Statistical Yearbook for Asia and the Pacific 2011
 
People - Health
Other health risks
Data sources: WHO Global Health Observatory Database (WHO/GHO), World Health Statistics and Global Information System on Alcohol and Health. WHO, Mental Health programme.

In developed countries, years of life lost (YLL) to communicable diseases are relatively low; in stark contrast with developing countries, where communicable diseases have a higher share of YLL than non-communicable diseases. This overview highlights the growing and disproportionate impact of communicable versus non-communicable diseases in the Asia- Pacific.

Cause of death

Causes of death are broadly classified in three categories, communicable diseases, noncommunicable diseases (such as cancer and heart disease) and injuries.

One way of assessing the impact of different causes of death is by assessing the years of life lost (YLL) for each broad cause of death. YLL, a measure of premature mortality, is an estimate of the average number of additional years a person would have lived if he or she had not died prematurely. YLL per person represents the difference between the global standard life expectancy, which is the same for all countries for a given year, and the age at death (if the age of death exceeds the life expectancy YLL is zero). YLL is an alternative to death rates that give more weight to deaths by younger people.

The shares of YLL for non-communicable and communicable diseases vary substantially among countries in the Asia-Pacific region. Developed countries have advanced healthcare systems and living conditions that help counter disease and prolong life, thus most developed Asian and Pacific countries have a high percentage of older people in their population. For developed countries, the risk of communicable disease is less than that of developing countries; however, as non-communicable diseases are more prevalent and severe among older persons (e.g., diabetes mellitus, cardiovascular disease, respiratory disease, genitourinary disease) these countries are more likely to have a higher percentage of YLL owing to non-communicable than to communicable diseases (and to have a lower YLL per capita).

Figure I.26 – Years of life lost by cause, high income Asia and the Pacific countries, 2008

Figure I.26 – Years of life lost by cause, high income Asia and the Pacific countries, 2008

On the other hand, developing and leastdeveloped Asian and Pacific countries are vulnerable to both non-communicable and communicable diseases. Since most of these countries have a relatively high proportion of deaths of young people (including children) which are often caused by communicable diseases, the figures for YLL due to communicable diseases are higher. Noticeably of the five Asia-Pacific countries with an YLL of 60% or more for communicable diseases (Timor- Leste, Afghanistan, Pakistan, Papua New Guinea and Tajikistan), three are LDCs.

Interestingly, non-communicable diseases kill at younger ages in low- and middle-income countries, where 29% of such deaths occur among people less than 60 years old; whereas in high-income countries, the proportion is 13.1 This further demonstrates the value of advanced healthcare systems.

Figure I.27 – Most affected countries with 60% or more years of life lost to communicable diseases in Asia and the Pacific, 2008

Figure I.27 – Most affected countries with 60% or more years of life lost to communicable diseases in Asia and the Pacific, 2008

Smoking

Smoking, the primary form of tobacco use, is one of the major risk factors related to noncommunicable diseases (lung cancer, obstructive pulmonary disease and heart attacks). Tobacco is one of the five main risk factors for noncommunicable diseases identified by the WHO (high blood pressure, raised cholesterol, tobacco use, alcohol consumption, and obesity). In 2008, more than 5 million people in the Asia-Pacific region died from tobacco use and exposure to tobacco smoke, for an average of 1 death every 6 seconds.2

In 2006, North and Central Asia had the highest smoking prevalence rate for both females (22%) and males (61%). Huge differences in percentages of female and male smokers are observable in all subregions except in the Pacific. The difference between smoking prevalence of males and females was large in the Democratic People’s Republic of Korea (58 percentage point difference), Armenia (58), Indonesia (57) and China (56), while it was minimal in New Zealand (2), Australia (3), Nauru (6), and Nepal and Cook Islands (8 each). Nauru was the only country in the region where the smoking prevalence of females (54%) was higher than males (48%).

Of serious concern for public health, many countries in Asia and especially the Pacific have very high percentages of adolescents (13 to 15 years old) who use tobacco, both male and female. All of he Pacific island developing economies, except Fiji, showed ranges of adolescent tobacco use at or above 20% (for both males and females) – in contrast with the lower rates, especially among adolescent females seen in most Asian countries. Continuation of tobacco use from such an early age puts people at a much greater risk of contracting non-communicable diseases at an earlier age. If not addressed effectively, the problem will increase pressure on healthcare systems in the future and cause health expenditures to rise in those countries.

