Too Much Smoking, Booze and Food

Poor lifestyle choices are threatening to blight Russia’s economic and demographic health. Although more than 95 percent of Russians think they are in good health, a staggering 82 percent put themselves at risk of severe illness or death by leading unhealthy lives.

Heavy smoking, hard drinking, obesity and lack of exercise are the leading factors that dramatically shorten lives and can cause grave illness or death.

The wide spectrum of chronic diseases that can be brought about by these four risk factors are known as noncommunicable diseases, which include cancer, chronic respiratory diseases, cardiovascular diseases and diabetes.

The need to address this growing epidemic has led the World Health Organization to convene the First Global Forum and Ministerial Meeting on Healthy Lifestyles and Noncommunicable Disease Control in Moscow on Thursday and Friday. The Russian government should be congratulated on hosting this important event.

The location was not chosen at random. A recent study conducted by the Association of  International Pharmaceutical Manufacturers and the International Federation of Pharmaceutical Manufacturers Associations shows that Russia, a middle-income country, is particularly vulnerable to noncommunicable diseases. The toll of unhealthy lifestyles has meant that the life expectancy of the average Russian male is only 58 years compared with 82 in France. Though there is widespread evidence that a healthy lifestyle significantly improves the quality of life and lengthens lives, the average Russian does not seem to apply this in practice.

Physical inactivity, overeating, the purchase of alcohol and tobacco are luxuries in some societies but commonplace in urbanized, affluent societies. It is thus not surprising that in high-income countries, the number of deaths due to noncommunicable diseases is high — 87 percent. But recently, high-income countries have begun to see the benefits of reducing risk factors among their populations, while noncommunicable diseases have emerged as the major health threat in low- and middle-income countries.

The steep rise of noncommunicable diseases in emerging market economies like Russia, India and China is particularly worrying. Experts say that between 2005 and 2015 these countries could lose a staggering $200 billion to $550 billion of national income due to the effects of noncommunicable diseases on their populations.

In 2010, the WHO established a multi-stakeholder group to look at this issue and organized the Moscow global forum to attract the political attention and momentum necessary to address this crisis.

One success story is Finland. Fifty years ago, Finland was faced with a high incidence of heart disease in its population, so the country invested in a multisectoral approach, involving education and lifestyle change. This strategy resulted in an 85 percent decrease in heart disease among working men. Changes at the individual, community and national level can have a significant impact on the rates of morbidity and mortality due to noncommunicable diseases.

To address the millions of deaths that are caused every year by noncommunicable diseases — 14 million of which are premature and could be averted or delayed — a sustained and global approach must be put in place. Given the sheer enormity of the challenge, this needs to involve governments, the private sector, nongovernmental organizations and each of us as individuals.

Governments have a number of tools available that have a direct impact. These include introducing fiscal and legislative measures from discouraging, for example, the use of tobacco, to imposing restrictions and bans.

At the same time, awareness-raising and communications campaigns are a key factor for prevention. Direct primary care intervention in high-risk groups is a proven way of combating noncommunicable diseases. The direct involvement of physicians in communicating to patients the risks of their behaviors is also important. Perhaps most important, people must develop a consciousness and a sense of responsibility toward their personal health — and acting on it by making healthy lifestyle choices.