Abstract
ABSTRACTThere have been many debates in recent years as to whether the communicable disease versus non-communicable disease (NCD) division is a meaningful one in disease classification. Several critiques have been raised about the framing of NCDs, regarding not only the prominent role that infections play in the aetiology of NCDs, but also the communicability of many social determinants of NCDs and the individualistic, ‘lifestyle’ framing of NCDs that tends to focus on health behaviours to the neglect of socio-political, environmental, and structural determinants of health. In this paper, we give a historical overview of the usage of the NCD terminology and analyse some of the recent debates regarding the naming and framing of NCDs. We argue that a lack of reflection on the assumptions underlying the naming and framing of NCDs may lead to the collection of insufficient epidemiological data, the development of inappropriate interventions and the provision of inadequate care. Work in social epidemiology, health promotion, medical anthropology, demography, and other fields may provide insights into the ways in which efforts targeting NCDs may be reframed to improve impact and efficacy. In addition, concepts such as multimorbidity and syndemics, frameworks such as ecosocial theory and approaches based in the social sciences may provide a way forward in the conceptualization of disease.
Highlights
There have been many debates in recent years as to whether the communicable disease versus non-communicable disease (NCD) division is a meaningful one in disease classification
Several critiques have been raised about the framing of NCDs, regarding the prominent role that infections play in the aetiology of NCDs, and the communicability of many social determinants of NCDs and the individualistic, ‘lifestyle’ framing of NCDs that tends to focus on health behaviours to the neglect of socio-political, environmental, and structural determinants of health
We argue that a lack of reflection on the assumptions underlying the naming and framing of NCDs may lead to the collection of insufficient epidemiological data, the development of inappropriate interventions and the provision of inadequate care
Summary
‘Non-communicable diseases (NCDs)’ seems to have become a catchphrase in global health. The commissioners put forward recommendations to address the epidemics of obesity, undernutrition and climate change, which they argued share common societal causes and co-occur and interact in place and time, affecting people worldwide in a global syndemic We believe that these concepts of multimorbidity and syndemics and the use of an ecosocial framework may be useful starting points for the health professions to start reframing the ways in which we think about and act on disease prevention and control. Data collection and interventions for NCDs would attempt to follow an ecosocial framework and consider multimorbidity and syndemics by including chronic conditions, health behaviours, and individual and household socioeconomic status, and infectious illnesses and other comorbidities, undernutrition, genetic and biological factors, psychosocial factors, and neighbourhood and environmental characteristics These data and interventions would incorporate life-course perspectives from childhood to adulthood, as well as intergenerationally. There may be lessons to be learned from health promotion in the battle against NCDs
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
