Increasing burden of non-communicable diseases

"Sweden has already achieved the World Health Organization (WHO) target to reduce premature mortality from causes that are not related to infection. At the same time, the problems are increasing in many other countries because it is probably not to be expected that there are universally applicable strategies of equal effectiveness for averting premature deaths in all situations. Therefore, every country needs to set contextually appropriate national targets for reducing premature deaths through implementing cost-effective actions," says Ailiana Santosa, doctoral student at the Department of Public Health and Clinical Medicine.

Three-quarters of Swedish adults who die prematurely -- between the ages of 30 and 70 -- die from cardiovascular disease, cancer, diabetes or chronic respiratory disease. Data from the international INDEPTH Network, covering low- and middle-income countries, showed that much lower proportions of deaths before the age of 65 were due to these same causes in other countries. This is partly because Sweden has already reached a late stage of epidemiological transition, with other possible causes of death in middle age relatively well controlled.

Emerging evidence on the increasing non-communicable disease burden among productive adults globally led the World Health Assembly to make a call for reducing premature deaths from non-communicable diseases by 25 per cent during the period from 2010 to 2025, the so-called 25x25 target.

In her dissertation, Ailiana Santosa shows that Sweden already met the 25x25 target in an earlier time period (1991-2006). This could, according to Ailiana Santosa, be an encouraging sign for other countries currently working towards the 25x25 target.

Non-communicable deaths are affected by levels and changes in behavioural risk factors (for example, tobacco use, high blood pressure, high cholesterol, physical inactivity, obesity and raised blood glucose). Explorations of relationships between risk factors and deaths in Västerbotten County, Sweden, highlighted the urgent need for holistic approaches for reducing the burden of non-communicable diseases and preventing people from dying prematurely.

"As for Sweden, it is important to continue delivering appropriate health system messages to the general population as well as to high-risk individuals. Furthermore, special efforts need to be carried out focusing on individuals with high risk of developing these chronic diseases," says Ailiana Santosa.