What are noncommunicable diseases. Diagnostic criteria for risk factors for the development of chronic non-communicable diseases. Elevated blood cholesterol

METHODOLOGICAL INSTRUCTIONS

FOR STUDENTS

by discipline " Healthy lifestyle »

for the specialty060101 – Medical business (full-time education)

TO PRACTICAL LESSON No. 1

TOPIC: “WATER ACTIVITY. THE CONCEPT OF HEALTH IN GENERAL. RISK FACTORS FOR MAIN CHRONIC NON-COMMUNICABLE DISEASES»

Minutes No. __ of "____" ___________ 2012 were approved at the cathedral meeting.

Department head

doctor of medical sciences, professor _________________ Petrova M.M.

Compiled by:

Candidate of Medical Sciences, Assistant _________________ Evsyukov A.A.

Krasnoyarsk

1. Lesson #1

Topic"Water activity. The concept of health in general. Risk factors for major chronic non-communicable diseases”.

2. Form of organization of the educational process- practical lesson.

3. Theme value.

The health of the population and each person individually is the most valuable benefit for society. The health of the nation affects the nature of all demographic processes in the country, and it determines not only the death rate, life expectancy, but also the birth rate, and ultimately determines the population.

Russia is currently experiencing a demographic crisis due to high mortality and reduced fertility. In 1992 Russia's population was 149 million. human. And as of 2008. it decreased by 11 million - and reached the figure of 138 million. human. If these trends continue over the next 50 years, we can expect a further decline in the country's population by more than 30%.

The fertility rate, which ensures the reproduction of the population, corresponds to 2.1 children per woman of childbearing age. In Russia, this indicator decreased to 1.1 and, according to forecasts, after 2025. Russia's total fertility rate will continue to be below replacement levels.

It has now been shown that the most common causes of death, morbidity and disability in Russia are non-communicable diseases and injuries, which account for 68% of the total mortality of the population.

Learning objectives:

common goal: the student must master

- the ability and readiness to analyze socially significant problems and processes, to use in practice the methods of the humanities, natural sciences, biomedical and clinical sciences in various types of professional and social activities (OK-1).

- the ability and readiness to apply modern socio-hygienic methods for collecting and medical and statistical analysis of information on the health indicators of the adult population and adolescents at the level of various departments of medical organizations (obstetrics and gynecology, pediatric rural medical district) in order to develop evidence-based measures to improve and preserve health of men and women (PC-10);

The ability and readiness to carry out preventive measures with the attached population to prevent the occurrence of the most common diseases, to carry out general health measures to promote a healthy lifestyle, taking into account age and sex groups and health status, to give recommendations on healthy nutrition, on motor regimens and physical education, to evaluate effectiveness of dispensary observation of healthy and chronic patients (PC-12).

learning goal- to familiarize students with risk factors for the development of chronic non-communicable diseases, explain the risk of developing chronic non-communicable diseases, explain the main strategies for the prevention of chronic non-communicable diseases.

4. Plan for studying the topic:

4.1. Control of the initial level of knowledge

4.2. Independent work on the topic

4.3. Final control of knowledge:

Solution of situational problems, tests on the topic;

Summarizing

5. Basic concepts and provisions of the topic. Chronic non-communicable diseases are a number of chronic diseases, including cardiovascular, oncological, broncho-pulmonary diseases, mental disorders, diabetes mellitus. They are characterized by a long period of pre-illness, a long course and manifestations leading to a deterioration in health.

Chronic noncommunicable diseases usually have a long incubation period and symptoms appear 5-30 years after exposure to lifestyle and environmental risk factors.

The greatest contribution to mortality from chronic non-communicable diseases is made by cardiovascular diseases, the mortality from which is characterized by an annual loss of approximately 1 million deaths. 200 thousand people, which is about 55% of the total mortality. At the same time, in the US, cardiovascular diseases account for 38%, in Portugal - 42%, in Brazil - 32%. Based on these data, the researchers concluded that if Russia could achieve a 20% reduction in mortality from cardiovascular diseases, then life expectancy would increase to 62.5 years for men and 79.5 years for women. And given that an unhealthy lifestyle, unfavorable natural and social environment play a significant role in the development of cardiovascular diseases, these diseases are preventable, accessible for early detection and treatment.

According to the Ministry of Health and Social Development of Russia, in 2007-2008. 13.5 million working citizens underwent medical examinations (additional medical examination), which is about 15% of the total working population. Half of the examined patients had certain chronic diseases, while before the examination, the majority of patients considered themselves healthy. And in order to examine the rest of the working citizens, it will take another 12-13 years if innovative special (“screening”) methods are not applied to detect health disorders.

And one more sad fact - about 60% of patients who died as a result of a heart attack have never previously applied to medical institutions at their place of residence with complaints of pain in the heart. Thus, in the short term, with minimal investment, it is possible to fundamentally change the approach to preserving the health of our citizens. The formation of a commitment to a healthy lifestyle will be more effective when it is supported by the results of instrumental studies. Prevention will take place not at the population level, but at the individual level, which will increase its effectiveness by an order of magnitude.

It is known that many non-communicable diseases have common risk factors, such as smoking, overweight, high blood cholesterol, high blood pressure, alcohol and drug use, physical inactivity, psychosocial disorders, environmental problems. The experience of developed countries convincingly shows that the result of vigorous measures to limit the prevalence of risk factors for non-communicable diseases is an increase in the average life expectancy of the population.

