Promoting Healthy Living in Latin America and the Caribbean

249 Pages·2013·3.83 MB·English

D I R E C T I O N S I N D E V E L O P M E N T
Human Development
Promoting Healthy Living in Latin
America and the Caribbean
Governance of Multisectoral Activities to Prevent
Risk Factors for Noncommunicable Diseases
María Eugenia Bonilla-Chacín, Editor
Promoting Healthy Living in Latin America and the Caribbean Bonilla-Chacín
Promoting Healthy Living in
Latin America and the Caribbean
D i r e c t i o n s i n D e v e l o p m e n t
Human Development
Promoting Healthy Living in Latin
America and the Caribbean
Governance of Multisectoral Activities to Prevent
Risk Factors for Noncommunicable Diseases
María Eugenia Bonilla-Chacín, Editor
© 2014 International Bank for Reconstruction and Development / The World Bank
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Attribution—Please cite the work as follows: Bonilla-Chacín, María Eugenia, ed. 2014. Promoting Healthy
Living in Latin America and the Caribbean: Governance of Multisectoral Activities to Prevent Risk Factors
for Noncommunicable Diseases. Directions in Development. Washington, DC: World Bank.
doi:10.1596/978-1-4648-0016-0.License: Creative Commons Attribution CC BY 3.0
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Contents
Acknowledgments xi
About the Authors xv
Abreviations xix
Overview 1
María Eugenia Bonilla-Chacín
The Health and Economic Burden of NCDs in LAC 1
Risk Factors for NCDs in LAC 2
International Experience in Multisectoral Interventions to
Prevent Health Risk Factors: Overcoming Governance
Challenges Involved in Their Design and Implementation 3
Multisectoral Interventions to Prevent Health Risk Factors
in LAC—The Unfinished Agenda 18
Notes 21
Bibliography 21
Introduction 23
Note 25
Bibliography 25
Chapter 1 Noncommunicable Diseases in Latin America and the
Caribean 27
María Eugenia Bonilla-Chacín
Who Is Most Affected? 33
Differences in NCD Death Rates by Sex 36
Notes 37
Bibliography 38
Chapter 2 Risk Factors for NCDs in Latin America and the
Caribean 39
María Eugenia Bonilla-Chacín
Underlying Factors 39
Modifiable Behavioral Risk Factors 41
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vi Contents
Intermediate Risk Factors 55
Notes 64
Bibliography 65
Chapter 3 Economic Impact of NCDs in Latin America and the
Caribean 69
Edmundo Murrugarra and María Eugenia Bonilla-Chacín
Household Out-of-Pocket and Catastrophic Health
Expenditures Associated with NCDs 69
Noncommunicable Diseases and Labor-Market Outcomes:
Evidence from Selected Latin American Countries 74
The Economic Cost of NCDs to Health Systems in the
Region 84
Notes 85
Bibliography 86
Chapter 4 Governance of Multisectoral Interventions to Promote
Healthy Living: International Examples 89
Claudia Trezza and María Eugenia Bonilla-Chacín
The Health Sector’s Role 91
Multisectoral Interventions to Prevent Risk Factors 91
Interventions to Promote Healthy Diets 92
Interventions to Promote Physical Activity 101
Community-Based Interventions to Promote Healthy
Diets and Increase Physical Activity 105
Tobacco-Control Policies 110
Alcohol-Control Policies 118
Notes 124
Bibliography 125
Chapter 5 Multisectoral Interventions to Promote Healthy Living
in Latin America and the Caribbean 133
María Eugenia Barbieri for the National Ministry of Health of
Argentina; Olga L. Sarmiento, Adriana Díaz del Castillo, and
Ethel Segura Durán; Evelyne Rodriguez; Amanda Sica, Franco
González Mora, Winston Abascal and Ana Lorenzo for the
Ministry of Public Health of Uruguay
Argentina: Amending the Food Code to Regulate Trans
Fats and Agreements between the Government and the
Food Industry to Reduce Sodium in Processed Foods 134
Bogotá, Colombia: A City with a Built Environment that
Promotes Physical Activity 147
Mexico: National Agreement on Food Health, Strategy
against Overweight and Obesity 166
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Contents vii
