IKGM 2

March 2022

THE EPIDEMIOLOGY OF
NON-COMMUNICABLE DISEASES
(NCDs)

Dini Setyowati, drg., MPH, Ph.D

01 Basic
Terminology
 Non-communicable
diseases (NCDs)

✤ = chronic diseases.
✤ are not passed from person to person.
✤ are of long duration and generally slow
progression*.

(WHO, 2011)
 Non-communicable
diseases (NCDs)

✤ NCDs also include:

❖ Chronic mental illness
❖ Injuries, which have an acute onset, but may be
followed by prolonged convalescence* and
impaired function
02 Communicable
vs
Non-Communicable
Diseases
Communicable Disease
v Diseases can be spread from
one person to another via
various means and methods.
v Usually Infectious diseases
v Sudden onset
v Single cause
v Short natural history
v Short treatment schedule
v Cure is achieved
v Single discipline
v Short follow up
v Back to normalcy
Non-Communicable Diseases
v A group of chronic slow-
progressing diseases
v Usually non-infectious diseases
v Gradual onset
v Multiple causes
v Long natural history
v Prolonged treatment
v Care predominates
v Multidisciplinary
v Prolonged follow up
v Quality of life after treatment
03 Characteristics of
NCDs
 Non-communicable
diseases (NCDs)
✤ are chronic conditions characterized by the following:
❖Do not result from an (acute) infectious process
❖Are “not communicable”
❖Cause premature morbidity, dysfunction, and
reduced quality of life
❖Usually develop and progress over long periods
❖Often initially insidious*
❖Once manifested there is usually a protracted* period of impaired health
(result in long-term health consequences and create a need for long-term
treatment and care)
 Characteristics of
NCDs
v Complex etiology (causes)
v Multiple risk factors
v Long latency period*
v Non-contagious* origin (non-communicable)
v Prolonged course of illness
v Functional impairment or disability
v Incurability
v Insidious onset
04 Types
 Types of NCDs
Cardiovascular disease
01 (Coronary heart disease, 04 Diabetes
Stroke)
Chronic neurologic
02 Cancer 05 disorders (Alzheimer’s,
dementias)

Chronic lung disease Arthritis/

03 06 Musculoskeletal
diseases
05 Mortality
& Burden
of NCDs
 Leading Causes of Attributable Global
Mortality and Burden of Disease, 2019
Top 10 global causes Top 10 global causes of
of death in 2019 disability-adjusted life years
(DALYs) in 2019
1. Ischemic heart disease à 8.9 million
1. Neonatal conditions
2. Stroke
2. Ischaemic heart disease
3. Chronic obstructive pulmonary disease
3. Stroke
4. Lower respiratory infections
4. Lower respiratory infections
5. Neonatal conditions
5. Diarrhoeal diseases
6. Trachea, bronchus, lung cancers
6. Road injury
7. Alzheimer disease and other dementias
7. Chronic obstructive pulmonary disease
8. Diarrhoeal diseases
8. Diabetes mellitus
9. Diabetes mellitus
9. Tuberculosis
10. Kidney diseases
10. Congenital anomalies
 Mortality and Burden of NCDs

Noncommunicable diseases (NCDs) kill 41 million people each year

worldwide, equivalent to 71% of all deaths globally.

Each year, 15 million people die from a NCD between the ages of 30 and 69
years

Over 85% of these "premature" deaths occur in low- and middle-income

countries.

Cardiovascular diseases account for most NCD deaths, or 17.9 million

people annually, followed by cancers (9.0 million), respiratory diseases
(3.9million), and diabetes (1.6 million), globally.

These 4 groups of diseases account for over 80% of all premature NCD
deaths.
 INDONESIA

World Health Organization - Noncommunicable Diseases (NCD) Country Profiles, 2018.

06 The Risk
Factors of
NCDs
 Risk Factors
“An aspect of personal behavior or lifestyle, an
environmental exposure, or a hereditary characteristic that is
associated with an increase in the occurrence of a particular
disease, injury, or other health condition.”
 Risk Factors
Modifiable Risk Factors Non-Modifiable Risk Factors
A risk factor that can be reduced or A risk factor that cannot be reduced or
controlled by intervention, thereby controlled by intervention, for
reducing the probability of disease. example:
• Age
The WHO has prioritized the • Gender
following four: • Race
• Physical inactivity • Family history (genetics)
• Tobacco use
• Alcohol use
• Unhealthy diets
Ø Modifiable behaviors increase the risk of NCDs.
Ø Tobacco accounts for over 7.2 million deaths every year (including
from the effects of exposure to second-hand smoke) and is projected
to increase markedly over the coming years.
Ø 4.1 million annual deaths have been attributed to excess salt/sodium
intake.
Ø More than half of the 3.3 million annual deaths attributable to
alcohol use are from NCDs, including cancer.
Ø 1.6 million deaths annually can be attributed to insufficient physical
activity.
Ø Modifiable behaviors contribute to four key metabolic changes that
increase the risk of NCDs:
1. Raised blood pressure

2. Overweight/obesity

3. Hyperglycemia (high blood glucose levels)

4. Hyperlipidemia (high levels of fat in the blood).

Ø In terms of attributable deaths, the leading metabolic changes

globally is elevated blood pressure (to which 19% of global deaths
are attributed), followed by overweight and obesity, and raised blood
glucose.
Common Risk
Factors*
 INDONESIA

World Health Organization - Noncommunicable Diseases (NCD) Country Profiles, 2018.

 INDONESIA

World Health Organization - Noncommunicable Diseases (NCD) Country Profiles, 2018.

 INDONESIA

World Health Organization - Noncommunicable Diseases (NCD) Country Profiles, 2018.

07 The Function of
Epidemiology in
Tackling NCDs
1. Public health surveillance : Ongoing, systematic collection, analysis, and
interpretation of NCDs data essential to the planning, implementation,
and evaluation of public health practice in tackling NCDs (prevention and
control).

2. Investigation

3. Data analysis :
§ Describe the distribution of NCDs in a community
§ Create a hypothesis about what causes or protect against NCDs
§ Learn about factors thought to be associated with NCDs
§ Assess between risk factors and NCDs, using statistical methods
§ Interpret result and disseminate information
4. Intervention: WHO ‘Best buys’ and other recommended interventions for
the prevention and control of NCDs
Ø Reduce tobacco use
Ø Reduce the harmful use of alcoho
Ø Reduce unhealthy diet
Ø Reduce physical inactivity
Ø Manage cardiovascular disease and diabetes
Ø Manage diabetes
Ø Manage cancer
Ø Manage chronic respiratory disease
5. Evaluation: Process and outcome
6. Communication
7. Management and teamwork
Thank You
CREDITS: This presentation template was created by Slidesgo, including
icons by Flaticon, infographics & images by Freepik

Please keep this slide for attribution