Smoking.

According to the WHO, tobacco smoking is a leading cause of ill health and premature death. Smoking is one of the most significant risk factors leading to the development of diseases such as cancer, cardiovascular, respiratory and other diseases. Up to 90% of all cases of lung cancer, 75% of cases of chronic bronchitis and emphysema, and 25% of cases of coronary heart disease are associated with smoking. It is also known that tobacco tar is not the only life-threatening substance inhaled during smoking. More recently, tobacco smoke counted 500, then 1000 components. According to modern data, the number of these components is 4720, including the most poisonous - about 200.

It should be noted that smoking exists in two completely different clinical varieties: in the form habits to smoking and in the form tobacco addiction. Those who smoke only out of habit can become non-smokers completely painlessly, without any medical help, and eventually forget that they smoked at all. And those who have developed tobacco dependence, with all their desire, cannot give up smoking forever, even if their first days without tobacco go relatively well. Sometimes, even after a long break (several months or even years), they relapse. This means that smoking has left a deep mark on the mechanisms of memory, thinking, mood and metabolic processes of the body.

According to scientific data, out of 100 systematic smokers, only seven smoke as a result of a habit, the remaining 93 are addicted to tobacco. As established by special studies, up to 68% of the smoke of burning tar and the air exhaled by a smoker enters the environment, polluting it with tar, nicotine, ammonia, formaldehyde, carbon monoxide, nitrogen dioxide, cyanides, aniline, pyridine, dioxins, acrolein, nitrosoamines and other harmful substances. substances. If several cigarettes are smoked in an unventilated room, then in one hour a non-smoking person will inhale as many harmful substances as enter the body of a person who has smoked 4-5 cigarettes. Being in such a room, a person absorbs as much carbon monoxide as a smoker, and up to 80% of other substances contained in the smoke of cigarettes, cigarettes or pipes. Regular exposure to a smoker (in the role of "passive smoker") increases his risk of fatal heart disease by 2.5 times compared to those people who were not exposed to second-hand smoke. Children under 5 years of age are most sensitive to tobacco smoke. Passive smoking contributes to the development of hypovitaminosis in them, leads to loss of appetite and indigestion. Children become restless, sleep poorly, they have a long, difficult to treat cough, often dry, paroxysmal in nature. During the year they suffer from bronchitis and acute respiratory viral infections (ARVI) 4-8 or more times. Much more often than children of non-smoking parents, they also get pneumonia.

According to scientists, due to getting rid of nicotine addiction, the average life expectancy of earthlings would increase by 4 years. In many countries, economic levers are used to reduce the number of smokers, such as systematically raising the price of tobacco products. Studies by American experts have shown that people who are just starting to smoke, especially teenagers, are most responsive to rising prices. Even a 10% increase in the retail price of cigarettes reduces their purchase by more than 20%, and deters many from smoking altogether. Worldwide, the number of smokers is declining, and in Russia their number is 65 million people. Many diseases that Russians acquire are associated with smoking. According to the Ministry of Health and Social Development of Russia, among middle-aged Russians, smoking-related mortality is 36% for men and 7% for women. More than 270,000 people die every year from smoking-related causes in the country - more than from AIDS, car accidents, drug addiction and murder combined. Due to the increase in tobacco consumption, the incidence of lung cancer has increased by 63% over the past 10 years. The prevalence of smoking in Russia among the male population is 70%, among the female - about 20%. Every year 280-290 billion cigarettes are consumed in our country, the production of tobacco products is growing steadily. Of particular concern is smoking among teenagers, which is acquiring the proportions of a national disaster. The peak of initiation to smoking falls on early school age - from 8 to 10 years. Among adolescents aged 15-17 years old - residents of cities, an average of 39.1% of boys and 27.5% of girls smoke.

Smoking and emphysema generally go hand in hand. Emphysema is characterized by the fact that tar, nicotine and other destructive poisons of tobacco remain in the tiny air sacs of the lungs, the walls of which for this reason first become thin and then completely destroyed, and the blood therefore cannot remove poisonous carbon dioxide and receive oxygen. A person dies from oxygen starvation. The death rate of smokers from chronic bronchitis and emphysema is 15-25 times higher than that of non-smokers.

The smoker's heart is exposed to a double danger: his blood is filled with tobacco poisons, and the blood vessels constrict, impairing blood supply.

Tobacco neutralizes the effects of vitamin C. In laboratory studies, it was found that smoking one cigarette destroys the amount of vitamin C that is contained in one orange. A person who smokes one pack of cigarettes a day must therefore eat 20 oranges to restore the balance of valuable vitamin C in the body.

With relatively short periods of smoking, inflammatory processes of the gastric mucosa (gastritis) occur with increased secretion, and with prolonged smoking - chronic gastritis with secretory insufficiency.

Back in 1974, at a meeting of the Committee of Experts of the World Health Organization (WHO) in Geneva, data were presented according to which peptic ulcer should be attributed to smoking-dependent diseases.

Smoking worsens the course of diabetes mellitus, leading to serious complications, and can cause hearing loss. Tobacco contributes to the development of caries and inflammation of the oral cavity, disrupts blood clotting, and suppresses the immune system.

Calculation of the smoking index.

To find out the risk of developing chronic lung diseases, WHO recommends calculating the so-called smoking index (SI): SI = 12 x N, (where N is the number of cigarettes smoked per day, multiplied by 12 months per year). People who have an index above 200 are classified as<злостным курильщикам>. The likelihood of developing chronic lung diseases is high already at an index value of 160. But the higher the smoking index, the higher the risk of developing chronic lung diseases, primarily chronic obstructive pulmonary disease (COPD).

