This is a study using historical data and forecasts of life expectancy for several countries. The data and forecasts come from the UN - Population Division. While the historical data is most interesting, the forecasts are highly optimistic as they project a linear trend way into the future. Meanwhile, those forecasts should have followed a much more realistic logarithmic curve reflecting slower increase in life expectancy as the life expectancy rises.
Burden of cardiovascular diseases in Indians: Estimating trends of coronary a...Apollo Hospitals
The global trends in disease specific mortalities indicate that ischemic heart disease (IHD) is the leading cause of death in age group ≥60 years. It is also being recognized that cardiovascular diseases (CVDs) and their risk factors are emerging as primary health problems in India with all socioeconomic groups being equally vulnerable. Though the high mortality rates due to CVDs in India may have major economic repercussions, the analysis on economic impact of CVDs remains incomplete, because of inadequate coverage of these diseases in India's vital event registration and absence of surveillance systems for disease specific mortality data. The per capita expenditure on health by public sector is very low making the poor to go for costly private healthcare facilities. We discuss here the burden of CAD and its risk factors in India and need for using population and individual based prevention strategies to halt and reverse the CVD epidemic. The country will need to create data for technical and operational factors for making prevention and control of CVDs feasible. National and international multidisciplinary collaborations will be needed to address the challenge posed by CVDs.
This is a study using historical data and forecasts of life expectancy for several countries. The data and forecasts come from the UN - Population Division. While the historical data is most interesting, the forecasts are highly optimistic as they project a linear trend way into the future. Meanwhile, those forecasts should have followed a much more realistic logarithmic curve reflecting slower increase in life expectancy as the life expectancy rises.
Burden of cardiovascular diseases in Indians: Estimating trends of coronary a...Apollo Hospitals
The global trends in disease specific mortalities indicate that ischemic heart disease (IHD) is the leading cause of death in age group ≥60 years. It is also being recognized that cardiovascular diseases (CVDs) and their risk factors are emerging as primary health problems in India with all socioeconomic groups being equally vulnerable. Though the high mortality rates due to CVDs in India may have major economic repercussions, the analysis on economic impact of CVDs remains incomplete, because of inadequate coverage of these diseases in India's vital event registration and absence of surveillance systems for disease specific mortality data. The per capita expenditure on health by public sector is very low making the poor to go for costly private healthcare facilities. We discuss here the burden of CAD and its risk factors in India and need for using population and individual based prevention strategies to halt and reverse the CVD epidemic. The country will need to create data for technical and operational factors for making prevention and control of CVDs feasible. National and international multidisciplinary collaborations will be needed to address the challenge posed by CVDs.
Non-Communicable Disease (NCDs) or Chronic Diseases and youth health in Bangl...Jahid Khan Rahat
In this slide you will learn about what is Non Communicable Diseases (NCDs) or Chronic Diseases,its risk factors, disease burden and statistic, effect of NCDs in children, its result, cure of diseases, development implications etc.
A report by the World Health Organisation on Chronic Disease as a Global Health Crisis (original article at http://www.who.int/chp/chronic_disease_report/presentation/en/index.html)
Non-communicalbe diseases and its preventionShoaib Kashem
Non communicable disease account for a large and increasing burden of disease worldwide. It is currently estimated that non communicable disease accounts for approximately 60% of global deaths and 43% of global disease burden. This is projected to increase to 73% of deaths and 60% of disease burden by 2020.
A Study of the Prevalence of Cardio-Vascular Diseases and Its Risk Factors (B...inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Epidemiology of Chronic Non- communicable diseases and ConditionsSheetal Singh
This presentation focuses on the most prevailing Non- Communicable diseases of the world. It includes the problem, causes, risk factors, prevention and worldwide statistics of each disease.
Non-Communicable Disease (NCDs) or Chronic Diseases and youth health in Bangl...Jahid Khan Rahat
In this slide you will learn about what is Non Communicable Diseases (NCDs) or Chronic Diseases,its risk factors, disease burden and statistic, effect of NCDs in children, its result, cure of diseases, development implications etc.
A report by the World Health Organisation on Chronic Disease as a Global Health Crisis (original article at http://www.who.int/chp/chronic_disease_report/presentation/en/index.html)
Non-communicalbe diseases and its preventionShoaib Kashem
Non communicable disease account for a large and increasing burden of disease worldwide. It is currently estimated that non communicable disease accounts for approximately 60% of global deaths and 43% of global disease burden. This is projected to increase to 73% of deaths and 60% of disease burden by 2020.
A Study of the Prevalence of Cardio-Vascular Diseases and Its Risk Factors (B...inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Epidemiology of Chronic Non- communicable diseases and ConditionsSheetal Singh
This presentation focuses on the most prevailing Non- Communicable diseases of the world. It includes the problem, causes, risk factors, prevention and worldwide statistics of each disease.
to download this presentation from this link
https://mohmmed-ink.blogspot.com/2020/12/obesity.html
obesity, causes, diagnosis, complications, treatment, prevention.
A presentation from the 2008 HIV Health and Treatments Update forum held in Sydney on 25 Nov 2008.
