Ruth Bonita

• MPH PhD MD (hon)
• Professor Emeritus at University of Auckland

The Sustainable Development Goal (SDG) target 3.4 is to reduce premature mortality from non-communicable diseases (NCDs) by a third by 2030 relative to 2015 levels, and to promote mental health and wellbeing. We used data on cause-specific mortality to characterise the risk and trends in NCD mortality in each country and evaluate combinations of re...

The third UN High-Level Meeting on Non-Communicable Diseases (NCDs) on Sept 27, 2018, will review national and global progress towards the prevention and control of NCDs, and provide an opportunity to renew, reinforce, and enhance commitments to reduce their burden. NCD Countdown 2030 is an independent collaboration to inform policies that aim to r...

In 2011, the United Nations set key targets to reach by 2025 to reduce the risk of premature noncommunicable disease death by 25% by 2025. With cardiovascular disease being the largest contributor to global mortality, accounting for nearly half of the 36 million annual noncommunicable disease deaths, achieving the 2025 goal requires that cardiovasc...

In 2011, the United Nations set key targets to reach by 2025 to reduce the risk of premature noncommunicable disease death by 25% by 2025. With cardiovascular disease being the largest contributor to global mortality, accounting for nearly half of the 36 million annual noncommunicable disease deaths, achieving the 2025 goal requires that cardiovasc...

Objectives: We sought to outline the framework and methods used by the World Health Organization (WHO) STEPwise approach to noncommunicable disease (NCD) surveillance (STEPS), describe the development and current status, and discuss strengths, limitations, and future directions of STEPS surveillance. Methods: STEPS is a WHO-developed, standardiz...

Background: Countries have agreed to reduce premature mortality from the four main non-communicable diseases (NCDs) by 25% from 2010 levels by 2025 (referred to as the 25 × 25 target). Countries also agreed on a set of global voluntary targets for selected NCD risk factors. Previous analyses have shown that achieving the risk factor targets can con...

Background: Non-communicable diseases (NCDs) place enormous burdens on individuals and health systems. While there has been significant global progress to guide the development of national NCD monitoring programs, many countries still struggle to adequately establish critical information systems to prioritise NCD control approaches. Discussion:...

Insufficient data exist on population-based trends in morbidity and mortality to determine the success of prevention strategies and improvements in health care delivery in stroke. The aim of this study was to determine trends in incidence and outcome (1-year mortality, 28-day case-fatality) in relation to management and risk factors for stroke in t...

Next week, the UN General Assembly will call on member states to bid farewell to the Millennium Dewvelopment Goals andadopt 17 new Sustainable Development Goals.

Suggests that an approach to treatment of raised blood pressure based on an arbitrary cut point, has failed in the USA and exporting failure to poor countries should be avoided.

This 2 page format summarises 3 papers published in Lancet March 2015

The time has come for the world to acknowledge the unacceptability of the damage being done by the tobacco industry and work towards a world essentially free from the sale (legal and illegal) of tobacco products. A tobacco-free world by 2040, where less than 5% of the world's adult population use tobacco, is socially desirable, technically feasible...

The time has come for the world to acknowledge the unacceptability of the damage being done by the tobacco industry and work towards a world essentially free from the sale (legal and illegal) of tobacco products. A tobacco-free world by 2040, where less than 5% of the world's adult population use tobacco, is socially desirable, technically feasible...

Two in every three deaths among women are caused by non-communicable diseases (NCDs) - largely heart disease, stroke, cancer, diabetes and chronic respiratory diseases. The global discourse on health, however, largely views women in terms of their reproductive capacity, a persisting myth reflecting gender bias that shifts the focus away from NCDs,...

Background: Countries have agreed to reduce premature mortality (defined as the probability of dying between the ages of 30 years and 70 years) from four main non-communicable diseases (NCDs)--cardiovascular diseases, chronic respiratory diseases, cancers, and diabetes--by 25% from 2010 levels by 2025 (referred to as 25×25 target). Targets for sel...

SUMMARY: The WHO MONICA Project is designed to measure the trends in mortality and morbidity from coronary heart disease (CHD) and stroke, and to assess the extent to which they are related to changes in known risk factors in different populations in 27 countries. Risk-factor data are collected from population samples examined in at least two popul...

It is unfortunate that British prisons have no plans to become smoke free, as reported by Ginn in his excellent series on promoting health in prisons and referred to by Jackson.1 2 3 There was a sense of fatalism in Jackson’s remarks. Yet it need not be so. On 1 July 2011, without incident, New Zealand became the first country in the …

Global health is widely regarded as being grounded in public and global engagement. But much of the process of global health is dominated by Northern institutions, expert groups, think-tanks, high- ...

