https://www.eejournals.

org Open Access

EURASIAN EXPERIMENT JOURNAL OF PUBLIC HEALTH

(EEJPH)
ISSN: 2992-4081 ©EEJPH Publications
Volume 5 Issue 3 2024

Page | 35

The Role of Public Health in Preventing Non-

Communicable Diseases
Mwende Muthoni D.
Faculty of Medicine Kampala International University Uganda
ABSTRACT
Non-communicable diseases (NCDs), such as cardiovascular diseases, diabetes, cancer, and chronic
respiratory conditions, represent the leading cause of morbidity and mortality worldwide, particularly in
low- and middle-income countries. This paper discusses the epidemiology, risk factors, and prevention
strategies for NCDs, emphasizing the role of public health in addressing the rise of these diseases. Public
health interventions, including policy development, community engagement, and advocacy, play an
important role in reducing NCD prevalence by promoting healthy lifestyle changes and facilitating early
detection and treatment. Moreover, multi-sectoral approaches that include public-private partnerships are
essential for creating supportive environments for NCD prevention. Regular monitoring, surveillance,
and community-driven programs further enhance public health's impact on mitigating NCDs. Ultimately,
the shift from acute care interventions to a prevention-focused public health model is vital for addressing
the global NCD burden.
Keywords: Non-communicable diseases (NCDs), Public health, Prevention strategies, Risk factors,
Lifestyle diseases, Multi-sectoral interventions.
INTRODUCTION
Non-communicable diseases are increasing in prevalence in low, middle, and high-income countries, and
68% of all deaths worldwide are attributable to chronic diseases. These diseases, such as coronary
atherosclerosis, hypertension, diabetes mellitus, cancer, and smoking-related pulmonary diseases, are also
major causes of morbidity and hospitalization. In 2002, over 4 million US hospital discharges included a
chronic disease in the principal discharge diagnosis. Research has demonstrated a clear association
between lifestyle choices and the development of non-communicable diseases. In contrast, protection from
NCDs is conferred by healthy lifestyles, such as avoiding the consumption of tobacco, poor diets, and
physical inactivity [1, 2]. Public health is a social and political concept aimed at improving and enhancing
the quality of life of the whole population and is achieved through ensuring the control of communicable
diseases and the diagnosis and prevention of non-communicable diseases. Both diseases characterized as
contagious and non-contagious are public health problems, resulting in the expenditure of considerable
resources primarily directed at interventions focused on acute care. Non-prevention of poor lifestyle
practices, however, means that efforts in public health are fighting an uphill battle and can only make
progress once illness is already prevalent. The purpose of this review is to examine how public health can
target poorly controlled lifestyle practices as an interim measure until a shift in philosophy and approach
results [3, 4].
Epidemiology of Non-Communicable Diseases
Non-communicable diseases (NCDs), often referred to as ‘lifestyle diseases’ or ‘civilization/affluence-
related diseases’, are the leading causes of mortality and morbidity across the world. Their aetiology is
complex, with behavioral, socio-cultural, environmental, and genetic determinants. NCDs are on an
increasing trend. Though there are no officially collected and authentic data to know the exact prevalence
and incidence of NCDs, non-communicable diseases accounted for over 36 million of the 56 million deaths
worldwide in 2015, of which two-thirds, or 26 million, were premature deaths before the age of 70. Unlike
in developed countries, where diseases of poverty and diseases of affluence occur, the diseases that are
https://www.eejournals.org Open Access
afflicting the poor to a large extent are non-communicable diseases. About 70% of all global deaths are
due to non-communicable diseases. The most common NCDs are cardiovascular diseases (CVDs),
diabetes, cancer, and chronic obstructive pulmonary disease (COPD). Worldwide, the number of cancer
patients is estimated to reach 30.7 million in 2040 [5, 6]. Epidemiological studies of non-communicable
diseases have assumed great importance because these diseases usually go along with increasing age, at
least in a large number of cases – cerebrovascular diseases, ischemic heart diseases, diabetes, etc. They are
projected to defy public health interventions. Hence, the significance of identifying the underlying
Page | 36
determinants, especially to account for the risks of occurrences of these diseases in the relatively young
population, assumes great significance. Few available community-based studies focus mostly on the level,
not on the pattern or distribution and detailed proportions of the various non-communicable diseases.
Hence, the present study is designed with the objective to find the prevalence of non-communicable
diseases among the rural adult population of Warangal district, Telangana, with a view to enlighten the
stakeholders in the planning of health programs, allocation of resources in the light of actual disease
burden, and to stimulate further research and identification of policy and program interventions [7, 8].
Risk Factors and Prevention Strategies
Risk factors for NCDs can be divided into three general categories: behavioral, environmental, and
genetic/metabolic. Behavioral factors associated with an increased risk of NCDs manifest as choices,
habits, preferences, and practices of individuals or an entire society. The unhealthiest lifestyle behaviors
