Related factors with NCD in developing countries: economic, diet and risk factors dimensions
DOI:
https://doi.org/10.4108/eetpht.10.3499Keywords:
Noncommunicable diseases, principal components analysis, cluster analysis, random forest, pervasive healthcareAbstract
INTRODUCTION: Noncommunicable diseases (NCD), such as cardiovascular, oncological, respiratory diseases and diabetes mellitus, remain the leading cause of mortality worldwide. These diseases are associated with factors such as lack of physical activity, poor diet, smoking and excessive alcohol consumption. The economic and social cost of NCD in developed countries is considerable. In addition to the effects on the quality of life and health of individuals, these diseases generate a significant financial burden on health systems and the economy in general. The main causes of mortality together with an analysis of mathematical models, can provide fundamental information to monitor trends in the health outcomes, recognize the pattern of diseases that affect mortality and disability, identify emerging health challenges, evaluate the effectiveness of interventions and aid in health decision-making.
OBJECTIVES: To evaluate the relationship of a selected set of economic, dietary health risk factors of the economically active population in 13 developing countries for the year 2019 in NCD. Apply a dimension reduction method to detect cross-sectional variability in the selected countries, carry out a behavioral analysis of the underlying variables, identify patterns and generate indices for monitoring related factors of NCD.
METHODS: A database was built for the 2019 period of 13 developing countries including 76 variables, considering economic, food and lifestyle indicators. The principal components method was used to create new dimensions to group relevant information from all the variables used and characterize the diseases in developing countries for 4 selected NCD: cardiovascular disease, chronic respiratory disease, neoplasia, and diabetes mellitus. NCD monitoring indices were created considering an index of diet, economic and factors that affect the mortality. Using the generated indices, a cluster model was applied to group countries with similar characteristics according to the information analysed for each index.
RESULTS: Some relevant characteristics were identified in the countries analyzed, as well as interesting patterns among the factors related to NCD. The countries could be grouped considering their economic and nutritional behavior. It was observed that Latin American countries and Poland behave similarly, just as Asian countries show a similarity in eating behavior. The economic indicators of investment in health, as well as hours worked, behave in a similar way. It was identified that there are certain foods that have a similar behavior both in their consumption and in how they affect NCD. Thanks to the elaboration of the indices, it was observed that the countries of the Middle East and North Africa have a better food balance, but not the countries of Latin America.
CONCLUSION: The application of a dimensionality reduction method and cluster analysis out of quantitative methods made it possible to characterize the behavior of a set of variables that impact NCD, as well as to synthesize this information into specific indices by category of analysis. Strategies focused on improving NCD indicators can have a greater impact by identifying similar behavior profiles among developing countries, in the same way, joint policies could be designed to address NCD through specific actions by dimension of analysis and extend these policies to countries with similar profiles.
Downloads
References
[1] WHO, World Health Organization (2014). Global Status Report on noncommunicable diseases 2014. Last accessed 06/15/2023. https://apps.who.int/iris/handle/10665/148114
[2] Shamah-Levy, T., Vielma-Orozco, E., Heredia-Hernández, O., Romero-Martínez, M., Mojica-Cuevas, J., Cuevas-Nasu, L., Santaella-Castell, J.A. & Rivera-Dommarco, J. (2020). National Health and Nutrition Survey 2018-19: National Results. National Institute of Public Health.
[3] Aguilar, C.A. (1999). Health promotion for the prevention of chronic-degenerative diseases linked to diet and lifestyle. Community Health and Health Promotion. ICEPSS Publishers.
