Historically the leading cause of death and disease in most areas around the world has been communicable/infectious diseases. In more recent times, the major cause of death and disease in Ghana and around the world now encompasses both communicable and noncommunicable diseases in comparison to traditionally predominately communicable diseases.1 

Communicable Diseases

Communicable diseases: illnesses that are caused by viruses or bacteria that spread between individuals  through contact with contaminated surfaces, bodily fluids, blood products, insect bites, or through the air.2 

Types of Communicable Diseases:2

  • HIV
  • Hepatitis A, B and C
  • Measles
  • Salmonella
  • Measles and blood-borne illnesses
  • COVID-19

Non-Communicable Diseases

Noncommunicable diseases: tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioural factors.3  

Types of Noncommunicable Diseases:3 

  • Cardiovascular Disease (Heart attack and stroke), 
  • Cancer
  • Chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) 
  • Diabetes

Chronic Diseases: conditions that last over a year and require ongoing medical attention and/or limit activities of daily living.4

Noncommunicable diseases are rising substantially, placing a significant strain on health systems which will result in catastrophically high healthcare expenditures in the future.5 The greatest contributor to non communicable diseases in recent times is our sedentary lifestyles that has significantly increased especially over the course of the COVID19 pandemic. Work, school and gym closures have forced people to stay at home decreasing their physical activity levels. Sedentary behaviour refers to physical inactivity such as prolonged sitting and lying down or activities that require little to no energy. Rapid urbanization, affluence and globalization are strong contributors to physical inactivity and sedentary lifestyles, especially in Ghana.5  

A sedentary lifestyle, that is free of physical activity, is destructive to health and wellbeing. This is the case because physical activity facilitates disease prevention, especially for Type 2 diabetes and Cardiovascular disease, which are the two main types of noncommunicable diseases.6,7 

Quite often, noncommunicable diseases are overlooked and ignored as they are diseases that do not spread from person to person and develop overtime, sometimes without symptoms. In Ghana, there is a dominant assumption amongst lay and expert groups that chronic diseases are rare and do not pose a big public health threat.8 This incorrect notion undermines the high prevalence of noncommunicable diseases in Ghana. In fact, noncommunicable diseases require just as much or perhaps even more attention than communicable diseases because they are significant public health problems that can have damaging and deadly implications on individuals’ health and health systems as a whole. Thus, chronic and noncommunicable diseases, which are very much public health and developmental issues, do in fact require the same intellectual and financial commitments and resources as communicable diseases such as Malaria and HIV.8 

Take a look at these staggering statistics: 

  • A non-communicable disease survey conducted in 1998 recorded a national prevalence of 27.8% for hypertension.9
  • At Korle-Bu hospital, the percentage of medical admissions due to diabetes increased almost two-fold from 3.5 in the mid-1970s to 6.4% in the mid-1980s.10,11

Chronic Disease Risks 12,13

  • Urbanization
  • Changing lifestyles (poor diets) 
  • Sedentary behaviour 
  • Ageing populations
  • Weak health systems 
  • Globalization

The two major risk factors responsible for the significant and growing burden of noncommunicable diseases is an unhealthy diet and physical inactivity which accounts for about 60% of the deaths world wide and almost half the global burden of disease.14,15 

Though a simple fix seems to be getting people to change their lifestyle, telling them to stop drinking the extra can of pop or shaming them for their choices, is counterproductive and does not work. Yes, individuals are responsible for their health and wellbeing but they aren’t the only people responsible. You can tell someone to purchase a gym membership, however oftentimes gym memberships are unaffordable. Grocery stores can easily highlight the organic section, but purchasing organic milk that is three times more expensive than the regular one versus purchasing other food items for dependents in the family is a difficult decision to make, especially if you’re short on funds. You can tell someone to walk to work instead of driving to get their physical activity in for the day, but if they’re working three jobs and managing 3 kids, that is quite impossible. 

In essence, victim blaming is not the solution. Instead, public and private partnerships can be extremely valuable in making healthier lifestyles more affordable and accessible for all. We need to make it easier to pick up a water bottle than a can of pop or going on a hiking trail instead of binge watching T.V all day. This is definitely not a quick fix. We need all hands on deck, and in doing so we won’t just be making people’s lives healthier, we’ll be making them better. 

Citations 

  1. de Graft Aikins, A., Addo, J., Ofei, F., Bosu, W.K. and Agyemang, C., 2012. Ghana’s burden of chronic non-communicable diseases: future directions in research, practice and policy. Ghana medical journal, 46(2), pp.1-3.
  2. Edemekong, P.F. and Huang, B., 2017. Epidemiology of prevention of communicable diseases.
  3. WHO: Noncommunicable Diseases. 2018. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
  4. Hwang W, Weller W, Ireys H, Anderson G. Out of pocket medical spending for care of chronic conditions. Health Aff 2001;20:268-9.
  5. Adua, E., Frimpong, K., Li, X. and Wang, W., 2017. Emerging issues in public health: a perspective on Ghana’s healthcare expenditure, policies and outcomes. EPMA Journal, 8(3), pp.197-206.
  6. Lakka, T. A., Laaksonen, D. E., Lakka, H.-M., Männikkö, N., Niskanen, L. K., Rauramma, R., & Salonen, J. T. (2003). Sedentary lifestyle, poor cardiorespiratory fitness, and the metabolic syndrome. Medicine & Science in Sports & Exercise, 35(8), 1279–1286. https://doi.org/10.1249/01.MSS.0000079076.74931.9A
  7. Sothern, M.S., Loftin, M., Suskind, R.M., Udall, J.N. and Blecker, U., 1999. The health benefits of physical activity in children and adolescents: implications for chronic disease prevention. European journal of pediatrics, 158(4), pp.271-274.
  8. Aikins, A.D.G., 2007. Ghana’s neglected chronic disease epidemic: a developmental challenge. Ghana Medical Journal, 41(4), p.154.
  9. Bosu, W.K., 2007. Ghana’s National NCD Programme: history, prospects and challenges. In 1st Annual Workshop, British Academy UK-Africa Academic Partnership on Chronic Disease in Africa, Noguchi Memorial Institute for Medical Research.(12th April 2007).
  10. Adubofour, K.O.M., Ofei, F., Mensah-Adubofour, J. and Owusu, S.K., 1993. Diabetes in Ghana: a morbidity and mortality analysis. International Diabetes Digest, 4(3), pp.90-92.
  11. Adubofour, K.O.M., Ofei, F., Mensah-Adubufour, J. and Owusu, S.K., 1997. Diabetes in Africa.
  12. Agyei-Mensah, S. and Aikins, A.D.G., 2010. Epidemiological transition and the double burden of disease in Accra, Ghana. Journal of urban health, 87(5), pp.879-897.
  13. Vita-Finzi, L., 2005. Preventing chronic diseases: a vital investment. World Health Organization.
  14. Waxman, A., 2004. WHO global strategy on diet, physical activity and health. Food and nutrition bulletin, 25(3), pp.292-302.
  15. World health report 2003: shaping the future. Geneva: World Health Organization, 2003.