Modifiable behavioral risk factors
Noncommunicable diseases (NCDs) or chronic diseases are not spread from person to person. They are long in duration and tend to progress slowly. Many non-communicable diseases have common risk factors to which everyone – children, adults, and the elderly – are vulnerable. They include smoking, alcohol and drug use, low physical activity; they are called intermediate risk factors that can lead to NCDs. However, these are modifiable behavioral risk factors, i.e., when giving up bad habits, one can significantly improve health and reduce the risk of developing NCDs (Gbadamosi & Tlou, 2020). The experience of some developed countries taking vigorous measures to limit the prevalence of risk factors for noncommunicable diseases strongly suggests that the result is an increase in the population’s average life expectancy.
Tobacco dependence is a chronic disease that often requires long-term treatment and repeated quitting attempts. Nicotine in tobacco is recognized as a substance that causes drug addiction. Tobacco smoking is the most common cause of respiratory disease; smokers have a six times higher risk of developing chronic obstructive pulmonary disease – COPD (Sim et al., 2017). Every 10th smoker develops lung cancer; on average, people who smoke reduce their lives by 10-15 years (Karthik, 2021). Smoking causes great harm to the body of a pregnant woman and a fetus (Lockhart et al., 2017). Children of mothers who smoke during pregnancy are often born prematurely. They usually have signs of hypotrophy, often get sick, and lag in development from their peers.
The body of a person who drinks alcohol wears out several times faster than a healthy person who does not drink. The human brain suffers the hardest from alcohol, as this substance sticks together red blood cells in the blood, leading to blood clots (Woodyatt, 2021). Without exception, it affects all systems and organs, weakens the immune system, and leads to frequent diseases. Alcohol changes the structure of the genetic code of DNA Рit contains information about a person and his descendants (Dugu̩ et al., 2021). People who abuse alcoholic beverages give birth to children with mental and congenital disabilities.
Alcohol use is a significant preventable risk factor for noncommunicable diseases such as cirrhosis of the liver, certain types of cancer and cardiovascular disease, and injury from violence and road clashes and collisions. It has been proven that alcohol consumption in hazardous amounts to health is the cause of diseases and injuries, leading to significant disability, premature death, and other socio-economic negative consequences (Oladipo., 2019). Strategies for preventing and reducing dangerous alcohol consumption should improving legislative and regulatory information, treatment, and rehabilitation measures (Esser & Jernigan, 2018). It is already known that only public education is ineffective; legislative, regulatory and legal acts and mechanisms for their implementation, early diagnostic and effective treatment and rehabilitation interventions are needed.
Drug addiction has a devastating effect on almost every human body organ, but the brain, cardiovascular and endocrine systems are most affected by addiction. Stimulants, euphoretics, depressants affect the body differently; however, they all contribute to a deterioration of the body systems (Jabeen et al., 2018). However, almost any drug, especially the “designer” type ones, leads to the development of the most severe pathologies.
There is brain damage, toxic encephalopathy, psychoses and neuroses, and polyneuropathy on the part of the nervous system (Luethi & Liechti, 2020). It is expressed as minor nervous system disorders, and paralysis, and paresis. The liver’s fatty degeneration occurs in the hepatobiliary system, including irreversible processes leading to cirrhosis. Continuous smoking of marijuana leads to psychomotor delays (Prashad & Filbey., 2017). Memory deteriorates, a person becomes inhibited, and a problem with cognitive functions and the ability to focus on work processes. Methamphetamine and cocaine lead to the development of toxic encephalopathy, tooth enamel is destroyed (Clague et al., 2017). Although each drug affects a person differently, many diseases are common to almost all addicts.
Such pathologies characterize drug addicts as tachycardia and hypertension, cardiomyopathy, ischemic heart disease, heart failure. Some disorders are reversible; some, such as cirrhosis or heart failure, are not. However, drug addiction treatment will stop the destructive processes and provide the patient with long-term remission. It is vital to prevent the onset of irreversible consequences that cannot be cured in any way and the situation when it is only possible to maintain life with special supportive treatment (Jordan & Andersen, 2017). There are no safe drugs; their recreational use leads to severe dependence, both physical and psychological, and dependence – to the development of diseases, including irreversible ones.
These risk factors are amenable to adjustment – any person can overcome addiction and switch to a healthier lifestyle. However, in some cases, medical attention is required for a smooth release from the influence of bad habits. Despite the availability of information on the dangers of smoking, alcohol, and drugs, many people ignore doctors’ recommendations. Government intervention is required to disseminate information on the risks of these substances and to combat their use.
Metabolic risk factors
Metabolism is a chain of chemical reactions in the body that ensure the normal functioning of a person. People get all the necessary substances from the external environment, mainly from food. A metabolic disorder is a malfunction of the body that affects the state of human health. Such risk factors contribute to four significant metabolic changes that increase the risk of NCDs: high blood pressure, overweight/obesity, hyperglycemia (high blood glucose), hyperlipidemia (high blood lipids).
