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The toll charged for Chronic Diseases in Brazil, USA and the World

16 de março de 2012

The toll charged for Chronic Diseases in Brazil, USA and the World

If an exercise or do a search on the most comprehensive reported by national and international media in mid-march 2012, we came coincidentally with a few facts that concern so urgent and so immediate society (or the media itself) : Economic Crisis in Europe and the United States, the Afghanistan crisis, the Brazilians travel abroad, a record of tax incessantly beaten by the government in Brazil, and violence both real life and virtual …
Very rarely has been observed that news will affect our daily life in 5 or 10 or 50 years.
There is an automatic search for media events that have impacted or will impact in the coming seconds, minutes, days, and would risk a maximum in the coming months.
The exploration of events that will occur in larger ranges become increasingly rare, except perhaps the 2014 World Cup and the Olympics in London in 2012 and the Election of the next president of the United States among a few others .. .

Although the World Health Organization (WHO) has made numerous warnings, a fact that has gone slightly unnoticed are the impacts and consequences caused by chronic diseases today and in the next 20 years.

But what is Chronic Disease?

Chronic diseases are prolonged conditions that often do not improve and are rarely cured completely.
There are those that are transmitted as tuberculosis, Chagas disease, hepatitis, AIDS, etc.., And those who are called non-communicable diseases (also called non-communicating) and among which include diabetes, dementia, cancer, congestive heart failure, COPD (Chronic Obstructive Pulmonary Disease) bronchial asthma.
The increasing incidence of chronic disease is a challenge for health services in Brazil and worldwide.

Chronic diseases are by far the leading cause of death worldwide, accounting for 63% of all deaths. Of the 36 million people who died from chronic diseases in 2008, nine million were under 60 years and ninety percent of these premature deaths occurred in low and middle income.

In Brazil 72% of all deaths were attributed to non-communicable diseases in 2007.

Over the next 10 years the WHO projects an increase of 22% to 10 million deaths from chronic noncommunicable diseases in Brazil, and cardiovascular disease as the major cause. Morbidity and mortality from noncommunicable diseases are greater in the poor. The most common causes associated with chronic diseases in Brazil are listed in Figure 1.

Fig 1 – Deaths designed for chronic diseases in Brazil. Adapted from WHO NCD Country Profiles 2011.

  • Why are chronic diseases have such an impact on health?

The Chronic diseases have a profound effect on the physical, emotional and mental well-being of individuals, often making it difficult to continue with normal daily activities and relationships. This implies severe personal cost with high impact on health that is associated with economic costs, since labor is associated with absenteeism, sick leave involving lead removal in temporary or even permanent job generating early retirement and therefore drop the index productivity of the country.

  • What are the risk factors? How to reduce the risk of chronic diseases?

Risk factors for chronic diseases are associated with both genetic and acquired the criteria as dietary habits and the amount of vegetables and fruit (fiber) consumed, the concentration of sodium (salt), fat, trans fat (industrialized) and behavioral as the use of tobacco and its derivatives.
Remember that all food processing industry that generated gains in scale adopted in the 19th and 20th centuries, have adopted practices that have raised since the quantities of pesticides and agrochemicals for food production to the levels of fat, salt, sugar, and other food preservatives, many of artificial origin. Sweeteners and artificial flavorings followed more recently by the introduction of the food industry’s use of modified fats called trans fats that increase not only the food durability, but are closely associated with the development of cardiovascular disease – There is therefore, a total prohibition of its use in Scandinavian countries and Canada for example.
However, we must clarify that in many cases, health outcomes can be improved, depending on access to preventive and early diagnosis and appropriate medical services, guarantee of therapeutic treatment, access to information and the possibility of individual choices ranging from the daily exercise, the protection of public smoke-free places (chronic lung diseases, cancers) and a healthier diet, with such low levels of sodium, total absence of trans fats in foods (CVD) and the creation of suitable institutions indexes that measure the amount of pesticides (associated with cancers), in parts per billion or trillion (ppb. or ppt.) compatible with the requirements of FAO (the UN body responsible for controlling the food production) and other European regulators and the U.S.D.A. and also the Food and Drugs Administration (FDA).

  • The toll charged for Tobacco in Brazil and the World

Among the chronic diseases, it is noteworthy that among the three major preventable causes, two are occupied by the use of tobacco products. The first and foremost active smoking in second place followed by traffic accidents and in third place by passive smoking or secondary.

