cardiovascular health is the heart of global development

CARDIOVASCULAR HEALTH

IS AT THE HEART OF

GLOBAL DEVELOPMENT

Prof K Srinath ReddyPresidentPublic Health Foundation of India Professor of Cardiology All India Institute of Medical Sciences Bernard Lown Professor of Global Cardiovascular Health Harvard School of Public Health

In The Second Half of The 20th Century

We Saw Progress in

CVD Prevention amp Care

Clinical Public Health

Q In The First Half Of The

21st Century

Will Global Cardiovascular Health

Be Better Or Worse

THE ANSWER DEPENDS ON helliphelliphellip

bull Content of Health Care(Science Technology Training Guidelines)

bull Delivery of Health Care(Health Systems Outreach Effectiveness Practice Patterns Access Affordability Regulation)

bull Risk Factors At The Population Level(Social Determinants Health Behaviours)

radic radic

radic

THE ROSE PRINCIPLEldquoSick Individuals Arise From Sick Populationsrdquo

- Geoffrey Rose

WITHIN EACH POPULATION

bull The number of persons who will have undesirable levels of any risk

factor is related to the mean level of the risk factor in the population

bull A shift of the whole distribution to the left would mean better health

(less lsquocasesrsquo) and a shift to the right means worse health

(more lsquocasesrsquo)

THE WORLD AS ONE POPULATION If we plot the distributions of

bull BP

bull Cholesterol

bull Exposure to Tobacco Smoke (ActivePassive)

bull Physical Inactivity

bull Dysglycemia

bull Overweight amp ObesityAT THE GLOBAL LEVEL

WE WILL FIND A RIGHTWARD SHIFT

In Each Of Their Distributions Compared To 20-30 Yrs Ago

GLOBAL DEATHS BY CAUSE 2004

0

5000

10000

15000

20000

HIVA

IDS TB

Malaria

CVD

Cance

r

Chronic

Res

pirato

ry

Diabete

s

(100

0s)

Preventing chronic diseases a vital investment WHO global report 2005

Presenter
Presentation Notes
FIGURE 1 Changing Patterns of Mortality (20th to 21st Century)13A century ago cardiovascular disease (CVD) accounted for less than 10 percent of all deaths worldwide Today CVD is responsible for about 30 percent of all deaths (1) This increase can be traced to a dramatic shift in the health status of people around the world during the 20th century and to a major change in the distribution of disease Prior to 1900 infectious diseases and malnutrition were the most common causes of death but due primarily to improved nutrition and public health measures they have gradually been supplanted by CVD and cancer in most countries As these improvements continue to spread to developing countries CVD mortality rates are also increasing In fact today about 80 percent of the global burden of CVD death occurs in low- and middle-income countries 13

CARDIOVASCULAR DEATHS GLOBAL PROFILE

Projected global numbers of deaths by cause for high- middle- and lowincomecountries (WHO 2008)

Age-adj death rates for total CVD diseases of the heart CHD and

Stroke USA 1900-1996

httpwwwcdcgovmmwrpreviewmmwrhtmlmm4830a1htmfig1

Deaths per 100000 population

Males Females

All cardiovascular diseases


Coronary heart disease


Bennett SA et al Med J Aust 1994161519-527

2

67

95105

2 25

41 45

123456789

1011

1960 1970 1980 1990 2000

Urban Rural

Increasing CHD in IndiaPrevalence ()

Gupta R CSI Cardiology Update Ed Manjuran RJ 2003

00

20

40

60

1990 2020Nu

mb

er

of

death

s (

mil

lio

ns)

Cardiovascular diseases

CVD Deaths

Trend of CVD mortality (1990-2000) China

Wang YJ International Journal of Stroke 2007

Why are different countries

showing different patterns of

CVD

bull RiseFall of Mortality Rates

bull CHDStroke As Dominant CVD

Stages of Health TransitionStage IAge of Pestilence and Famine

Stage IIAge of Receding Pandemics

Stage IIIAge of lsquoMan Madersquo Degenerative Diseases

Stage IVAge of Delayed Degenerative Diseases

Stage VAge of Social Upheaval and Health Regression

Stage VIEra of Environmental Degradation

Omran (1971) Olshansky and Ault (1986)

Yusuf and Reddy (2001)

Thakker and Reddy (2008)

