Cardiovascular diseases are the leading cause of death globally, which has increased drastically over the last two decades. Low- and middle-income countries experience the highest burden of cardiovascular diseases, which is important to note since East Africa’s poverty levels are uniformly high. This is caused by factors such as a lack of primary health care programmes, to detect and treat risk factors, or a lack of access to effective and equitable health care services. Even though high-income countries might not face these issues, cardiovascular diseases are still one of the biggest causes for death as well.
Causes/risk factors of the problem
Major risk factors for the development of cardiovascular diseases are unhealthy diet, physical inactivity and tobacco and alcohol use. Bluntly stated, the increase in cardiovascular diseases can be explained by a change in behavior. Changes in behavior do not happen overnight, but explanations can be identified. Three important factors that can influence one’s behavior are the migration from a rural area to an urban area, meaning a city, employment and education. How these factors can influence behavior is explained below:
- Rural to urban area: The blog ‘Urbanization vs rural areas’ describes the big migration from rural to urban areas in East-Africa. This can lead to dietary changes, because people rely on purchased foods. This is often highly processed and with long supply chains. It is also said that in urban areas, people tend to buy conveniently purchased foods with higher amounts of fat and lower levels of micronutrients.
- Employment: Employment, or simplified as income, influences how much a family can spend on food and what foods they are able to afford. Affordability of foods has been researched, which showed that the costs for both fruits and vegetables were substantially higher in low-income countries. It doesn’t come as a surprise that a low income as a household is associated with reduced consumption.
- Education: The first way in which education influences behavior, is the positive link between education and employment. Better education and thus better employment, could improve one’s capacity to afford a healthy lifestyle. However, it is of greater relevance to have sufficient knowledge about the diseases itself and how to prevent them. Not only people themselves should be educated on this topic, also healthcare workers should have sufficient knowledge.
Solutions
To tackle the rising problems that cardiovascular diseases cause, the WHO prioritizes the implementation of policies to reduce behavioral risks and drug therapies and counselling for eligible people. In order to be able to achieve these goals, strengthening health systems is crucial.
Below a video is shown of a campaign in Kenya that raises awareness for cardiovascular diseases, also an important element in the battle against the issue.
Sources used:
– https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
– https://www.nature.com/articles/nrcardio.2017.19
– https://assets.publishing.service.gov.uk/media/5bae42ffed915d259eaa7769/383_Urban_Food_Systems_and_Nutrition.pdf
– https://www-sciencedirect-com.vu-nl.idm.oclc.org/science/article/pii/S2214109X16301863?via%3Dihub
– http://www.samj.org.za/index.php/samj/article/view/10456
– https://www.youtube.com/watch?v=5qN9-Qcr4CE (video)
East Africa 
First of all: the blog looks great, especially with the video in the end. When scrolling through the page it really grabs the readers attention and makes the overall understanding of the subject easier. What is not really clear to me is how the migration flows have influence on their behavior. You have stated the effects of migrating but not really what it does to their behavior and eventually to their health, since you do not get back at the factors of unhealthy diet, physical inactivity, tobacco and alcohol use. Does the migration to urban areas go hand in hand with these risk factors or are they just a possible consequence?
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Hi!
The point is that migration to urban areas influences behaviour in various ways. In urban areas, people tend to rely on purchased and more unhealthy foods and exercise less. This is related to financial status, and for example not producing their own foods. To answer your question, I think the migration to urban areas does go hand in hand with an increased risk.
Kind regards,
Marieke, Jinke, Imke, Joanne and Thom
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Hi group!
Great start of your blog with a clear website! I really like the use of media in your blog which gives context to your blog. Cardiovascular diseases is a very broad topic and I am interested if there is a difference between the diseases in these countries and how they can tackle these problems. As you stated behaviour is a important determinant in this problem, but maybe include other determinants as well. Maybe you can also try and find some data such as the prevalence of CVD in these countries and compare them to others (such as the Netherlands or countries in your region).
I am interested in what you will write next!
Good luck!!
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Hi Max,
First of all I would like to thank you for your comment. To answer your questions, I would like to recommend the article ‘Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015’ by Roth et al. (2017). They give a nice overview of the global burden of cardiovascular diseases. As you can see in figure 2, there is a large difference in the prevalence of cardiovascular diseases of European countries and East African countries. Within the region, the differences are not as large, except for two outliers, being Kenya and Mozambique. I hope this answers your questions to some extent.