You have to remember that smoking itself is considered a pathology that has its own  ICD (International Classification of Disease)  to designate it, the F17.2.

Smoking is responsible for the generation of 52 other diseases, so that you can illustrate your power to see damage to be the main cause of disease is not communicating, causing 30% of all cancer deaths, including Lung cancer, head of the pathology of deaths among both men and women in the United States and Brazil, and be responsible for 80% of deaths from chronic obstructive pulmonary disease (COPD), popularly known as emphysema and chronic bronchitis.

The US Toll Charged for Chronic Diseases

Just to compare the US proportionally mortality is:

Cardiovascular Diseases answers for 35%; Cancers for 23%; Respirtory Diseases 7%; Diabetes 3%; Injuries 7%; Communicable, maternal, perinatal and nutritional comditions 6%; Other NCDs 19%;

  • Toll Charged in Lives:

Tobacco use unfortunatelly killed 100 million people in the 20th century. If current trends continue, tobacco will kill a billion people in the 21st century.

• Tobacco kills in the world more than 5 million people per year and accounts for one in 10 deaths among adults.
• The tobacco will kill more than 8 million people worldwide each year until the year 2030, with 80 percent of those deaths in low and middle income.
• Secondhand smoke kills more than 600,000 people worldwide each year, including 165,000 children.
• Tobacco production damages the environment by using too many pesticides, pollute groundwater and disposal, in addition to diverting agricultural land that could be used to produce food.
Toll in Brazil:
The costs of tobacco in Brazil, according to World Bank study carried out taking into account the tobacco-related hospitalizations occurred in the Public Service named SUS from 1996 to 2005, revolve around Us $ 500 million.

In Brazil, approximately R$ 340 million (Real$) is spent on hospitalization only for cases of cancer, cardiovascular and respiratory diseases attributable to smoking. Sum equivalent to almost 30% of total hospital costs for health care to treat these diseases.
Remember: This follows from the fact that smoking be related to different types of conditions, generating another 52 international code of diseases. Therefore, smoking leads to a number of deaths of about 200,000 people per year in Brazil, killing more than Malaria, Smallpox, and AIDS combined, according to the Brazil’s National Cancer Institute and the Ministry of Health.
The Brazilian National Institute of statistics (IBGE) has recently revealed that the number of smokers in Brazil is 24.6 million, of which 81.3% (20 million) are over 18 years. And according to the Datafolha there in relation to smoking a favorable opinion to the tax increase, with 63% of the population in favor of waving, and 88% agree that taxes paid by the industry should go to the health sector and can provide a solution to the non-return the CPMF unpopular, while balancing the government budget.
In 2011 the Brazilian government finally adopted a historic measure to protect public health from more than 190 million Brazilians to enact a comprehensive law on tobacco control. Signed by the president Rousef, the new law has made Brazil the largest country in the world completely free of active and secondhand smoking.
Meanwhile, it is noteworthy that further adjustments are still needed as the proposition to ban sale of cigarettes at school perimeter, popularize the spirometry test – to assess lung function and allows earlier diagnosis of COPD (the popular test of breath”) as well as increased surveillance to curb the sale of spare product, which could greatly improve the protection among children and adolescents.  After all, nicotine is a proven drug that causes more deaths worldwide and is directly responsible for more than 90% of cases of lung cancer, a disease with poor prognosis and extremely lethal.
Regarding chronic diseases some solutions can be identified as suggestions and are adopted not only by public power, but that due to the gain that can provide both health and in terms of economic productivity, would be required knowledge and persecuted by administrators private insurers and the companies and industrialists such as OGX, Gerdau, Embraer, Azul Airlines,  Jet Blue, Boeing, Apple, Walgreens, Ford, General Eletric, etc..

  1. That at least 80% of cardiovascular disease, stroke and type 2 diabetes and 40% of cases of cancers could be preventable when encouraging a healthy diet, regular exercise, and avoiding the use of all derivatives such as tobacco or cigarettes Nargileh;
  2. WHO estimates that if there was an additional reduction of 2% in the number of deaths from chronic diseases in Brazil over the next 10 years, this would allow the country to an economic gain of $ 4 billion – money that could be applied in Health and education. Thus eliminating the worst weight that a land can support… which is ignorance!

SOURCES:
WHO – World Health Organization: NCD Country Profiles, 20011

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