Sub Saharan Africa

Rural China amp India

Urban India Russia

Latin AmericaEastern Europe

STAGE I

Life Expectancy ~ 35 years

Dominant Diseases Infections Nutritional Deficiencies

CVD RHD Cardiomyopathies

STAGE II


Dominant Diseases Mixed Pattern ndashStage I DiseasesProminent But Chronic Diseases Emerge

CVD RHD High BP ampHemorrhagic Stroke

HIGH BLOOD PRESSURE

HEMORRAGIC STROKE

HYPERTENSIVE HEARTFAILURE

THROMBOTIC STROKE

CORONARY HEART DISEASE

OTHER RISK FACTORS( Lipids Smoking Diabetes)

STAGE III


Dominant Diseases Chronic Diseases

CVD CHD Both Forms of Stroke

STAGE IV

Life Expectancy gt 70 years


CVD CHD Both Forms of Stroke (Mainly Thrombotic)

CHD and Stroke are still dominant but kill much later in life

THE TASK BEFORE US

Stage I Stage II Stage III Stage IV

Avoid Abbreviate the Stage of Mid-Life Death and Disability

RAPID EPIDEMIOLOGIC TRANSITION FROM INFECTIOUS

AND NON-COMMUNICABLE CAUSES MEXICO 1950-2010

0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010

Infectious ampparasitic NCDs

Bobadilla et al In Jamison ed Disease Control

Priorities in DC Oxford UP WB 1993

bullMassive total deaths

bull Large absolute and

proportionate in NCDs

bull Large absolute infectious diseases

THE CVD EPIDEMICS THE THREE TRANSITIONS

BURDEN OF DISEASE SHIFTS

EARLY LIFE MIDLIFE

RISK BEHAVIOURS RISK FACTORS

EARLY ADAPTER LATE ADAPTER

(HIGH SES) (LOW SES)

DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC

Risk factors tobacco use on the rise in developing countries

The Nutrition Transition in Developing Countries

Shift in diet structure ndash towards a high fat and refined sugar Western Diet

Accelerating rate of change in diet Shift in activity patterns Link between diet and activity

changes and increases in obesity Popkin 2001

Mean Plasma Cholesterol Values in China

0

50

100

150

200

250

mg

dl

1958 1981 1997 2003

NUMBER OF PEOPLE WITH DIABETES IN THE ADULT POPULATION

(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350

Developed Developing World

Mill

ions 2000

2025

Source Global Burden of Diabetes 1995-2025 King H etal Diabetes Care19

OECD countries Obesity rates in women aged 15-64 (age-adj)

Trends in Obesity amp Overweight Mexico

143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007

Major risk for chronic diseases in Middle East

Overweight amp Obesity based on STEPwise Surveillance (BMIgt=25)

669 674563

812 764

539

0

20

40

60

80

100

Iraq Jordan Syria Kuwait Egypt Sudan

Perc

ent

Hypertension in the EMR Based on STEPwise Surveillance

255 26 288246

334

236

404

05

1015202530354045

Iraq Jordan SaudiArabia

Syria Kuwait Egypt Sudan

DM in the EMR (STEPwise Surveillance)

104

16179

199167 165

192

0

5

10

15

20

25



Low Physical Activity

567

79

338 329

554 504

868

0

20

40

60

80

100



VARIATIONS IN HEALTH TRANSITION ETHNIC DIVERSITY

What is ethnicity

Differences due to genes or environment or both

Lessons from Migrant studies (Ni-Hon-Son Chinese Indians Kenyan nomads)

Multi-ethnic comparisons (London Canada INTERHEART Seven Countries)

Q How Is Cardiovascular Health Linked to Development

Poor CV Health Development (-) Development (+)

bull darrProductivity

bull uarr Poverty

bull uarrHealth Care Costs

bull Unhealthy Living

Habits (Urbanization)

bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income

(uarr Access To Healthier

Products amp Services)

HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH

(not numbers) of CVD deaths by age group 2000-2030 assuming stable risks

0

10

20

30

40

50

60

70

US Russia S Africa Brazil

lt4545-6465-7475 +

Note how deaths from CVD in the US occur principally at ages gt75+ while in developing economies

they occur at younger ages

Years Of Life Lost Due To CVD In PopulationsAged 35-64 Years

PPYLL= Potentially Productive Years of Life Lost

Lost National Income due to IHD Stroke and Diabetes (2005-2015)

0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)

