I came across an interesting read last week in The Lancet. In it, Drs Allen and Feigl make an interesting case for changing how we refer to non-communicable diseases
The global health community does not spend much time on branding, which perhaps explains why existing classifications for the three largest groups of diseases are both outdated and counterproductive. The first Global Burden of Disease study described infectious diseases, non-communicable diseases (NCDs), and injuries. This grouping reflected a predominantly infectious disease burden in low-income and middle-income countries, which has since tilted towards NCDs. A name that is a longwinded non-definition, and that only tells us what this group of diseases is not, is not befitting of a group of diseases that now constitute the world’s largest killer.
Language is powerful, and subtle changes can make a difference in how we perceive not only the individual, but how value them, and in some cases, how we assign blame. By calling something “non-communicable” the immediate association may be that the disease is a “non-issue,” and lead to a sense of apathy and putting less emphasis on tackling these diseases quickly; despite them being responsible for 63% of annual deaths. These aren’t rare diseases, and include cardiovascular diseases like heart attacks and stroke, cancer, chronic respiratory diseases e.g., chronic obstructed pulmonary disease and asthma, and diabetes. Delays in funding and intervening to address these diseases early on can lead to longer term problems, and is just kicking the can down the road. And on top of this, language can also impact how you perceive a health risk. As we discussed previously:
“we’ve also got to consider the effect of the media and how the media reports the same issues that we’re concerned about. Fabiana Kubke over at Mind the Brain had a great post about this following the tragic events of Newtown, CT, highlighting how by adding the word “mental” implies that this is something different to “regular” health. It’s a subtle difference, but once you see it, you can’t unsee it. Why is mental health somehow viewed differently to physical health? Why can’t we refer to it as health? Again, we see how adding a label to something changes how we perceive it.”
It also doesn’t help that the name – non-communicable diseases – is not one that is easy to understand. The authors make an interesting point, and suggest that there be a global consultative process to determine the appropriate name that should be used for this class of diseases. I particularly like this approach, as these diseases are not the exclusive purview of some countries, and affect all of us. Having a global consultative process ensures that the terminology used means the same in different cultures and regions, and that any potential for misinterpretation or mistranslation can be identified and addressed early on.
In the spirit of that, what do you think? What would rather call non-communicable diseases, or are you okay with their current name?
Allen, L.N. and Feigl, A.B., 2017. What’s in a name? A call to reframe non-communicable diseases. The Lancet Global Health, 5(2), pp.e129-e130. Available online at: http://thelancet.com/journals/langlo/article/PIIS2214-109X(17)30001-3/abstract