60% of deaths in AS caused by NCDs
The United States of America’s globalization and urbanization helped shift the environment and lifestyle in the territory, and is being blamed for the rise of non-communicable diseases in American Samoa, which are a major local public health challenge, according to the strategic action plan for non-communicable disease (NCD) prevention and control launched by the Department of Health (DOH) last week.
The plan, which was distributed among those who attended the launch, contained framework, vision, goals, objectives and strategic actions that have been identified through collaborative and participatory process by the different NCD stakeholders in the territory.
American Samoa communities are susceptible to tobacco and alcohol use, unhealthy diets, and physical inactivity and in turn these have caused NCD risk factor prevalence to rise, according to the plan’s introduction.
“According to the WHO STEPS survey 2007 report, nearly all adults (93.5%) are overweight or obese; close to half (47.3%) have diabetes, and more than one third (34.2%) have hypertension,” the intro states.
"These are among the highest rates in the Western Pacific and in the world.”
The plan further states disease patterns have changed in recent years with NCDs overtaking infectious diseases. “NCDs have also surpassed infectious disease as the leading cause of death and today, NCDs claim the most number of lives in American Samoa. Three of five deaths (60%) are caused by NCDs.”
The plan also points out the cost of NCDs to the territory is significant. Direct health care costs are compounded by the need for chronic health care services, including expensive overseas care. This is exemplified by the rising demand for dialysis.
“The Dialysis center reported a 73% increase in patients requiring chronic dialysis from 2001-2007 and it is estimated that 80%-90% of these patients require dialysis because of complications from diabetes, resulting in significant productivity losses that adversely impact economic growth. Premature deaths from NCDs deprive the workforce of able-bodied workers. Thus, at the societal level, NCDs retard national development by draining health care budgets and impeding worker productivity.”
The plan also points out that at the family level, the cost of caring for an individual with NCDs can drain family resources and lead to impoverishment.
“Unchecked, the NCD epidemic is like an ocean vortex, inexorably draining resources and pulling the whole of society into a downward spiral of chronic disability, early death and poverty… “Ironically, all of the NCD risk factors are preventable,” the plan states.
Set goals included in the plan, notes American Samoa has already begun the process for strategic action to halt the progression of NCDs — pointing to an increase of taxation on cigarettes and alcohol and having smoke free workplaces and public places already in place.
Health information and warnings along with advertising and promotion of the importance of being smoke free will be included, as will the call to have salt reduced on food and a replacement of trans fats, coupled with greater public awareness about diet and physical activity, the plan says.
Goals also include a call for public awareness and counseling on multi-drug therapy, which includes glycemic control for diabetics, and counseling on treatment of heart attacks with aspirin. It further indicated there is also a need to have screening and treatment of pre-cancerous lesions to prevent cervical cancer.
The NCD prevention and control vision is for a healthier American Samoa with the mission to promote healthy environments and lifestyles and mitigate the preventable consequences of NCD risk factors and diseases through prevention, detection and education, the strategic action plan says.