Background: Recent research has used cardiovascular risk scores intended to estimate "total cardiovascular disease (CVD) risk" in individuals to assess the distribution of risk within populations. The research suggested that the adoption of the total risk approach, in comparison to treatment decisions being based on the level of a single risk fact...

Strong leadership from heads of state is needed to meet national commitments to the UN political declaration on non-communicable diseases (NCDs) and to achieve the goal of a 25% reduction in premature NCD mortality by 2025 (the 25 by 25 goal). A simple, phased, national response to the political declaration is suggested, with three key steps: plann...

Data for trends in cardiovascular disease (CVD) risk factors are needed to set priorities and evaluate intervention programmes in the community. We estimated time trends in blood pressure (BP), anthropometric variables and smoking in the Vietnamese population and highlighted the differences between men and women or between rural and urban areas. A...

Background Health promotion is a key component for primary prevention of cardiovascular disease (CVD). This study evaluated the impact of healthy lifestyle promotion campaigns on CVD risk factors (CVDRF) in the general population in the context of a community-based programme on hypertension management. Methods A quasi-experimental intervention stu...

Background. Data on cardiovascular disease risk factors (CVDRFs) in Vietnam are limited. This study explores the prevalence of each CVDRF and how they cluster to evaluate CVDRF burdens and potential prevention strategies. Methods. A cross-sectional survey in 2009 (2,130 adults) was done to collect data on behavioural CVDRF, anthropometry and blood...

Cancer is a leading global cause of death and disability, responsible for approximately 7.6 million deaths each year. Around one-third of cancers are attributable to a small number of preventable risk factors - including smoking and the harmful consumption of alcohol - for which effective interventions exist at the population level. Despite this, p...

The UN High-Level Meeting on Non-Communicable Diseases (NCDs) in September, 2011, is an unprecedented opportunity to create a sustained global movement against premature death and preventable morbidity and disability from NCDs, mainly heart disease, stroke, cancer, diabetes, and chronic respiratory disease. The increasing global crisis in NCDs is a...

Non-communicable diseases (NCDs), principally heart disease, stroke, cancer, diabetes, and chronic respiratory diseases, are a global crisis and require a global response. Despite the threat to human development, and the availability of affordable, cost-effective, and feasible interventions, most countries, development agencies, and foundations neg...

Costly efforts have been invested to control and prevent cardiovascular diseases (CVD) and their risk factors but the ideal solutions for low resource settings remain unclear. This paper aims at summarising our approaches to implementing a programme on hypertension management in a rural commune of Vietnam. In a rural commune, a programme has been i...

The UN High-Level Meeting on Non-Communicable Diseases (NCDs) in September, 2011, is an unprecedented opportunity to create a sustained global movement against premature death and preventable morbidity and disability from NCDs, mainly heart disease, stroke, cancer, diabetes, and chronic respiratory disease. The increasing global crisis in NCDs is a...

The UN High-Level Meeting on Non-Communicable Diseases (NCDs) in September, 2011, is an unprecedented opportunity to create a sustained global movement against premature death and preventable morbidity and disability from NCDs, mainly heart disease, stroke, cancer, diabetes, and chronic respiratory disease. The increasing global crisis in NCDs is a...

The objective of this study was to estimate mean blood pressure (BP), prevalence of hypertension (defined as BP ≥140/90 mm Hg) and its awareness, treatment and control in the Vietnamese adult population. This cross-sectional survey took place in eight Vietnamese provinces and cities. Multi-stage stratified sampling was used to select 9832 participa...

Southeast Asia faces an epidemic of chronic non-communicable diseases, now responsible for 60% of deaths in the region. The problem stems from environmental factors that promote tobacco use, unhealthy diet, and inadequate physical activity. Disadvantaged populations are the hardest hit, with death rates inversely proportional to a country's gross n...

The term global health is used rather than global public health to avoid the perception that our endeavours are focussed only on classical, and nationally based, public health actions. Global health builds on national public health efforts and institutions. In many countries public health is equated primarily with population-wide interventions; glo...

Several categories of ill health important at the global level are likely to be affected by climate change. To date the focus of this association has been on communicable diseases and injuries. This paper briefly analyzes potential impacts of global climate change on chronic non-communicable diseases (NCDs). We reviewed the limited available eviden...

The burden of chronic non-communicable diseases (NCD), especially heart disease, stroke, hypertension, diabetes, cancer and chronic respiratory disease, is rising in low and middle-income countries, particularly in Asia (1). NCD deaths account for 60% of all deaths in the world and one in two deaths in the Asian region. Prevention programmes and po...