According to WHO, in general, the life expectancy of smokers is 4:8 years less than that of non-smokers.

1. Introduction

2.Smoking

3. Overweight

4.High levels of cholesterol in the blood

5.High blood pressure

6. Alcohol consumption

7. Drug prevalence

8.Low physical activity

9. Ecological condition

10. List of used literature

1. Introduction

According to the territorial body of the Federal State Statistics Service for the Krasnodar Territory, the population of the region as of June 1, 2006 amounted to 5,094 thousand people, of which 53 percent live in cities and 47 percent are rural residents. Since the beginning of the year, the population of the region has decreased by 2.4 thousand people (by 0.05%). Compared to January-May 2005, the death rate of the population decreased by 7 percent, there were 505 fewer births (2 percent less). The number of population losses were compensated by the migration gain by only 81 percent.

2.Smoking

According to WHO, tobacco smoking is the leading cause of ill health and premature death. Smoking is one of the most significant risk factors leading to the development of diseases such as cardiovascular, respiratory, and some forms of cancer. Up to 90% of all cases of lung cancer, 75% of cases of chronic bronchitis and emphysema, and 25% of cases of coronary heart disease are associated with smoking. It is also known that tobacco tar is not the only life-threatening substance inhaled during smoking. More recently, tobacco smoke counted 500, then 1000 components. According to modern data, the number of these components is 4720, including the most poisonous - about 200.

It should be noted that smoking exists in two completely different clinical varieties: in the form of smoking habit and in the form of tobacco dependence. Those who smoke only out of habit can become non-smokers completely painlessly, without any medical help, and eventually forget that they smoked at all. And those who have developed tobacco dependence, with all their desire, cannot give up smoking forever, even if their first days without tobacco go relatively well. Sometimes, even after a long break (several months or even years), they relapse. This means that smoking has left a deep mark on the mechanisms of memory, thinking, mood and metabolic processes of the body. According to available data, out of 100 systematic smokers, only seven smoke as a result of a habit, the remaining 93 are sick.

As established by special studies, up to 68% of the smoke of burning tar and the air exhaled by a smoker enters the environment, polluting it with tar, nicotine, ammonia, formaldehyde, carbon monoxide, nitrogen dioxide, cyanides, aniline, pyridine, dioxins, acrolein, nitrosoamines and other harmful substances. substances. If several cigarettes are smoked in an unventilated room, then in one hour a non-smoking person will inhale as many harmful substances as enter the body of a person who has smoked 4-5 cigarettes. Being in such a room, a person absorbs as much carbon monoxide as a smoker, and up to 80% of other substances contained in the smoke of cigarettes, cigarettes or pipes.

Regular exposure to the role of a "passive smoker" increases his risk of fatal heart disease by 2.5 times compared to those people who were not exposed to second-hand smoke. Children under 5 years of age are most sensitive to tobacco smoke. Passive smoking contributes to the development of hypovitaminosis in them, leads to loss of appetite and indigestion. Children become restless, sleep poorly, they have a long, difficult to treat cough, often dry, paroxysmal in nature. During the year, they suffer from bronchitis and SARS 4-8 or more times. Much more often than children of non-smoking parents, they also get pneumonia.

According to scientists, due to getting rid of nicotine addiction, the average life expectancy of earthlings would increase by 4 years. In many countries, economic levers are used to reduce the number of smokers, such as systematically raising the price of tobacco products. Studies by American experts have shown that people who are just starting to smoke, especially teenagers, are most responsive to rising prices. Even a 10% increase in the retail price of cigarettes reduces their purchase by more than 20%, and deters many from smoking altogether.

Worldwide, the number of smokers is declining, and in Russia their number is 65 million people. Many diseases that Russians acquire are associated with smoking. According to the Ministry of Health and Social Development of Russia, among middle-aged Russians, smoking-related mortality is 36% for men and 7% for women. More than 270,000 people die every year from smoking-related causes in the country - more than from AIDS, car accidents, drug addiction and murder combined. Due to the increase in tobacco consumption, the incidence of lung cancer has increased by 63% over the past 10 years. The prevalence of smoking in Russia among the male population is 70%, among the female - more than 14%. Every year 280-290 billion cigarettes are consumed in our country, the production of tobacco products is growing steadily. Of particular concern is smoking among teenagers, which is acquiring the proportions of a national disaster. The peak of initiation to smoking falls on early school age - from 8 to 10 years. Among adolescents aged 15-17 years old - residents of cities, an average of 39.1% of boys and 27.5% of girls smoke. Similar indicators in the Krasnodar Territory are lower than the Russian average - 35.7% for boys and 22.5% for girls.

3. Overweight

Almost all countries (both high- and low-income) are experiencing an obesity epidemic, albeit with great variation between and within countries. In low-income countries, obesity is more common among middle-aged women, people of higher socioeconomic status, and people living in cities. In wealthier countries, obesity is not only common among middle-aged women, but is becoming more common among younger adults and among children. It is also increasingly affecting people of lower socioeconomic status, especially women. As for the differences between urban and rural areas, they are gradually decreasing or even changing places.