High blood sugar weakens the body’s resistance -infectious diseases, especially those with fever, can dramatically worsen the condition of diabetics – even those whose illness is well controlled with medication. Nevertheless, with diabetes mellitus, not only is carbohydrate metabolism disturbed. The disease can affect blood vessels and affect the state of internal organs, subjecting them to additional stress (Dong et al., 2018). Then, it becomes much more difficult for the immune system to protect the body from foreign and harmful interference. An imbalance in the content of glucose and insulin in the blood plasma leads to a radical metabolic disorder, stimulates hypertension, develops vascular atherosclerosis, and increases the risk of heart attack or stroke (Khan et al., 2019). Many people with diabetes die of heart attacks before they develop vision, leg, or kidney problems.
Hypertension is considered one of the leading causes of death on our planet. It also increases the risk of developing diseases of the cardiovascular system, brain, and other conditions (Singh et al., 2017). High blood pressure leads to damage to arterial vessels and affects the work of the heart, which is forced to be in a state of overload (Martinez-Quinones et al., 2018). This can lead to the development of severe cardiovascular diseases and, as a result, weaken the body’s resistance to viruses and other infections.
High blood lipids do not usually cause symptoms. At very high levels, fat builds up in the skin and tendons and forms bumps called xanthomas. Occasionally, patients develop dull white or gray rings along the edge of the cornea. Very high triglyceride levels can cause an enlarged liver or spleen, tingling or burning sensations in the hands and feet, shortness of breath, and confusion, increasing the risk of pancreatitis (Laufs et al., 2020). Pancreatitis can cause abdominal pain and is sometimes fatal.
The cardiovascular system suffers primarily from obesity; fat is deposited around the heart and in the walls of blood vessels. The ability of the heart muscle to push blood into large vessels gradually decreases, and fatty degeneration develops (Hruby et al., 2016). Obese patients cannot inhale deeply; their breathing is shallow. This, in turn, is a risk factor for the development of bronchitis and pneumonia (Mafort et al., 2016) – the symptoms are most severe in smokers. Reduced oxygen supply to the blood leads to oxygen starvation of the brain, pathological drowsiness develops.
Due to the stretching and weakness of the anterior abdominal wall, all abdominal organs, mainly the stomach, go down and stretch. Intestinal motility suffers, hence flatulence and constipation. The skeleton, ligaments, and muscles experience additional, sometimes even double, stress. Diseases associated with malnutrition of bones and cartilage, osteochondrosis, arthritis develop (Sheng et al., 2017). The most effective way to combat obesity is to combine diet and vigorous regular exercise. At the same time, it must be remembered that a doctor should be involved in diagnosing and treating obesity. Only he will find out the exact reason for weight gain, adjust the diet and give recommendations for lifestyle changes.
When genetic factors influence the course of the disease, it is more difficult to control the development and spread of the disease, but this is not a reason not to engage in disease prevention. It is essential to keep in mind that there are technologies that allow one to regulate pressure, blood sugar levels, and other risk factors at the current stage of medical development (Milani et al., 2016). The diversity of risk factors can cause short aggravations of the condition that do not lead to chronic exacerbations. Temporary disorders are possible against the background of micronutrient deficiencies, dehydration, overhydration of the body, severe illness, overheating, hypothermia, and other unfavorable factors. Complex medical care is needed if the pathological process arose long ago, provoked by genetic factors. Depending on the type of disorder, the patient can be prescribed a special diet, and a complex of vitamins and minerals; however, with serious complications, more intense medical intervention is possible.
Noncommunicable disease among adolescents
It should be emphasized that an official definition of the exact age for adolescents does not yet exist. Therefore, adolescence is determined differently depending on a particular country and even its regions, cultural and national characteristics, gender. In most publications on age periodization, it is noted that it lasts from 13 to 16 for boys and from 12 to 15 years for girls. At the same time, early adolescence is 10-13 years old, middle adolescence – 14-17 years old, and late adolescence – from 18 to 21 years. There may be some differences between boys and girls due to the gender influence on the intensity of an organism’s development. Each of these periods is characterized by its features which affect the course and outcome of noncommunicable diseases.
Noncommunicable diseases, also known as chronic diseases, tend to be long-term and result from a combination of genetic, physiological, environmental, and behavioral factors. The main types of NCDs are cardiovascular diseases (such as heart attacks and strokes), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma), and diabetes. The burden of NCDs is disproportionately high in low- and middle-income countries, which account for more than three NCD deaths worldwide.