Preventing chronic diseases a vital investment WHO global report

Presenter
Presentation Notes
Figure 14 CVD deaths per population13 While 80 of CVD deaths come from the low and middle-income regions the death rates for most regions are still below the rate of the high-income countries of 320 per 100000 annually The marked exception is Europe and Central Asia region which has a rate of 690 CVD deaths per 100000 more than double that of the high-income countries

Projected per capita income path conditional on different CVD scenarios

(Scenario 1 and 2 1 and 3 annual decline in mortality)

CVDs THE SOCIAL GRADIENT

As socio-economic and health transitions advance within each countryhelliphellip

The Social gradient for NCD risk factors and for NCD events progressively reverses till

THE POOR BECOME MOST VULNERABALE

(Reddy KS et al PNAS 2007)

SES GRADIENTORDER OF REVERSAL FOR CVD RISK FACTORS

Tobacco

Blood Pressure

Plasma Cholesterol

darr Physical Activity

Obesity

Health Transition

Tanzania Smoking amp HT uarr in low SES BMI uarr in High SES Group(Bovet P 2002)

China Smoking HT Obesity inversely correlated with years of education in Chinese women (Zhije Yu 2000)

India Higher risk of MI in urban residents with low level of education and income (Rastogi T 2004)

In Industrial employees and families all CVD risk factors are inversely correlated with education (Reddy KS 2007)

Brazil Obesity rates declining in High SES Rising in Low SES(Bell 2000)

STROKE CHINA QUEST STUDY (2009)4739 Survivors of stroke71 Patients Experienced Catastrophic OOPE

- Heeley E et al Stroke 2009 402149-5

bull OOPE from Stroke pushed 37 of

patients and their families below

the poverty line 62 without

insurance went into poverty

CVD IMPACT ON HOUSEHOLDS (KERALA INDIA)

(Harikrishnan 2010)

bull Catastrophic Health Expenditures (729)bull Distress Financing Common (50)

bull 40 of CVD patients lost sources of income

bull 82 did not have health insurance

bull 13 could not continue medication due to cost factors

Response to Health Transition

Low Risk High Risk

POPULATIONS

Demographic and Social Determinants

Public Health Interventions

Low Risk High Risk

INDIVIDUALS

Biology + Beliefs + Behaviors

Clinical + Behavioral Interventions

GLOBAL NATIONAL COMMUNITY FAMILY INDIVIDUAL

Development(stage and speed)

Distribution(equity)

Demand- Supply(trade)

Beliefs

Behaviours

Biology

Perceptions(cultural)

Priorities(socio-economic)

Pathways(availability access)

THE HEALTH OF

PERSONS PEOPLE

POPULATIONS

CALLS FOR DIFFERENT LEVELS OF ACTION

POLICY APPROACHES(Global National Local)

Financial TradeRegulatoryLegal

Environment To Enable Individuals To Make and Maintain Healthy Choices

INDIVIDUALFAMILY

NEIGHBORHOOD COMMUNITY

Enhancement of Knowledge Motivation and Skills of Individuals

Media Settings BasedCommunity Interventions

HEALTH COMMUNICATIONPr

even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities

Cultural and Social Norms

Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes
Thirdhellip133 Delivery high-quality health care to those who need it13Evidence-based guidelines are available for pharmaceutical management of biological risk factors and for treatment of cardiovascular events1313This represents the ideal -- the more difficult task was to grapple with the reality of the available evidence13Given limited resources to allocate to CVD developing country governments and other stakeholders need to focus on efforts that promise to be economically feasible have the highest likelihood of intervention success and have the largest potential impact on morbidity 13Context matters Low and middle and income countries have resource constraints cultural contexts social structures and social and behavioral norms that are distinct from high income countries and distinct among different developing countries 13Therefore the committee focused on the available evidence to support implementation of these ideal approaches in low and middle income countries13Although there is strong evidence from developed countries and a few key examples in developing countries there is very little high quality evaluation evidence from programs that have been proven effective when successfully implemented in a range of low and middle income countries

As the definition of lsquonormalrsquorsquooptimalrsquo BP moves from lt16095 to lt14090 lt12080(or even lt11575 as WHO now says)

Drug Therapy of lsquoPatientsrsquo Has Less Impact

Than Dietary Changes (egSalt Reduction)