Food and food products have evolved into a marketed and marketed commodity that has evolved from a once predominantly "local market" to an ever-growing global market. Changes in the global food industry are reflected in dietary changes, such as increased consumption of high-calorie, high-fat foods, in particular saturated-fat foods that are low in unrefined carbohydrates. These trends are exacerbated by trends in the reduction of physical energy consumption of the population caused by a sedentary lifestyle, in particular, the presence of vehicles, the use of household appliances that reduce the labor intensity of working at home, the curtailment of jobs that require manual physical labor, and leisure, which is mainly a pastime that does not associated with physical activity.

As a result of these dietary and lifestyle changes, chronic non-communicable diseases - including obesity, diabetes, cardiovascular disease (CVD), high blood pressure and strokes, and some types of cancer - are becoming more and more causes of disability and premature death. in developing and newly developed countries, thus representing an additional burden on already burdened national health sector budgets.

In the Krasnodar Territory, according to the territorial body of the Federal State Statistics Service for the Krasnodar Territory, the consumer market is growing. In January-June 2006, the retail trade turnover amounted to 110 billion rubles, which is 7% more in comparable prices than in the same period last year. In the structure of retail trade turnover, the share of food products amounted to 46%. In the group of food products, prices for poultry meat decreased by 11%, for chicken eggs by 32%. The cost of the minimum set of food products included in the consumer basket (for a man of working age) by the end of June of this year amounted to 1451 rubles per person per month (in Russia - 1512 rubles), since the beginning of the year its cost has increased by 10.3 %. According to the territorial administration of Rospotrebnadzor for the Krasnodar Territory, since 1995, the consumption of meat, fish, and fruits has been increasing in the region. At the same time, as of the beginning of 2005, there remains a significant shortage of consumption by the population of the region of the main food groups in comparison with physiological norms: meat and meat products - by 18.5%, milk and dairy products - by 56%, vegetables and melons - by 27.4%, potatoes - by 18.3%, fruits - by 16.8%. There is an excess consumption of carbohydrates due to sugar and confectionery by 37%, vegetable fats - by 37%, eggs - by 26%. The structure and nature of nutrition is regarded as unbalanced in terms of proteins, fats, carbohydrates - their ratio in the nutrition of the region's population is 1:1:1.3.

According to the WHO European Office in most European countries, about 50% of the adult population - both men and women - have a body mass index greater than the desired value (BMI> 25). In Russia, according to monitoring studies conducted in various regions of Russia, overweight is observed in 15-40% of the adult population. Medical statistics provided by the State Health Institution "Medical Information and Analytical Center" of the Department of Health of the Krasnodar Territory indicates a steady increase in indicators for the line "diseases of the endocrine system, eating disorders and metabolic disorders." According to the results of 2005 alone, the increase in indicators was 2.5 for the adolescent population (15-17 years old) and 1.55 for the adult (18 years and older) population of the region per 1000 population of this age group. In order to achieve the best possible results in the prevention of chronic diseases, the primacy of diet must be fully recognized.

4. High blood cholesterol

There is a definite relationship between elevated blood cholesterol levels and the development of CVD. According to the World Health Organization, a 10% reduction in average cholesterol levels among the population reduces the risk of developing coronary heart disease by 30%. Elevated cholesterol, in turn, is determined by excessive consumption of animal fats, especially meat, sausages, fatty dairy products and milk. The prevalence of hypercholesterolemia in Russia is very high. So, up to 30% of men and 26% of women aged 25-64 have cholesterol above 250 mg%.

For most people in the world, especially in developing countries, animal products remain a favorite food for their nutritional value and taste. Excessive consumption of animal products in some countries and classes of society can, however, lead to excessive consumption of fats. The increase in the amount of fat in the diet worldwide exceeds the increase in the amount of protein in the same diet.

Nutrition remains one of the most complex and insufficiently studied issues in the field of improving the health of the Russian population. Until recently, in the field of prevention of major non-communicable diseases in Russian health care, a point of view was cultivated on nutrition as one of the aspects of treatment, as a type of therapy, a medicine. The task of organizing a system for measuring the level of cholesterol in the blood of the population, as well as improving the quality of measurements of blood lipids in laboratories of practical health care with the widespread introduction of the procedure for internal and external quality control of measurements, seems to be extremely urgent. This will enable health planners to objectively assess and monitor the population's lipid profile and therefore guide preventive interventions in the right direction. In addition, it will help to avoid both underestimation and overestimation of the number of people with hypercholesterolemia and to adequately estimate the cost of preventive measures.

The importance of nutrition both for the preservation and promotion of health, and for the prevention of diseases, is beyond doubt. Much of the evidence regarding the strength of the relationship between nutrition and chronic disease has been accumulated in the field of cardiovascular disease. The relationship between diet, blood plasma lipid levels and the incidence of coronary heart disease (CHD) has been best studied, where extensive experimental, clinical and epidemiological material has been accumulated. As a result of these and other studies, by the beginning of the 1970s, an opinion was formed about the negative role of saturated fatty acids (FA), the positive role of polyunsaturated fatty acids.

5. High blood pressure

Among cardiovascular diseases, arterial hypertension is one of the most common diseases. Its frequency increases with age. Cardiovascular complications of arterial hypertension, primarily cerebral stroke, myocardial infarction, are the main cause of death and disability in the working-age population and cause significant socio-economic damage.