Uruguay: Tobacco-Control Policies 176
Argentina: Tobacco-Control Policies 187
Notes 198
Bibliography 199
Chapter 6 Lessons Learned and Agenda for the Future 205
María Eugenia Bonilla-Chacín and Claudia Trezza
International and Regional Experiences with
Multisectoral Interventions to Prevent Health
Risk Factors—Lessons for LAC 206
Unfinished Agenda for LAC 211
Notes 214
Bibliography 214
Appendix A Survey Sources, Health Status Surveyed, and Information
on NCDs and Disability, for Brazil, Chile, Colombia,
El Salvador, and Honduras, Various Years 215
Appendix B Dietary Analysis Methodology 219
Notes 21
Bibliography 221
Box
5.1 The Special Tobacco Fund (FET) 190
Figures
1.1 Age-Standardized Death Rates (Estimates for 2004 and 2008)
and DALYs Lost (Estimates for 2004), Latin America and the
Caribbean and OECD 27
1.2 Age-Standardized DALYs from NCDs, Communicable Diseases,
and Injuries, Selected Latin American and Caribbean
Countries, Estimates for 2004 28
1.3 Percentage of Age-Standardized Deaths, by Disease Groups,
Latin America and the Caribbean, 2008 29
1.4 Age-Standardized Mortality Rates from Specific NCDs, Latin
American and Caribbean and OECD Countries, 2008 30
1.5 Age-Standardized Mortality Rates from Diabetes, Selected
Latin American and Caribbean Countries and Regional
Average, 2008 31
1.6 Age-Standardized Death Rates from Specific Cardiovascular
Diseases, Selected Latin American and Caribbean Countries
and Regional, OECD, and Worldwide Averages, 2008 32
1.7 Prevalence of NCDs, by Rural and Urban Areas, Sex, Age, and
Educational Subgroups and Income Levels 33
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viii Contents
1.8 Age-Standardized Death Rates from Diabetes, by Sex, Selected
Latin American and Caribbean Countries, 2008 37
2.1 Determinants of and Risk Factors for Chronic,
Noncommunicable Diseases 40
2.2 Calorie Sources in the Diet, Selected Central American
Countries, Various Years 44
2.3 Levels of Sodium Consumption (Total Intake and Intake from
Food Only) Per Adult Equivalent 46
2.4 Percentage of the Population that Falls below the Recommended
Level of Physical Activity, by Age, Sex, and Income Quintile,
Guatemala, 2006 47
2.5 Percentage of the Population that Falls below the Recommended
Level of Physical Activity, by Age, Sex, and Income Quintile,
Costa Rica, 2004 49
2.6 Age-Standardized Rates of Current Smoking of Any Tobacco
Product among Adults, by Sex, Selected Latin American and
Caribbean Countries, 2006 and 2009 51
2.7 Rates of Current Use of Any Tobacco Product among Youth
13–15 Years Old, by Sex, Selected Countries, 2008 51
2.8 Rates of Current Use of Any Tobacco Product among Youth
13–15 Years Old, by Sex, Selected Latin American and
Caribbean Countries, 2008 and 2010 52
2.9 Percentage of Women Smokers in Bolivia and Guyana, and
Percentage of Men Smokers in the Dominican Republic and
Guyana, by Asset Quintile, Various Years 53
2.10 Yearly Average of Per Capita Consumption of Pure Alcohol
among Adults 15 Years Old and Older, Latin American and
Caribbean Countries, 2003–05 55
2.11 Percentage of Adults Older than 20 Years with High Blood
Pressure (SBP ≥ 140 or DBP ≥ 90, or Who Are on Medication),
Selected Latin American and Caribbean Countries and OECD
and Regional Averages, 2008 57
2.12 Age-Standardized Percentage of Adults 20 Years Old or Older
with High Blood Cholesterol (≥5.0 mmol/L), by Sex, Selected
Latin American and Caribbean Countries and OECD and
Regional Averages, 2008 58
2.13 Age-Standardized Percentage of Adults with High Blood-
Glucose Levels (≥7 mmol or Who Are on Medication), by
Sex, Selected Latin American and Caribbean Countries and
OECD and Regional Averages, 2008 59
2.14 Mean Average Body Mass Index (BMI) among Adults 20 Years
Old and Older, Selected Latin American and Caribbean
Countries and OECD and Regional Averages, 2008 60
Promoting Healthy Living in Latin America and the Caribbean • http://dx.doi.org/10.1596/978-1-4648-0016-0