Across The Whole Population

Individual lsquoRisk Factorrsquo Becomes A lsquoSocial

Causersquo

Clinical Medicine Merges Into Public Health

ldquoDo we not always find the diseases of the populace traceable to defects in societyrdquo

ldquoIf disease is an expression of individual life under unfavourablecircumstances then epidemics must be indicative of mass disturbancesrdquo

- Rudolf Virchow (1821-1902)

PUBLIC HEALTH INTERVENTIONS

Policy Interventions Educational Interventions

Enabling Environment Health Beliefs and Behaviours(Financial Social Physical) (Community Individual) Desired

Change

POWER OF POLICY FOR CHRONIC DISEASE PREVENTION

TOBACCOEvidence is available from many countries

(including LMIC) that

- Taxation- Ad Bans- Smoke Free Policies- Health Warnings

ARE EFFECTIVE 481 of mortality averted in UK (1981-2000) is attributable to reduced

smoking(Unal B et al Circulation 2004)


DIETbull Evidence of preventive potential of policy

interventions available from

Mauritius (Price of Edible Oils) Poland (Import of F-V and Healthy Fats) Finland (Farming Marketing Community

Education)New Initiativesbull Food Labelingbull Reduced Salt in Processed Foodsbull Ban on Trans-Fatsbull Advertising Restrictions

Salt Reduction Strategy Tobacco Reduction Strategy

- 85 Million Deaths - 55 Million Deaths

In 23 Low amp Middle Income Countries (During 2006-2015)

- Asaria P et al Lancet 2007

+

138 Million Deaths Averted

ldquoHealth leaps out of science and

draws nourishment from the society

around itrdquo

-Gunnar Myrdal (Swedish Economist

Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport

ManufacturedImported

Food

Sanitation

Modified from Ritenbaugh C Kumanyika S Morabia A Jeffery R Antipathies V IOTF website 1999 httpwwwiotforg

POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME

SchoolFood ampActivity

Infections

Labour

Worksite Food amp Activity

LeisureActivityFacilities

Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density

Societal policies and processes influencing the population prevalence of obesity

NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective

INTERNATIONAL FACTORS

Development

Globalizationof

markets

Media programs

amp advertising

NUTRITION PYRAMID ADVERTISING PYRAMID

Colas and other sugary drinks Chips and salted snacks Biscuits chocolates and other candyFast food (Burgers pizzas etc)

COMMUNICATION TO CONSUMERS MIS-MATCH BETWEEN SCIENCE AND COMMERCE

Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS

INTERNATIONAL AGENCIES TRANS-NATIONAL TRADE AND MEDIA

GLOBAL COVENANTS COMMERCE amp COMMUNICATIONS

INDUSTRY PRACTICES

Private-Public Partnerships Health Dividend

CONSUMER CONCIOUSNESS

NATIONAL POLICY FRAME WORK

Political Economic Social Motivators

Health Professionals Civil Society Media

CONVERGENCE OF CONCERNS

In The Policy Arenahellip

Common Determinants Link

bull NCDs and Environment

bull NCDs and Zoonotic Pandemics

bull NCDs and Food Security

bull NCDs and Human Rights

CONVERGENCE IN RECOMMENDATIONS

bull Protection of Environment bull Chronic Disease Prevention

Sustainable Development Needs

bull Urban environments which reduce vehicular congestion promote physical activity and energy efficiency

bull Diets which promote appropriate nutrient intake through sustainable consumption patterns at the population level

bull RemovalReduction of pollutants amp toxic chemicals from the environment

TOBACCO AND THE ENVIRONMENT

l Deforestation due to - lsquoFlue Curingrsquo- Packaging

l Subsoil Water Depletionl Soil Erosionl Pesticide Usel Forest Firesl Litterl Environmental Tobacco Smoke

INDUSTRIAL SCALE LIVESTOCK BREEDING

ObesityCVDCancer

Climate Change(uarr Methane Deforestation)

Food Crisis(Grain Diversion)

Pandemics (Zoonotic Diseases rising)

Global Meat Production Will Double From 229 Million Tonnes in 2009 To 465 Million Tonnes In 2050

+ +

WATER

Praise without end the go-ahead zeal of whoever it was invented the wheel but never a word for the poor soulrsquos sakethat thought ahead and invented the brake

- Howard Nemerov(ldquoTo the Congress of the United States

Entering Its Third Centuryrdquo) 1989

INTER-GENERATIONAL IMPACT OF NCD RISK FACTORS NEW KNOWLEDGE FROM EPIGENETICS

bull Epigenetic effects of Diet Physical Activity and Smoking Are Being Increasingly Recognized

bull Risk of CVD DM and Cancers may be partly mediated through such epigenetic effects

bull These epigenetic alterations and influences may be transmitted across several generations