AH is one of the main risk factors for the development of cardiovascular complications. However, this risk increases dramatically if hypertension is combined with other risk factors for CVD, especially dyslipidemia, diabetes mellitus, and smoking. Therefore, when conducting a program to control hypertension, it is advisable, in addition to pressure, to try to correct other risk factors. Then it will greatly increase the effectiveness of preventing myocardial infarction and stroke. Thus, when assessing the risk of cardiovascular complications in people with hypertension, it is necessary to take into account not only the degree of increase in blood pressure, but also other risk factors, i.e. assess the global or total risks, based on its magnitude, determine the tactics of treating a particular patient.

In Russia, according to screening studies of the State Research Center for Preventive Medicine of the Ministry of Health and Social Development, the prevalence of arterial hypertension was: among men of working age from 24 to 40%, among women - 26-38%. In the older age groups (50-59 years old), this indicator among women was 42-56%, and among men 39-53%.

In the Krasnodar Territory, according to the State Health Institution "Medical Information and Analytical Center" of the Department of Health of the Krasnodar Territory for 2005, the overall incidence rate of the adult population of the region (18 years and older) in the line "diseases of the circulatory system" is the highest and amounted to 160.26 per 1000 population of this age. In the structure of the general morbidity of the population, the regions of diseases of the circulatory system are in first place in terms of prevalence and account for 15.2% among other classes of diseases. An analysis of the causes of temporary disability of the working population in 2005 showed that hypertension in the list of diseases of the circulatory system leads in terms of the number of days and the number of cases per 100 workers.

6. Alcohol consumption

According to WHO experts, the main cause of the demographic crisis in Russia, along with "the collapse of the healthcare system and psychosocial stress," is excessive alcohol consumption: over the past few years, Russia has become the world leader in terms of alcohol consumption per capita - 13 liters per person per year. year, with an average European indicator of 9.8 liters.

In terms of the extent of damage to which alcohol consumption leads, chronic alcoholism, one of the types of diseases associated with addiction, should be ranked first. The prevalence of alcoholism according to various sources is 2-20% of the population. And although the difference in indicators largely depends on the difference in the evaluation criteria, nevertheless, everyone recognizes the large magnitude of the negative consequences that alcohol leads to. In addition to the direct harm caused by alcohol to direct consumers, its negative impact manifests itself in the form of a secondary problem - a "codependent" environment from among his relatives, who develop neurotic states, depression, personality pathology, and psychosomatic suffering. This negatively affects the quality of life of the entire population, creates additional burdens of a medical and social nature.

It is reliably known that chronic alcoholism significantly increases mortality due to other causes, in particular, diseases of the cardiovascular system, liver, gastrointestinal tract, domestic and industrial injuries. The overall mortality of patients with alcoholism is 2 times higher than in a similar situation, and among the total number of sudden deaths, 18% is associated with drunkenness. In recent years, there have been reports of the pathogenic role of ethanol in the development of cancer. In experiments on animals, it has been proven that ethanol prevents the natural destruction of carcinogenic substances that enter the body.

Of particular concern is the increase in the prevalence of alcohol consumption among adolescents, especially among urban teenagers - schoolchildren. According to monitoring studies conducted by the Center for Monitoring Bad Habits among Children and Adolescents of the Central Research Institute for the Organization and Informatization of Healthcare of the Ministry of Health of the Russian Federation, the prevalence of alcohol consumption among urban schoolchildren aged 15-17 years on average in Russia was 81.4% for boys and 87. 4% in girls.

7. Drug prevalence

The problem of drug abuse is determined by a complex of negative interrelated factors and events, among which are:

1) Deep destructive mental and physical consequences from abuse, entailing the impossibility of the normal functioning of a person as an individual and as a member of society;

2) the growing prevalence of drug addiction throughout the world, taking on the character of epidemics in many societies and affecting mainly people of working age, youth and adolescents;

3) significant social and economic losses associated with the above two factors, the growth of criminogenic events, the destruction of the national gene pool;

4) an increase in the influence of the drug mafia, its penetration into administrative, managerial and economic structures, law enforcement agencies, which entails an environment of anomie (disorganization) of society;

5) destruction of attributes of traditional culture, including sanitary culture.

Studies of the medical and social center for the prevention of drug addiction among minors of the State Healthcare Institution "Narcological Dispensary" of the Department of Health of the Krasnodar Territory, conducted over several years, show: a large proportion of drug pathology occurs among schoolchildren - 45.2%; growth is noted in the groups of students of secondary schools and universities - 14.3% and 10.1%, respectively; among registered users of psychoactive substances, the share of girls is constantly growing - 26.7% in 2005 against 17.8% in 2003.

A study of the prevalence of "accidental" use of narcotic and toxic substances among urban adolescent schoolchildren aged 15-17 years, conducted by the method of anonymous questioning of the State Health Institution "Center for Medical Prevention of the Health Department of the Krasnodar Territory", showed that the group of "accidental" users of psychoactive substances amounted to 14.5 % in boys and 7.1% in girls per 100 adolescents aged 15-17. The data obtained are somewhat lower than the similar average Russian indicators - 17.0% for boys and 9.8% for girls.

8. Low physical activity

Low physical activity or a sedentary lifestyle is an independent risk factor for the development of cardiovascular and other diseases, including coronary heart disease, stroke, high blood pressure, non-insulin-dependent diabetes mellitus, and osteoporosis. In physically untrained people, the risk of developing CVD is 2 times higher than in physically active people. The degree of risk for sedentary people is comparable to the relative risk of the three most known factors contributing to the development of CVD: smoking, arterial hypertension and hypercholesterolemia.