Kind regards,
Marieke, Imke, Thom, Jinke and Joanne
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Really interesting, and great that you found information about a good health promotion plan. I wonder whether anyone has ever measured the activity level differences between rural and urban people in any of these countries. When you’re not as active but your diet stays the same, that can be a reason behind obesity and cardiovascular problems. (Very much the case in my own family – when my grandparents moved into town from the farm, they still ate big breakfasts and dinners, pies etc. Healthy when you are working like mad, not so when you are retired…)
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Hi Mitzi!
The differences in physical activity of people living in urban and rural areas have definitely been researched. I have found that people living in rural areas are most likely to have a more active lifestyle. An example of a study is ‘Physical Activity and Associated Socioeconomic Determinants in Rural and Urban Tanzania: Results from the 2012 WHO-STEPS Survey’ by Mashili et al. (2018). Like you said, maintaining the same diet when moving to an urban area but changing the physical activity pattern can definitely influence weight and the additional risks for cardiovascular diseases.
Kind regards,
Marieke, Jinke, Imke, Joanne and Thom
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Hello all!
I love how your blog is set up. Everything is easy to locate, and the tabs, as well as the homepage, are visually appealing. The information you displayed in this blog post is beneficial to invidual’s knowledge on a health issue and is easy to read for a general audience. I think one way to improve your posts is by providing hyperlinks to your references as well as your other blog posts. Especially since you mention other blog posts throughout this one, it could be more comfortable for one to access the information with quick links. Overall, I like this post, and I think the information is relevant to your topic.
I look forward to following along with your blog posts and enjoy your weekend!
Emily McDowell
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Hi Emily,
Thank you for your comment. We appreciate it!
Kind regards,
Jinke, Joanne, Marieke, Imke and Thom
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Hi Group,
First of all, I am still very enthusiastic about the layout of your blog. I think everything is very clear and it’s easy to find your way through the blog. With regard to this post I think it’s very smart to use a video in the end. In this way you provide a better understanding of both the problem and the efforts that needs to be done to overcome the diseases. You mainly focus on the risk factors of the problem, but what about the prevalence, morbidity and risk groups with regard to cardiovascular diseases?
Good Luck with writing the rest of the blog!
Anouk Haremaker
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Hi Anouk!
Thank you for your response and kind words. To answer your question, I will have to dive into the available data. I will definitely do this and add the information to the blog post. I hope you will come back to find the information to your question.
Kind regards,
Marieke, Jinke, Imke, Joanne and Thom
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Hi all,
I enjoyed reading your blog post about cardiovascular diseases. It was very interesting and educational! Very nice that you have also added a video to support your topic. However, there were some points that are not clear to me. You mentioned that low- and middle-income countries experiences the highest burden of cardiovascular diseases. Maybe it is of added value to indicate how big this burden is, so it will become clear to the reader what the impact of cardiovascular diseases are on health. I also wondered why high-income countries not have to do with the burden of cardiovascular diseases? Is there a specific reason for that? You mentioned the risk factors, but it’s not really clear to me. Unhealthy diets, use of tobacco and alcohol also occurs a lot in high-income countries, or not?
Good luck!
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Hi all,
I enjoyed reading your blog post about cardiovascular diseases. It was very interesting and educational! Very nice that you have also added a video to support your topic. However, there were some points that are not clear to me. You mentioned that low- and middle-income countries experiences the highest burden of cardiovascular diseases. Maybe it is of added value to indicate how big this burden is, so it will become clear to the reader what the impact of cardiovascular diseases are on health. I also wondered why high-income countries not have to do with the burden of cardiovascular diseases? Is there a specific reason for that? You mentioned the risk factors, but it’s not really clear to me. Unhealthy diets, use of tobacco and alcohol also occurs a lot in high-income countries, or not?
Good luck!
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Dear Kübra,
The burden of cardiovascular diseses differs in every country. If you are interested in a particular country you can find it here: http://www.healthdata.org/results/country-profiles. Also High Income Countries do have a burden of cardiovascular disease, but the issues because of this burden differ from Low and Middle Income Countries. As you mention risk factors occur also in high income countries.
Kind regards,
Marieke, Joanne, Jinke, Thom and Imke
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