[4] WHO, World Health Organization. (2022). Diabetes https://www.who.int/health-topics/diabetes#tab=tab_1
[5] Li, S., Wang, J., Zhang, B., Li, X., & Liu, Y. (2019). Diabetes mellitus and cause-specific mortality: a population-based study. Diabetes & metabolism journal, 43(3), 319-341. https://doi.org/10.4093/dmj.2018.0060
[6] WHO, World Health Organization. (2021). Cardiovascular diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
[7] Mancia, G., Fagard, R., Narkiewicz, K., Redán, J., Zanchetti, A., Böhm, M., ... & Zannad, F. (2013). 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension. Journal of hypertension, 31(10), 1925-1938. https://doi.org/10.3109/08037051.2013.817814
[8] NICE. (2022). Clinical guideline. Hypertension in adults: diagnosis and management: National Institute for Health and Care Excellence (NICE). https://www.nice.org.uk/guidance/ng136/resources/hypertension-in-adults-diagnosis-and-management-pdf-66141722710213
[9] Scichilone, N., Benfante, A., Bocchino, M., Braido, F., Paggiaro, P., Papi, A., ... & Sanduzzi, A. (2015). Which factors affect the choice of the inhaler in chronic obstructive respiratory diseases? Pulmonary Pharmacology & Therapeutics, 31, 63-67. https://doi.org/10.1016/j.pupt.2015.02.006
[10] WHO, World Health Organization. (2022). Chronic obstructive pulmonary disease (COPD). https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)
[11] Mannino, D. M., Watt, G., Hole, D., Gillis, C., Hart, C., McConnachie, A., ... & Vestbo, J. (2006). The natural history of chronic obstructive pulmonary disease. European Respiratory Journal, 27(3), 627-643. https://doi.org/10.1183/09031936.06.00024605
[12] WHO, World Health Organization. (2022). Cancer. https://www.who.int/health-topics/cancer#tab=tab_1
[13] Rongen, A., Robroek, S. J., van Lenthe, F. J., & Burdorf, A. (2013). Workplace health promotion: a meta-analysis of effectiveness. American journal of preventive medicine, 44(4), 406-415. https://doi.org/10.1016/j.amepre.2012.12.007
[14] WHO, World Health Organization (2014). Global Status Report on noncommunicable diseases 2014 Last accessed 06/15/2023. https://apps.who.int/iris/handle/10665/148114
[15] WHO, World Health Organization. (2013). Plan of Action for the Prevention and Control of Noncommunicable Diseases in the Americas 2013-2019. https://www.paho.org/hq/dmdocuments/2015/plan-accion-prevencion-control-ent-americas.pdf
[16] Jeet, G., Thakur, J. S., Prinja, S., & Singh, M. (2017). Community health workers for non-communicable diseases prevention and control in developing countries: evidence and implications. PloS one, 12(7), e0180640. https://doi.org/10.1371/journal.pone.0180640
[17] Ding, D., Lawson, K. D., Kolbe-Alexander, T. L., Finkelstein, E. A., Katzmarzyk, P. T., Van Mechelen, W., & Pratt, M. (2016). The economic burden of physical inactivity: a global analysis of major non-communicable diseases. The Lancet, 388(10051), 1311-1324. https://doi.org/10.1016/S0140-6736(16)30383-X
[18] Allen, L. N., Wigley, S., & Holmer, H. (2021). Implementation of non-communicable disease policies from 2015 to 2020: a geopolitical analysis of 194 countries. The Lancet Global Health, 9(11), e1528-e1538. https://doi.org/10.1016/S2214-109X(21)00359-4
[19] Zhao, Y., Atun, R., Oldenburg, B., McPake, B., Tang, S., Mercer, S. W., ... & Lee, J. T. (2020). Physical multimorbidity, health service use, and catastrophic health expenditure by socioeconomic groups in China: an analysis of population-based panel data. The Lancet Global Health, 8(6), e840-e849. https://doi.org/10.1016/S2214-109X(20)30127-3
[20] Wang, Y., & Wang, J. (2020). Modelling and prediction of global non-communicable diseases. BMC public health, 20(1-13). https://doi.org/10.1186/s12889-020-08890-4
[21] Hosseinpoor, A. R., Bergen, N., Kunst, A., Harper, S., Guthold, R., Rekve, D., ... & Chatterji, S. (2012). Socioeconomic inequalities in risk factors for non communicable diseases in low-income and middle-income countries: results from the World Health Survey. BMC public Health, 12(1), 1-13. https://doi.org/10.1186/1471-2458-12-912
[22] Shikdar, A. A., & Sawaqed, N. M. (2003). Worker productivity, and occupational health and safety issues in selected industries. Computers & industrial engineering, 45(4), 563-572. https://doi.org/10.1016/S0360-8352(03)00074-3
[23] Kirsten, W. (2008). Health and productivity management in Europe. International journal of workplace health management, 1(2), 136-144. https://doi.org/10.1108/17538350810893928
[24] Saha, S. (2013). Impact of health on productivity growth in India. Inter J Eco, Finance & Manag, 2(4). https://www.ejournalofbusiness.org/archive/vol2no4/vol2no4_6.pdf
[25] Siddique, H. M. A., Mohey-ud-din, G., & Kiani, A. (2020). Human health and worker productivity: evidence from middle-income countries. International Journal of Innovation, Creativity and Change, 14(11), 523-544. Available at SSRN: https://ssrn.com/abstract=3748998