Part 1: an overview of HIV in 2008 and treatment trends, presented by Bill Whittaker.
NCD, Hypertension, Diabetes, Chronic Kidney Disease, heart disease, coronary artery disease
Noncommunicable diseases (NCDs), also known as chronic diseases, are not passed from person to person.
Noncommunicable diseases (NCDs), including heart disease, stroke, cancer, diabetes and chronic lung disease, are collectively responsible for 74% of all deaths worldwide. More than three-quarters of all NCD deaths, and 86% of the 17 million people who died prematurely, or before reaching 70 years of age, occur in low- and middle-income countries.
The epidemic of NCDs poses devastating health consequences for individuals, families and communities, and threatens to overwhelm health systems. The socioeconomic costs associated with NCDs make the prevention and control of these diseases a major development imperative for the 21st century.
HSC PDHPE Core 1: Health Priorities in AustraliaVas Ratusau
Class of 2017 - updated PowerPoint presentation that includes current data, updated syllabus & content.
Includes class activities & examination style questions
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Jan 3 how healthy is the filipino revised december 10
1. How healthy is the
Filipino?
Dr. Ramon Lorenzo Luis R. Guinto
Independent Consultant
1
2. What is Health?
World Health
Organization
• “complete state of physical, mental, and social
wellbeing, and not merely the absence of
disease or infirmity “
Universal
Declaration on
Human Rights
• “Everyone has the right to a standard of living
adequate for the health and well-being of
himself and of his family...”
protect and promote the
1987 Constitution of • “The State shall people and instill health right
to health of the
the Philippines
consciousness among them”
2
3. How do we measure health?
Health
Outcomes
• What are the changes affecting the
Philippine population, including major
causes of disease and death?
Health
Determinants
• What are the factors that influence the
health of Filipinos, both at the individual
and population level?
Health System
• How do Filipinos gain access to health
care when they need it?
3
4. How healthy is the Filipino?
We are living longer, and
the elderly population is
gradually increasing.
We get sick and we die
more often than ever
from chronic
noncommunicable
diseases.
The factors that lead to
disease affect the
population differently.
People are not protected
enough from financial
risks that come with ill
health.
4
5. We are living longer, and
the elderly population is
gradually increasing.
We get sick and we die
more often than ever
from chronic
noncommunicable
diseases.
The factors that lead to
disease affect the
population differently.
People are not protected
enough from financial
risks that come with ill
health.
5
6. The Philippine population is continuously growing,
expecting to reach 140 million by 2040.
16000000
135301100
14000000
120224500
141669900
128110000
12000000
111784600
102965300
Population
10000000
94013200
85261000
80000000
76946500
60000000
40000000
20000000
0
2000
2005
2010
2015
2020
2025
2030
2035
2040
Year
Summary of Projected Population, Philippines: 2000-2040 (Medium Assumption)
Source: National Statistics Coordinating Board
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
6
Health financing
7. The Philippines remains to be a generally young
population, but the number of elderly people is
expected to further increase.
Source: UN DESA
7
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
8. While life expectancy across the ASEAN region has generally
increased over the past fifty years, Philippines remained in the
middle, with Vietnam recently catching up.
Source: Chongsuvivatwong, et al, 2011
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
8
Health financing
9. While generally, Filipinos are now living longer
lives, men still die earlier than women.
Life Expectancy at Birth
75
73
70
70
69
65
59
67
69
66
Both
63
61
Male
55
57
53
50
66
63
60
55
71
55
51
1960
1970
59
Female
1980
1990
2000
2011
Year
But retirement age stays at 65 – hence, more life
years as an elderly!
9
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
10. Life expectancy is projected to further
increase, with females still living longer than
males.
80
Life Expectancy at Birth
75
70
65
60
55
50
2000-2005
2005-2010
2010-2015
2015-2020
2020-2025
2025-2030
2030-2035
2035-2040
Year Interval
Male
Female
Both
Projected Population, by Five-Year Interval, Philippines: 2000-2040 (Medium Assumption)
Source: National Statistics Coordinating Board
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
10
Health financing
11. Longer Lives: Implications
2
1
Individuals need to
ensure financial
security as their
chances of joining
the elderly
population increase
3
In the long
run, health systems
will need more
resources, especially
health workforce, to
meet the needs of
the aging population
Cautionary tale:
Today’s younger
generation has to
consider this
transition as they
prepare for future
life
11
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
12. We are living longer, and
the elderly population is
gradually increasing.
We get sick and we die
more often than ever
from chronic
noncommunicable
diseases.
The factors that lead to
disease affect the
population differently.
People are not protected
enough from financial
risks that come with ill
health.
12
13. Infectious Diseases
• caused by disease-causing
microorganisms, such as
bacteria, viruses, parasites or
fungi
• can be spread, directly or
indirectly, from one person to
another
• generally treated with
antimicrobial agents that
eradicate microbes
Noncommunicable Diseases
• not caused by a pathogen and
cannot be shared from one
person to another
• caused by either the
environment, nutritional
deficiencies, lifestyle
choices, or genetic
inheritances
• not communicable or
contagious, although some
kinds can be passed down
genetically to the children of a
carrier
• treated with a wide range of
drugs, mostly to delay
progression
13
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
14. For the past three decades, Filipinos have been getting
sick of infectious disease, but chronic hypertension is
rising as a leading cause of illness.