NCD RISK FACTORS MAY THWART THE DEVELOPMENTAL POTENTIAL OF SEVERAL FUTURE GENERATIONS

- IT IS A RIGHTS ISSUE

ldquoShould medicine ever fulfill its great ends it must enter into the larger political and social life of our time it must indicate the barriers which obstruct the normal completion of the life cycle and remove them Should this ever come to pass Medicine whatever it may then be will become the common good of allrdquo


SUSTAINABLE DEVELOPMENT

PUBLIC HEALTH

MEDICINE20th Century

21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10

Age-adj death rates for total CVD diseases of the heart CHD and Stroke USA 1900-1996

Slide Number 12

Slide Number 13


Slide Number 15

Stages of Health Transition

Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23





NUMBER OF PEOPLE WITH DIABETES IN THE ADULT POPULATION (AGED 20 YEARS)




Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36

Projected per capita income path conditional on different CVD scenarios (Scenario 1 and 2 1 and 3 annual decline in mortality)


Slide Number 39

Slide Number 40

STROKE CHINA QUEST STUDY (2009)



Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47

ldquoDo we not always find the diseases of the populace traceable to defects in societyrdquoldquoIf disease is an expression of individual life under unfavourable circumstances then epidemics must be indicative of mass disturbancesrdquo - Rudolf Virchow (1821-1902)

Slide Number 49

Slide Number 50


Salt Reduction Strategy

Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61

Inter-generational Impact of NCD Risk Factors New Knowledge from Epigenetics

Slide Number 63

Slide Number 64

Slide Number 65

In The Second Half of The 20th Century

We Saw Progress in

CVD Prevention amp Care

Clinical Public Health


21st Century


Be Better Or Worse





radic radic

radic


- Geoffrey Rose








bull BP

bull Cholesterol



bull Dysglycemia





0

5000

10000

15000

20000

HIVA

IDS TB

Malaria

CVD

Cance

r

Chronic

Res

pirato

ry

Diabete

s

(100

0s)


Presenter
Presentation Notes







Males Females






2

67

95105

2 25

41 45

123456789

1011

1960 1970 1980 1990 2000

Urban Rural



00

20

40

60

1990 2020Nu

mb

er

of

death

s (

mil

lio

ns)


CVD Deaths





CVD












Sub Saharan Africa


Urban India Russia


STAGE I




STAGE II




HIGH BLOOD PRESSURE

HEMORRAGIC STROKE


THROMBOTIC STROKE



STAGE III




STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65


21st Century


Be Better Or Worse





radic radic

radic


- Geoffrey Rose








bull BP

bull Cholesterol



bull Dysglycemia





0

5000

10000

15000

20000

HIVA

IDS TB

Malaria

CVD

Cance

r

Chronic

Res

pirato

ry

Diabete

s

(100

0s)


Presenter
Presentation Notes







Males Females






2

67

95105

2 25

41 45

123456789

1011

1960 1970 1980 1990 2000

Urban Rural



00

20

40

60

1990 2020Nu

mb

er

of

death

s (

mil

lio

ns)


CVD Deaths





CVD












Sub Saharan Africa


Urban India Russia


STAGE I




STAGE II




HIGH BLOOD PRESSURE

HEMORRAGIC STROKE


THROMBOTIC STROKE



STAGE III




STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65





radic radic

radic


- Geoffrey Rose








bull BP

bull Cholesterol



bull Dysglycemia





0

5000

10000

15000

20000

HIVA

IDS TB

Malaria

CVD

Cance

r

Chronic

Res

pirato

ry

Diabete

s

(100

0s)


Presenter
Presentation Notes







Males Females






2

67

95105

2 25

41 45

123456789

1011

1960 1970 1980 1990 2000

Urban Rural



00

20

40

60

1990 2020Nu

mb

er

of

death

s (

mil

lio

ns)


CVD Deaths





CVD












Sub Saharan Africa


Urban India Russia


STAGE I




STAGE II




HIGH BLOOD PRESSURE

HEMORRAGIC STROKE


THROMBOTIC STROKE



STAGE III




STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65


- Geoffrey Rose








bull BP

bull Cholesterol



bull Dysglycemia





0

5000

10000

15000

20000

HIVA

IDS TB

Malaria

CVD

Cance

r

Chronic

Res

pirato

ry

Diabete

s

(100

0s)


