Communicable (infectious) diseases are illnesses caused by microorganisms (pathogens) such as viruses, bacteria, fungi, or parasites and can be spread from one person to another. Examples include malaria, hepatitis, tuberculosis, Ebola, HIV/AIDS etc. On the other hand, non-communicable (chronic) diseases are sicknesses that are not spread from person to person and are long lasting with slow progression. Main examples of chronic diseases include cardiovascular diseases (heart attack and stroke), chronic respiratory diseases (e.g. asthma), cancers, and diabetes. The incidence of and the risk factor for these diseases varies across countries dependent on the each country’s capacity to respond to them. This paper examines a comparison of communicable and non-communicable disease rates between developing countries and developed countries.
The study considers study cases of Indonesia as a developing country and United States as a developed country. Indonesia has a total population of about 247 million people with a lower middle income whereas, the U.S. has a population of 318 million with a high income. In Indonesia, non-communicable diseases (NCDs) account for an estimated 71% of the total deaths. On the other hand, in the United States, a developed country, NCDs account for an estimated 88% of the country’s total deaths. The most significant NCDs include cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes among other NCDs. In Indonesia, communicable, maternal, perinatal and nutritional conditions account for an estimated 22% of the country’s total deaths whereas, in the U.S., communicable, maternal, perinatal and nutritional conditions combined approximately account for 6% of the total deaths (World Health Organization, n.d.).
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In Indonesia, the incidence of NCDs is preferentially caused by modifiable behavioral risk factors associated with low-income population group. These behaviors include tobacco smoking and exposure to second-hand smoking which accounts for 35% of deaths and excess intake of salt which causes raised blood pressure responsible for 27.8% of deaths in the country. These trends are significantly lower in the U.S. because of factors such as well-established policies on smoking, awareness of impacts of smoking, access to healthcare insurance and higher income levels to finance medical care. Raised blood pressure, in the U.S., accounts for 18.2% of deaths, which is relatively lower than Indonesia and may be attributed to unhealthy eating lifestyles (World Health Organization, n.d.).
Deaths caused by NCDs associated with alcohol consumption and obesity are relatively higher in developed countries than in developing countries because citizens of developed countries have higher incomes which define their lifestyles that favor high body mass indices, raised blood glucose and cholesterol levels leading to obesity. These factors coupled with inadequate physical activity can be attributed to the increasing death rates among people (male and female) under age 70 in the U.S. over the past decade. Obesity and unhealthy alcohol consumption risk factors are relatively insignificant in developing countries as represented by Indonesia since people have low to middle incomes making it difficult to afford high fat and cholesterol foods and pure alcohol. Raised blood pressure, obesity, hyperglycemia, and hyperlipidemia are the main metabolic causes of cardiovascular diseases, diabetes, and cancers (World Health Organization, 2018).
Developed countries such as the U.S. have higher capacities to respond to NCDs compared to developing countries such as Indonesia. For instance, the US has an established NCD surveillance and monitoring system as well as a national population-based cancer registry for purposes of reporting against the international NCD targets which facilities are lacking in Indonesia. This gives developed countries an upper hand in responding to NCDs. In addition, developed countries have adequate health insurance coverage which provides universal access to important NCD programs. Developing countries, on the other hand, do not have adequate health insurance causing the low-income households to drain their limited resources in meeting the expensive costs of NCDs while others who do not afford the costs end up easily losing their loved ones.
In order to address the high incidence of NCDs, community-based intervention programs should incorporate community organizations through a collaboration that ensures that people participate in NCDs prevention programs. A clear understanding of the community is essential in ensuring that prevention interventions are successful and effective. The nursing industry should actively participate in sensitizing people on the risk factors for NCDs and assist them in adopting lifestyle modification in both developed and developing countries. In developing countries, nursing interventions should be extended to community-based primary care education on risk factors of communicable diseases and need for an early check-up, diagnosis, and treatment to ensure control and prevention of further spreading. Administrative planning and decision making should consider delivering adequate and timely palliative care in order to eliminate infectious diseases in developed countries. The impact caused by chronic and communicable diseases can be reduced through a comprehensive strategy towards the reduction of the risk factors. The strategy combines all sectors that work collaboratively to ensure early detection and timely treatment is delivered.
References
World Health Organization. (2018, June 1). Non communicable diseases. Retrieved from http://www.who.int/en/news-room/fact-sheets/detail/noncommunicable-diseases
World Health Organization. (n.d.). Noncommunicable diseases country profiles 2014. Retrieved from http://www.who.int/nmh/countries/en/
