hey sp200 Welcome to our Thursday class focused on continuing our conversation on chronic disease uh we'll break this Thursday class down into four modules which uh I think will logically build it towards um sort of an understanding of what are some of the drivers from the perspective of the determinance of Health um of chronic disease and then how uh will some of our understanding of the causes of chronic diseases uh lead to some interesting Innovations and potentially ethical issues in the area of Public Health and I think this is a an emerging very interesting area that um I'm sure some of you have thought about already and maybe are interested in thinking about more so in this module I'm just going to uh remind everybody about some of the global importance of chronic disease and how there's a global discrepancy in terms of where chronic diseases are most impactful compared to communicable diseases like we talked about in a previous week so the global importance of chronic disease we've talked about this um in uh the Tuesday lectures I think that um hopefully all that's reasonably clear I wanted to just sort of re-emphasize a couple of the concepts that we've talked about uh in those Tuesday lectures so this will be a reasonably short module um globally uh if we look uh at the leading causes of death we see ischemic heart disease stroke um COPD um sort of these top three all being related to chronic disease and then we have lower respiratory infections um being our first uh leading cause of death globally that come from a communicable disease and then we see um uh neonatal conditions which uh encompasses a number of issues um uh from the birth perspective um and during that sort of early phase of development for children and infants uh and then we have another set of chronic diseases uh lung cancers trachea bronchus lung cancers Alzheimer's dial diseases comes in number eight and then diabetes and kidney disease rounded off so you can see in the blue here are our chronic or non-communicable diseases and as you can see from this graph which is showing you a difference between the year 2000 and 2019 with 2000 being the open circles and 2019 being the closed what this is showing you based on number of deaths in the millions globally is that between 2 and 2019 the relative importance of chronic diseases have generally in almost all cases I think all cases here been increasing over the last 20 years or so so the 2000 to 2019 you can see there's this incre increase and the um and the relative importance of infectious diseases or communicable diseases in all three cases has been decreasing so you can see that these are flipped where we have the 200 data set being higher and the 2019 data being less that's important and as we break down this data set into the two um different uh socioeconomic statuses that we can break most R into with what we might call low middle- inome countries and high income countries you can see that there's an interesting discrepancy in this trend where we see chronic diseases the blue predominate in the uh high-income countries and the infectious diseases predominate in the low middle-income countries the trend however towards a reduction in the importance of infectious disease um or communicable diseases holds true where we see this decline from over the last 19 years of many infectious diseases in terms of the number of deaths globally um in even the low middle- inome countries and we see an increase in the importance of chronic disease and we see this import increase in the importance of most chronic diseases in the high income countries as well with um only a few exceptions being esic heart disease and stroke this is important to note because it really emphasizes uh that a a chronic diseases are important globally they do comprise the three most uh sort of leading leading causes of death globally um and they are on the rise in what we might consider Low Middle inome countries or developing countries and they continue to rise predominantly in um High income countries as well in terms of their importance if we look in Canada specifically we can see in 2020 most of uh the leading causes of death are C diseases as you might expect with Canada being a high inome country with covid-19 being really the only um exception here and accidents um or unintentional injuries so um oh sorry influenza is on there as well so um Canada fits quite easily into um into the sort of global Trend and this inclusion now of covid-19 as a leading cause of death is actually mirrored globally um so this is the United States data where you can see covid-19 um uh if you we're working kind of opposite the way I would normally do this so in 2020 um these are the leading causes of death in the United States you can see heart disease cancer 2020 we see covid-19 um in this data set now as the third leading cause of death and it remains in that position up until uh late September 2022 and if we were to look now um I think it has dropped one position but it still remains in the top 10 so um my purpose in showing you this is really just to reemphasize to you this concept that we had from the Tuesday lectures which is that um chronic diseases are an important cause of death globally and that they are increasing in the their sort of relative importance with respect to infectious diseases over time as countries continue to move towards a higher um sort socioeconomic status to that high income uh category um so thanks uh for listening to this we're going to move into sort of some of risk factors for chronic diseases in the next few modules of this Thursday set