The main indicators of the WHO Global Monitoring Framework (GMF) on Noncommunicable Diseases

Transcription

1 The main indicators of the WHO Global Monitoring Framework (GMF) on Noncommunicable Diseases 2016 In the spotlight diabetes, target indicators

2 Preface Noncommunicable diseases (NCD) are major public health threats in the European Region with effects extending beyond health, impacting economic and societal development. Four major groups of NCD, cardiovascular diseases, cancer, diabetes and chronic respiratory diseases, are responsible for the largest share of disease burden, including premature and avoidable death, morbidity and disability. These NCD also share common risk factors, e.g. tobacco use, harmful alcohol consumption, unhealthy diet, physical inactivity and obesity, making them a target for health promotion, prevention and control. The NCD are considered strategic priorities for action of the World Health Organization (WHO) and its Member States, as reflected in the 2012 Global Action Plan for the prevention and control of Noncommunicable Diseases and its Global Monitoring Framework, with nine voluntary targets and twenty-five indicators. Additionally, in 2014 the United Nations (UN) General Assembly proposed strengthening progress on the implementation of high-impact cost-effective interventions on NCD and setting four time-bound commitments, including defined indicators. Further recognizing NCD relevance, in 2015 the UN proposed the inclusion of a specific health target with NCD indicators in the Sustainable Development Goals , while considering involvement of other healthrelated ones in the monitoring framework. Moreover, at the European regional level, the Health 2020 policy framework includes 6 targets and 21 core health indicators, among which are several NCDrelated ones. The above mandates highlight the need for improved availability, quality and timeliness of country information to allow monitoring progress on such targets. A requisite for planning and evaluation for NCD prevention and control is the assessment of data on disease situation and trends, their risk factors and the response of the health system. Assembling and analyzing such information demands comprehensive integration of data from many sources, a challenge in some countries. The WHO Regional Office for Europe, through its NCD Project Office in Moscow, is supporting Member States to improve their capacity to present and interpret their NCD data in a manner suitable for policy-making. When required, assistance is also provided for strengthening data availability through survey implementation, disease registries functioning and compilation of other relevant information, to achieving Health 2020 and the time-bound UN NCD review of Furthermore, the Regional Office is monitoring current conditions and changes on NCD in its Member States, as well as progress towards global and regional targets. This is done jointly with other WHO technical units, for example, through collaboration in the European Health Information Gateway, where multiple European health databases and other related information resources are compiled in the Web. We are pleased to present The main indicators of the WHO Global Monitoring Framework (GMF) on Noncommunicable Diseases 2016, which exemplifies the joint effort of WHO and its Member States to offer recently available, comparable and policy-relevant NCD information. This set of data and graphs come from diverse WHO sources and altogether provide an account of the status and progress of key indicators, highlighted in colour, in countries of the European Region. Also, selected diabetes-related indicators are presented in a section to showcase the relevance of this special topic in the Region. We expect that this publication will become a useful tool for policy-makers, public health professionals and other interested users. Gauden Galea Director

3 Noncommunicable diseases targets: demographic and mortality indicators Mid-year population (thousands) All causes mortality, both sexes Proportion of all deaths due to (%) cancer Age-standardized death rates per population Major noncommunicable diseases (cardiovascular disease, cancer, diabetes, or chronic respiratory disease), (30 69 years), diseases of circulatory system Both Males Females Country Albania Andorra Armenia a 20.7 a 47.6 a c a c a c a a a a a Azerbaijan c 9.3 c 58.6 c c c c Belarus b 13.9 b 50.2 b c b c b c b a 28.0 a 25.8 a b b b Bosnia and Herzegovina b 19.5 b 53.2 b b b b b 16.7 b 63.5 b b b b a 23.1 a 35.9 a a a a a 31.8 a 23.3 a a a a b 24.5 b 48.6 b a a a a a a b 32.7 b 22.1 b b b b a a a a 27.6 a 39.3 a a a a Iceland c 30.7 c 34.1 c c c c c c c a 31.1 a 31.3 a c c c c c c Israel a a a a 32.2 a 32.9 a b b b a 12.2 a 30.7 a a a a Kyrgyzstan a 21.4 a 51.7 a a a a a 20.4 a 50.5 a a a a a a a Malta b b b Monaco Montenegro c 15.2 c 54.6 c c c c c c c a a a a a a a a a a a a a 20.2 a 56.4 a a a a b 15.3 b 54.1 b b b b San Marino c 44.2 c 40.1 c c c c c 23.1 c 51.8 c c c c c c c c 32.7 c 36.4 c c c c c c c a a a a a a Switzerland c c c c c c Tajikistan c 7.7 c 59.6 c MKD* c 18.3 c 58.9 c c c c c c c Turkmenistan a 15.0 a 61.3 a a a a b 31.7 b 27.1 b c c c c c c c 6.7 c 65.6 c c c c WHO European Region a 20.8 a 45.3 a a a a Note: a = 2012, b = 2011, c =