Leading Causes of Disease
Source: Philippine Health Statistics, various years
14
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
15. While we still get sick of infectious disease, today we
Filipinos die more of chronic, noncommunicable diseases
– like heart disease and cancer.
Leading Causes of Death
Living longer and older
Getting sick and dying of NCDs
Source: Philippine Health Statistics, various years
15
How disease factors affect people
Health financing
16. Transition in Causes of Death:
More people have been dying of lifestyle-related diseases.
120
Communicable Diseases
Rate (per 100,000) of Communicable Diseases
110
Cancer
390
100
360
330
90
Diseases of the Heart
300
80
270
240
70
210
60
180
50
150
40
120
30
90
20
60
30
10
0
Rate (per 100,000) of Malignant Neoplasm and Diseases of the Heart
420
0
1959 1961 1963 1965 1967 1969 1971 1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009
Year
Source: Philippine Health Statistics, 1959-2009
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
16
Health financing
17. NONCOMMUNICABLE DISEASES
comprise 61% of total deaths in 2010.
Communicable, m
aternal, pregnancy
-related, and
nutritional
conditions, 30
Other NCDs, 13
Diabetes, 4
Respiratory
diseases, 5
Cancers, 10
Injuries, 8
Source: WHO, 2010
Cardiovascular
diseases, 30
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
17
Health financing
18. We get more sick because of our LUNGS,
but we die because of our HEART.
Morbidity
Mortality
Cause
Per 100,000
Cause
Per 100,000
1. Acute Respiratory Infection
1203.0
1. Diseases of the heart
109.4
2. Acute Lower Respiratory Tract
Infection and Pneumonia
612.6
2. Diseases of the vascular system
71.0
3. Bronchitis / Bronchiolitis
380.7
3. Cancer
51.8
4. Hypertension
366.3
4. Pneumonia
46.2
5. Acute Watery Diarrhea
354.5
5. Accidents
39.0
6. Influenza
297.7
6. Tuberculosis, all forms
27.6
7. Urinary Tract Infection
91.0
24.7
8. TB Respiratory
80.9
7. Chronic lower respiratory
disease
8. Diabetes mellitus
9. Injuries
38.9
9. Nephritis, nephrotic syndrome
and nephrosis
15.0
10. Acute Febrile Illness
22.2
10. Certain conditions originating
in the perinatal period
12.5
Source: Philippine Health Statistics, 2009
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
24.2
18
Health financing
19. HEART DISEASES are affecting both men and women.
0
10,000
20,000
30,000
40,000
50,000
60,000
Stroke
Myocardial Infarction
Disease of pulmonary circulation and other heart diseases
Hypertension without heart involvement
Atherosclerosis
Aortic aneurysm and dissection
Angina Pectoris
Hypertension with heart involvement
Atherosclerosis
Hypertension
without heart
involvement
Disease of
pulmonary
circulation and
other heart
diseases
Myocardial
Infarction
Stroke
343
889
9,959
10,322
23,440
28,911
211
1,217
8,119
9,209
12,759
22,364
Hypertension
with heart
involvement
Angina Pectoris
Aortic aneurysm
and dissection
Male
58
255
Female
38
185
19
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
20. In general, elderly people experience more HEART
ATTACKS, but females past midlife are at increased risk.
6
5.1
5
Percentage (%)
4
3.6
20-29
3.4
30-39
40-49
3
50-59
2.4
60-69
2
70 and above
2
1.3
1
0.6
0.1
0.7
0.2
0.8
0.8
Total
0.8
0.2
0
Male
Female
Distribution of population diagnosed with myocardial infarction, by age, 2008
Source: Ulep, et al., 2012
20
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
21. While prevalence of CORONARY HEART DISEASE increases
with age, more males are affected by the disease.
6
5
5
Percentage (%)
4
20-29
30-39
3
40-49
3
2.6
2.4
2.3
50-59
60-69
2
70 and above
2
1.3
1.2
1.4
1.3
Total
0.8
1
0.2
0.3
0.3
0
Male
Female
Distribution of population diagnosed with coronary heart disease, by age, 2008
Source: Ulep, et al., 2012
21
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
22. While BREAST CANCER is the leading cause of death
among women, LUNG CANCER is the leading cause of
death for both sexes.