For thousands of years of existence on Earth of the biological species "thinking man" the only source of his life support was the muscular apparatus. Over the past 100 years, the share of physical labor in ensuring human life has decreased by 200 times. This has led to the fact that a modern civilized person spends 500-750 kcal per day on physical work, which is 2-2.5 times less than what is inherent in the human genotype and is necessary for normal life. A healthy person should expend 350-500 kcal of energy daily or 2000-3000 kcal weekly for physiologically justified loads due to recreational physical education and sports.

Physical activity is an important determinant of body weight. In addition, physical activity and fitness (which refers to the ability to engage in physical activity) are important modifiers of mortality and morbidity associated with overweight and obesity. There is unequivocal evidence that moderate to high levels of fitness are associated with a significantly lower risk of cardiovascular disease and all-cause mortality. According to many scientists, a properly constructed system of physical exercises not only preserves active longevity, but also prolongs life by an average of 6-8 years.

According to the results of 2005, about 20% of the population in the Krasnodar Territory go in for physical culture and sports, mainly children, adolescents, and young people.

9. Ecological state.

According to the territorial department of Rospotrebnadzor for the Krasnodar Territory, in recent years in the Krasnodar Territory there has been a tendency to increase the level of atmospheric air pollution with chemicals in relation to the established standards (MPC). The high level of air pollution in the territory of the region is due, firstly, to the high anthropogenic pressure on the atmosphere associated with the operation of vehicles, thermal power facilities, oil pipeline transport, enterprises of the fuel, chemical, oil refining industries, the construction industry and the agro-industrial complex, the activities of ports for the transshipment of various cargo, including oil and oil products; and, secondly, special climatic conditions characterized by a reduced scattering power of the atmosphere, which worsens the state of the air environment in the region.

According to the Research Institute of Applied and Experimental Ecology of the Kuban State Agrarian University, a big problem that requires thorough study and analysis is the river systems of the region and, first of all, the Kuban river basin, the Black Sea and steppe rivers, the water of which was used only 45-50 years ago for drinking purposes, today heavily polluted. Often the concentrations of pollutants (for example, oil products) in surface waters exceed the permissible limits. The regional center discharges more than 20 million cubic meters per year into the Kuban River in the form of open storm drains without treatment due to a lack of capacity of treatment facilities and sewerage problems. Such cities as Armavir, Labinsk, Kropotkin, Slavyansk-on-Kuban, Tikhoretsk, Timashevsk, Ust-Labinsk, Krymsk, Belorechensk and a number of others have a very significant impact on the pollution of water systems. Industrial enterprises of the region discharge sewage contaminated with oil products, heavy metals, surfactants, phenols and other hazardous substances; many enterprises do not have effective wastewater treatment plants and directly discharge them into water systems, having a negative impact on living organisms. A big problem is created by the housing and communal services of cities and villages, which discharge sewage (often untreated) into small and large reservoirs. A significant source of surface water pollution is the discharge of rice fields with a high content of residual pesticides used in rice cultivation. Currently, up to 1.5 million cubic meters are annually discharged into rivers and estuaries. m of water contaminated with pesticides, heavy metals, as well as nutrients (nitrogen, phosphorus, potassium) and soil organic matter.

List of used literature.

1. Early to die. Problems of a high level of morbidity and premature mortality from non-communicable diseases and injuries in the Russian Federation and ways to solve them. - Russia "Alex", 2006.

2. Monitoring behavioral risk factors for noncommunicable diseases in the population: A guide. - M.: MAKS Press, 2004. - 54 p.

New methods of electrocardiography, ed. Gracheva S.V., Ivanova G.G., Syrkina A.L. - M.: Technosphere, 2007.

3. Oganov R.G., Maslennikova G.Ya., Shalnova S.A., Deev A.D. The importance of cardiovascular and other non-communicable diseases for the health of the Russian population. // Disease prevention and health promotion. – 2002

4. Main indicators of health and healthcare of the Russian Federation (statistical materials).

5. Statistical collection. Federal State Statistics Service Rostovstat. - Rostov - on - Don, 2004.

Noncommunicable diseases (NCDs), also known as chronic diseases, are not transmitted from person to person. They have a long duration and tend to progress slowly. The four main types of noncommunicable diseases are cardiovascular diseases (such as heart attack and stroke), cancer, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes.

NCDs already disproportionately affect low- and middle-income countries, where about 80% of all NCD deaths, or 29 million, occur. They are the leading cause of death in all regions except Africa, but current projections indicate that by 2020 the largest increase in NCD deaths will occur in Africa. By 2030, the number of deaths from NCDs in African countries is projected to exceed the total number of deaths from infectious and nutritional diseases, as well as maternal and perinatal deaths, which are the main causes of death.

Who is at risk for such diseases?

NCDs are common in all age groups and all regions. These diseases are often associated with older age groups, but evidence suggests that nine million people who die from NCDs are in the under 60 age group. 90% of these "premature" deaths occur in low- and middle-income countries. Children, adults and the elderly are all vulnerable to risk factors that contribute to the development of noncommunicable diseases, such as unhealthy diets, physical inactivity, exposure to tobacco smoke or the harmful use of alcohol.

Factors such as aging, rapid unplanned urbanization and the globalization of unhealthy lifestyles influence the development of these diseases. For example, the globalization of such a phenomenon as unhealthy eating can manifest itself in individuals in the form of high blood pressure, high blood glucose, high blood lipids, overweight and obesity. These conditions are called "intermediate risk factors" that can lead to the development of cardiovascular disease.