4 Noncommunicable diseases targets: mortality indicators Probability (%) of dying between ages 30 and 70 from cancer, diabetes, cardiovascular or chronic respiratory disease, both sexes Diseases of circulatory system, Age-standardized death rates per population Ischaemic heart disease, Cerebrovascular diseases, Males Females Males Females Males Females Diseases of the respiratory system, both sexes Diabetes, both sexes Country Albania Andorra Armenia a a a a 98.5 a 82.2 a 53.8 a 41.5 a Azerbaijan c c c 93.2 c c c 55.9 c 13.8 c Belarus b b b b b b 27.6 b 2.5 b a a 63.8 a 26.1 a 35.0 a 29.7 a 53.0 a 8.3 a Bosnia and Herzegovina b b 93.5 b 54.8 b b 97.2 b 27.7 b 40.2 b b b b 73.5 b a a 36.1 b 13.2 b a a 92.5 a 34.6 a 36.3 a 34.5 a 38.5 a 32.8 a a a 64.2 a 31.7 a 39.3 a 30.4 a 59.2 a 14.6 a b b b b 73.5 b 45.1 b 21.7 b 8.1 b b 81.0 b 45.0 b 16.4 b 28.7 b 20.8 b 26.3 b 9.1 b a a 92.3 a 35.3 a 68.2 a 62.0 a 47.3 a 5.6 a Iceland c c c 54.6 c 42.7 c 31.8 c 42.4 c 7.6 c b b a 58.4 a 34.2 a 33.2 a 61.7 a 9.7 a Israel a a 75.2 a 37.7 a 44.9 a 37.5 a 29.4 a 15.8 a a a a 81.4 a a 95.9 a 79.7 a 9.9 a Kyrgyzstan a a a a a a 24.0 a 14.2 a a a a a a 92.8 a 27.3 a 6.9 a Malta Monaco Montenegro c c 83.5 c 39.7 c 66.6 c 74.8 c 38.7 c 11.2 c a a a a a a 49.4 a 7.9 a b b b b b b 44.7 b 5.2 b San Marino c c 30.9 c 8.3 c 58.9 c 49.4 c 6.9 c 4.5 c c c c c c 76.9 c 52.0 c 10.3 c c c 94.9 c 40.5 c 71.2 c 49.1 c 32.3 c 7.8 c Switzerland Tajikistan c c c c c 94.4 c 78.8 c 23.3 c MKD* c c c 57.1 c c c 34.4 c 34.1 c Turkmenistan a a a a a a 29.0 a 4.0 a b b b 44.4 b b 5.4 b c c c c c c 66.4 c 30.2 c WHO European Region a a a a 99.4 a 77.0 a 45.0 a 12.9 a Note: a = 2012, b = 2011, c =

