Cardiovascular Disease And Its Risk Factors Jeopardize Middle-Aged Populations, Economic Growth In Developing Countries

Health Affairs Article Says Global Health Community Can Blunt Effects By Altering Its Focus On Infectious Diseases And Infant Mortality

BETHESDA, MD — The rising prevalence of cardiovascular disease and its risk factors put developing nations “at an epidemiological crossroads” that can lead to a healthier population with resources to spend on other social needs or a country in which declining health cripples the economy, according to a new article posted today on the Health Affairs Web site.

To combat the growth in chronic diseases, the global health community needs to alter its focus from population control, infant survival, and infectious diseases and embrace early intervention strategies to combat cardiovascular disease risk factors and other chronic diseases such as diabetes, writes Henry Greenberg, associate professor of clinical medicine at Columbia University, and two colleagues.

Greenberg and colleagues forecast potential growth in cardiovascular and other chronic diseases in developing countries that could repeat the experience of Russia, where the working-age cardiovascular disease mortality rate in men is more than five times that of the United States. In Russia, the growth of cardiovascular diseases has damaged worker productivity and affected demographics in ways that have endangered national retirement plans.

“The risk-factor density in less developed countries suggests that the already high incidence of cardiovascular disease will rise at an accelerated rate unless they enact prevention programs now,” Greenberg says.

“If prevention is not instituted, the national epidemiological trajectory may replicate the Russian experience,” Greenberg says. “If a modest preventive effort is successful, the U.S. experience in which the impact has been put off to an older generation awaits; if a full-court press is successful, then the less developed world could escape both epidemics.”

For global disease prevention efforts to work, the international health community needs to recognize that its scope must go beyond traditional health services delivery.

“Because chronic disease management is intertwined with tax and agricultural policies, public information programs, education, and urban planning as well as patient care, the systems put in place will be quite different from what exists now,” Greenberg says.

Greenberg’s coauthors are Susan U. Raymond, managing director of Changing Our World Inc. in New York City, and Stephen Leeder, director of the Australian Health Policy Institute at the University of Sydney.

The article is one of two on international health issues published today on the Health Affairs Web site. The second, by Ian S. Mutchnick, a resident in neurological surgery at the University of Louisville, and two colleagues, examines the effect of an international services trade treaty on the globalization of health care delivery.

Greenberg’s article can be read at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w5.31.

Mutchnick’s article can be read at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w5.42.

####

Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research. Additional peer-reviewed papers are published weekly online as Health Affairs Web Exclusives at www.healthaffairs.org. Health Affairs Web Exclusives are supported in part by a grant from the Commonwealth Fund.

©2005 Project HOPE–The People-to-People Health Foundation, Inc.