Trachea, B
ronchus
Lungs
33%
Others
29%
Breast
15%
MALES
Colon
9%
Others
41%
Leukemia
7%
Leukemia
7%
Lip, Oral
Cavity and
Pharynx
8%
Colon
11%
Prostate
12%
Breast
29%
Others
31%
Prostate
6%
BOTH SEXES
FEMALES
Lungs and
respiratory
22%
Source: NSO Mortality Data, 2008
Living longer and older
Getting sick and dying of NCDs
Leukemia
7%
Other Female
Genitalia
7%
How disease factors affect people
Trachea, bron
chus, lungs
11%
Cervix
7%
Health financing
Colon
8%
22
23. 10 Most Common Cancers in 2010
Number
0
2000
4000
Breast
6000
8000
9184
11458
7331
6819
Colon/Rectum
5787
3060
Cervix Uteri
4812
1984
3153
2609
Leukemia
Stomach
2274
1410
3129
2712
2236
1855
Brain/Nervous System
1016
2165
New Cases
Death
Source: GLOBOCAN, 2008
Living longer and older
14000
12262
Liver
Ovary
12000
4371
Lung
Prostate
10000
Getting sick and dying of NCDs
How disease factors affect people
Health financing
23
24. 10 Most Common Cancers among Males, 2010
Number
0
1000
2000
3000
4000
5000
6000
Lung
5102
Colon/Rectum
1340
8772
5522
1920
1669
1381
Leukemia
1236
1069
Brain/Nervous System
Other Pharynx
804
598
389
1145
982
848
New Cases
Deaths
Source: GLOBOCAN, 2008
Living longer and older
10000
2712
1410
Stomach
9000
3208
1690
Prostate
Kidney
8000
6987
Liver
Non-Hodgkin Lymphona
7000
Getting sick and dying of NCDs
How disease factors affect people
Health financing
24
25. 10 Most Common Cancers among Females, 2010
Number
0
2000
4000
Breast
12000
12262
2579
1370
Ovary
2165
1016
1809
1717
Liver
1760
796
1484
1228
Leukemia
450
1474
1209
934
New Cases
Deaths
Source: GLOBOCAN, 2008
Living longer and older
14000
2686
2197
Colon/Rectum
Stomach
10000
4812
1984
Lung
Thyroid
8000
4371
Cervix Uteri
Corpust Uteri
6000
Getting sick and dying of NCDs
How disease factors affect people
Health financing
25
26. Q & A: Diabetes Checklist
Sex
• Male
• Female
Residence
• Urban
• Rural
Income Group
•
•
•
•
•
Poorest
Poor
Middle
Rich
Richest
Education
• No formal
education
• Elementary
• Secondary
• Tertiary
26
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
27. Diabetes Mellitus in Focus:
You’re more likely to get diabetes if you are female, rich, based in
an urban city, and college-educated.
9
8
7
6
5
4
3
2
1
0
5.5
4.8
4
Male
Female
9
8
7
6
5
4
3
2
1
0
Total
8.1
6.4
1.8
Poorest
Sex
9
8
7
6
5
4
3
2
1
0
3.7
Urban
9
8
7
6
5
4
3
2
1
0
Middle
Rich
Richest
Y-axis – prevalence (in percent)
5.3
4.6
4.4
Elementary
Secondary
2.6
No Education
Urbanization
Living longer and older
Poor
Socio-economic Status
5.6
Rural
3.5
3
Educational Attianment
Source: National Nutrition Survey 2008
Getting sick and dying of NCDs
Tertiary
How disease factors affect people
Health financing
27
28. Non-communicable diseases:
Common characteristics
Require long-term treatment
May require acute care for
complications
Require more than one drug
Can be debilitating and
disabling
Limit productivity
Cost financial burden to
entire household
Necessitate involvement of
family and friends in
providing holistic care
Require management by
more than one healthcare
provider
But –
preventable, avoidable, and
manageable
29. We are living longer, and
the elderly population is
gradually increasing.
We get sick and we die
more often than ever
from chronic
noncommunicable
diseases.
The factors that lead to
disease affect the
population differently.
People are not protected
enough from financial
risks that come with ill
health.
29
30. How are NCDs produced?
Globalization
Urbanization
Poverty
Low Education
Aging
Stress
High blood pressure
Tobacco use
High blood glucose
Heart disease
Unhealthy diet
Abnormal blood
lipids
Stroke
Diabetes
Central obesity
Cancer
Abnormal lung
function
Chronic lung disease
Biological risk
factors
Chronic
noncommunicable
diseases
Physical inactivity
Alcohol intake
Culture
Social and
environmental
determinants
Behavioral/
lifestyle factors
Modified from WHO, 2005
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
30
31. Biological Risk Factors
High blood pressure
Heart disease
High blood glucose
Stroke
Abnormal blood lipids
Diabetes
Cancer
Central obesity
Biological risk factors
Chronic noncommunicable
diseases
31
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
32. Prevalence of Selected Risk
Factors, by Sex, Philippines 2008
80
71.1
70
57.8
60
Percentage
50
40
30
29.1
22.2
18.5
20
15
12.8
10
11.2
8.1
7.3
0
Hypertension
High Total
Cholesterol
High Bad Cholesterol
Low Good
Cholesterol
High Triclyceride
Risk Factors
Males
Females
Source: National Nutrition Survey, 2008
32
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
33. While risk for HYPERTENSION increases with age, nearly half of
Filipinos in early adulthood have blood pressures above normal.
