Preventing chronic disease

According to the WHO, 80 per cent of premature heart disease, stroke and type 2 diabetes, and up to 40 per cent of cancers, are preventable through leading healthy lifestyles. However, cross-sectoral approaches are needed if healthy choices are to be at least as available and accessible as unhealthy choices. A staged approach to achieving this includes:

• structural change – interventions such as advocating for and implementing policy change, environmental change (improving opportunities and safe environments for physical activity, such as in schools, workplaces or streets) and economic change (imposing taxes on tobacco products);
• education – a key component in long-term health, dissemination of health messages requires trained health professionals, and the use of mass media messaging or peer educators. Education of women is particularly important, as they are often responsible for education of children, and decisions about families’ food and physical activity;
• community working – key stakeholders (community leaders, families, local government and businesses) can work together to encourage healthy lifestyle change throughout the community, such as creating farmers’ markets and safe areas for physical activity, and enforcing smoke-free environments.
  

Targeting prevention at the most at-risk communities is likely to have the greatest benefit, and establishing accurate records of disease prevalence and risk factors is essential if the case for prevention is to be made. Results based on developed-country experience show that prevention of CVD using drugs to control blood pressure and serum cholesterol are highly cost-effective for those risk factors