5 Noncommunicable diseases targets: cancer indicators Age-standardised rates per population Incidence, Mortality, All cancers Lung Colorectum Breast Cervix uteri Lung Colorectum Breast Cervix uteri Both Both Both Females Females Both Both Females Females Country Albania Andorra Armenia a 14.1 a 32.7 a 5.5 a b Azerbaijan c 3.8 c 7.6 c 2.1 a Belarus b 19.3 b 18.1 b 5.4 b a a 16.4 a 25.4 a 2.3 a Bosnia and Herzegovina b 17.4 b 17.8 b 4.5 a b 20.1 b 22.2 b 7.3 a a b a 12.0 a 19.6 a 1.3 a b a 21.9 a 25.9 a 2.7 a b b 20.4 b 22.6 b 7.4 b a a b 16.1 b 22.5 b 1.8 b c a 12.9 a 20.7 a 1.9 a Iceland a c 17.1 c 20.1 c 1.4 c a a 19.2 a 26.6 a 4.0 a Israel a a 16.8 a 21.7 a 0.9 a a 13.6 a 19.7 a 9.1 a Kyrgyzstan a 23.3 a 22.6 a 8.5 a a a 19.1 a 22.3 a 9.0 a b Malta Monaco Montenegro c 11.4 c 20.4 c 3.5 c a a c a 20.5 a 21.2 a 12.0 a b 22.0 b 23.3 b 6.9 b San Marino b c 19.4 c 16.7 c 0.0 c a c c 28.0 c 22.0 c 6.3 c b c 25.6 c 24.7 c 3.0 c Switzerland b Tajikistan 36.7 a c 3.0 c 7.2 c 2.9 c MKD* c c 17.5 c 27.7 c 2.8 c c Turkmenistan a 21.0 a 24.0 a 7.5 a a b 16.3 b 24.6 b 2.4 b c 3.9 c 11.6 c 5.7 c WHO European Region a a 17.4 a 20.6 a 4.2 a Note: a = 2012, b = 2011, c =

6 Risk factors: alcohol and tobacco Recorded alcohol per capita (15 years & over) consumption (litres of pure alcohol), 3-year average, total Heavy episodic drinking (population 15 years & over) past 30 days, (%), total** years old heavy episodic drinkers (population), (%), total Alcohol use disorders (15 years & over), 12 month prevalence (%), total** Prevalence current smoking any tobacco product, (%), ** Both Males Females Price of 20-cigarette pack of most sold brand (Intn'l. dollars at PPP) Specific excise tax as a % of price of most sold brands Country Albania Andorra Armenia Azerbaijan Belarus Bosnia and Herzegovina Iceland Israel Kyrgyzstan Malta Monaco Montenegro San Marino Switzerland Tajikistan MKD* Turkmenistan Regional average ** Age-standardized figures

7 Risk factors: blood pressure, cholesterol and immunization Prevalence, percent of population with raised blood pressure (SBP 140 or DBP 90), (18 years and over), (age-standardized estimate), Prevalence, percent of population with total cholesterol 190 mg/dl (5.0 mmol/l), (25 years and over), (age-standardized estimate), Immunization coverage, 1-year-olds, Hepatitis B, both sexes, (%) Both Males Females Both Males Females Country Albania Andorra Armenia Azerbaijan Belarus Bosnia and Herzegovina Iceland Israel Kyrgyzstan Malta Monaco Montenegro San Marino Switzerland Tajikistan MKD* Turkmenistan WHO European Region

