Cutting heart attacks and strokes: children need to be at the heart of the agenda

Non-Communicable Diseases (or NCDs) include heart attacks and strokes, cancers, diabetes and chronic respiratory disease.

Every year, NCDs kill 9 million people under 60 and account for over 63% of deaths in the world today.

They are also referred to as ‘lifestyle diseases’ because the four primary risk factors for NCDs are tobacco use, an unhealthy diet, harmful use of alcohol and physical inactivity.

NCDs have a major impact on rich countries such as the UK but more than 90% of premature deaths from NCDs occur in developing countries.

Not just a rich world problem

Countries battling to address infectious diseases and reduce high rates of maternal and child mortality are at the same time having to halt growing rates of obesity and smoking-related illnesses.

Urgent action is needed as experts estimate that the global burden of NCDs is set to increase by 17% over the next ten years. In Africa, it is expected to increase by 27%.

It is for this reason that world leaders will be holding a high level meeting on NCDs this week at the United Nations General Assembly in New York. 

Impact on children

There is a common misconception that NCDs do not affect children, but are diseases of adulthood only. As a result, children have been largely excluded from the NCD discourse.

NCDs and their risk factors have an enormous impact on the health of children. Cancer, diabetes, chronic respiratory diseases (such as asthma), obesity, congenital and acquired heart disease all directly affect children and can start in childhood.

There is a close link between NCDs and undernutrition – the underlying cause of 1 in 3 child deaths. Children with an undernourished mother during pregnancy, or who have suffered from under-nutrition in childhood, are more vulnerable to developing NCDs later in life.

Child survival

The increasing prevalence of obesity, high blood pressure and diabetes, and increased exposure to risk factors such as tobacco among women of child-bearing age has direct consequences in terms of maternal health complications, pregnancy outcomes and child survival.

The growing trend of NCDs has other secondary impacts upon children. NCDs greatly increase the likelihood of households falling into poverty in developing countries due to “catastrophic” out of pocket expenses and lost income from ill-health.

Children can be expected to act as carers for parents who are unwell, or may be expected to work to bring in an income to the family home. Such examples have a negative impact upon a child’s social and educational development.

Targets needed

It is hoped that the UN high-level meeting will result in countries adopting an action-oriented outcome document that will shape the global agenda on NCDs for generations to come.

However, there are concerns that powerful lobbies from the tobacco, alcohol and food industries will hold back progress.

Children and young people in particular are often targeted by companies advertising fast food, tobacco or alcohol, and many grow up in environments that are not conducive to them adopting healthy lifestyles.

Fewer protections

Children in developing countries are less likely to be protected by interventions such as smoke-free laws and regulations to reduce the content of unhealthy ingredients in food.

There are also concerns that the UN’s final outcome document will fail to include strong targets for the reduction of preventable diseases caused by NCDs and will fail to sufficiently address the impact of NCDs on children.

Children are not only living with and at risk of NCDs, but must also be core to global efforts to prevent and control NCDs.

Starting early

Governments must promote and support a range of interventions to address NCDs in children including promoting nutrition and health lifestyles and protecting them from harmful risk factors.

The current global shortage of 3.5 million nurses, midwives, doctors, and community health workers across the poorest countries is a major barrier to managing the growing burden of NCDs as well as other health issues.

Governments must invest urgently in strengthening health systems and ensuring there are adequate numbers of appropriately trained health workers with the right skills to address NCDs and the major causes of newborn and child deaths.