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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 towards 2025 and 2030
In 2012, the World Health Organization (WHO) adopted a resolution to reduce premature mortality from NCDs by 25 per cent between 2010 and 2025. This was later adjusted to a 33 per cent reduction during 2015-2030 and is included in the United Nations' goals for sustainable development. There are eight additional targets, see below. The nine targets are often described as the “NCD targets.”
In Norway, the number of premature NCD deaths declined from 212 per 100 000 inhabitants in 2015 to 176 in 2021, corresponding to a 17 % decrease.
A reduction of 17 per cent in premature mortality between 2015 and 2021 indicates that Norway is making progress towards achieving the 33 per cent target by 2030. However, the greatest challenge for Norway may be that high levels of smoking cessation have already consolidated some of the effects. The question remains whether there will be a further decline in the years to come. The past two years may also have been affected by the COVID-19 pandemic.
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 six out of the nine targets. We have been unable to reverse the trend for two of the targets. This concerns the target on a 15 percent reduction in physical inactivity, and the target on 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 counselling to prevent myocardial infarction and stroke, and data on 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.
Comments on the table and links to relevant chapters:
Target 1. Premature mortality
- 17 per cent reduction in the proportion with premature NCD deaths for the age group 30-69 years (2015-2021).
Target 2. Alcohol
- 8 per cent reduction in alcohol consumption (2010-2019).
- No definite change in self-reported alcohol consumption (2012-2022).
- 6 % decrease in the proportion reporting episodic high alcohol consumption (2012-2022).
- We lack valid indicators for alcohol-related diseases.
Target 3. Physical inactivity
- A small decline in the proportion of adults who are insufficiently physically active (inactive) 2009-2015.
- No change in the proportion of children and adolescents who are insufficiently physically active (inactive) in 2005, 2011 to 2018.
Target 4. Salt intake. Here, we have data from 2015/16 but we lack data on progress over time.
Target 5. Tobacco use
Smoking, daily or non-daily (2009-2019)
- 38 per cent relative reduction in the proportion of adult males who smoke and/or use snus (moist powder tobacco).
- 47 per cent relative reduction in the proportion of adult females who smoke and or use snus.
- 29 per cent relative reduction in the proportion of young males who smoke and/or use snus.
- 41 per cent relative reduction in the proportion of young females who smoke and or use snus.
Snus use (moist powder tobacco), daily or non-daily (2009-2019)
- 34 per cent relative increase in the proportion of adult males who use snus.
- >100 per cent relative increase in the proportion of adult females who use snus.
- 21 per cent relative reduction in the proportion of young males who use snus.
- Signs of reduction in the proportion of young females who use snus.
Target 6. Raised blood pressure, for the period 2006-2019:
- 15 per cent reduction in the proportion of adult males with raised blood pressure in Nord Trøndelag during 2006-2019.
- 14 per cent reduction in the proportion of adult females with raised blood pressure in Nord Trøndelag during 2006-2019.
- 24 per cent reduction in the proportion of adult males with raised blood pressure in Tromsø during 2008-2016.
- 25 per cent reduction in the proportion of adult females with raised blood pressure in Tromsø during 2008-2016.
Target 7. Diabetes and obesity
Diabetes for the period for 2007-2016:
- 54 per cent rise in the proportion of males who have diabetes in Tromsø.
- 63 per cent rise in the proportion of females who have diabetes in Tromsø.
- No change in the proportion of children and adolescents with obesity (2010-2018).
- 10 per cent rise in the proportion of adult males with obesity in Nord Trøndelag during 2006-2019.
- 2 per cent rise in the proportion of adult females with obesity in Nord Trøndelag during 2006-2019.
- 26 per cent rise in the proportion of adult males with obesity in Tromsø during 2007-2016.
- 18 per cent rise in the proportion of adult females with obesity in Tromsø during 2007-2016.
Target 8. Drug therapy and counselling to prevent heart attacks and strokes.
Comment: In Norway the proportion receiving drug therapy is much higher than 50 per cent. We lack data on counselling.
Target 9. Access to drug therapy and counselling for NCDs (NCD medicines).
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.