Alcohol

Alcohol is a causal factor in 60 types of diseases and a component cause in 200 others and it is also a precursor to injury and violence.3 Asia and the Pacific has a lower level of alcohol consumption than most other regions of the world – 5 litres of pure alcohol per adult (15 years and older) per year in 2005, compared with a worldwide average of 6 litres per adult per year. Such a low figure derives mostly from the large proportion of non-consumers in the population of many countries, as the Asia-Pacific region consumes 16 litres of alcohol per consumer as compared to the world average of 17.

Among subregions there is considerable variation in alcohol consumption, the regions with the highest consumption per capita are North and Central Asia (at 13 litres per adult per year) and the Pacific island countries (9 litres per adult per year). Based on alcohol consumption per consumer, the regions with the highest consumption figures are North and Central Asia (at 25 litres per consumer per year) and South and South-West Asia (21 litres). The Russian Federation has the highest adult consumption of the region, at 16 litres per adult per year, followed by the Republic of Korea (15 litres), Armenia (11 litres), Azerbaijan (11 litres) and Kazakhstan (11 litres). Some countries show a high level of alcohol consumption among consumers only, while per capita consumption among all adults is low. That duality indicates that many alcohol consumers in those countries are drinking at very high levels.

For every Asian and Pacific country with available data, women who consume alcohol drink less than men (differences range from 1 in Singapore to 24 in Tonga).

Figure I.28 – Alcohol consumption per adult and per alcohol consumer, Asia-Pacific subregions, 2005

Figure I.28 – Alcohol consumption per adult and per alcohol consumer, Asia-Pacific subregions, 2005

Figure I.29 – Alcohol consumption per adult and per alcohol consumer in some Asia and the Pacific countries, 2005

Figure I.29 – Alcohol consumption per adult and per alcohol consumer in some Asia and the Pacific countries, 2005

Suicide

The incidence of suicide is very country-specific, with no distinct pattern among Asian and Pacific countries. China, Japan, Kazakhstan, Mongolia, the Republic of Korea, the Russian Federation, Samoa and Sri Lanka have the highest reported suicides. Huge differences between female and male suicide rates can be seen in many countries. In all Asia-Pacific countries, with the exception of China, male suicide rates are higher. The greatest gender differences can be seen in the Russian Federation (with 54 for men versus 10 for women, per 100,000 people) and Kazakhstan (with 46 versus 9). These two countries are also the two countries in the region with the highest reported suicide rates among men.

Prevention to counter the threat of non-communicable diseases

Non-communicable diseases are a serious health threat and were the leading cause of death globally in 2008, according to the WHO Global Status Report on Non-communicable Diseases 2010. Chief among the non-communicable diseases causes of deaths were cardiovascular diseases, diabetes, cancers and chronic respiratory diseases, constituting almost two thirds (63%) of all deaths due to non-communicable diseases.

Deaths from non-communicable diseases by sex, Asia and the Pacific subregions, 2008

Deaths from non-communicable diseases by sex, Asia and the Pacific subregions, 2008

Many non-communicable diseases are preventable through reduction of the main behavioural risk factors: tobacco use, physical inactivity, harmful use of alcohol and an unhealthy diet. Interventions to prevent non-communicable diseases are both achievable and cost-effective. For governments – as a public health measure – and for the affected individuals or families, prevention is cheaper than treatment.


1 WHO, Global Status Report on Noncommunicable Diseases 2010 (Geneva, 2011). Accessible at http://whqlibdoc.who.int/publications/2011/9789240686458_eng.pdf.

2 WHO, WHO Report on the Global Tobacco Epidemic, 2008: The MPOWER Package (Geneva, 2008). Accessible at www.who.int/tobacco/mpower/mpower_report_full_2008.pdf.

3 WHO, Global Status Report on Alcohol and Health (Geneva, 2011). Accessible at www.who.int/substance_abuse/publications/global_alcohol_report/msbgsruprofiles.pdf.

 
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