The Rising Tide of Lifestyle Diseases in the Pacific

Author: Macquin Anduwan - Bachelor of Oral Health

Lifestyle diseases, the most common cause of non-communicable diseases (NCDs), are said to have reached epidemic proportions throughout the Pacific Islands [1]. These diseases are contracted from unhealthy lifestyle practices such as tobacco use, an unhealthy diet, and lack of exercise [2]. In addition, the ever-increasing pressure of Western influence means that most native islanders are leaving behind their traditional diet of root crops, coconuts, sea foods, leafy greens and nuts, and various local fruits in exchange for more starchy, sweet and processed foods [3]. This has led to a growing concern in regards to non-communicable disease caused by poor lifestyle choices.

After the fall of Japan during the close of World War II, much of the Pacific Island Countries (PICs) were occupied by the U.S. and a few European countries [3]. Even after many of them claimed independence, a few of the Islands still remained territories to foreign nations to this date [3].

Around the 1940s, a survey was conducted by the U.S Navy in Micronesia after World War II. The study, remarkably, showed almost no signs of obesity, hypertension, or diabetes among the population [3]. Presently, more than 50 years later, we have reached the position where Pacific Island countries rank among the highest in terms of non-communicable diseases due to poor lifestyle choices. According to the International Diabetes Federation, of the top ten countries with the highest prevalence of diabetes among 20 – 79 year olds, seven out of the ten spots are occupied by Pacific Island countries [4].

These lifestyle diseases were previously thought of as a problem only High-Income Countries (HIC) faced, while Low and Middle Income Countries (LMIC) mostly dealt with communicable diseases – diseases that are transmissible from one host to another and result from infectious pathogens [5], [1]. However, the shift from communicable diseases, as the number one cause of premature mortality rates, to non-communicable diseases is now complete [1]. Indeed, it has been shown that most LMICs are responsible for most of the deaths world-wide caused by non-communicable diseases, taking up 86% of these premature deaths [1]. Non-communicable diseases are already the leading cause of most deaths in the Pacific with ranges from approximately 60% of deaths in Solomon Islands to 77% of deaths in Fiji [6].

These lifestyle diseases which plague the Pacific Island Countries can be identified as cardiovascular diseases, diabetes, chronic respiratory diseases, and cancer [7], [6].

An article released by the World Bank suggests that PICs face particular challenges in regards to lifestyle diseases [6]. They also state that the percentage of NCDs will rise rapidly over the next few decades given that most Pacific Island Countries have high population growths which could stimulate economic growth. A second factor in the projected levels of NCD risk prevalent around the Pacific is behavioural risk factors such as tobacco use, lack of physical activity and an unhealthy diet [6].

Dietary Risk factors account for the highest behavioural risk factors for death due to diabetes while tobacco use has been identified as the most significant and only risk factor that is common to the four main non-communicable diseases [6].

With the ever-increasing population and percentage of those developing NCDs, as well as the already large percentage of public expenditure on health as a percentage of GDP in the Pacific, the challenge has kept many health care systems struggling [3]. Due to this economic burden placed on governments, it would be more cost effective to prevent or make awareness on unhealthy lifestyle choices rather than increase spending on treatments [8]. Often, many of the PICs have increased use of foreign aid to fund their health care initiatives [8]. However, the sustainability of using much of their GDP for health is taking a toll on their economic growth.

To control the unprecedented rise in lifestyle diseases, governments may get involved through regulations such as Food Policing and Sin Taxation. Fiji, for example, has banned the import of lamb/mutton flap while about half of the countries in the Pacific have existing sin taxations on soft drinks, consequently raising the price of soft drinks because of the higher tax placed on them [3]. Despite all these controlled measures, the ever-increasing prevalence of lifestyle diseases indicates that a cooperative effort between government regulators, non-profit organisations, public health awareness, and individual commitment will see positive results [6].

It has, therefore, become imperative that much of the emphasis should be placed on healthier lifestyle practices such as a nutritious diet, exercising at least thirty minutes each day, getting enough rest, abstinence or limited use of alcohol, tobacco, and other drugs, and practicing good personal hygiene. Taking into consideration the health, economic, and social benefits, a preventative course of action would be better than curative. After all, lifestyle diseases can be prevented. All we need is a change in lifestyle choices.

References

[1]

L. M. Kent, P. Reierson and D. P. Morton, "'Live more': Study protocol for a community-based lifestyle education program addressing non-communicable diseases in low-literacy areas of the South Pacific," BMC Public Health, 9 December 2015. [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4674910/. [Accessed 23 July 2020].

[2]

F. Al-Maskari, "LIFESTYLE DISEASES: An Economic Burden on the Health Services," United Nations, [Online]. Available: https://www.un.org/en/chronicle/article/lifestyle-diseases-economic-burden-health-services. [Accessed 23 July 2020].

[3]

J. Ruikka, "The Western diet's negative impact on the health of the Pacific," University of Louisville, May 2016. [Online]. Available: https://ir.library.louisville.edu/cgi/viewcontent.cgi?article=1131&context=honors. [Accessed 23 July 2020].

[4]

International Diabetes Federation, IDF Diabetes Atlas (7th Edition ed.), Brussels: International Diabetes Federation, 2015.

[5]

"Communicable Diseases," Wisconsin Department of Health Services, 22 November 2016. [Online]. Available: https://www.dhs.wisconsin.gov/disease/communicable.htm. [Accessed 24 July 2020].

[6]

X. Hou, I. Anderson and E.-J. Burton-Mckenzie, "Pacific Possible: Health & Non-Communicable Diseases," The World Bank, June 2016. [Online]. Available: http://pubdocs.worldbank.org/en/942781466064200339/pacific-possible-health.pdf. [Accessed 23 July 2020].

[7]

R. Taylor, "Prevention and control of non-communicable diseases in Pacific Island nations. Prospects and constraints," PubMed, 15 October 1983. [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/6621487/. [Accessed 23 July 2020].

[8]

M. N. Khan, "AusAID AND HEALTH SERVICES IN FIJI: A CASE STUDY OF NON-COMMUNICABLE DISEASES," The University of the South Pacific, Suva, 2014.