Prevention vs treatment of NCDs - how much time and effort?
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Prevention vs treatment of NCDs - how much time and effort?
Discuss what's in the BMJ and on bmj.com
There is a big conference in New York on Non Communicable Diseases in September. WHO/UN define NCDs as: "cardiovascular disease, diabetes, chronic obstructive pulmonary disease, and common cancers&mda
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Prevention vs treatment of NCDs - how much time and effort?
posted at 9/8/2011 11:06 AM BST
on bmj.com
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*Moderator*
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First: 7/4/2011 Last: 21/5/2013 |
There is a big conference in New York on Non Communicable Diseases in September. WHO/UN define NCDs as: "cardiovascular disease, diabetes, chronic obstructive pulmonary disease, and common cancers—but many neurological, rheumatological, and psychiatric conditions" In the BMJ, there has been a mini debate between Iona Heath and Richard Smith about they way to tackle NCDs. Richard Smith favours the preventative approach by targetting the problem early, whilst Iona Heath says we shouldn't be so eager to identify patients before they're patients - favouring the treatment approach. The number of people with NCDs, particularly in the West is increasing, and Smith claims that a lot of what needs to be done in this area is in fact outside the medical profession. Creating environments and conditions where people can make healthy decisions is not just down to doctors giving advice but governments and companies nudging people in a healthy direction. But the crux of this particular debate seems to be how much time and effort should be spent in preventing NCDs versus treating NCDs. What do you think is the priority? |
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Re: Prevention vs treatment of NCDs - how much time and effort?
posted at 9/8/2011 3:05 PM BST
on bmj.com
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Posts: 25
First: 9/8/2011 Last: 22/3/2012 |
it's all to do with environment. ncds are more prevalent in the west and much less in africa i reckon this is to do with how our governments intervene in our lifestyles. a more laissez faire approach to fast food companies means that there is a consequence at the other end (health problems)we need a more joined up approach so we don't have to spot patients before they get an ncd , which will hopefully lead to treating less ncd patients |
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Re: Prevention vs treatment of NCDs - how much time and effort?
posted at 9/8/2011 4:12 PM BST
on bmj.com
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Posts: 193
First: 24/9/2010 Last: 27/10/2011 |
NCDs are on the increase and not just in the 'west'. India http://ncd.in/ China http://www.nutritionanddevelopmentinchina.com/1/post/2011/6/what-are-ncds-and-what-are-they-doing-in-china.html Prevention v treatment? Hmmm. Well I think both are equally important and neither can be ignored to focus on the other. I don't agree with Iona's argument about making people patients earlier than necessary. And dsepite what Richard says, we need more input on prevention from public health doctors, not just governments and companies. |
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Re: Prevention vs treatment of NCDs - how much time and effort?
posted at 9/8/2011 10:04 PM BST
on bmj.com
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Posts: 193
First: 24/9/2010 Last: 27/10/2011 |
It's a bit like asking whether the police should focus on stopping the rioters currently causing havoc across England or spend their energies trying to avoid riot damage in the future. It's important to have good strategies for both which will probably involve different groups of police with different skill sets. Just like we need different groups of doctors to work on treatment of ncds (?hospital docs & GPs) and different groups of doctors to work on prevention (?public health docs and GPS). |
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Re: Prevention vs treatment of NCDs - how much time and effort?
posted at 16/8/2011 11:11 AM BST
on bmj.com
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*Moderator*
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First: 10/9/2009 Last: 21/5/2013 |
BMJ blog by Richard Smith: UN meeting on non-communicalble diseases goes wobbly: He worries plans are not going as well as they could for the New York conference next month due to several things including ... * Euro vulnerability * Lobbying from tobacco, alcohol and food companies * Countries in Africa not wanting diversion from Millennium Development Goals (infectious disease, maternal and child health, etc) * Political pressure on heads of state to attend is not strong However, he goes on to say the conference has already achieved a lot - awareness raised among governments, spirited debates sparked, etc. Do you think the conference will be a success? Has it already been successful? |
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Re: Prevention vs treatment of NCDs - how much time and effort?
