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Nurses as agents for change – tackling the global challenge of non-communicable diseases (NCDs) Christine Hancock Director, C3 Collaborating for Health 8 March 2014
Transcript of Nurses as agents for change tackling the global challenge ... · Nurses as agents for change –...
Nurses as agents for change – tackling the global challenge of
non-communicable diseases (NCDs)
Christine Hancock Director, C3 Collaborating for Health
8 March 2014
The NCD burden: global deaths
Source: Global Burden of Disease Study 2010, The Lancet 380(9859), p. 2102, table 1.
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Percentage of all deaths due to NCDs (%)
Slide 3
Source: http://whqlibdoc.who.int/publications/2011/9789241502283_eng.pdf?ua=1
Nurses as agents for change
An example: rural Bangladesh
Sources: Global Health Action (2009) and Center for Global Development‘, Where have all the donors gone?’ (2010)
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Why it matters
• Many cases of NCD are premature, striking people of working age
• 9 million deaths a year from NCDs in people aged <60, 90% of which are in developing countries
• These are not ‘diseases of affluence’ – they often fall hardest on those least able to afford it
• Widening social inequalities
• Limited access to medication
• Catastrophic for families: early retirement or death, children as carers
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• NCDs are responsible for 65.5% of all deaths worldwide – 34.5 million people died from NCDs in 2010
• 80% of NCD deaths occur in low- and middle-income countries
• Almost half of NCD deaths occur in people below age 70
• Around the world, NCD affects women and men equally
• Without action, 17 million people will die prematurely this year from a chronic disease
• 1.4 billion adults are overweight or obese
• 22 million children under five years old are overweight
• Tobacco use causes at least 5 million deaths each year
Some facts about NCDs
Sources: WHO, Preventing Chronic Disease: A Vital Investment, October 2005 and the Global Burden of Disease Study 2010
Nurses as agents for change
It turns out we know exactly what to do
It’s simple, affordable and effective
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The 3FOUR50 message
• 3 risk factors cause four chronic diseases (cardiovascular disease, type 2 diabetes, many cancers and chronic lung disease) that cause over 50% of the disease burden worldwide
• The risk factors are:
Tobacco use
Lack of physical activity
Unhealthy diet (including harmful use of alcohol)
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We can prevent much of the burden...
• Up to
• 80% of cases of type 2 diabetes
• 80% of cases of heart disease and stroke
• 40% of cases of some cancers
can be prevented or delayed
• Nurses can lead this, making every contact count
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Smoking prevalence among adults (%)
Slide 10
Source: WHO, http://whqlibdoc.who.int/publications/2011/9789240686458_eng.pdf
Nurses as agents for change
Adults who are overweight (%)
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Source: http://www.who.int/gho/publications/world_health_statistics/EN_WHS2012_Full.pdf
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Physical inactivity among adults (%)
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Source: http://www.who.int/gho/publications/world_health_statistics/EN_WHS2012_Full.pdf
Nurses as agents for change
Obesity: a global issue
• Obesity is increasing most rapidly in lower- and middle-income countries.
• In Asia, North Africa and Latin America, rates of increase in obesity are two to five times higher than in the USA.
• The burden of obesity is increasingly falling on the poor.
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Source: Popkin and Gordon-Larsen, 2004
Nurses as agents for change
Sources:
* H.-C. Hung 2005 (J Nat Cancer Ins)
** F.B. Hu 2001 (New Eng J Med)
Five servings of fruit and vegetables each day reduces the risk of:
• Cardiovascular disease by 28%*
• Type 2 diabetes by 24%**
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Benefits of five-a-day
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Physical activity reduces the risk of:
• breast cancer by approximately 20–40% among those who do vigorous physical activity for 30–60 minutes on 5 days each week;
• colon cancer: the most active people are at 30% lower risk than the least fit;
• stroke by 25–30% among active individuals;
• coronary heart disease: physically inactive people can have as much as twice the risk;
• significantly reduces risk of diabetes;
• plus benefits for musculoskeletal and mental health.
