Non-communicable diseases are still underestimated, only 59% consider diabetes very harmful

Is it possible to underestimate the greatest killer in the world? In a word, yes. In short, unfortunately yes.

As you may have heard, non-communicable diseases (NCDs) have become the leading cause of death worldwide. That’s because NCDs kill an average of about 41 million people each year, accounting for about 74 percent of all deaths worldwide, according to the World Health Organization (WHO). Yet a new Gallup poll commissioned by the WHO and Bloomberg Philanthropies found that a significant percentage of people still may not consider the top five NCDs to be “very harmful.” This is a remarkable break because death is a very damaging thing.

For the survey, Gallup interviewed adults 18 and older from five different countries: the United States, Colombia, India, Jordan and Tanzania. In many cases, the Gallup folks didn’t exactly get “killer” answers, so to speak. For example, only 83% of those interviewed considered cancer “very harmful”. That rate dropped to 72% for heart disease and stroke, and the numbers for diabetes and lung disease were even lower, at 59% and 51% respectively.

In fact, in Jordan, where diabetes is the third leading cause of death, only 36% indicated that diabetes was “very harmful”. Similarly, only 49% of respondents in Tanzania, 44% of those in the US, and 36% of those in Jordan had a “very harmful” perception of lung disease, even though lung disease kills over four million people each year. Turn all those percentages around and you’re talking about potentially millions and millions of people in every country who underestimate how bad NCDs really are.

“There were some differences by country,” emphasized Kelly Henning, MD, director of the public health program at Bloomberg Philanthropies. “This kind of granularity of data has not been collected before.” Henning pointed out that the results show that not everyone is sufficiently aware of NCDs and their risk factors, and that this awareness will be important in the prevention and control of NCDs.

Of course, survey results don’t always accurately reflect what everyone in the population actually thinks. Naturally, the Gallup staff did not interview every single person in the United States, Colombia, India, Jordan, and Tanzania. That would take a very, very long time. Instead, the Gallup team selected probability-based and nationally representative random samples of adults in each of the five countries. Specifically, the samples consisted of 1,028 adults in the United States, 1,000 in Colombia, 1,001 in Jordan, 1,000 in Tanzania, and 3,000 in India. Interviews in the U.S. were conducted by phone, while interviews in the other four countries were in-person, conducted from November 2021 to January 2022. Although the results may not represent the exact percentages of people in each country who may feel that way statistical tests suggest that all results are likely to be within a few percentage points of the true percentages. Suffice it to say, too many people still don’t realize how bad for the bones — and bad for the heart, lungs, kidneys, brain, eyes, and other body parts you really like — NCDs can be.

So why is there this disconnect between reality and perception of NCDs? Did NCD just hire a really good publicist? Well, non-communicable diseases are quite difficult. They don’t brandish knives or ray guns or say really threatening things on Twitter. They’re not like a giant telepathic starfish that destroys a city like Staro the Conqueror did in the movie The Suicide Squad. Instead, NCDs can be much quieter killers, at least initially. They can quietly creep up on you like hair growing out of your ears or your YouTube habit. For example, diabetes may initially seem like little more than “your blood sugar levels are low.” It can take time for problems with your heart, kidneys, eyes, nerves, legs, kidneys, and other parts of your body to develop and become life-threatening. Likewise, lung disease early in its course can seem like a little breathless thing, kind of like when you see something amazing like a really big plate of nachos.

Then there is the old misconception about NCDs. “Many people may think of NCDs as diseases of the elderly,” Henning explained. “But it’s not just about the extremely elderly. They affect many working-age adults. For example, the Centers for Disease Control and Prevention (CDC) website indicates that “type 2 diabetes most often develops in people over the age of 45, but more and more children, teenagers, and young adults are also developing it.” O , and 45 isn’t exactly a withdraw-your-401k age. Heck, a lot of Hollywood actors turned 45 last year, and some will still be rolling around in super-tight red spandex suits and saying words like “back cheeks” way too often for years to come.

There may also be a misconception that non-diseases are a natural part of aging and not things that can be prevented. Studies show how many cancers, heart disease, strokes, diabetes and lung disease are highly preventable. And even if you can’t prevent the diagnosis of these five major non-communicable diseases, you can prevent or at least slow their progression. Now, if you think that NCDs are something that each person chooses for themselves and it’s all personal choice, you’d be wrong, as wrong as a bathroom gong. Many risk factors for NCDs lie in the systems that surround people, such as their social, political and physical environments. For example, if the air around you is polluted, you cannot simply choose not to breathe. Likewise, if all the food around you has too much salt, then you can’t just remove each salt granule one by one by hand. Also, no matter how often your life coach tells you that “you are yourself,” you are actually influenced in many ways, often subtly, by the people and things around you. So to prevent and control NCDs, the will and cooperation of the public and governments around the world is needed.

This brings us to the positive findings from the Gallup interviews: that majorities of adults in all five countries support policy measures that can help fight NCDs. For example, 69%, 66% and 59% of those interviewed support higher taxes on alcohol, tobacco and sugary drinks respectively. Such results contradict the narrative put forth by some politicians that people don’t want to pay more taxes at all, period.

There was even greater support for laws restricting or banning smoking in public places (a national average of 69% supported this), advertising of high-sugar foods and drinks to children (72% said they accepted it) and companies to promote unhealthy products (72% are fine, fine, fine with that). These findings contradict the political narrative that people don’t want restrictions, that people want the freedom to do whatever they want.

Support jumped above 90 percent for running media campaigns to promote healthy behaviors (91%), increase access to health services (93%), and create spaces to support healthier lifestyles such as public parks or safe walking routes (95%). It kind of makes you wonder who the seven percent are who don’t want more access to health care. But okay.

All in all, this is not so good news, but promising news at the same time. While there may not yet be enough awareness of NCD harm, “the support for more policies is there,” Henning said. Henning went on to say that there are opportunities to overcome what she sees as the two main obstacles to better control of NCDs: a relative lack of awareness and political will. In fact, the time may be right for even greater efforts against NCDs in the coming years. Earlier this year, the WHO identified 16 “best buy” interventions to tackle NCDs, as I described Forbes in February. These are interventions that will not only save lives, but are also very affordable and, in some cases, cost-effective. At the same time, increasing efforts are being made to raise awareness and implement policies, especially in low- and middle-income countries, where the burden of noncommunicable diseases is increasing rapidly. Oh, and if you’ve been keeping up with the news for the past few years, there’s been this little thing called the Covid-19 pandemic. “The pandemic has shone a light on how important it is to have healthy populations,” Henning added. “People with non-communicable diseases are more likely to do worse. This makes a strong case for doing more to control NCDs.”

If indeed more efforts can be made to raise awareness and better prevent and control NCDs, then this could be a ‘killer’ result, meaning that it would be a perfectly fine thing to be able to thwart the world’s leading killers .