100
2
3.7
11.5
8.4
90
18.3
13.8
7.4
28.8
80
19.5
11.6
Percentage (%)
70
26.7
28.3
27.1
10.3
60
24.7
27.2
Hypertension Stage 2
50
14.3
26.1
Hypertension Stage 1
15.6
40
30
21.8
14.1
High Normal
18.2
53.9
17.8
43.7
20
Pre-Hypertension
Normal
17.8
32.5
22.6
10
17.8
14.7
60-69
70 and above
0
20-29
30-39
40-49
50-59
Age Group
Percent distribution of blood pressure readings based on a single visit among adults, by age
Source: National Nutrition Survey, 2008
33
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
34. 1 out of 4 Filipinos are HYPERTENSIVE.
30
25.3
25
22
22.5
21
20
15
10
5
0
1993
1998
2003
2008
Year
Prevalence of hypertension among adults based on a single Visit, Philippines 1993-2008
Source: National Nutrition Survey, 2008
34
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
35. 1 out of 20 Filipinos have
HIGH FASTING BLOOD SUGAR.
6
4.8
5
3.9
4
3.4
3
2
1
0
1998
2003
2008
Year
Prevalence of High Fasting Blood Sugar among Adults, Philippines 1998-2008
Source: National Nutrition Survey, 2008
35
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
36. Nearly 1 out of 4 Filipinos are either
OVERWEIGHT or OBESE.
80
70
66.1
61.6
57.3
60
50
Underweight
40
Normal
Overweight
30
24.4
Obese
22.3
20.1
20
10
10.7
9.2
7.6
4.5
10
6.1
0
Male
Female
Both
Nutritional Status of Adults, 20 years old and over, by sex based on BMI
classification, Philippines 2011
Source: National Nutrition Survey, 2011
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
36
Health financing
37. The proportion of overweight and obese
Filipinos is increasing over the years.
28.4
30
26.6
24
25
Prevalence (%)
20.2
20
16.6
15
13.9
13.2
12.3
11.6
10
10
5
0
1993
1998
Underweight
2003
2008
Overweight/Obese
2011
Trends in the Prevalence of Underweight and Overweight among Adults 20 years old and over
based on BMI, Philippines 1993-2011
Source: National Nutrition Survey, 2011
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
37
Health financing
38. Females are roughly 6 times more likely to have
a high WAIST CIRCUMFERENCE than males.
25
20
Prevalence (%)
19.9
19
17
15
10.7
10
2.7
2.4
3.1
3.2
1998
5
2003
2008
2011
0
Year
Male
Female
Trends in the High Waist Circumference Prevalence among Adults, 20 years old and
over, Philippines 1998-2011
Source: National Nutrition Survey, 2011
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
38
Health financing
39. Females are roughly 10 times more likely to
have a high WAIST TO HIP RATIO than males.
65.5
70
54.8
60
Prevalence (%)
62.5
50
39.5
40
30
20
10
12.1
7.9
11.1
6.9
0
1998
2003
2008
2011
Year
Male
Female
Trends in High Waist to Hip Ratio (WHR) Prevalence among Adults, 20 years old and
over, Philippines 1998-2011
Source: National Nutrition Survey, 2011
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
39
Health financing
40. The people who are most likely to have diabetes –
female, rich, urban, and college-educated – are the same
people most likely to become OBESE.
9
8
7
6
5
4
3
2
1
0
6.6
5.2
3.7
Male
Female
9
8
7
6
5
4
3
2
1
0
Total
7.9
6.2
5
2.5
1.1
Poorest
Sex
9
8
7
6
5
4
3
2
1
0
3.6
Urban
9
8
7
6
5
4
3
2
1
0
Rich
Richest
6.3
4.9
3.6
0.5
No Education
Urbanization
Y-axis – prevalence (in percent)
Living longer and older
Middle
Socio-economic Status
5.7
Rural
Poor
Elementary
Secondary
Educational Attianment
Source: National Nutrition Survey 2008
Getting sick and dying of NCDs
Tertiary
How disease factors affect people
Health financing
40
41. The people who are most likely to have diabetes and obesity –
female, rich, urban, and college-educated – are the same people most likely
to acquire HIGH CHOLESTEROL levels in the blood.
20
18
16
14
12
10
8
6
4
2
0
12.8
10.2
7.3
Male
Female
20
18
16
14
12
10
8
6
4
2
0
Total
17.3
12.5
4.7
Poorest
Sex
20
18
16
14
12
10
8
6
4
2
0
8
Urban
20
18
16
14
12
10
8
6
4
2
0
Middle
Rich
Richest
13.1
8.3
Y-axis – prevalence (in percent)