posted at 16/8/2011 11:42 AM BST
on bmj.com
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*Moderator*
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First: 10/9/2009 Last: 21/5/2013 |
And here is an analysis article suggesting nutritional change is not a simple answer to non-communicable disease due to salt intake and crop shortages. [Written by the senior vice president of global health and agriculture policy.] |
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Re: Prevention vs treatment of NCDs - how much time and effort?
posted at 23/8/2011 12:11 PM BST
on bmj.com
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*Moderator*
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First: 10/9/2009 Last: 21/5/2013 |
This is interesting about prevention of NCDs ... Last night, the BBC programme Horizon showed an episode called "The Nine Months That Made You." They discussed the Barker Theory of CHD and type 2 dm risk being more to do with low birthweight than adult lifestyle choices. They reviewed several studies from around the world ... * Hertfordshire, UK: birth registers and health records showed people with lower birthweight had higher ncd incidence. * Rural India: type 2 diabetics are thin with healthy lifestyles, not obese and unhealthy. * Wartime Amsterdam, Holland: when there was famine (food rationing) during pregnancy, offspring suffered more adulthood CHD, hypercholestrolaemia, hypertension, and breast cancer than siblings born in times of non-famine. * Unizah, Saudi Arabia: the smaller placenta size of pregnant women who fasted during the month of Ramadan doesn't affect birth weight - placenta efficiency is what is important. (Smoking was the example given of something that reduces placenta efficiency.) * Mumbai, India: nutrient rich snacks are being handed out to some pre-pregnant women in slums and vegetable-less "placebo" snacks to others to investigate the theory further. So, if prevention of NCDs is important, according to Barker we should be focusing on pregnant/pre-pregnant women rather than giving healthy eating messages to young people and adults. Is this as controversial as the BBC suggests? Do you think it warrants coverage at the NCD conference next month? Here is the iPlayer link to the programme if you're interested in watching it http://www.bbc.co.uk/iplayer/episode/b013ywz4/Horizon_20112012_The_Nine_Months_That_Made_You/ |
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Re: Prevention vs treatment of NCDs - how much time and effort?
posted at 23/8/2011 2:31 PM BST
on bmj.com
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Posts: 4
First: 28/6/2010 Last: 8/9/2011 |
In Response to Re: Prevention vs treatment of NCDs - how much time and effort?: .... Here is the iPlayer link to the programme if you're interested in watching it http://www.bbc.co.uk/iplayer/episode/b013ywz4/Horizon_20112012_The_Nine_Months_That_Made_You/ Posted by Sabreena The bbc link is only available in the UK. So it would be great to have a youtube link. |
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Re: Prevention vs treatment of NCDs - how much time and effort?
posted at 23/8/2011 2:43 PM BST
on bmj.com
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Posts: 4
First: 28/6/2010 Last: 8/9/2011 |
Not to label people as patients.. yes it is really important but to change the point of view for NCDs as in pregnancy is best. School dropout rates is another example. From Reframing School Dropout As A Public Health Issue "If medical researchers were to discover an elixir that could increase life expectancy, reduce the burden of illness, delay the consequences of aging, decrease risky health behavior, and shrink disparities in health, we would celebrate such a remarkable discovery. Robust epidemiological evidence suggests that education is such an elixir. Yet health professionals have rarely identified improving school graduation rates as a major public health objective, nor have they systematically examined their role in achieving this objective. Seizing the opportunity to do so can improve health and reduce disparities" |
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Re: Prevention vs treatment of NCDs - how much time and effort?
posted at 23/8/2011 2:47 PM BST
on bmj.com
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Posts: 193
First: 24/9/2010 Last: 27/10/2011 |
In Response to Re: Prevention vs treatment of NCDs - how much time and effort?: * Mumbai, India: nutrient rich snacks are being handed out to some pre-pregnant women in slums and vegetable-less "placebo" snacks to others to investigate the theory further. Posted by Sabreena This is not very ethical is it?!? Do you think they'd try the same on "pre-pregnant women" in Hertfordshire? |