Presenter
Presentation Notes







Males Females






2

67

95105

2 25

41 45

123456789

1011

1960 1970 1980 1990 2000

Urban Rural



00

20

40

60

1990 2020Nu

mb

er

of

death

s (

mil

lio

ns)


CVD Deaths





CVD












Sub Saharan Africa


Urban India Russia


STAGE I




STAGE II




HIGH BLOOD PRESSURE

HEMORRAGIC STROKE


THROMBOTIC STROKE



STAGE III




STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65


bull BP

bull Cholesterol



bull Dysglycemia





0

5000

10000

15000

20000

HIVA

IDS TB

Malaria

CVD

Cance

r

Chronic

Res

pirato

ry

Diabete

s

(100

0s)


Presenter
Presentation Notes







Males Females






2

67

95105

2 25

41 45

123456789

1011

1960 1970 1980 1990 2000

Urban Rural



00

20

40

60

1990 2020Nu

mb

er

of

death

s (

mil

lio

ns)


CVD Deaths





CVD












Sub Saharan Africa


Urban India Russia


STAGE I




STAGE II




HIGH BLOOD PRESSURE

HEMORRAGIC STROKE


THROMBOTIC STROKE



STAGE III




STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65


0

5000

10000

15000

20000

HIVA

IDS TB

Malaria

CVD

Cance

r

Chronic

Res

pirato

ry

Diabete

s

(100

0s)


Presenter
Presentation Notes







Males Females






2

67

95105

2 25

41 45

123456789

1011

1960 1970 1980 1990 2000

Urban Rural



00

20

40

60

1990 2020Nu

mb

er

of

death

s (

mil

lio

ns)


CVD Deaths





CVD












Sub Saharan Africa


Urban India Russia


STAGE I




STAGE II




HIGH BLOOD PRESSURE

HEMORRAGIC STROKE


THROMBOTIC STROKE



STAGE III




STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65







Males Females






2

67

95105

2 25

41 45

123456789

1011

1960 1970 1980 1990 2000

Urban Rural



00

20

40

60

1990 2020Nu

mb

er

of

death

s (

mil

lio

ns)


CVD Deaths





CVD












Sub Saharan Africa


Urban India Russia


STAGE I




STAGE II




HIGH BLOOD PRESSURE

HEMORRAGIC STROKE


THROMBOTIC STROKE



STAGE III




STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65

2

67

95105

2 25

41 45

123456789

1011

1960 1970 1980 1990 2000

Urban Rural



00

20

40

60

1990 2020Nu

mb

er

of

death

s (

mil

lio

ns)


CVD Deaths





CVD












Sub Saharan Africa


Urban India Russia


STAGE I




STAGE II




HIGH BLOOD PRESSURE

HEMORRAGIC STROKE


THROMBOTIC STROKE



STAGE III




STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65





CVD












Sub Saharan Africa


Urban India Russia


STAGE I




STAGE II




HIGH BLOOD PRESSURE

HEMORRAGIC STROKE


THROMBOTIC STROKE



STAGE III




STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65










Sub Saharan Africa


Urban India Russia


STAGE I




STAGE II




HIGH BLOOD PRESSURE

HEMORRAGIC STROKE


THROMBOTIC STROKE



STAGE III




STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65

STAGE I




STAGE II




HIGH BLOOD PRESSURE

HEMORRAGIC STROKE


THROMBOTIC STROKE



STAGE III




STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65

STAGE II




HIGH BLOOD PRESSURE

HEMORRAGIC STROKE


THROMBOTIC STROKE



STAGE III




STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65

HIGH BLOOD PRESSURE

HEMORRAGIC STROKE


THROMBOTIC STROKE



STAGE III




STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65

STAGE III




STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65

STAGE IV





THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65

THE TASK BEFORE US





0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65



0

100

200

300

400

500

600

1950 1960 1970 1980 1990 2000 2010










EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65



EARLY LIFE MIDLIFE




DEMOGRAPHIC

LIVING HABITS

SOCIO -ECONOMIC







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65







0

50

100

150

200

250

mg

dl

1958 1981 1997 2003


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65


(AGED ge 20 YEARS)

