According to Centers for Diseases Control and Prevention (CDC), the definition of chronic diseases is that the health conditions last 1 year or longer and require ongoing medical attention or limit activities of daily living or both. The common chronic diseases include cardiovascular disease, cancers, diabetes, and chronic respiratory diseases. The influence of chronic disease significantly impacts personal well-being, and it is also leading nationally economic cost on certain level. In recent years, the extent of influence from chronic disease has been more and more apparent compared with other communicable diseases. Based on the global status report from World Health Organization in 2014, there were 38 million people died of noncommunicable diseases which is 68% of world population. In particular, among the 38 million people, the proportion of premature death (younger than 70 years old) was over 40%. Gradually, the importance of noncommunicable diseases was formally recognized over years and concluded four major risk factors: tobacco use, excessive alcohol consumption, poor nutrition, lack of physical activity.
Achievement of Tobacco Prevention-A 30% Relative Reduction of Tobacco Use
In Taiwan, the government actively promotes and supports various health prevention policies and provides evidence-based health preventive interventions, which including annual physical exam, diseases screening, smoking cessation, establishment of health environment (such as school, working place, military, medical facility, community, and city) to address the importance of the four major risk factors on noncommunicable disease prevention. Taiwan also corresponds to the Global action plan for the prevention and control of noncommunicable diseases 2013−2020 (known as the Global NCD Action Plan), and adopts a comprehensive health monitoring system, including a set of nine voluntary global targets and 25 indicators. Furthermore, people will benefit from the development of interdisciplinary care and comprehensive index reference by lowering the exposure of different risk factors.
In Taiwan, there has been remarkable progress in the prevention of noncommunicable diseases through the government and citizens’ effort. On the reduction of tobacco use, Taiwan applies the WHO Framework Convention on Tobacco Control(FCTC) into legislation for tobacco-free environment, tobacco tax and price control, providing smoking cessation, and prohibition of cigarette commercial. From the statistics, among people in Taiwan, the relative rate of tobacco use was 13.0% in 2018 compare to the 20% in 2009. Among people aged 18-21, the relative rate of tobacco use was 8.0% in 2018, significantly decreased from 14.8% in 2009. Besides, among those aged 14-17, the relative rate of tobacco use also evidently declined from 7.8% to 2.8 in 2009 and 2018, respectively. It indicates that Taiwan almost achieves the goal of WHO: a 30% relative reduction in prevalence of current tobacco use. Compared to the results of Global Youth Tobacco Survey, in Taiwan, the prevalence of current tobacco use among 14 to 17-year-old is lower than the United States (7.2%), Italy (20.8%), and Korea (9.4%).
Healthy Diet and Physical Activity- Decreasing Obesity Prevalence
Promotion of breastfeeding, reducing salt, sugar, saturated fats consumption, and avoiding consuming trans fats to maintain healthy eating and overall health. According to the survey in Taiwan, among adult population, the prevalence of overweight and obesity was 43.5% from 2005-2008, and it slightly lowered in 2013-2014, 43.0%. Overall, the rates of obesity among population in Taiwan is decreasing and toward the target of WHO in 2025. More recent, people begin to recognize the importance of physical activity and the quality of life, the rate of regularly physical activity was increased from 26% to 33% in 2010 and 2014, respectively.
Significant Achievement of Diabetes Integrated Care- Prevention vs. Mortality from noncommunicable diseases
Diabetes is the fifth cause of the death among Taiwan population. In the beginning of 2003, the government and local medical facilities strongly promoted the Diabetes Integrated Care to strengthen the quality of care, develop training and certification programs, and also build interdisciplinary healthcare team. In the meantime, 269 health promotion facilities were built for diabetes population under quality control and stay monitoring. In order to provide sufficient services and well-managed blood sugar condition to diabetes patients, the Universal Health Insurance cover the cost of services for diabetes population. In 2017, the rate of diabetes care was 51.1%. In addition, the diabetes pamphlet “Health Promotion and Health Management for Diabetes in Taiwan” was published to further people’s understanding of diabetes prevention and management. In Taiwan, the mortality from diabetes was decreasing from 37.1to 23.5 people in every one hundred thousand people between 2002 to 2017. The drop of 36.7% indicated that the Diabetes Integrated Care Net was making progress in Taiwan.
In the era of rapid population aging and the growing threat of noncommunicable diseases, the National Health Service will carry out the World Health Organization’s global goal of noncommunicable diseases prevention and control in 2013-2020 with the mission of improving health and reducing health inequalities. Reduce premature deaths of the four major noncommunicable diseases (cancer, cardiovascular disease, diabetes, chronic respiratory diseases) by 25%, and strengthen inter-disciplinary integration of source prevention, promote e-distribution, improve national health, and strengthen human resources And the professional effectiveness of the organization, etc., to enhance the depth and breadth of services to promote national health.
