Unit 9: Control of Noncommunicable Diseases

Learning Outcomes

At the end of this unit, students will be able to:

1. Define NCD.
2. Identify the difference lifestyle –related diseases.
3. Discuss the different risk factors of lifestyle related disease.
4. Enumerate ways to prevent NCD.
5. Differentiate between disability and impairment.
6. List different health programs on the control of NCD.
7. State the different laws affecting control of NCD.

Presentation of Contents

Noncommunicable Diseases
§ It is a medical condition that is noninfectious and nontransmissible.
§ NCDs are referred to as “chronic diseases” due to their long duration.
o The condition interferes with the individual’s way of living a normal
life brought about by different signs and symptoms lasting more than
6 months.
§ “Lifestyle-related diseases”

Cardiovascular and Cerebrovascular disease

Cardiovascular disease
§ “heart disease”
§ refer to diseases that involve the heart or blood vessels (arteries,
capillaries, veins)
Cerebrovascular disease
§ “stroke”
§ a group of brain dysfunction related to disease of the blood vessels
supplying the brain
§ Note: The most common causes of these two diseases are atherosclerosis
and hypertension.

Hypertension and Atherosclerosis

Hypertension
§ or high BP, is defined as a systolic BP ≥ 140 mmHg or a diastolic BP ≥
90 mmHg

Atherosclerosis
§ is a disease of the blood vessels characterized by the deposition of fats and
cholesterol within the walls of the artery (WHO, 2011).

Note: Uncontrolled hypertension and atherosclerosis can lead to heart attack,

stroke, kidney damage, and a host complications (Stanhope & Lancaster, 2010)
Contibuting Factors:
§ A person’s genetic make-up
§ Socioeconomic group
§ Mental health
§ Diet
§ Overweight and obesity
§ Inactivity
§ Tobacco
§ Alcohol
§ Diabetes
§ Globalization and urbanization

Prevention:
§ Focusing on risk factors for cardiovascular and cerebrovascular disease
§ Implementing medical screening for individuals at risk
§ Providing effective and affordable treatment to those who require it

Cancer
§ Cancer or malignant neoplasm is a group of various diseases involving
unregulated cell growth (Newtow, 2009).
§ The cells divide, grow uncontrollably forming malignant tumors, and invade
parts of the body.
§ Substances that cause some cells to undergo genetic mutations are called
carcinogens.

Risk Factors for Cancer:

§ unhealthy diet
§ insufficient physical activity
§ the harmful use of alcohol
§ Infections (hepatitis B, hepatitis C (liver cancer), human papillomavirus (HPV;
cervical cancer), Helicobacter pylori (stomach cancer)
§ radiation
§ variety of environmental and occupational exposures of varying importance

The Majority of Cancer Deaths

§ Lung, breast, colorectal, stomach and liver cancers
§ In high-income countries, the leading causes of cancer deaths are lung
cancer among men and breast cancer among women.
§ In low- and middle-income countries cancer levels vary according to the
prevailing underlying risks. In sub-Saharan Africa, for example, cervical
cancer is the leading cause of cancer death among women.
Warning signals of cancer (American Cancer Society):
§ Change in bowel or bladder habits
§ A sore throat that does not heal
§ Unusual bleeding or discharge
§ Thickening or lump in breast
§ Indigestion or difficulty of swallowing
§ Obvious change in a wart or mole
§ Nagging cough or hoarseness
§ Unexplained anemia
§ Sudden weight loss

WHO’s approach to cancer has five pillars:

§ Prevention
§ Early Detection
§ Screening
§ Treatment
§ Palliative Care

Chronic Obstructive Pulmonary Disease (COPD)

§ It is disease of the lungs in which the airways narrow over time.
§ It includes chronic bronchitis, chronic asthma, and emphysema.
§ It is estimated that 7% of deaths worldwide are due to chronic respiratory
diseases (WHO, 2010)
§ Smoking is a strong risk factor for COPD and statistics shows that 15% of
cigarette smokers develop COPD.
§ Second-hand smoke and pollution also aggravate the problem.

Diabetes
§ Diabetes is a group of metabolic disease in which an individual has high
blood sugar because the pancreas does not produce enough insulin (a
hormone that regulates blood sugar) or the cells do not respond to the
insulin produced.
§ Long term consequences include increased risk of heart disease, kidney
disease, blindness, neural damage.