0

50

100

150

200

250

300

350


Mill

ions 2000

2025




143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65



143 181 216 233361 36959

87 69 92

249324

0

10

20

30

40

50

60

70

80

1999 2006 1999 2006 1999 2006

ObesityOverweight

33

14

14

202268

285325

610

693

66094 ppyr

4057 ppyr

8312 ppyr

Fernald et al 2007



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65



669 674563

812 764

539

0

20

40

60

80

100


Perc

ent


255 26 288246

334

236

404

05

1015202530354045




104

16179

199167 165

192

0

5

10

15

20

25




567

79

338 329

554 504

868

0

20

40

60

80

100




What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65


What is ethnicity







bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65




bull uarr Poverty




bull Marketing of

Unhealthy Products

(Globalization)

bull Education amp

Communication

(uarr Awareness)

bull Income



HINDERS DEVELOPMENT

DAMAGES CV HEALTH

PROMOTES CV HEALTH


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65


0

10

20

30

40

50

60

70


lt4545-6465-7475 +






0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65




0

200

400

600

China

Russia

IndiaBraz

il UK

Pakist

an

Inte

rnat

iona

l $ (b

illio

ns)


Presenter
Presentation Notes









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65









Tobacco

Blood Pressure

Plasma Cholesterol


Obesity

Health Transition













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65













(Harikrishnan 2010)






Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65


Low Risk High Risk

POPULATIONS



Low Risk High Risk

INDIVIDUALS







Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65





Beliefs

Behaviours

Biology




THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65

THE HEALTH OF

PERSONS PEOPLE

POPULATIONS





INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65




INDIVIDUALFAMILY





even

tive

Dia

gnos

tic

Ther

apeu

tic

Reh

abili

tativ

e Se

rvic

es

HEA

LTH

CA

RE

DEL

IVER

Y

WIDER SOCIETY

DET

ERM

INA

NTS

Globalization

Acce

ss

to C

are

Syst

ems

Infr

astr

uctu

reH

ealth

W

orkf

orce

Qua

lity

of C

are

Dru

gs amp

Te

chno

logi

es

Demographic Change

Globalization

Social Determinants

Health Inequities


Education

Biological Risk

Behavioral Risk

Presenter
Presentation Notes






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65






Causersquo








Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65







Change
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65
















+




around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

Slide Number 3

Slide Number 4

Slide Number 5

Slide Number 6

Slide Number 7

Slide Number 8

Slide Number 9

Slide Number 10


Slide Number 12

Slide Number 13


Slide Number 15


Slide Number 17

Slide Number 18

Slide Number 19

Slide Number 20

Slide Number 21

Slide Number 22

Slide Number 23









Slide Number 32

Slide Number 33


Slide Number 35

Slide Number 36



Slide Number 39

Slide Number 40




Slide Number 44

Slide Number 45

Slide Number 46

Slide Number 47


Slide Number 49

Slide Number 50



Slide Number 53

Slide Number 54

Slide Number 55

Slide Number 56

Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65



around itrdquo


Nobel Laureate)

COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

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COMMUNITYLOCALITY

AgricultureGardens

Local markets

Health Care

PublicSafety

PublicTransport


Food

Sanitation


POPULATION

OBESE

AND OVER--WEIGHT

WORKSCHOOL HOME


Infections

Labour



Family ampHome

INDIVIDUAL

EnergyExpenditure

Food intake

Nutrient density


NATIONAL REGIONAL

Education

Food amp Nutrition

Urbanization

Health

Social security

Transport

Media ampCulture

Nationalperspective


Development

Globalizationof

markets

Media programs

amp advertising




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

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Slide Number 63

Slide Number 64

Slide Number 65




Occasional

IN MODERATION

PLENTY

MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

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MOULDING

THE

MARKETS



INDUSTRY PRACTICES























ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

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Slide Number 50



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Slide Number 55

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Slide Number 57



Slide Number 60

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Slide Number 64

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ObesityCVDCancer





+ +

WATER













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

Slide Number 2

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Slide Number 57



Slide Number 60

Slide Number 61


Slide Number 63

Slide Number 64

Slide Number 65













PUBLIC HEALTH


21st Century

Persons

PeoplePopulations

PLANET

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Persons

PeoplePopulations

PLANET

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cardiovascular health is the heart of global development

Documents

worse health

better health

cardiovascular deaths

cardiovascular disease

public health measures

global burden of cvd

global levelwe

global report