Non-communicable diseases in low- and middle-income countries: context, determinants and health policy.
Non-communicable diseases in low- and middle-income countries: context, determinants and health policy.
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DOI：
10.1111/j.1365-3156.2008.02116.x
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发表时间：
2008-10
期刊：
影响因子：
--
通讯作者：
Ebrahim S
中科院分区：
文献类型：
--
作者：
Miranda JJ;Kinra S;Casas JP;Davey Smith G;Ebrahim S
近年来，非传染性疾病的增加及其在中低收入国家的影响得到了更多的关注。然而，对这一增长的解释主要是从高收入国家的历史中推断出来的，这些国家的经验与影响当今中低收入国家的发展进程不同。本次审查评估了这些差异，以便更好地了解低收入和中等收入国家的非传染性疾病流行情况。对非传染性疾病的发展和退化决定因素的理论进行了讨论，以便为因果知情的预防方法提供强有力的证据。从减少人口风险和个人易感性的干预措施角度考虑非传染性疾病的卫生政策，并讨论了低收入和中等收入国家的研究需求。最后，强调需要进行保健系统改革，以加强初级保健，这是减少这一日益严重的流行病造成的死亡人数的一项重大政策。
The rise of non-communicable diseases and their impact in low- and middle-income countries has gained increased attention in recent years. However, the explanation for this rise is mostly an extrapolation from the history of high-income countries whose experience differed from the development processes affecting today’s low- and middle-income countries. This review appraises these differences in context to gain a better understanding of the epidemic of non-communicable diseases in low- and middle-income countries. Theories of developmental and degenerative determinants of non-communicable diseases are discussed to provide strong evidence for a causally informed approach to prevention. Health policies for non-communicable diseases are considered in terms of interventions to reduce population risk and individual susceptibility and the research needs for low- and middle-income countries are discussed. Finally, the need for health system reform to strengthen primary care is highlighted as a major policy to reduce the toll of this rising epidemic.
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