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The impact of physical activity
Nurses as agents for change
C3: an opportunity for prevention
C3 Collaborating for Health is a policy and advocacy organisation: www.c3health.org
C3 believes that only by working together can we make it easier to be healthy.
C3 works with many different people and organisations to promote three behaviour changes:
stopping tobacco use, healthy eating and drinking, and increasing physical activity.
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C3 works globally
• C3 works collaboratively and constructively with stakeholders: health professionals (particularly nurses), governments and parliamentarians, urban planners, schools, consumer organisations, academics, nutritionists, NGOs, international organisations, and the private sector
• The United Nations, World Health Organization and governments are increasingly recognising the need to take an ‘all of government, all of society’ approach to NCDs
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• United Nations High-level Meeting – held on 19-20 September 2011
• Only the 2nd such meeting on a disease (2001: HIV)
• 133 country delegations spoke in the plenary – including 34 heads of state
• Political Declaration includes strong call for partnership working, including with the health sector
UN High-level Meeting
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Events
• C3 holds a variety of events to discuss NCD prevention and share best practice.
• Our International Breakfast Seminars bring experts from our network to talk about ‘what works’ in their country
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Communities
• C3 partners with local organisations to shift preventative public-health efforts from the desktops of professionals to the doorsteps of communities.
• C3’s community engagement framework allows us – with local people – to assess the health needs of communities and the best use of assets
‘Health starts where we live, learn, work and play’
Sir Michael Marmot
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Working with business
• C3 facilitates discussion to canvass opinion and foster change in company, customers and community
• C3 introduces workplace health programmes
• C3 produces reports for businesses that translating research into actionable, plain English - essential for ‘making the case’ for tackling NCDs
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NIH/UnitedHealth Centers of Excellence
• Established 2009
• 11 Centers
• Each has a network of local and international partners, in developing and developed countries
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Early origins of health
• EOH is a great opportunity to link NCD prevention, maternal and child health, and delivery of the MDGs
• C3 has brought together expertise from the private sector, UN and academia to discuss enabling more women to have a healthy pregnancy and for their children to have a healthy start in life – for example, nutrition, diabetes and the use of mobile technology
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Working with health professionals
Why nurses?
If the millions of nurses in a thousand different places articulate the same ideas and convictions ... and come together as one force, they could act as a powerhouse
for change.
Dr Haefden Mahler, WHO Director General (1985)
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C3 Nursing Programme – Healthier nursing students
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• Developing and piloting an intervention study with academic colleagues focused on UK nursing students to evaluate the impact of a health-promotion intervention on:
• student nurses’ self-reported lifestyle and health status and
• their observations and practice of ‘making every contact count’ on placement
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C3 Nursing Programme – Diaspora
• Raising awareness of NCDs among nurses from other countries, who are living and working in the UK
• Workshops in collaboration with the Commonwealth Nurses Federation
• Supporting diaspora nurses to deliver interventions with local communities in the UK and in home countries
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Healthier nurses are better for patients
• Healthier nurses are more productive, more alert, and safer practitioners
• Nurses have the potential and the opportunity to act as agents for change for their families, patients and communities through health education and role-modelling healthy behaviour
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C3 Nursing Programme – International networking
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• Collaborating with international nurse leaders and nursing organisations to share experiences and identify opportunities for collaboration and leadership
• Developing social media presence – e.g. @C3Nursing
• Reviewing literature and doing key informant interviews related to nurses’ health and workplace interventions
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‘Ought not the [nurse] that is
giving counsel to a sick man
who is indulging in a mode of
life that is bad for his health to
try first of all to change his life,
and only proceed with the rest
of his advice if the patient is
willing to obey?’
[Plato, Letters 330c–330d] c.350 BC
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Thank you!
C3 Collaborating for Health: www.c3health.org
@C3Nursing and @C3Health
Christine Hancock: [email protected]
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