include a diet based mainly on processed and energy-dense foods and alcohol, lack of physical activity,
high consumption of tobacco, sleeping abnormalities, sedentary behavior, and psychological problems.
The word “diet” in relation to the risk of NCDs is also associated with high consumption of salt, sugar,
and trans fatty acids [9, 10]. For the prevention of these diseases, these risk factors must be minimized.
Preventive efforts may target changing lifestyle in general and, more importantly, the lifestyle of those
with a higher risk of getting sick. Strategies advocate dealing with the problem at the individual level and
include modifying personal behavior by providing appropriate patient education. Multi-disciplinary
assessments and provision of information on the medical, social, financial, and psychological impacts
awaiting identified high-risk individuals are done in a healthcare delivery setting. Other healthcare-
centered strategies include developing policies for the early detection of high-risk individuals via regular
check-ups or screening tests in a healthcare setting. Irrespective of which healthcare-centered strategy is
used, periodic monitoring is essential [11, 12].
Public Health Policies and Interventions
Public health policies and interventions have a critical role in reducing NCDs. Several frameworks and
guidelines support nations, sectors, and communities in developing strategies and health programs.
Country-specific information about the NCD burden, the impact of different risk factors, the effectiveness
of possible interventions, and the cost of diseases and prevention for policy analysis and effective
intervention planning are very critical. Equally, the NCD policy comprises a roadmap that may guide
healthy public policy, multi-sectoral action, and underlying social determinants, as well as comprehensive
responses in health systems and community and individual levels of intervention to reduce NCDs. In
addition, the policy aims to promote and protect health by creating conducive environments and adopting
regulations to address the modifiable risk factors of NCDs [13, 14]. The consensus about multi-sectoral
health interventions to combat risk factors is evident across the globe. The adopted strategy is a strategic
combination of public and private sector action, where health is integrated into social and economic
policies with a view to encouraging healthy choices and the development of communities and
environments that foster healthy living. The community sector also has the potential to contribute to
NCD prevention by promoting health and mobilizing communities to take action from the bottom up to
create environments that are supportive of NCD prevention. The effectiveness of multi-sectoral
interventions that draw on the combined strengths of government, the health care and non-health care
sectors, and community-based and nongovernmental organizations in reducing NCDs is supported by
theoretical frameworks, systematic reviews, and field experience. Interventions also need to be based on
accurate evidence about NCDs and their determinants. While the surveillance of NCDs has improved,
much work remains to be done, particularly in low-income and smaller Pacific countries. NCD risk factor
surveillance has transformed strategies to reduce inequalities. This is an indication of the impact of
regular and accurate surveillance of NCDs and their risk factors. Surveillance can highlight emerging
problems and provide a platform for reform of the policy environment to better support population
health. Regular monitoring allows countries to track the evolving picture of NCDs and to modify their
public health strategies accordingly. Key tools during implementation are the monitoring and evaluation
of NCD strategy implementation [15, 16].
https://www.eejournals.org Open Access
Community Engagement and Advocacy
1. Engagement of communities can lead to community-driven programs. Best practice includes
listening to, valuing, and respecting the opinions and views of the community, rather than
tokenistic representation of vulnerable or marginalized populations. Communities can be
engaged not only as participants in programs and services, but as equal partners in the design,
implementation, and management.
2. Awareness raising is one strategy for promoting individual and community support for primary Page | 37
prevention activities. Information about NCD risk factors and what people can do to reduce their
risk should be made generally available in formats that are accessible to the target population,
e.g., books, videos, DVDs, radio, television, children's movies, school newsletters, handbooks, and
playgroups. Regular educational sessions provide ongoing opportunities for information
dissemination.
3. Advocacy involves actions that systematically and persistently draw attention to and work
towards change in community values, individual behaviors, societal attitudes, health beliefs, and
environmental standards to influence policy decisions and resources and funding allocations. A
critical step in any advocacy process is evidence gathering, which involves a critical analysis of a
range of materials and informants on the status of an issue. Public opinion, research, and local
data can be very useful in highlighting issues for discussion at the community level and in
providing support for known solutions.
4. Developing partnerships and encouraging the development and growth of non-government
organizations and coalitions to work in health promotion is essential. In order for public opinion
and political issues to be effective in changing policy and creating environments that promote
health, partnerships across government and policies, stakeholder groups, and between
