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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Add
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ressing the context or circumstances in which physical activity occurs may promote physical activity at a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
more
Risk factors for noncommunicable diseases in Ukraine in 2019. This document summarizes the findings of the STEPS survey in Ukraine and compares them with the results of STEPS surveys carried out in
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other countries in the WHO European Region, as well as with selected other surveys in Ukraine. The survey is designed to be repeated approximately every five years in each country to allow assessment of trends.
The study revealed very high prevalence of NCDs and their behavioural and biological risk factors in Ukraine. Data on behavioural risk factors include tobacco and alcohol use, diet, and physical activity. Data on biological risk factors include overweight and obesity, blood pressure, blood glucose, and blood lipid levels.
more
Addressing comorbidities and risk factors for TB is a crucial component of Pillar one of the End TB Strategy, which focuses on integrated patient-centred care and prevention, including action on TB
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and comorbidities. The Framework for collaborative action on TB and comorbidities aims to support countries in the evidence-informed introduction and scale-up of holistic people-centred services for TB, comorbidities and health-related risk factors, with the goal of comprehensively addressing TB and other co-existing health conditions. It should be used in conjunction with relevant WHO guidelines. The Framework is intended for use by people working in ministries of health, other relevant line-ministries, policymakers, international technical and funding organizations, researchers, nongovernmental and civil society organizations, as well as primary care workers, specialist health practitioners, and community health workers who support the response to TB and comorbidities in both the public and private sectors.
more
Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy.
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This WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, based on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The third edition includes guidance for HIV-associated TB, mental health conditions and diabetes, which are three conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.
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WHO consolidated guidelines on tuberculosis: Module 6: tuberculosis and comorbidities, 2nd ed
recommended
Addressing TB comorbidities and risk factors is central to the World Health Organization (WHO) End TB Strategy. These guidelines consolidate the la
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test WHO recommendations on TB and key comorbidities. The guidelines are a living document and will include dedicated sections for each key TB comorbidity or health-related risk factor. The first edition focused on HIV-associated TB, updating the WHO policy on collaborative TB/HIV activities. This second edition expands on the previous edition and consolidates new and existing recommendations on interventions to address undernutrition in people with TB, to provide food assistance to households of people with TB in food-insecure settings, and to screen for TB among those who are undernourished or food insecure.
more
The STEPS survey of noncommunicable disease (NCD) risk factors in Zambia was carried out from July to September 2017. Zambia carried out Step 1, Step 2 and Step 3. Socio demographic and behavioural
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information was collected in Step 1. Physical measurements such as height, weight and blood pressure were collected in Step 2. Biochemical measurements were collected to assess blood glucose and cholesterol levels in Step 3. The survey was a population-based survey of adults aged 18-69. A multi-stage cluster sample design was used to produce representative data for that age range in Zambia. A total of 4,302 adults participated in the survey. The overall response rate was 74% for Step 1 and 2 and 65% for Step 3. A repeat survey is planned for 2022 if funds permit.
more
Unhealthy diets and excess body weight are leading risk factors for death and disability in the WHO European Region. Addressing malnutrition in all its forms is essential to ensure
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health and well-being for all and, consequently, sustainable development. It requires coherent and innovative actions covering the entire food system and across other sectors to ensure access to a diversified, balanced and healthy diet for all.
more
Infograpth from 2016, Diabetes is on the rise. Risk factors for type 2 diabetes. Genetics, age and family history of diabetes can increase the likelihood of becoming diabetic and cannot be changed.
The World Health Organization's fact sheet on hypertension provides a comprehensive overview of high blood pressure, highlighting its prevalence, risk fac
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tors, and health implications. It emphasizes that hypertension is a major cause of premature death worldwide, with an estimated 1.28 billion adults aged 30–79 years affected, two-thirds of whom live in low- and middle-income countries.
The document outlines modifiable risk factors, including unhealthy diets, physical inactivity, tobacco and alcohol use, and being overweight or obese. It also discusses non-modifiable risk factors such as family history, age over 65 years, and co-existing conditions like diabetes or kidney disease. The fact sheet underscores the importance of regular blood pressure monitoring, as hypertension often presents without symptoms, and highlights lifestyle changes and medications as effective treatments. Additionally, it mentions global targets aimed at reducing the prevalence of hypertension by 33% between 2010 and 2030.
more
Everyone in the world is exposed to risk factors for chronic respiratory disease (CRD). Three billion people live in urban areas and are exposed to outdoor air pollution. Two billion people are expo
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sed to solid fuel combustion which represents one of the major risk factors worldwide. One billion people are exposed to tobacco smoke and everyone is exposed to allergens. These risk factors are of particular concern in developing countries and deprived areas.
more
troke, a major Non-Communicable Disease (NCD), is responsible for 3.5% of disabilityadjusted life year (DALY) in India.Apart from risk factors like hypertension, diabetes, heart diseases and positiv
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e family history, other lifestyle related factors such as unhealthy diet, obesity, lack of physical activity, stress and tobacco use account for its occurrence. Changes in lifestyles, behavioural patterns, demographic profile (aging population), socio-cultural and technological advancements are leading to sharp increases in the prevalence of stroke. The disease by and large can be prevented by making simple changes in the way people live their lives or simply by changing our lifestyle.
