevos enfoques en políticas, prestación de servicios, organización, capacitación, tecnología y financiamiento. Las políticas deben tener como propósito procurar una vida saludable, aprovechando las intervenciones que garanticen el envejecimiento saludable. El sistema de salud debe ser proactivo, estructurando las intervenciones para reducir la incidencia de nuevos casos de ENT y para prevenir las complicaciones relacionadas. Las intervenciones deben centrarse en optimizar la capacidad funcional, la autonomía y el desenvolvimiento general de la persona dentro de un entorno adaptado y con el apoyo necesario del sistema de salud en materia de atención preventiva, cuidados a largo plazo, de autocuidado y de atención en la comunidad.


[RESUMO]. Os países do Caribe estão passando por transições sociais, epidemiológicas e demográficas configuradas pela população de idosos cada vez maior e a ascensão das doenças não transmissíveis (DNTs), já responsáveis por 78% de todas as mortes. Essas circunstâncias exigem repensar o modelo de atenção para melhorar os desfechos de saúde e construir sistemas de saúde mais sustentáveis, com novas orientações de política, prestação de serviços, organização, treinamento, tecnologia e financiamento. As políticas devem ser orientadas para a vida saudável, alavancando intervenções que asseguram o envelhecimento saudável. O sistema de saúde deve estruturar proativamente intervenções para reduzir a incidência de novos casos de DNT e a prevenir as complicações relacionadas. As intervenções devem se concentrar na otimização da capacidade do indivíduo, das habilidades funcionais e da autonomia dentro de ambientes adaptados, e também nas ações preventivas a para assistência de longa duração, no autocuidado, na atenção na comunidade e no apoio pelos sistemas de saúde.


Assuntos
Sistemas de Saúde , Envelhecimento , Doenças não Transmissíveis , Aruba , Curaçao , Sistemas de Saúde , Envelhecimento , Doenças não Transmissíveis , Sistemas de Saúde , Envelhecimento , Doenças não Transmissíveis , Curaçao
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