The global public health agenda is daunting. It ranges from the unfinished work on Millennium Development Goals (MDGs), which are especially relevant to the poorer countries, to chronic non-communicable diseases, global environmental changes and the social determinants of health, which are relevant to all countries. While we are generally optimist...

This chapter provides an overview of the global health status and highlights the importance of capturing, with a range of new measures, the health transformations that are taking place in the context of continuing global change. Topics discussed include measures of health status, life expectancy, mortality and causes of death, morbidity and disabil...

This chapter summarizes the state of global public health and suggests the way forward for improving the practice of global public health. It begins by reviewing the main themes from the earlier chapters: the daunting context, the weakness of the public health infrastructure and workforce, the challenges presented by the broad scope of public healt...

This book provides an account of the international state of public health, including an agenda for improving the practice of the discipline across the world. It addresses three major issues, presented in distinct sections: the changing global context for public health; the state of public health theory and practice in both developed and developing...

Global health is increasingly dominated by chronic diseases--cardiovascular diseases, cancer, chronic respiratory diseases and diabetes. New Zealand cardiovascular disease death rates have fallen by over 60% since their peak in the late 1960s. Most of the decline can be explained by favourable trends in the main risk factors. Despite these gains, t...

Traducción de: Basic Epidemiology

Global health is attracting an unprecedented level of interest. In this paper, we summarise recent trends and identify the unfinished and new agendas in global public health. We propose a global public health scorecard as a simple way to assess progress and suggest actions by public health practitioners and their organisations for improving the eff...

We assessed the prevalence of substance use and its association with high blood pressure among adults in Addis Ababa, Ethiopia. We employed a cross-sectional descriptive study design. The World Health Organization instrument for stepwise surveillance of risk factors for chronic diseases was applied on a probabilistic sample of 4001 men and women ag...

See related article, pages 1668–1674. Results from the long-term surveillance of stroke as part of the Sino-MONICA project in Beijing, published in this month’s issue of Stroke , show marked changes in both stroke incidence and stroke subtypes.1 The authors conclude that characteristics of the stroke transition found over 2 decades and which refl...

See related article, pages 3063–3069. Stroke is a cause of poverty and is caused by poverty. Stroke prevention, along with the prevention of other chronic (noncommunicable) diseases, is a grossly neglected feature of the global development agenda,1 despite the huge economic and health burdens due to stroke. The reasons for this neglect are comple...

Background: Stroke is a leading global cause of death, with an estimated 5.8 million fatal events in 2005, two-thirds of which happened in low-income and middle-income countries. In these regions, epidemiological methods to establish hospital-based stroke registers for clinical audit or studies to estimate incidence are scarce. Our aim was to asce...

Stroke caused an estimated 5.7 million deaths in 2005, and 87% of these deaths were in low-income and middle-income countries. Without intervention, the number of global deaths is projected to rise to 6.5 million in 2015 and to 7.8 million in 2030. The rising burden of stroke, especially in low-income and middle-income countries, leads us to propos...

There is uncertainty regarding the impact of changes in stroke care and natural history of stroke in the community. We examined factors responsible for trends in survival after stroke in a series of population-based studies. We used statistical models to assess temporal trends in 28-day and 1-year case fatality after first-ever stroke cases registe...

Despite a growing burden of obesity and hypertension in developing countries, there is limited information on the contribution of body mass index (BMI) to blood pressure (BP) in these populations. This study examines the association between BMI and BP in three populations across Africa and Asia. Data on BMI, BP and other background characteristics...

One of the paradoxes of globalization is that an increasingly interconnected and interdependent world is simultaneously marked by widening health gaps between privileged and less advantaged groups, both between and within countries. Ambitious development and health objectives, most prominently the Millennium Development Goals (MDGs), have been set...

Reliable data on stroke incidence and prevalence are essential for calculating the burden of stroke and the planning of prevention and treatment of stroke patients. In the current study we have reviewed the published data from EU countries, Iceland, Norway, and Switzerland, and provide WHO estimates for stroke incidence and prevalence in these coun...

To gain a better understanding of the health transition in Indonesia, we sought to describe the prevalence and distribution of risk factors for noncommunicable diseases and to identify the risk-factor burden among a rural population and an urban population. Using the protocol of the WHO STEPwise approach to Surveillance (STEPS), risk factors for no...

OBJECTIVE: To gain a better understanding of the health transition in Indonesia, we sought to describe the prevalence and distribution of risk factors for noncommunicable diseases and to identify the risk-factor burden among a rural population and an urban population. METHODS: Using the protocol of the WHO STEPwise approach to Surveillance (STEPS),...