nongovernment agencies must be built, developed, and maintained. Culturally tailored
prevention strategies and policy influences may be a key approach in rural communities to foster
positive change related to NCD prevention.
5. Success stories showcase best practice and community leadership that has the potential to reduce
the burden of NCDs. Abused by the majority of the people, often illiterate and ignorant, facing
family violence and sexual abuse, exposure to poverty, and the lack of access to health services,
refugees shoulder the burden of numerous preventable diseases. The term "community
development" is defined as: "a process that aims to improve the skills, knowledge, attitudes, and
potential of people and can benefit society as a whole." This definition recognizes the important
role of the individual in changing society overall and sets community development apart from
other approaches crucial to the prevention or management of NCDs.
CONCLUSION
Non-communicable diseases present a critical challenge to global health, with increasing mortality and
morbidity rates worldwide. Public health initiatives play an essential role in mitigating the impact of
NCDs by addressing modifiable risk factors and promoting healthier lifestyles. Through comprehensive
prevention strategies, policy reforms, community engagement, and sustained advocacy, public health can
significantly reduce the burden of NCDs. A holistic, multi-sectoral approach is necessary to ensure that
interventions are both effective and sustainable, with regular surveillance providing the data needed to
adjust strategies as needed. By shifting the focus from reactive care to proactive prevention, public health
can lead the way in reducing the global burden of non-communicable diseases.
REFERENCES
1. Soriano JB, Kendrick PJ, Paulson KR, Gupta V, Abrams EM, Adedoyin RA, Adhikari TB,
Advani SM, Agrawal A, Ahmadian E, Alahdab F. Prevalence and attributable health burden of
chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease
Study 2017. The Lancet Respiratory Medicine. 2020 Jun 1;8(6):585-96. thelancet.com
2. Cockwell P, Fisher LA. The global burden of chronic kidney disease. The Lancet. 2020 Feb
29;395(10225):662-4.
3. De Guimarães JC, Severo EA, Júnior LA, Da Costa WP, Salmoria FT. Governance and quality of
life in smart cities: Towards sustainable development goals. Journal of Cleaner Production. 2020
Apr 20;253:119926. [HTML]
4. Cristea M, Noja GG, Stefea P, Sala AL. The impact of population aging and public health
support on EU labor markets. International journal of environmental research and public health.
2020 Feb;17(4):1439. mdpi.com
5. Menon GR, Yadav J, John D. Burden of non-communicable diseases and its associated economic
costs in India. Social Sciences & Humanities Open. 2022 Jan 1;5(1):100256.
https://www.eejournals.org Open Access
6. Zou S, Wang Z, Bhura M, Tang K. Association of multimorbidity of non-communicable diseases
with mortality: a 10-year prospective study of 0.5 million Chinese adults. Public Health. 2022
Apr 1;205:63-71.
7. Devaux M, Lerouge A, Giuffre G, Giesecke S, Baiocco S, Ricci A, Reyes F, Cantarero D,
Ventelou B, Cecchini M. How will the main risk factors contribute to the burden of non-
communicable diseases under different scenarios by 2050? A modelling study. PLoS One. 2020
Apr 29;15(4):e0231725. plos.org
Page | 38
8. Blangiardo M, Boulieri A, Diggle P, Piel FB, Shaddick G, Elliott P. Advances in spatiotemporal
models for non-communicable disease surveillance. International Journal of Epidemiology. 2020
Apr 1;49(Supplement_1):i26-37. oup.com
9. Schwartz LN, Shaffer JD, Bukhman G. The origins of the 4× 4 framework for noncommunicable
disease at the World Health Organization. SSM-Population Health. 2021 Mar 1;13:100731.
10. de Lima AP, Schneider BC, Bertoldi AD, Tomasi E, Gonzalez MC, Demarco FF, Domingues
MR, Bielemann RM. NCD behavioral risk factors and mortality among older adults in Brazil.
Clinical Nutrition ESPEN. 2021 Oct 1;45:462-8.
11. Zhou X, Siegel KR, Ng BP, Jawanda S, Proia KK, Zhang X, Albright AL, Zhang P. Cost-
effectiveness of diabetes prevention interventions targeting high-risk individuals and whole
populations: a systematic review. Diabetes Care. 2020 Jul 1;43(7):1593-616. diabetesjournals.org
12. Kaminsky LA, German C, Imboden M, Ozemek C, Peterman JE, Brubaker PH. The importance
of healthy lifestyle behaviors in the prevention of cardiovascular disease. Progress in
cardiovascular diseases. 2022 Jan 1;70:8-15. sciencedirect.com
13. Ndubuisi NE. Noncommunicable diseases prevention in low-and middle-income countries: an
overview of health in all policies (HiAP). INQUIRY: The Journal of Health Care Organization,
Provision, and Financing. 2021 Aug;58:0046958020927885. sagepub.com
14. Magnusson R, Patterson D. Global action, but national results: strengthening pathways towards
better health outcomes for non-communicable diseases. Critical Public Health. 2021 Aug
8;31(4):464-76.
15. Dhimal M, Dhimal ML, Dahal S, Shrestha MP, Gyanwali P, Shao R, Mikkelsen B,
Wickramasinghe K, Marten R, Jha AK, Townsend N. Barriers and facilitators to the
implementation of a national multisectoral action plan for the prevention and control of
noncommunicable diseases in Nepal: perspectives of stakeholders. Global health action. 2021 Jan
1;14(1):1963069. tandfonline.com
16. Thondoo M, Mogo ER, Tatah L, Muti M, van Daalen KR, Muzenda T, Boscott R, Uwais O,
Farmer G, Yue A, Dalzell S. Multisectoral interventions for urban health in Africa: a mixed-
methods systematic review. Global Health Action. 2024 Dec 31;17(1):2325726. tandfonline.com

CITE AS: Mwende Muthoni D. (2024). The Role of Public Health in

Preventing Non-Communicable Diseases. EURASIAN
EXPERIMENT JOURNAL OF PUBLIC HEALTH, 5(3):35-38