9.6
5.8
No Education
Urbanization
Living longer and older
Poor
Socio-economic Status
11.9
Rural
8.1
6.7
Elementary
Secondary
Educational Attianment
Source: National Nutrition Survey 2008
Getting sick and dying of NCDs
Tertiary
How disease factors affect people
Health financing
41
42. Metabolic Syndrome
Central Obesity
Raised triglycerides
Reduced HDL cholesterol
Raised blood pressure
Raised fasting plasma glucose
42
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
43. Behavioral/Lifestyle Factors
Tobacco use
High blood glucose
Unhealthy diet
High blood pressure
Physical inactivity
Abnormal blood lipids
Central obesity
Alcohol intake
Behavioral/lifestyle factors
Biological risk factors
43
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
44. Men smoke five times more than women.
60
Percentage (%)
50
47.7
38.2
40
28.3
30
Men
22.5
20
10
Women
Overall
9
6.9
0
Current Smoker
Current Daily Smoker
Smoking Status
Percentage Distribution of Adults 15 years and older by Smoking Status and Sex, Philippines
Source: Global Adult Tobacco Survey (GATS), 2009
44
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
45. Men smoke five times more than women.
70
60
57.4
54
53.2
Percentage (%)
50
40
35.2
32.7
31
30
Males
Females
Both
20
12.6
10.9
12.5
10
0
1998
2003
2008
Year
Prevalence Trend of Cigarette Smoking, by Sex in the Philippines
Source: National Nutrition Survey, 2008
45
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
46. SMOKING is most prevalent among males, the poor, those who live
in rural areas, and those who never went to school.
60
60
53.2
50
50
40
40
31
30
39.9
36.4
29.7
30
20
25.3
24.8
Rich
Richest
20
12.5
10
10
0
0
Male
Female
Total
Poorest
Sex
Poor
Middle
Socio-economic Status
60
60
50
50
40
40
33.1
28.9
30
41.3
35.1
31.5
30
20
20
10
10
0
23.7
0
Rural
Urban
No Education
Urbanization
Y-axis – prevalence (in percent)
Living longer and older
Elementary
Secondary
Educational Attianment
Source: National Nutrition Survey 2008
Getting sick and dying of NCDs
Tertiary
How disease factors affect people
Health financing
46
47. Who consumes the highest level of SATURATED OILS in their diet?
The males, the rich, the urbanized, and the college-educated
14
14
12
12
10
10
9.4
8.8
10
8
8.9
Poor
Middle
Rich
2
0
8.9
4
2
9
6
4
8.1
8
6
11.7
0
Male
Female
Total
Poorest
Sex
Socio-economic Status
14
14
12
10
Richest
10
11.4
12
9.4
10
8.7
8
8
6
4
2
2
0
8
6
4
7.2
0
Rural
Urban
No Education
Urbanization
Y-axis – grams per day
Living longer and older
Elementary
Secondary
Educational Attianment
Source: National Nutrition Survey 2008
Getting sick and dying of NCDs
Tertiary
How disease factors affect people
Health financing
47
48. Unhealthy diets: Filipinos are #3
consumers of take-away food
Percentage of population that eats at take-away restaurants at least
once a week, by selected countries, 2004.
70%
61%
60%
59%
54%
50%
50%
44%
41%
40%
37%
35%
30%
29%
Australia
New Zealand
30%
20%
10%
0%
Hong Kong
Malaysia
Philippines
Singapore
Thailand
China
India
U.S.A
Source: AC Nielsen Consumer Survey Report, 2004
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
48
Health financing
49. Who consumes the highest level of SOFTDRINKS?
The males, the rich, the urbanized, and the college-educated
100
90
80
70
60
50
40
30
20
10
0
53.4
50.3
47.4
Male
Female
100
90
80
70
60
50
40
30
20
10
0
Total
86.5
59.4
44.1
33.5
19.2
Poorest
Sex
100
90
80
70
60
50
40
30
20
10
0
39
Urban
100
90
80
70
60
50
40
30
20
10
0
Rich
Richest
81.8
53
25.1
12.5
No Education
Urbanization
Y-axis – grams per day
Living longer and older
Middle
Socio-economic Status
60.3
Rural
Poor
Elementary
Secondary
Educational Attianment
Source: National Nutrition Survey 2008
Getting sick and dying of NCDs
Tertiary
How disease factors affect people
Health financing
49
50. Who consumes the highest level of SALT in their diet?
The poor, those who live in rural areas, and those who did not
undergo any formal education
14
14
12
12
10
10
8
8
6
4
12.6
6
3.6
3.3
3
4
2
0
1.4
2
1.1
1.6
1.3
Poor
Middle
Rich
Richest
0
Male
Female
Total
Poorest
Sex
Socio-economic Status
14
14
12
12
10
10
8
6
10.3
8
5.8
6.2
6
4
4
1
2
0
1.6
2
1.1
Secondary
Tertiary
0
Rural
Urban
No Education
Urbanization
Y-axis – grams per day
Living longer and older
Elementary
Educational Attianment
Source: National Nutrition Survey 2008
Getting sick and dying of NCDs
How disease factors affect people
Health financing
50
51. Men consume alcohol nearly five times
more than women.
90
78.2
80
70
Percentage
60
53.3
53
47.5
50
Males
40
30.6
25.6
30
26.9
Females
Both
20
11.1
9.8
10
0
1998
2003
2008
Year
Prevalence Trend of Alcohol Drinking, by Sex in the Philippines
Source: National Nutrition Survey, 2008
51
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
52. In general, Filipinos have low physical
activity, regardless of the purpose.
