Premature death related to community health

1. PREMATURE DEATH
Hawler Medical University
College of Medicine
Community Health
Prepared by:
Hawraz Faris Saadi
BSN, MD Student

2. Pre mature Death
• Definition: Death that occurs before the average age of death
in a certain population.
• Its between 45 and 65 years old.

3. Pre mature Death Cont.
• In low and middle income countries, about 29% of deaths
occurred before the age of 60 in 2008, and about 48% are
estimated to have occurred under the age of 70, compared
with 26% in high income countries. Worldwide, approximately
44% of all non communicable disease deaths occurred before
the age of 70.

4. Pre mature Death Cont.

5. Risk factors
1. Tobacco
2. Unhealthy Diet
3. Raised blood pressure
4. Over weight & Obesity
5. Insufficient physical activity
6. Raised Cholesterol
7. Harmful use of alcohol

6. 1. Tobacco
• Is in legal use everywhere in the world, yet it causes far more
deaths than all other psychoactive substances combined.
About 3 million premature deaths a year (6% of the world
total) are already attributed to tobacco smoking.
• Tobacco is responsible for about 30% of all cancer deaths in
developed countries.

7. 1. Tobacco. Cont.
• Smoking damages the lining of arteries, leading to a build up of
fatty material (atheroma) which narrows the artery.
• The carbon monoxide induced atherogenesis and in tobacco
smoke reduces the amount of oxygen in the blood. This means
the heart has to pump harder to supply the body with the
oxygen it needs.

8. 1. Tobacco . Cont.
• The nicotine in cigarettes stimulates the body to produce
adrenaline, which makes the heart beat faster and raising the
blood pressure, making the heart work harder and raising
myocardial oxygen demand.

9. 2. Unhealthy Diet
• high salt consumption is an important determinant of high
blood pressure and cardiovascular risk.
• High consumption of saturated fats and trans-fatty acids is
linked to heart disease.
• Adequate consumption of fruit and vegetables reduces the risk
for cardiovascular diseases, stomach cancer and colorectal
cancer.

10. 3. Raised blood pressure
• Raised blood pressure is estimated to cause 7.5 million
deaths, about 12.8% of all deaths. It is a major risk factor for
cardiovascular disease.
• The prevalence of raised blood pressure is similar across all
income groups.

11. 4. Over weight & Obesity
• At least 2.8 million people die each year as a result of being
overweight or obese.
• Risks of heart disease, stroke and diabetes increase steadily
with increasing body mass index (BMI).
• Raised BMI also increases the risk of certain cancers.
• The prevalence of overweight is highest in upper-middle-
income countries.

12. 5. Insufficient physical activity
• Approximately 3.2 million people die each year due to physical
inactivity.
• People who are insufficiently physically active have a 20-30%
increased risk of all-cause mortality.
• Regular physical activity reduces the risk of cardiovascular disease,
including high blood pressure, diabetes, breast and colon cancer
and depression.
• Insufficient physical activity is highest in high income countries

13. 6. Raised Cholesterol
• Raised cholesterol is estimated to cause 2.6 million deaths
annually.
• It increases the risk of heart disease and stroke.
• Raised cholesterol is highest in high-income countries.

14. 7. Harmful use of alcohol
• Approximately 2.3 million die each year from the harmful use
of alcohol, accounting for about 3.8% of all deaths in the
world.
• More than half of these deaths occur from NCDs including
cancers cardiovascular disease and liver cirrhosis.
• Is highest in high-income countries

15. Prevention
1. Primordial prevention
2. Primary prevention
3. Secondary prevention
4. Tertiary prevention

16. 1. Primordial prevention
a) That is prevention of the emergence of risk factors in
countries in which they have not yet appeared
b) The preventive measures comprise maintenance of
normal body weight .
c) Through adoption of healthy nutritional habits and
physical exercise

17. 1. Primordial prevention Cont.
d) Since the etiology of premature death are multifactorial
the approach to prevention should be multifactorial aimed
at controlling or modifying as many risk factors as
possible.
e) The aim should be to change the community as a whole,
not the individual subjects living in it.

18. 2. Primary prevention
A. Population strategy: the population strategy include the
following key areas
1. Dietary changes.
2. Smoking.
3. Blood pressure.
4. Physical activity.

19. 1. Dietary changes
Dietary modification is the principal preventive strategy by :
a) Reduction of fat intake to 20-30% of total energy intake.
b) consumption of saturated fats must be limited to less
than 10% of total energy intake.
c) Reduction of dietary cholesterol to below 100 mg per
1000 kcal per day.

20. 1. Dietary changes Cont.
d) increase in complex carbohydrate consumption
(vegetables, fruits, whole grains and legumes).
e) avoidance of alcohol consumption.
f) Reduction of salt intake to 5 g daily or less.

21. 2. Smoking
a) The goal should be to achieve a smoke-free society, and
several countries are progressing towards this goal.
b) To achieve the goal of a smoke-free society, a
comprehensive health program would be required which
includes effective information and education activities

22. 3. Blood pressure
The goal of the population approach to high blood
pressure would thus be to reduce mean population
blood pressure levels. This involves a multifactorial
approach based on a "Prudent Diet"

23. 4. Physical activity
• Regular physical activity should be a part of normal daily
life.
• It is particularly important to encourage children to take
up physical activities that they can continue throughout
their lives.

24. B. High risk strategy
1) Identifying risk
2) Specific advice

25. 1) Identifying risk
• High-risk intervention can only start once those at
high risk have been identified.
• By means of simple tests such as blood pressure and
serum cholesterol measurement it is possible to
identify individuals at special risk.
• Individuals at special risk also include those who
smoke, those with a strong family history of diabetes
and obesity.

26. 2) Specific advice
Having identified those at high risk, the next step will be to
bring them under preventive care and motivate them to
take positive action against all the identified risk factors.

27. 3. Secondary prevention
• Secondary prevention must be seen as a continuation of
primordial prevention and primary prevention, it forms an
important part of an overall strategy.
• The aim of secondary prevention is to prevent the
recurrence and progression of diseases.
• Despite advances in treatment

28. 4. Tertiary Prevention
• Rehabilitations to prevent Complication and death

29. we can increase the life expectancy

31. References
1. http://www.who.int/gho/ncd/mortality_morbidity/ncd_premature_text/en/
2. https://en.wikipedia.org/wiki/Middle_age#Definitions
3. https://healthyforgood.heart.org/eat-smart/articles/trans-fat
4.Nicki R., Brian R., Stuart H., (2010) Davidson’s Principles and Practice of
Medicine.
5.Park K. (2015) Park’s Textbook of Preventive and Social Medicine.