Bid to Curb Diseases Associated with Sedentary Lifestyle (Feb 12, 2010)
The prevalence of diseases associated with an inactive lifestyle has been on the rise, resulting in
close to 100 billion baht in health care costs per year.
Diabetes, high blood pressure, and heart and brain blood vessel diseases which usually come with a
sedentary way of living have increasingly become a social burden in Thailand and need to be tackled
with by effective policies in improving primary health care and health promotion.
The National Health Security Office (NHSO) has aimed to control these diseases in especially the
aging and child populations that have a markedly rising rate of overweight and obesity problems.
The overweight and obesity rate in children living in the urban areas is two times higher than in their
counterparts who live in the rural areas. And to deal with this problem, the NHSO has planned to
step up measures to screen the people for signs of the body weight problem.
On Feb 11, about 600 provincial public health chief officers and health care workers attended a
workshop on control of diabetes and high blood pressure. Entitled “Disease Prevention Policies:
Silent Health Threats Facing Thai Health System”, the event was aimed at emphasizing on the Public
Health Ministry’s policies on these matters as well as informing the participants about the ministry’s
new guidelines on control, prevention and treatment of diabetes and high blood pressure.
Dr Winai Sawasdivorn, the NHSO secretary-general, said these chronic diseases were silent health
threats that had intensified as an adverse effect of the country’s improvement in nutrition.
About 30% of the adult population, or roughly 15 million people, were overweight. Still, one in five
of the primary school students are diagnosed with obesity and 15% of pre-school children have a
severe obese problem.
Urban children have twice the overweight and obesity rate of their counterparts living in the rural
areas. And as high as 25% of those who live in Bangkok have a severe problem of obesity.
About a thousand million people around the world are overweight, 300 million of who have become
obese. The vast majority of the overweight and obesity cases have stemmed from unhealthy eating
behaviors and a lack of physical exercise. These body weight problems are major causes of diabetes,
high blood pressure, and heart and brain blood vessel diseases.
“This health problem is becoming an important problem of the country. It has cost 30 billion baht
per year in diabetic treatment alone. And if the cost of treatment for the common complications
faced by diabetic patients -- such as diabetic blindness, kidney failure, and heart disease – is also
included into the diabetic treatment cost, the number will reach 100 billion baht per year.
The number of new cases of paralysis associated with the overweight problem is about 150,000 per
year and the cost of treatment for this health problem is approximately 75 billion baht per year,
which is a huge burden to both the patients’ families and the country as a whole,’’ said Dr Winai.
The NHSO has had collaboration with the Public Health Ministry and other health care partners on
health promotion and prevention, he said, adding that as for those who have already developed
such diseases, health care and medical treatment services were at hand.
Health volunteers in every village and community will have a role in cooperating with the tambon
health promotion hospitals across the country to improve health care knowledge of the families and
develop primary health care services.
The more than 900,000 health volunteers plus staff members of the tambon hospitals in all parts of
the country will be screening the people for diabetes and high blood pressure, campaigning to
encourage prevention of these diseases by cutting risk factors, and transfer the patients to a larger
medical institution if necessary.
That is why the tambon health promotion hospitals, health centers, and tambon administration or
municipal health funds are key mechanisms to cope with this health issue. They have an important
role in not only health promotion and prevention but also chronic disease care in the communities.
Dr Winai said that in terms of quality of treatment and service, the NHSO aimed to reduce the
complications of the diseases such as to bring down the rates of leg amputation and blindness in the
diabetic patients by 50% and 30% respectively within three years from now.
The office also aims to cut the brain blood vessel disease rate by 10% during the same period and
accelerate the Public Health Ministry’s drafting of a new road map for handling of chronic diseases.
All of the above-mentioned projects could not happen without help from all sides especially the
provincial public health offices, medical centre hospitals, general hospitals, community hospitals,
and tambon health promotion hospitals, said Dr Winai.
Anyway, diabetic and high blood pressure patients’ access to health care services remained limited.
An official report shows only about 30% of patients with diabetes and 50% of those who have high
blood pressure receive proper care.
Still, only 35% of all diabetic patients and 20% of all patients with high blood pressure have
successfully kept their diseases at bay even though they have sufficient access to medical treatment
and health care services.
The main reason for this low successful treatment rate is that many people are not aware that they
are sick and the current medical service system has been designed to deal mainly with contagious
diseases or acute health problems.
That explains why the system does not suit demands for chronic disease treatment that needs to be
done for a long time and deal more with the roles of medical personnel than of the patients’ families
or communities.
For the coming fiscal year 2010, the NHSO had set aside an additional budget for control and
prevention of diabetes and high blood pressure, said the NHSO secretary-general, adding that the
office also had developed new guidelines on control and prevention of these diseases.
A new fund is set up to manage the budget that will be spent on controlling and delaying the
progress of complications associated with diabetes and high blood pressure.
This health care program places emphasis on local health funds’ roles in health and disease
screening and improving the capacity of the primary care units especially the tambon health
promotion hospitals. The hospitals should be made ready for providing care to patients who return
to the communities from a treatment at a larger hospital.
The quality of health care units that regularly care for diabetic and high blood pressure patients will
also be improved under the same health care program. The patients themselves as well as their
families and communities will be supported to play a role in taking better care of their health such as
by changing bad health habits. The success of this program will depend largely on the provincial
public health offices that will manage the program in their own provinces.
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