Adolescents are likely to need extra help to control asthma because they are at greater risk of misusing inhalers and engaging in activities that can worsen asthma (such as smoking). At present, sufficient evidence has been accumulated that the transformation of childhood asthma into adulthood occurs precisely at puberty (Withers & Green, 2019). It makes the problem of adolescent bronchial asthma especially urgent. The clinical course of this disease in adolescents can interfere with various factors, which affect the onset and further progression of the disease, inadequate response to treatment, compliance, control over BA, etc.
Diabetes mellitus in adolescents is characterized primarily by worse glycemic control, higher, as a rule, dangerous glucose levels, and many reasons lead to this. They include poor self-control, lack of adherence to dietary recommendations, insulin therapy (Temneanu et al., 2016). In general, adolescents do not devote enough time to their diabetes, as they have many other interests and tend to be independent. However, such inattention to the problem can negatively affect the health of the child. In adolescents with diabetes, more often than not, protest turns into a protest against diabetes because their parents always control this process.
In recent years, heart ailments are rapidly “getting younger,” affecting children, juveniles, and young people. It is worth emphasizing that the clinical symptoms at the initial phase of cardiac pathologies in the young generation are often insignificant or absent altogether. Therefore, it is possible to identify changes in the work of the heart only through laboratory and neuroimaging diagnostic methods.
Rapidly progressive disease at a young age is hypertrophic cardiomyopathy. This pathology is characterized by an abnormal thickening of the left ventricle wall; lesions of the right or both sections are rarely observed. Mutations in specific genes cause this disease. Their functions are the coding for the synthesis of myocardial proteins. It leads to a change in the location of muscle fibers in the heart muscle.
Problems arise if adolescents do not visit doctors on time in case of heart ailments.
This is especially true if there is a tendency to heart defects in the family. It should be noted that the leading cause of death among children and adolescents was precisely congenital malformations not diagnosed in time, with the greatest risk group being young men who are actively involved in playing sports. There are a number of symptoms that indicate a malfunction of the heart. Ignoring them during sports or in free time can lead to an exacerbation of the disease.
Timely contacting health professionals and following their recommendations will reduce the risk of complications due to noncommunicable diseases. It is also essential to adhere to a healthy lifestyle and not give up on the necessary treatment. An illness that emerged or worsened during adolescence can significantly impair the health indicators of young people as they grow up. At all stages, parental support and supervision are necessary to avoid situations where adolescents neglect treatment.
Prevention of noncommunicable Disease
Noncommunicable diseases (NCDs) are the leading cause of death in the world. There are four main groups of noncommunicable diseases – cardiovascular disease, cancer, chronic lung disease, and diabetes. Premature deaths from NCDs can be prevented by actively involving healthcare providers, but their impact alone is insufficient. Not all people adhere to simple rules for maintaining health, and therefore the state should make more efforts to convince the population to follow doctors’ recommendations. The fight against cardiovascular diseases and diabetes requires separate steps on the part of the government.
Primary prevention is a complex of medical and non-medical measures aimed at preventing deviations in health and preventing diseases common to the entire population and individual (regional, social, age, professional and other) groups and individuals. This stage includes forming a paradigm of a healthy lifestyle by creating a permanent information and propaganda system. It also requires an increase in the level of knowledge of the population about the impact of negative factors on health and reducing their impact and sanitary and hygienic education (Kisling & Das, 2021). Measures are needed to prevent mental illnesses and injuries, accidents, disability and mortality from external causes, road traffic injuries.
Secondary prevention is a set of medical, social, sanitary, hygienic, psychological, and other measures aimed at early detection and prevention of exacerbations and complications of diseases and a set of steps to prevent a decline in working capacity, including disability premature mortality. Medical institutions are faced with the task of introducing holistic methodological approaches to assessing research results in the course of preventive measures and diagnosis. It is also necessary to organize and control of high-quality and effective monitoring of patients’ health. Secondary prevention measures allow early detection of conditions when they are asymptomatic, and timely treatment can stop their development (Kisling & Das, 2021). Most of the secondary prevention activities are carried out in health care settings using screening methods.
Since 2011 UN General Assembly adopted the Political Declaration on Noncommunicable Diseases, WHO has developed a global monitoring system to track progress on prevention and control (World Health Organization, 2012). This system includes nine global goals; it is recommended for adoption by the Member States. Once adopted, Member States are encouraged to consider developing national NCD targets and indicators. The mortality target is a 25% reduction in premature mortality from noncommunicable diseases by 2025(World Health Organization, 2012). The monitoring system provides the basis for advocacy, awareness-raising, political commitment, and global action to tackle these deadly diseases. The monitoring system will also help shape a new development agenda that encompasses three dimensions of sustainable development: economic development, environmental sustainability, and social inclusion.
Regular measurement of blood pressure, blood sugar, and cholesterol levels, knowledge of body mass index allows one to keep abreast of what is happening with the body. It also helps to understand the risks of developing diseases and know what actions should be taken to reduce them. Regular and age-appropriate physical activity is also essential, as well as rejection of bad habits, routine checkups, and stress reduction.
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