The myth that the poor are less at risk to develop non-communicable diseases (NCD) such as diabetes or cardio-vascular diseases is slowly disappearing. Previously seen as the adverse effects of an affluent lifestyle we know today that more than 80% of all non-communicable disease deaths occur in low- or middle-income countries. The good news is that the debilitating effects of NCDs and related deaths often can be prevented if their environmental causes such as unhealthy working or living conditions or behavioral triggers such as bad eating habits or substance abuse are addressed.
However, the poor are often times not aware of potential causes of ill health in their lives and even if they are – their options to reduce their exposure to unhealthy factors or modify unhealthy behaviors are likely fairly limited. Even worse, when they develop an NCD the probability that they will receive the long-term treatment that those diseases require is much lower than it is for more affluent patients. Most community health programs that provide health care services for the urban poor continue to be focused on detecting and curing communicable diseases such tuberculosis. They are much less equipped to handle the chronic care associated with conditions such as diabetes.
According to Shree Ravindranath, author of the article “No magic bullet: NCD’s and the Urban Poor,”“diagnosing and managing NCDs is even more complex for the migrant urban poor who have little time and few facilities to turn to.” While a number of new initiatives are underway that have the goal to address the gap between a changing disease burden and a health care approach that continues to focus on communicable diseases many of those don’t take the necessary multi-pronged approach required to effectively address the growing challenge of NCD’s. Even more importantly, those efforts are most often not targeted towards the needs of the poor and their more limited options to reduce unhealthy components in their lives and lifestyle.