Risk factors

Modifiable behavioral risk factors

Tobacco use, lack of physical activity, unhealthy diets and the harmful use of alcohol increase the risk of or lead to most NCDs.

Metabolic/physiological risk factors

These behaviors lead to four metabolic/physiological changes that increase the risk of developing NCDs, such as high blood pressure, overweight/obesity, hyperglycemia (high blood glucose levels) and hyperlipidemia (high blood fat levels).

In terms of attributable deaths, the main risk factor for NCDs globally is raised blood pressure (associated with 16.5% of global deaths(1)). It is followed by tobacco use (9%), elevated blood glucose (6%), physical inactivity (6%) and overweight and obesity (5%). Low- and middle-income countries are experiencing the fastest growth in the number of overweight young children.

NCD prevention and control

Reducing the impact of NCDs on people and society requires a comprehensive approach that requires the collaboration of all sectors, including health, finance, international relations, education, agriculture, planning and others, to reduce the risks associated with NCDs, as well as to take action to prevention and control.

One of the most important ways to reduce the burden of NCDs is to focus on reducing the risk factors associated with these diseases. There are inexpensive ways to reduce common modifiable risk factors (mainly tobacco use, unhealthy diet and physical inactivity, and the harmful use of alcohol) and to map the NCD epidemic and risk factors.(1)

Other ways to reduce the burden of NCDs are major high-impact interventions to strengthen early detection and timely treatment of diseases that can be delivered through primary health care. Evidence suggests that such interventions are an excellent economic investment because they can reduce the need for more expensive treatments if done in a timely manner. The greatest impact can be achieved by developing health-promoting public policies that stimulate the prevention and control of NCDs and reorient health systems to meet the needs of people with these conditions.

Lower-income countries tend to have less capacity to prevent and control NCDs.

High-income countries are four times more likely to have NCD services covered by health insurance than low-income countries. It is unlikely that countries with inadequate health insurance will be able to provide universal access to essential NCD interventions.

WHO activities

Action plan for the implementation of the global strategy for the prevention and control of noncommunicable diseases 2008-2013. provides advice to Member States, WHO and international partners on how to take action to combat NCDs.

WHO is also taking action to reduce the risk factors associated with NCDs.

The adoption by countries of the anti-tobacco measures outlined in the WHO Framework Convention on Tobacco Control can significantly reduce the impact of tobacco on people.

The WHO Global Strategy on Diet, Physical Activity and Health aims to promote and protect health by empowering individual communities to reduce morbidity and mortality associated with unhealthy diets and physical inactivity.

The WHO Global Strategy to Reduce the Harmful Use of Alcohol proposes measures and identifies priority areas for action to protect people from the harmful use of alcohol.

In line with the UN Political Declaration on NCDs, WHO is developing a comprehensive global monitoring system for the prevention and control of NCDs, including indicators and a set of voluntary global targets.

In accordance with the resolution of the World Health Assembly, WHO is developing the Global NCD Action Plan 2013-2020, which will be the program for implementing the political commitments of the UN High Level Meeting. A draft action plan will be submitted for adoption at the World Health Assembly in May 2013.

1. Introduction

2.Smoking

3. Overweight

4.High levels of cholesterol in the blood

5.High blood pressure

6. Alcohol consumption

7. Drug prevalence

8.Low physical activity

9. Ecological condition

10. List of used literature

1. Introduction

According to the territorial body of the Federal State Statistics Service for the Krasnodar Territory, the population of the region as of June 1, 2006 amounted to 5,094 thousand people, of which 53 percent live in cities and 47 percent are rural residents. Since the beginning of the year, the population of the region has decreased by 2.4 thousand people (by 0.05%). Compared to January-May 2005, the death rate of the population decreased by 7 percent, there were 505 fewer births (2 percent less). The number of population losses were compensated by the migration gain by only 81 percent.

2.Smoking

According to WHO, tobacco smoking is the leading cause of ill health and premature death. Smoking is one of the most significant risk factors leading to the development of diseases such as cardiovascular, respiratory, and some forms of cancer. Up to 90% of all cases of lung cancer, 75% of cases of chronic bronchitis and emphysema, and 25% of cases of coronary heart disease are associated with smoking. It is also known that tobacco tar is not the only life-threatening substance inhaled during smoking. More recently, tobacco smoke counted 500, then 1000 components. According to modern data, the number of these components is 4720, including the most poisonous - about 200.

It should be noted that smoking exists in two completely different clinical varieties: in the form of smoking habit and in the form of tobacco dependence. Those who smoke only out of habit can become non-smokers completely painlessly, without any medical help, and eventually forget that they smoked at all. And those who have developed tobacco dependence, with all their desire, cannot give up smoking forever, even if their first days without tobacco go relatively well. Sometimes, even after a long break (several months or even years), they relapse. This means that smoking has left a deep mark on the mechanisms of memory, thinking, mood and metabolic processes of the body. According to available data, out of 100 systematic smokers, only seven smoke as a result of a habit, the remaining 93 are sick.

As established by special studies, up to 68% of the smoke of burning tar and the air exhaled by a smoker enters the environment, polluting it with tar, nicotine, ammonia, formaldehyde, carbon monoxide, nitrogen dioxide, cyanides, aniline, pyridine, dioxins, acrolein, nitrosoamines and other harmful substances. substances. If several cigarettes are smoked in an unventilated room, then in one hour a non-smoking person will inhale as many harmful substances as enter the body of a person who has smoked 4-5 cigarettes. Being in such a room, a person absorbs as much carbon monoxide as a smoker, and up to 80% of other substances contained in the smoke of cigarettes, cigarettes or pipes.