100
92.6
94.5
92.6
92.7
90
Percentage (%)
80
76.3
72.2
70
60
50
Work-related PA
40
Travel-related PA
30
Leisure-related PA
20
10
0
2003
2008
Year
Comparison of Low Physical Activity (PA) by Domain, Philippines: 2003 and 2008
Source: National Nutrition Survey, 2008
52
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
53. While in general, Filipinos are physically
inactive, males are a bit more physically active than
females.
Female
Work-related PA
76.2
Nonwork-related PA
23.8
70
30
Travel-related PA
95.2
4.8
Liesure-related PA
95.7
4.3
Low
Male
Work-related PA
76.3
Nonwork-related PA
High
23.7
83
Travel-related PA
17
93.8
Liesure-related PA
6.2
89.1
0
10
20
30
40
10.9
50
60
70
80
90
100
Prevalence (Percentage)
Percent distribution of adults 20 years and over, by Physical Activity (PA)
and by Sex, Philippine 2008
Source: National Nutrition Survey, 2008
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
53
Health financing
54. Increasing URBANIZATION in the Philippines has a role to
play in limiting physical activity and shaping lifestyles
that lead to chronic noncommunicable disease.
Level of Urbanization (in Percent)
60
48
47
50
50.3
37.3
40
31.8
30
20
10
Total Population
0
1970
1890
1990
2000
2008
Year
54
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
55. Social Determinants of Health
The poorest pay the most as a share of their monthly income
for food, which is a critical determinant of health.
AVERAGE HOUSEHOLD MONTHLY INCOME
Poorest
5,958
Poor
Middle
Income
8,594
12,269
Rich
18,497
Richest
40,590
FOOD EXPENDITURE SHARE
67%
57%
49%
40%
Source: Family Income and Expenditure Survey, 2009
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
27%
55
56. The Vulnerable Filipino Woman
Biological Risk Factors
• Predilection for diabetes
• Risk factors: Obesity, High cholesterol levels, Physically inactivity
Social Determinants of Health
• What more – the poor, uneducated woman who lives in the
province?
Other Social Issues Confronting Women
• Social factors will further complicate the situation: limited
employment opportunities, less working years, role in child
rearing, gender violence, access to reproductive health services
56
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
57. We are living longer, and
the elderly population is
gradually increasing.
We get sick and we die
more often than ever
from chronic
noncommunicable
diseases.
The factors that lead to
disease affect the
population differently.
People are not protected
enough from financial
risks that come with ill
health.
57
58. As of 2011. the Philippines spends 4.4% of its GDP for
health – still short of the 5% WHO recommendation.
5
4.4
4.3
4.5
3.9
4
4
3.9
4.2
3.9
Percentage (%)
3.5
3
3.1
3.1
3.1
3.1
2005
2006
2007
2008
3.2
3.2
2009
2010
3.3
2.5
2
1.5
1
0.5
0
2011
Year
Share to GNI
Share to GDP
Share of Health Expenditure to GDP and GNI, 2005-2011
Source: Philippine National Health Accounts, 2011
58
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
59. In 2011, the Philippines spent only PhP 4,577
per person for health care for the entire year.
5000
4577
4500
4112
3759
4000
3377
In Philippine Pesos
3500
3000
2500
3061
2624
2783
2639
2022
2083
2159
2179
2005
2006
2007
2008
2442
2298
2000
1500
1000
500
0
2009
2010
2011
Year
At Current Prices
At Constant 2000 prices
Per capita health expenditure, 2003-2011
Source: Philippine National Health Accounts, 2011
59
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
60. The Philippines is financing a predominantly “disease
care” system, with little funding allotted for health
promotion and disease prevention.
Others
9%
Public Health
12%
Personal Care
79%
Total Health Expenditure by Use of Funds, 2011
Source: Philippine National Health Accounts, 2011
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
60
61. In 2011, Filipinos spent more from OUT-OF-POCKET
sources for health care than any other source.
1%
6%
4%
National Government
12%
Local Government
Social Insurance
15%
Out-of-Pocket
9%
Private Insurance
Health Maintenance
Organizations
53%
Others
Source: Philippine National Health Accounts, 2011
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
61
62. HEALTH INSURANCE COVERAGE increases with
income, with private health insurance only comprising
2.1% of the total population.
70
65
60
48.2
Percentage
50
42
39.4
40
37.3
35.3
31
30
20
57
53.8
28.6
20.6 19.6
7
10
0.2
0
Lowest
Second
Third
2.1
2
1.1
0.3
Fourth
Highest
Total
Wealth Quintiles
Any Insurance
PhilHealth
Private Insurance/HMO
Source: National Demographic and Health Survey, 2008
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
62
63. Even with PRIVATE HEALTH INSURANCE, there is very
little coverage among the middle and upper class.
0
10
20
30
40
50
60
70
80
90
100
NCR
CAR
I
II
III
IVA
IVB
V
VI
VII
VIII
IX
X
XI
XII
XIII
ARMM
Population covered with private insurance
Uncovered population from 3rd to 5th wealth quintiles
Source: National Demographic and Health Survey, 2008
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
63
64. The elderly spend the most for health care, and they
pay mostly from out of their pockets.