[26] Naicker, A., Venter, C. S., MacIntyre, U. E., & Ellis, S. (2015). Dietary quality and patterns and non-communicable disease risk of an Indian community in KwaZulu-Natal, South Africa. Journal of Health, Population and Nutrition, 33, 1-9. https://doi.org/10.1186/s41043-015-0013-1
[27] Pomeroy-Stevens, A., Bachani, D., Sreedhara, M., Boos, J., Amarchand, R., & Krishnan, A. (2022). Exploring urban health inequities: the example of non-communicable disease prevention in Indore, India. Cities & health, 6(4), 726-737. https://doi.org/10.1080/23748834.2020.1848327
[28] Aslani, Z., Qorbani, M., Hébert, J. R., Shivappa, N., Motlagh, M. E., Asayesh, H., ... & Kelishadi, R. (2019). Association of Dietary Inflammatory Index with anthropometric indices in children and adolescents: the weight disorder survey of the Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease (CASPIAN)-IV study. British Journal of Nutrition, 121(3), 340-350. https://doi.org/10.1017/S0007114518003240
[29] Angeles-Agdeppa, I., Sun, Y., & Tanda, K. V. (2020). Dietary pattern and nutrient intakes in association with non-communicable disease risk factors among Filipino adults: A cross-sectional study. Nutrition journal, 19(1), 1-13. https://doi.org/10.1186/s12937-020-00597-x
[30] Felisbino-Mendes, M. S., Cousin, E., Malta, D. C., Machado, Í. E., Ribeiro, A. L. P., Duncan, B. B., ... & Velasquez-Melendez, G. (2020). The burden of non-communicable diseases attributable to high BMI in Brazil, 1990–2017: Findings from the Global Burden of Disease Study. Population Health Metrics, 18(1), 1-13. https://doi.org/10.1186/s12963-020-00219-y
[31] Chidumwa, G., Olivier, S., Ngubane, H., Zulu, T., Sewpaul, R., Kruse, G., ... & Wong, E. B. (2023). Tobacco smoking and prevalence of communicable and non-communicable diseases in rural South Africa: A cross-sectional study. https://doi.org/10.21203/rs.3.rs-2730894/v1.
[32] Gatimu, S. M., & John, T. W. (2020). Socioeconomic inequalities in hypertension in Kenya: a decomposition analysis of 2015 Kenya STEPwise survey on non-communicable diseases risk factors. International journal for equity in health, 19, 1-11. https://doi.org/10.1186/s12939-020-01321-1.
[33] Zere, E., Mandlhate, C., Mbeeli, T. et al. Equity in health care in Namibia: developing a needs-based resource allocation formula using principal components analysis. Int J Equity Health 6, 3 (2007). https://doi.org/10.1186/1475-9276-6-3.
[34] Ochola, S., Kanerva, N., Wachira, L. J., Owino, G. E., Anono, E. L., Walsh, H. M., ... & Fogelholm, M. (2023). Wealth and obesity in pre-adolescents and their guardians: A first step in explaining non-communicable disease-related behaviour in two areas of Nairobi City County. PLOS Global Public Health, 3(2). https://doi.org/10.1371/journal.pgph.0000331.
[35] Liu, L., Wu, X., Li, H. F., Zhao, Y., Li, G. H., Cui, W. L., ... & Cai, L. (2023). Trends in the Prevalence of Chronic Non-Communicable Diseases and Multimorbidity across Socioeconomic Gradients in Rural Southwest China. The journal of nutrition, health & aging, 1-6. https://doi.org/10.1007/s12603-023-1932-y
[36] Jolliffe, I. (2005). Principal component analysis. Encyclopedia of statistics in behavioral science. https://doi.org/10.1002/0470013192.bsa501
[37] World data. Developing countries. Last accessed 06/23/2023. https://www.worlddata.info/developing-countries.php.
[38] OECD, Organization for Economic Cooperation and Development (2023), Working age population (indicator). doi:10.1787/d339918b-en. https://data.oecd.org/pop/working-age-population.htm
[39] WBOD, World Bank Open Data. (2023). global development data. Last accessed 06/01/2023. https://data.worldbank.org/
[40] Feenstra, R. C., Inklaar, R. & Timmer, M.P. (2022), The Next Generation of the Penn World Table. American Economic Review, 105(10), 3150-3182. Last accessed 06/15/2023. https://www.rug.nl/ggdc/productivity/pwt/
[41] FAO, Food and Agriculture Organization of the United Nations. (2023). Food Balances. Last accessed 06/01/2023. https://www.fao.org/faostat/en/#data/FBSH
[42] IHME - Institute for Health Metrics and Evaluation (2020). Global Burden of Disease Study 2019, Results. https://vizhub.healthdata.org/gbd-results/.
[43] Shlens, J. (2014). A tutorial on principal component analysis. arXiv preprint arXiv:1404.1100. https://doi.org/10.48550/arXiv.1404.1100
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Sergio Arturo Dominguez Miranda, Roman Rodríguez Aguilar
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open access article distributed under the terms of the CC BY-NC-SA 4.0, which permits copying, redistributing, remixing, transformation, and building upon the material in any medium so long as the original work is properly cited.