Article

Inequalities in non-communicable diseases and effective responses

MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK.
The Lancet (Impact Factor: 45.22). 02/2013; 381(9866):585-97. DOI: 10.1016/S0140-6736(12)61851-0
Source: PubMed

ABSTRACT In most countries, people who have a low socioeconomic status and those who live in poor or marginalised communities have a higher risk of dying from non-communicable diseases (NCDs) than do more advantaged groups and communities. Smoking rates, blood pressure, and several other NCD risk factors are often higher in groups with low socioeconomic status than in those with high socioeconomic status; the social gradient also depends on the country's stage of economic development, cultural factors, and social and health policies. Social inequalities in risk factors account for more than half of inequalities in major NCDs, especially for cardiovascular diseases and lung cancer. People in low-income countries and those with low socioeconomic status also have worse access to health care for timely diagnosis and treatment of NCDs than do those in high-income countries or those with higher socioeconomic status. Reduction of NCDs in disadvantaged groups is necessary to achieve substantial decreases in the total NCD burden, making them mutually reinforcing priorities. Effective actions to reduce NCD inequalities include equitable early childhood development programmes and education; removal of barriers to secure employment in disadvantaged groups; comprehensive strategies for tobacco and alcohol control and for dietary salt reduction that target low socioeconomic status groups; universal, financially and physically accessible, high-quality primary care for delivery of preventive interventions and for early detection and treatment of NCDs; and universal insurance and other mechanisms to remove financial barriers to health care.

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    • "Non-communicable diseases (NCDs) are a growing burden on individuals and health systems globally (Di Cesare et al. 2013). While studies from high-income settings indicate that this burden disproportionately falls on individuals with lower socio-economic position (SEP), evidence from low and middle income (LMIC) settings is more mixed (Gupta et al. 2012; Zaman et al. 2012; Subramanian et al. 2013). "
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    Journal of Public Health 03/2015; 23(3). DOI:10.1007/s10389-015-0662-y · 2.06 Impact Factor
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    • "On the other hand, inverse association between EC incidence rate and SR in the current study is in line with previous individual and ecological studies (Brown et al., 2001; Singh et al., 2002; Weiderpass and Pukkala, 2006; Torres- Cintron et al., 2012; Jansson et al., 2005; Dar et al., 2013; Ljung et al., 2013). It is argued that risk factors of EC such as smoking, low consumption of fruit and vegetables and obesity are more prevalent among people and areas with low SR (Ellaway et al., 1997; Dubowitz et al., 2008; Hiscock et al., 2012; Di Cesare et al., 2013). Inverse associations between SR and these risk factors have been also reported in Iran (Dastgiri et al., 2006; Mehrabi et al., 2007; Kiadaliri, 2013). "
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