Symptoms of Diabetes:
§ Increased frequency and amount of urination- Polyuria
§ Increased thirst- Polydipsia
§ Increased hunger - Polyphagia
§ Weight loss, vision changes, and fatigue

Prevention
§ To help prevent type 2 diabetes and its complications, people should:
§ Achieve and maintain healthy body weight
§ Be physically active - at least 30 minutes of regular, moderate-intensity
activity on most days
§ Early diagnosis can be accomplished through relatively inexpensive blood
testing
§ Treatment of diabetes involves lowering blood sugar and the levels of other
known risk factors that damage blood vessels
 § Tobacco cessation is also important to avoid complications
Control
§ Screening and treatment for retinopathy (which causes blindness);
§ Blood lipid control (to regulate cholesterol levels);
§ Screening for early signs of diabetes-related kidney disease and treatment.

Risk Factors for Noncommunicable Diseases

§ Physical inactivity
§ It is defined as less than 5 times of 30 minutes of moderate activity per
week, or less than 3 times of 20 minutes of vigorous activity per week
(WHO, 2011).
§ Physical activity is a key determinant of energy expenditure and is thus
fundamental to energy balance and weight control.
§ Physical activity contributes to weight loss, glycemic control, improved blood
pressure and lipid profile, and insulin sensitivity (Kelley, 2005).
§ The risk of getting cardiovascular disease increases by 1.5 times for
noncompliance of the minimum recommendations for physical activity.

§ Cigarette smoking
§ It is a primary risk factor for development of NCDs (Gruber and Zinman,
2001).
§ Smoking-related diseases like cerebrovascular disease, COPD, and lung
cancer
§ It damages the lining of blood vessels and reduces HDL cholesterol and
oxygen in the blood (WHO, 2013).
§ Chemicals found in cigarettes are known to
§ cause cancer (National Cancer Institute, 2004).
§ It causes lung cancer, cancer of the mouth, pharynx, larynx, and esophagus
(Laudico, 2010).

3. Unhealthy eating
§ “Obesogenic” or unhealthy eating is one of the major risk factors
responsible for the global increase of cardiovascular disease, cancer,
diabetes, and obesity worldwide (WHO, 2002).
§ Unhealthy eating has adverse metabolic effects on BP, cholesterol, TAG,
and insulin resistance (Strazzullo, 2009).

4. Excessive alcohol drinking

§ Alcohol may cause malabsorption, inflammation of the GIT, liver problems,
and cancer.
§ It is associated with colon and rectal cancer (Bongaerts et al., 2006).

5. Viruses
§ Viruses play an important role in the development of certain cancers
(Philippine Cancer Society, 2010).
§ HPV : cervical and vulvar cancer
§ Epstein-Barr virus : nasopharyngeal and anal cancer
§ HTLV-1 : non-Hodgkin lymphoma
§ HBV & HCV : liver cancer
 § Oncoviruses- viruses capable of causing cancer

6. Radiation
§ 2 most common forms: UV and ionizing radiation (X-rays, gamma rays)
§ UV radiation adversely affects the genes, and the cell enzymes causing
DNA
§ Ionizing radiation causes tissue and cell damage by breaking the DNA
molecule (Newton, 2009).
§ Solar radiation is the primary source of UV radiation and the major source
of skin cancer worldwide (Cadet et al., 2005).

Prevention of NCDs
§ Promote physical activity and exercise
§ Promote healthy diet and nutrition
§ Promote a smoke-free environment
§ Stress management

Laws Affecting Control of NCDs

EO No. 958 : National Healthy Lifestyle Advocacy Campaign
RA No. 1054 : Free emergency medical and dental treatment for employees
RA No. 9211 : Tobacco Regulation Act of 2003
RA No. 6425 : Penalties for Violations of the Dangerous Drug Act of 1972
RA No. 9165 : Comprehensive Dangerous Drug Act of 2002
RA No. 8423 : Traditional and Alternative Medicine Act of 1997
AO No. 179 s. 2004 : Guidelines for the Implementation of the National Prevention
of Blindness Program
Department Personnel Order No. 2005-0547 : Creation of a Program
Management Committee for the National Prevention of Blindness Program
Proclamation No. 40 : Declaring the month of August every year as “Sight Saving
Month”
RA No. 7277 : Magna Carta for Disabled Persons
RA No. 10352 : An act restructuring the Excise Tax on Alcohol and Tobacco

Reflection

Now that you have reached this far, it is time to reflect and make a move by
answering the following questions?

1. Which strategies of this studying do you find effective? Which are not?

2. How can you improve your style?

3. How did you gain learning?

References:

Araceli S. Maglaya.(2009). Nursing Practice in the Community,

Cuevas, Frances Prescilla L.(2007). Public Health Nursing in the Philippines 10th
edition, c.

Guy, Howard.(2000)A guide for Communities and Community Health Workers,