Latin America Advisor

A Daily Publication of The Dialogue

How Much Is Poor Health Costing Latin America?

Cases of noncommunicable diseases are only expected to rise in coming decades in the Western Hemisphere.

Every year in the Americas, noncommunicable diseases, such as cardiovascular disease, cancer, respiratory diseases and diabetes, cause four out of every five deaths, with that figure only expected to grow in the coming decades, according to the Pan American Health Organization. Moreover, the organization points out that such diseases are increasingly not just affecting the elderly, as a third of the deaths caused by non-communicable diseases are in working-age people younger than 70, putting new strains on employers. What effect are poor health habits having on the economies and productivity of Latin American and Caribbean countries? Are governments in the region focusing enough on preventing and treating lifestyle diseases, and how can they pay for those efforts? Which policies in the region are successfully helping citizens prevent illness and can be replicated on a broader scale?

Jennie Ward-Robinson, president and CEO of the PAHO Foundation: "Noncommunicable diseases (NCDs) pose the greatest threat to health, wellbeing and economic vitality, as the rise in obesity and subsequently NCDs, is most evident and impactful during the most productive years. Consequently, NCDs threaten productivity, have social and economic implications at the familial, community, employer and country levels. In the Americas and the Caribbean, this is especially poignant as economies experiencing growth are now threatened by rising rates of diabetes, vascular diseases and cancers that pose a threat to sustainability. According to the World Health Organization, about a third of NCD deaths in the Americas occur in people under 70 years of age, and this number is growing. Most visible responses are seen through policy enactment. However, taxation strategies are limited in their capacity to drive the behavior change necessary in addressing these lifestyle diseases within NCDs. These strategies, though helpful, appear limited in response to the burgeoning rise and burden of NCDs. Central to mitigating these risks implicit in lifestyle diseases are consideration of culture, socio-economics and the environment. Beginning with familial practices, nutrition and with a special focus on school-aged children, as well as consideration for the built environments to foster physical activity is imperative. Finally, one must not overlook the challenges facing countries that struggle to balance economic tradeoffs due to health emergencies and disease management. Ministries are burdened with both treating and preventing diseases, which dictates the need for multi-stakeholder approaches to create opportunities for ameliorating these threats to sustainable public health in the region."

Núria Homedes, associate professor at the School of Public Health at the University of Texas: "Poor health habits are at the root of most chronic disease problems, and I would assert that most countries face increasing difficulties providing the living and environmental conditions that can lead to healthy lifestyles. To engage in healthy behaviors, at the very minimum, people need to have easy access to affordable produce free of dangerous chemicals and pesticides, clean stoves and a refrigerated space to keep their food, in addition to decent housing that is mold and insect free and capable of insulating residents from inclement weather. Also needed are safe working environments that protect workers from accidents and exposure to pollutants, as well as reliable transportation, decent air quality, clean and affordable water, and pollution-free environments that allow residents to engage in outdoor activities and exercise. It is easy to affirm that none of the Latin American and Caribbean countries guarantees these living conditions to all their citizens. However, I would also question if the responsibility for paying for these conditions falls solely on the Latin American governments. Having signed trade agreements, most countries have lost their ability to control their agricultural sectors, and they have experienced a rapid urbanization with the proliferation of shanty towns around most major cities. They have also been unable to provide full employment despite failing to enforce environmental and workers’ safety conditions in exchange for foreign-direct investment. Additionally, they have yielded control of utilities and other services, including health, to the private sector—oftentimes to for-profit multinationals—and have been unable to control the penetration of obesogenic foodstuffs such as sugary drinks, corn-syrup, processed foods and fast-food chains. At the same time, people have become acutely aware of existing inequities, perpetuating the cycle of sickness, violence, addictions and other unhealthy behaviors. In a globalized world, the responsibility for ensuring that people have the conditions to age in a healthy environment is also global."

Livio Vanghetti, vice president of global stakeholder advocacy at Philip Morris International: "As recognized in 2011 by the United Nations General Assembly, ‘prevention must be the cornerstone of the global response to NCDs.’ Therefore, key actions against burden of NCDs in the Americas must be based on ‘reducing the level of exposure of individuals and populations to common modifiable risk factors’ such as tobacco smoke. Thus, we believe that novel smoke-free tobacco products, like e-cigarettes or heat-not-burn tobacco, can play a key role in reducing the level of exposure of smokers to the harmful or potentially harmful constituents of cigarette smoke if they switch to these products. Scientifically proven reduced-risk products could accelerate the decrease of smoking-related diseases, which still represent a significant share of NCDs. The U.N. General Assembly resolution also acknowledges that prevention should strengthen ‘the capacity of individuals and populations to make healthier choices and follow lifestyle patterns that foster good health.’ We believe that innovative, less harmful smoke-free nicotine products, supported by policies that actively seek to switch existing smokers to these products, can promote healthier choices and better lifestyles. We believe that the private sector has a role in developing and marketing innovations and that tobacco control regulatory policies should safeguard public health interests while encouraging innovation by the private sector. We are convinced that science-based regulatory policies that are built on the risk profile of the different nicotine-containing products will incentivize the tobacco industry to transform at the expense of the more harmful products and to the benefit of public health objectives."

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