8 Diabetes and related risk factors: glucose, overweight and obesity, physical activity, policy There is a policy, strategy, or action plan for diabetes Age-standardized death rates per population Proportion of all discharges (%) Diabetes, Hospital discharges,average length of stay, (in days) Total number of discharges from all causes (thousands) Prevalence, percent population with fasting glucose 126 mg/dl (7.0 mmol/l) or on medication for raised blood glucose, (18 years and over),, (%)** Prevalence, percent of population with body mass index (BMI) of 25 kg/m 2 or higher, (18 years and over), (age-standardized estimate), Prevalence of overweight (including obesity), (%) Prevalence of insufficient physical activity among school going adolescents (crude estimate), (%) Prevalence of insufficient physical activity among adults (age-standardized estimate), (%) 13 years old years 18 years and over Males Females Males Females Males Females Males Females Males Females Males Females Boys Girls Boys Girls Males Females Country Albania Andorra Armenia a 45.4 a a 0.9 a 11.4 a 10.9 a 1057 a 1221 a Azerbaijan c 15.5 c Belarus b 2.3 b a 7.2 a 1.2 c 0.9 c 9.1 c 9.6 c 836 c 1005 c *** 9.5*** Bosnia and Herzegovina b 41.7 b b 12.0 b a 27.7 a 0.4 a 0.2 a 8.4 a 5.7 a 35 a 35 a a 0.9 a 12.8 a 14.3 a 940 a 1168 a a 10.2 a 1.1 c 0.7 c 6.6 c 6.1 c 413 c 488 c b 7.6 b a 0.7 a 9.4 a 12.7 a 431 a 530 a b 6.8 b 1.2 a 1.0 a 6.7 a 6.8 a 5018 a 5952 a a 0.9 a 12.4 a 11.1 a 9499 a a a 4.4 a a 1.6 a 8.3 a 9.3 a 862 a 1142 a Iceland 9.4 c 5.7 c 0.6 c 0.4 c 10.8 c 10.3 c 19 c 26 c a 7.4 a 1.4 a 0.7 a 8.7 a 7.8 a 253 a 372 a Israel c 0.4 c 6.1 c 6.3 c 562 c 715 c a 13.7 a 0.6 a 0.4 a 8.7 a 9.0 a 3582 a 4086 a a 10.6 a Kyrgyzstan a 12.7 a 0.8 a 0.7 a 6.8 a 7.5 a 155 a 199 a a 5.9 a 1.0 a 1.0 a 8.5 a 8.5 a 313 a 402 a a 0.8 a 9.1 a 10.0 a 34 a 41 a Malta a 0.7 a 15.0 a 15.0 a 30 a 33 a Monaco Montenegro c 11.4 c a 0.5 a 7.9 a 7.5 a 906 a 1082 a c 0.5 c 4.3 c 4.2 c 397 c 460 c a 1.1 a 8.2 a 8.0 a 2810 a 3440 a a 7.1 a 1.5 a 1.4 a 6.9 a 6.9 a 2017 a 2415 a b 5.6 b San Marino c 3.6 c a 2.6 a 0.1 a 0.1 a 442 a 536 a c 9.4 c 1.1 b 0.9 b 8.9 b 9.3 b 423 b 568 b c 6.5 c 0.7 a 0.5 a 8.9 a 7.3 a 157 a 195 a a 0.5 a 8.7 a 8.0 a 2182 a 2489 a c 0.8 c 6.7 c 6.5 c 690 c 834 c Switzerland a 0.3 a 10.9 a 9.7 a 614 a 716 a Tajikistan c 22.4 c MKD* c 35.7 c 1.7 c 1.8 c 12.4 c 11.3 c 96 c 107 c b 1.7 b 6.6 b 5.9 b 4976 b 6461 b Turkmenistan a 3.8 a b 0.5 b 8.0 b 7.2 b 3616 b 4807 b **** 34.0**** c 30.7 c WHO European Region a 11.9 a ** Age-standardized figures *** The average between Flanders and Wallonia **** The average between England, Scotland and Wales Note: a = 2012, b = 2011, c =

9 Noncommunicable diseases: quantitative and qualitative indicators Incidence and mortality from malignant neoplasm of lungs, both sexes, European Region, Incidence and mortality from malignant neoplasm of breast, females, European Region, Montenegro MKD* Armenia Iceland Belarus Bosnia and Herzegovina Switzerland Azerbaijan Israel Malta Kyrgyzstan Tajikistan Mortality Incidence Armenia MKD* Israel Malta Montenegro Iceland Switzerland Belarus Bosnia and Herzegovina Kyrgyzstan Azerbaijan Tajikistan Mortality Incidence Age-standardised rates per Age-standardised rates per Raised blood pressure (sbp 140 OR dbp 90) prevalence difference between 2010 and 2014,, European Region Fasting glucose 126 mg/dl (7.0 mmol/l) prevalence difference between 2010 and 2014,, European Region Iceland Andorra Israel Malta Switzerland Belarus Montenegro MKD* Armenia Albania Azerbaijan Bosnia and Herzegovina Turkmenistan Tajikistan Females Males Turkmenistan Tajikistan Azerbaijan Kyrgyzstan Switzerland Andorra Armenia Belarus Israel MKD* Montenegro Albania Iceland Bosnia and Herzegovina Females Males Prevalence (%) Prevalence (%)