more
Risk factors for asthma among schoolchildren who participated in a casecontrol study in urban Uganda
Data on asthma aetiology in Africa are scarce. We investigated the risk factors for asthma among schoolchildren (5–17 years) in urban Uganda. We conducted a case-control study, among 555 cases and
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1115 controls. Asthma was diagnosed by study clinicians. The main risk factors for asthma were tertiary education for fathers (adjusted OR (95% CI); 2.32 (1.71–3.16)) and mothers (1.85 (1.38–2.48)); area of residence at birth, with children born in a small town or in the city having an increased asthma risk compared to schoolchildren born in rural areas (2.16 (1.60–2.92)) and (2.79 (1.79–4.35)), respectively; father’s and mother’s history of asthma; children’s own allergic conditions; atopy; and cooking on gas/electricity. In conclusion, asthma was associated with a strong rural-town-city risk gradient, higher parental socio-economic status and urbanicity. This work provides the basis for future studies to identify specific environmental/lifestyle factors responsible for increasing asthma risk among children in urban areas in LMICs.
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a "risk factor" is something that increases your chances of getting a disease or condition. In the case of asthma there are two diffrent type of risk fact
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ors. There are risk factors for developing asthma , and there are separate risk factors for those who already have asthma getting a severe asthma attack. We like to refer to the second as "triggers for asthma attacks" instead of "risk factors" to avoid confusion.
more
Key facts
- Cardiovascular diseases (CVDs) are the leading cause of death globally.
- An estimated 17.9 million people died from CVDs in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke.
- Over three quarters of CVD deaths take place in low- an
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d middle-income countries.
- Out of the 17 million premature deaths (under the age of 70) due to noncommunicable diseases in 2019, 38% were caused by CVDs.
- Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol.
- It is important to detect cardiovascular disease as early as possible so that management with counselling and medicines can begin.
more
The materials focus on promoting healthy eating habits and reducing risk factors for non-communicable diseases such as obesity, diabetes, and heart disease. They emphasize actions to limit sugar, sa
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lt, and fat intake, including policy recommendations for eliminating trans-fats, reducing saturated fats, and improving public awareness through education and labelling. These strategies aim to create healthier food environments and improve dietary behaviors globally.
more
Cardiovascular diseases (CVDs) are a growing public health problem in Ghana and other African countries. Strokes and other CVDs have become a leading cause of death due to increasing risk
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factors such as hypertension. According to the Global Burden of Disease study (GBD), ischaemic heart disease was the fourth leading cause of death in Ghana in 2016. The prevalence of hyper-
tension, a major risk factor for CVDs, is increasing rapidly and ranges from 19% to 48%, according to the Ghana Health Service Annual Report, 2017, due to rising life expectancy and the increasing prevalence of contributing factors such as overweight/obesity. Early diagnosis and adequate management of the risk factors can reduce the fatal consequences of CVDs.
At the heart of improving risk assessment and management of CVDs are nationally approved guidelines, which facilitate standardisation of care approaches.
These guidelines developed by experts from all levels of health care and stakeholders capture all recommended approaches and necessary information for clinicians and other healthcare workers on CVDs. They also serve as a practical guide for assessing and managing the most important CVDs prevalent in Ghana and can be used at all levels of care namely health facilities without a doctor; with a general practitioner and with a physician specialist.
more
This booklet presents data on NCD mortality and prevalence of NCD risk factors, by country, for the Region of the Americas. The focus is on the 5 x 5 NCD agenda which includes the main NCDs (cardiov
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ascular diseases, cancer, diabetes, and chronic respiratory diseases), and mental health (suicide); as well as the main NCD risk factors (tobacco use, harmful use of alcohol, unhealthy diet, insufficient physical activity), along with air pollution. It includes information on the number and percentage of deaths, age-standardized death rates, premature death from NCDs and the prevalence of NCD risk f actors.
more
"Tackling Noncommunicable Diseases (NCDs), risk factors and mental health during the time of COVID-19" is a series of high-level strategic discussi
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ons on transforming the approach to noncommunicable diseases, its risk factors and mental health as a result of the pandemic in terms of strengthening health systems and services, responding to emergencies, investing to transform the NCD, RF and MH agenda, optimizing partnerships, among others, with a focus on big picture thought leadership.
more
The IHME webpage discusses alcohol use as a significant global health risk, responsible for over 1.8 million deaths annually. It highlights age-related differences in alcohol's
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health impacts, with no benefits for individuals aged 15–39 and potential small benefits for those aged 40 and above under certain conditions. The page emphasizes the need to consider factors like age, disease patterns, and individual health in assessing alcohol-related risks.
more
The Gulf CDC Technical Guide for Rapid Risk Assessments of Acute Public Health Events provides a structured, multi-sectoral approach to evaluate and manage public
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health threats in Gulf Cooperation Council (GCC) countries. It focuses on rapid, evidence-based assessments (within 2-5 days) to determine risk levels, propose control measures, and guide communications
more
