非传染病悖论

惠灵顿—艾尔伯特·爱因斯坦有一句名言:“越简单越好,但不要太简单。”但当下关于全球性爆发的非传染性疾病(NCD,即心脏病、中风、糖尿病、癌症等慢性病)显然没有把这句话当回事。决策者将这一挑战简单化了,他们专注于NCD越来越普遍的发生——即罹患疾病人数的陡峭增加,但我认为,真正的问题并不在这里。

诚然,几乎在世界所有地区,都在经历NCD的普遍发生,这部分是因为随着急性传染病和伤害致命人数的下降,人们的寿命得到了增加,使得越来越多的人患上了NCD。但CND的增加同样也有人口和流行病因素在其中,弄清楚此中缘由将对卫生政策甚至经济发展都带来重大影响。

世界上有很多地区同时发生着人口的增加和老化。大部分NCD的出现伴随着年龄的老化——这是一生中累积风险因素的结果(包括吸烟等不健康行为以及高血压等生物性风险因素)。在其他条件相同的情况下,人口的增加和老化意味着更多的人患上NCD。

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