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Diseases of Affluence V

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Diseases of Affluence V 24 World Healt~ • November-December 1992 Diseases of affluence V. Ramalingaswami Tobacco consumption fell by 2-3% a year over the past decade in the USA, but the decline in smoking in rich countries is more than offset by its rise in poor countries. Tobacco is iseases of affluence refer to already causing three million deaths a those so-called chronic year and, on present smoking patterns, "degenerative" diseases whose D seven million people a year may be incidence has been rising dying by 2025. As the 20th century conspicuously in industrialized closes, developed countries are societies as incomes have risen, as entering a phase in which coronary living standards have gone up and heart disease, strokes and even cancer even as health indices have improved. will diminish as threats to longevity Mortality rates in younger age groups and quality of life. Meanwhile have fallen to low levels, and life developing countries, with the expectancy at birth has increased addition now of the countries of substantially. In those societies today, central and eastern Europe, will be in deaths under the age of 40 are mostly a phase of rising incidence of these avoided and maternal death is an Health education about the dangers of diseases. smoking has not reached this young mother in extremely rare event; on the other Nepal. Time is of the essence. The hand, deaths above 40 are dominated knowledge we possess today about the by the diseases of affluence - prevention of diseases of affluence is particularly cardiovascular diseases reasonably sufficient to be put to and cancer. Increases in living social use. To be sure, not all the standards and life expectancy have answers are in yet, nor has the generally been accompanied by response to programmes of reduction behavioural risk factors such as in these diseases been uniform in all increased tobacco and alcohol use, countries. But the consequences can Time is of the essence if the greater consumption of saturated fats, be grave if we wait for absolute proof cholesterol, and dietary calories and developing world is to ovoid of absolute good. decreased physical activity. Developing countries have a the disasters that unhealthy Many developing countries valuable opportunity to formulate registering rapid economic growth are policies and programmes in food and habits and life-styles hove today poised to experience the same nutrition, in habits and in life-styles to post-transitional phase in their health afflicted on the industrialized inhibit the advance of diseases of evolution as the industrialized nations. affluence. There is an obligation to countries. So history is set to repeat itself. use public health knowledge in an But it need not and should not be anticipatory way for preventive and allowed to. Through public education, promotive action- and equally an enabling services and life-style obligation to use that knowledge in an changes, many developed countries equitable way. Human life-styles and have now achieved dramatic reduction humari behaviour are the key to the in mortality rates from these diseases future health of human kind. • of affluence. Tobacco-free life-styles, balanced and health-promoting diets, and regular physical activity have played an important role. For example, in the USA, coronary heart Professor V. Ramalingaswami is Professor disease now claims 40% fewer lives Emeritus of the All India Institute of Medical than in 1975 and strokes 55% fewer Sciences, Ansari Nagar, New Delhi 1 10 029; India, and Secretary-General of the lives; similar reductions have taken International Conference on Nutrition, Rome, place in Australia and Canada. December 1992. .
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