10 Noncommunicable diseases: quantitative and qualitative indicators Body mass index (bmi) of 30 kg/m 2 or higher prevalence difference between 2010 and 2014,, European Region Females Males Prevalence (%) Prevalence of insufficient physical activity among adults, 18 years+,, 2010, European Region Kyrgyzstan Bosnia and Herzegovina Andorra Malta Montenegro MKD* Israel Andorra Malta Armenia Iceland Switzerland Albania Belarus Kyrgyzstan Tajikistan Turkmenistan Azerbaijan Females Males Prevalence (%) Percentage of countries having a policy, strategy or action plan for ncd, European Region, Saturated fatty acids Marketing of foods Unhealthy diet WHO, Regional Office for Europe Overweight/obesity Physical inactivity Tobacco use Harmful use of alcohol Diabetes Chronic respiratory diseases Cancer Cardiovascular diseases 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

11 Technical notes The WHO Global Monitoring Framework (GMF) on Noncommunicable Diseases (NCD) includes 9 voluntary targets for prevention and control by 2025 and 25 indicators for monitor progress. To facilitate identification, GMF indicators are marked in a colour, while those on diabetes mellitus (the special topic), are coloured differently. Mortality from major NCD and cancer incidence (indicators 5, 12) are based on WHO European Mortality and Health for All databases ( and Probability of dying (indicator 6) shows the percentage of 30-year-old-people who would die before their 70th birthday from any of cardiovascular disease, cancer, diabetes or chronic respiratory disease and was calculated using cause-specific mortality rates in standard life table methods. Recorded alcohol per capita consumption (indicator 21) is defined as the recorded amount of alcohol consumed per capita (15+ years) over a calendar year in a country, in litres of pure alcohol. Heavy episodic drinking (indicators 22 23) is defined as the proportion of adults (15+ years) who have had at least 60 grams or more of pure alcohol on at least one occasion in the past 30 days. Prevalence of current smoking of any tobacco product (indicator 25) by persons aged 15 years and above, resulting from analysis of the full set of adult tobacco use surveys. Prevalence of raised blood pressure (indicator 28) is a percent of defined population with raised blood pressure (systolic blood pressure 140 OR diastolic blood pressure 90). Prevalence of raised total cholesterol (indicator 29) is a percent of defined population with total cholesterol 190 mg/dl (5.0 mmol/l). Immunization coverage (indicator 30) is the percentage of oneyear-olds who have received three doses of hepatitis B vaccine in a given year. Prevalence of raised fasting blood glucose (indicator 36) is a percent of defined population with fasting glucose 126 mg/dl (7.0 mmol/l) or on medication for raised blood glucose. Prevalence of overweight, Body Mass Index 25 (indicator 37) is a percentage of defined population with a body mass index (BMI) of 25 kg/m 2 or higher. For detailed definition of other indicators of the GMF and others used here, see the following documents/ links: Indicator Source of data 1 European Health for All database (HFA-DB) 2,5, 7 12, 32, , 21 25, 28 30, 36 37, 39, 40 European mortality database (MDB) Global Health Observatory (GHO) 38 European Database on Nutrition, Obesity and Physical Activity (NOPA) 31 Noncommunicable Diseases Progress Monitor ncd-progress-monitor-2015/en/ GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in European hospital morbidity database (HMDB) european-hospital-morbidity-database-hmdb WHO Report on the Global Tobacco Epidemic, 2015 Raising taxes on tobacco World Health Organization, 2016 All rights reserved. The European Regional office of the World Health Organization willing to satisfy requests to reproduce or translate its publications, in part or in full. The designations used in this publication and in cited materials do not reflect any opinions of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. World Health Organization, Regional Office for Europe UN City, Marmovej 51, DK-2100 Copenhagen, Phone: Fax: contact@euro.who.int Web: