Communicating Non-communicable Diseases: From 3Four50 to 4Four60

By Gillian Christie

In 2003, the Oxford Health Alliance (OHA) proposed 3Four50 to effectively communicate the prevention of non-communicable diseases (NCDs). The idea was simple: three risk factors (unhealthy diet, physical inactivity, and tobacco use) led to four NCDs (cardiovascular disease, diabetes, chronic lung diseases, and certain cancers), which contribute to more than 50% of global deaths. Vitality’s Chief Health Officer, Dr. Derek Yach, was an original member of the OHA and was instrumental in the development of 3Four50. Over the more than a decade since its development, the 3Four50 model has catalyzed actions to communicate and influence the global NCD agenda.

Since 2003, the global disease burden has changed, meaning that the communications of NCDs and their associated risk factors must evolve too. To build upon 3Four50 and to reflect the latest science, evidence, and data underlying the global disease burden, we propose a new conceptualization: 4Four60. Four risk factors (poor diet, physical inactivity, tobacco use, and excess alcohol intake) lead to four NCDs (cardiovascular disease, diabetes, chronic lung disease, and various cancers), which contribute to 60% of global deaths.

Physical and psychological illness, injury, and death can arise from the increase in consumption and excess intake of alcohol. Excess alcohol intake is closely associated with cardiovascular diseases, various cancers, and poor mental health. Alcohol use can also lead to road fatalities and interpersonal violence. Overall, alcohol is a causal factor in more than 200 diseases and injury conditions.

Interventions at the population level have been proven to reduce alcohol use and abuse. Taxation of alcohol products and restrictions on alcohol availability in addition to drink-driving policies, including laws governing blood alcohol concentration (BAC) and random breath testing, have been shown to be effective. Nonetheless, these measures must be complemented by personalized approaches that can entail face-to-face interactions with a physician or caregiver, or delivery of text message prompts and reminders through technology.

With increases in alcohol intake, any global strategy to address its effects must leverage current and future tools to ensure impact for all ages and all populations.

Interested in learning more? Read our full briefing here. Any questions? Tweet at us @VitalityUSA

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