25
In Billion Pesos
20
15
10
5
0
0-4y
5-9y
10-14y
Natl Govt
15-19y
20-39y
Local Govt
Philhealth
40-49y
50-64y
65y and above
Out of Pocket
Health expenditures by financing agent and by population age group, 2003
Source: Racelis, et al., 2007
64
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
65. The rich pays the most for health care, and mostly from out of
their pockets – because the poor has no pocket at all.
60
In Billion Pesos
50
40
30
20
10
0
Poorest
Poor
Natl Govt
Middle
Local Govt
Philhealth
Rich
Richest
Out of Pocket
Health expenditures by financing agent and by income quintile, 2003
Source: Racelis, et al., 2007
65
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
66. Filipino households spend 68% of its out-of-pocket
payments for health care just for DRUGS AND
MEDICINES alone.
15.60%
4.30%
Drugs and Medicine
8.00%
Hospital Charges
Professional fees
4.10%
68.00%
Contraceptives
Others
Households' out-of-pocket payments, by expenditure item, 2006
Source: Family Income and Expenditure Survey, 2006
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
66
67. Despite the Cheaper Medicines Act, there is still a
wide variation of medicine prices at retail.
Product
Unit
GENERIKA
Generics
Pharmacy
Watson's
Pharmacy
Mercury
Drug Store
Current
Price
Amlodipine
tablet
peso/10mg
3.25-19.65
3.25-8.00
7.25-38.50
5.00-38.50
3.25-38.50
Losartan
tablet
peso/50mg
4.75-19.50
5.00-8.75
11.00-24.00 10.75-24.50
4.75-24.50
Metoprolol
tablet
peso/50mg
1.75-3.10
1.75-2.50
2.42-15.00
2.75-18.75
1.75-18.75
Telmisartan
tablet
peso/40mg
25.00-25.75
NA
25.75
25
25.00-25.75
Warfarin Na
tablet
peso/1mg
14.75-18.00
NA
21.75
Aspirin
tablet
peso/
100mg
1.25-1.75
1.8
2.50-2.75
14.75-21.75 14.75-21.75
1.90-4.50
Source: DOH Price Monitoring Chart, July 2013
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
1.25-4.50
67
68. While the COST OF HEALTH CARE is higher in private
facilities, the Filipino still cannot pay for health care
without incurring the risk of impoverishment.
Type of care
Both Types
Public Facility
Private Facility
Person visited a health facility in the past 30 days
Average cost of
transport
109
80
134
Average cost of
treatment
1,872
1,051
2,864
Person confined in a hospital or clinic in past 12 months
Average cost of
confinement
16,802
9,849
24,278
* In Philippine Pesos
Source: National Demographic and Health Survey, 2008
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
68
69. Paying for Health Care in the Philippines
Filipinos still pay
mostly from out of
their pockets for
health care, which
oftentimes leads to
impoverishment.
Health care costs
remain high, with
the bulk being
spent to cover for
medicines and
drugs.
There is a role for
both publiclyadministered and
privately-provided
insurance schemes
to ensure financial
risk protection
during times of
illness.
69
Living longer and older
Getting sick and dying of NCDs
How disease factors affect people
Health financing
70. How healthy is the Filipino?
We are living longer, and
the elderly population is
gradually increasing.
We get sick and we die
more often than ever
from chronic
noncommunicable
diseases.
The factors that lead to
disease affect the
population differently.
People are not protected
enough from financial
risks that come with ill
health.
70
71. Are we ready to address their health needs?
40 year old single mother,
20 year old fresh
obese, with a history of
graduate, chain smoker,
diabetes, working in the working in his first job in a
corporate sector
call center
65 year old grandmother,
widow, with high blood
pressure and history of
heart disease, about to
retire
34 year old businessman,
with wife and three
children, heavy eater and
drinker, running his
restaurant business
71
72. Are we ready to address their health needs?
40 year old single
mother, obese, with a
history of
diabetes, working in the
corporate sector
20 year old fresh
graduate, chain
smoker, working in his
first job in a call center
65 year old
34 year old
grandmother, widow, with businessman, with wife
high blood pressure and and three children, heavy
history of heart
eater and drinker, running
disease, about to retire
his restaurant business
72
73. Are we ready to address their health needs?
40 year old single
mother, obese, with a
history of
diabetes, working in the
corporate sector
20 year old fresh
graduate, chain smoker,
working in his first job in a
call center
65 year old grandmother,
widow, with high blood
pressure and history of
heart disease, about to
retire
34 year old businessman,
with wife and three
children, heavy eater and
drinker, running his
restaurant business
73
74. Are we ready to address their health needs?
40 year old single mother,
20 year old fresh
obese, with a history of
graduate, chain smoker,
diabetes, working in the working in his first job in a
corporate sector
call center
65 year old grandmother,
widow, with high blood
pressure and history of
heart disease, about to
retire
34 year old businessman,
with wife and three
children, heavy eater and
drinker, running his
restaurant business
74