Regular exposure to the role of a "passive smoker" increases his risk of fatal heart disease by 2.5 times compared to those people who were not exposed to second-hand smoke. Children under 5 years of age are most sensitive to tobacco smoke. Passive smoking contributes to the development of hypovitaminosis in them, leads to loss of appetite and indigestion. Children become restless, sleep poorly, they have a long, difficult to treat cough, often dry, paroxysmal in nature. During the year, they suffer from bronchitis and SARS 4-8 or more times. Much more often than children of non-smoking parents, they also get pneumonia.

According to scientists, due to getting rid of nicotine addiction, the average life expectancy of earthlings would increase by 4 years. In many countries, economic levers are used to reduce the number of smokers, such as systematically raising the price of tobacco products. Studies by American experts have shown that people who are just starting to smoke, especially teenagers, are most responsive to rising prices. Even a 10% increase in the retail price of cigarettes reduces their purchase by more than 20%, and deters many from smoking altogether.

Worldwide, the number of smokers is declining, and in Russia their number is 65 million people. Many diseases that Russians acquire are associated with smoking. According to the Ministry of Health and Social Development of Russia, among middle-aged Russians, smoking-related mortality is 36% for men and 7% for women. More than 270,000 people die every year from smoking-related causes in the country - more than from AIDS, car accidents, drug addiction and murder combined. Due to the increase in tobacco consumption, the incidence of lung cancer has increased by 63% over the past 10 years. The prevalence of smoking in Russia among the male population is 70%, among the female - more than 14%. Every year 280-290 billion cigarettes are consumed in our country, the production of tobacco products is growing steadily. Of particular concern is smoking among teenagers, which is acquiring the proportions of a national disaster. The peak of initiation to smoking falls on early school age - from 8 to 10 years. Among adolescents aged 15-17 years old - residents of cities, an average of 39.1% of boys and 27.5% of girls smoke. Similar indicators in the Krasnodar Territory are lower than the Russian average - 35.7% for boys and 22.5% for girls.

3. Overweight

Almost all countries (both high- and low-income) are experiencing an obesity epidemic, albeit with great variation between and within countries. In low-income countries, obesity is more common among middle-aged women, people of higher socioeconomic status, and people living in cities. In wealthier countries, obesity is not only common among middle-aged women, but is becoming more common among younger adults and among children. It is also increasingly affecting people of lower socioeconomic status, especially women. As for the differences between urban and rural areas, they are gradually decreasing or even changing places.

Food and food products have evolved into a marketed and marketed commodity that has evolved from a once predominantly "local market" to an ever-growing global market. Changes in the global food industry are reflected in dietary changes, such as increased consumption of high-calorie, high-fat foods, in particular saturated-fat foods that are low in unrefined carbohydrates. These trends are exacerbated by trends in the reduction of physical energy consumption of the population caused by a sedentary lifestyle, in particular, the presence of vehicles, the use of household appliances that reduce the labor intensity of working at home, the curtailment of jobs that require manual physical labor, and leisure, which is mainly a pastime that does not associated with physical activity.

As a result of these dietary and lifestyle changes, chronic non-communicable diseases - including obesity, diabetes, cardiovascular disease (CVD), high blood pressure and strokes, and some types of cancer - are becoming more and more causes of disability and premature death. in developing and newly developed countries, thus representing an additional burden on already burdened national health sector budgets.

Elevated blood pressure - systolic blood pressure is equal to or higher than 140 mmHg, diastolic blood pressure is equal to or higher than 90 mmHg. or antihypertensive therapy.

Dyslipidemia - a deviation from the norm of one or more indicators of lipid metabolism (total cholesterol more than 5 mmol / l; high-density lipoprotein cholesterol in women less than 1.0 mmol / l, in men less than 1.2 mmol / l; low-density lipoprotein cholesterol more than 3 mmol / l; triglycerides more than 1.7 mmol / l) or lipid-lowering therapy.

Hyperglycemia - fasting plasma glucose level of more than 6.1 mmol / l or hypoglycemic therapy.

Tobacco smoking is the daily smoking of one or more cigarettes.

Irrational nutrition - excessive consumption of food, fats, carbohydrates, consumption of table salt more than 5 grams per day (adding salt to cooked food, frequent use of pickles, canned food, sausages), insufficient consumption of fruits and vegetables (less than 400 grams or less than 4-6 servings per day). day).

Overweight - body mass index 25-29.9 kg/m 2 , obesity - body mass index over 30 kg/m 2 .

Low physical activity - walking at a moderate or fast pace for less than 30 minutes a day.

The risk of harmful alcohol consumption and the risk of using narcotic drugs and psychotropic substances without a doctor's prescription is determined using a questionnaire, in accordance with Appendix No. 3 to the Procedure for medical examination of the adult population approved by this Order.

The total cardiovascular risk is established in the absence of proven diseases associated with atherosclerosis in a citizen.

Application No. 3

to the procedure for medical examination of the adult population, approved by order of the Ministry of Health

Russian Federation

dated ______________ No. ___

The form of the questionnaire for the identification of chronic non-communicable diseases, risk factors for their development and tuberculosis and the rules for making a conclusion based on the results of the survey (questionnaire)