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Non-communicable diseases (NCDs) are among the most significant causes of premature mortality among adults in both wealthy and poor countries.
The term “premature mortality” here means death before the age of 70. The NCDs included in these statistics are: heart attacks, strokes and other cardiovascular diseases, cancer, diabetes and chronic obstructive pulmonary disease (COPD).
Targets for the period 2010-2025
In May 2012, the World Health Organization (WHO) adopted a resolution to reduce premature mortality from NCDs by 25 per cent between 2010 and 2025. There are eight additional targets, see below. The nine targets are often described as the “NCD targets.”
In Norway, the premature mortality rate fell from 257 per 100 000 population in 2010 to 203 in 2017, which corresponds to a reduction of 21 per cent.
An 21 per cent reduction in premature mortality between 2010 and 2017 indicates that Norway is making good progress towards achieving the 25 per cent target by 2025. However, the greatest challenge for Norway may be that high levels of smoking cessation have already consolidated some of the effects, and the question is whether there will be a further decline in the years to come.
Norway: positive trends for seven out of nine targets
The nine targets established by WHO to combat NCDs are shown in Figure 1. In addition to reducing premature mortality before the age of 70 (Target 1), the objective is also to reduce the four most important common risk factors:
- Tobacco use
- Unhealthy diet
- Physical inactivity
- High alcohol consumption
There are also other targets concerning blood pressure, obesity and access to treatment for everyone who needs it.
The Government has drawn up its own National NCD Strategy for the period 2013-2017. There are plans to develop a follow-up strategy.
Norway’s status shows apparent progress in respect of seven out of the nine targets. We have been unable to reverse the trend for one of the targets; indeed, the situation has deteriorated. This concerns halting the rise in obesity and diabetes, see Figure 1. For another target, reducing salt in the diet, we do not currently have data showing trends over time.
Nevertheless, we need to monitor progress closely. Several areas are in need of better temporal data, for example, data on physical inactivity in children and salt intake in the population over time. There is also the question of whether a negative trend in certain targets will occur due to the increasing prevalence of adults with obesity.
The nine NCD targets give just one of many perspectives on the population’s state of health. For Norway, it will be important to monitor whether progress is taking place within all social classes or if we are heading towards wider social disparities in health.
Figure 1 below shows the nine targets and Norway’s current status.
Figure 1. Norway’s status is based on currently available data. Progress has been made towards achieving most of the targets. We have been unable to halt the rise in diabetes and obesity.
*NCD = non-communicable disease. The term “non-communicable disease” here refers to cardiovascular disease, cancer, chronic lung diseases (primarily COPD) and diabetes.
Comments on the table and links to relevant chapters:
Target 1. Premature mortality, comment: Applies to the period 2010-2017.
Target 2. Alcohol, comments:
- No change in the proportion with episodic high alcohol consumption (2012-2016).
- 8 per cent reduction in alcohol consumption (2010-2017).
- 9 per cent reduction in alcohol-related mortality (2010-2017).
- We lack indicators for alcohol-related diseases.
Target 3. Physical inactivity, comments:
- A small decline in the proportion of adults who are unsufficiently physically active (inactive) 2010-2015.
- No change in the proportion of children and adolescents who are sufficiently physically active 2018.
Target 4. Salt intake. Here, we have data from 2015/16 but we lack data on progress over time.
Target 5. Tobacco use, comment: All data refer to the period 2010-2016:
- 10 per cent reduction in the proportion of adult males who smoke and/or use snus (moist powder tobacco) (daily or non-daily).
- 19 per cent reduction in the proportion of adult females who smoke and or use snus (daily or non-daily).
- 19 per cent reduction in the proportion of young males who smoke and/or use snus (daily or non-daily).
- 22 per cent reduction in the proportion of young females who smoke and or use snus (daily or non-daily).
Target 6. Raised blood pressure, comment: Data from the period 2007/08-2015/16 show the following:
- 24 per cent reduction in the proportion of adult males with raised blood pressure.
- 25 per cent reduction in the proportion of adult females with raised blood pressure.
Target 7. Diabetes and obesity, comment:
- 54 per cent rise in the proportion of males who have diabetes (2007/08-2015/16).
- 63 per cent rise in the proportion of females who have diabetes (2007/08-2015/16).
- No change in the proportion of children with obesity (2005-2015).
- 26 per cent rise in the proportion of adult males with obesity (2007/08-2015/16).
- 18 per cent rise in the proportion of adult females with obesity (2007/08-2015/16).
Target 8. Drug therapy and counselling to prevent heart attacks and strokes.
Comment: In Norway the proportion is much higher than 50 per cent.
Target 9. Access to drug therapy and counselling for NCDs (NCD medicines).
Comment: In Norway, the proportion of individuals with access to NCD medicines is close to 100 per cent.
In Norway, a national group was established to collect and present data on the nine targets. The group forms the editorial team for this publication. The data have been published on the Norwegian Institute of Public Health’s web pages in the form of indicators. Each indicator is described in a separate chapter of this web publication.
There are 25 indicators in total, of which some are directly linked to the NCD targets, while others are additional indicators that underpin the NCD targets more indirectly.