Slide 1OutlineNon-communicable diseases (NCD)WHO Statistics 2012Slide 5Chronic diseasesChronic DiseaseHow do assess disease?What does CDC do?Epidemiological Concepts Disease and HealthMorbidity and MortalityMorbidity and MortalityRisk FactorRisk Factors and Disease ProgressionExample: CVDExample: CVDPhysical activity and healthPhysical activity and healthPhysical activity and healthSlide 20Morris et al., 1953Slide 22Slide 23Decrease in percentage of children walking to school, AustraliaSlide 25SummaryWhy do we care about physical activity and disease?Unit 1 Lecture 2Fall 2017Outline•Chronic Disease•Epidemiology•Morbidity and Mortality•Risk Factor Theory•You should be reading Chapters 1&2!Non-communicable diseases (NCD)•Diseases not transmitted by contact with people•Post-WWII shift in public health to focus on NCD’s•There were 56 million global deaths in 2012•68%, were due to NCD’s–World Health Organization (WHO) statisticsWHO Statistics 2012Deaths attributable to cardiovascular disease (United States: 1900–2010). Go A S et al. Circulation. 2014;129:e28-e292Copyright © American Heart Association, Inc. All rights reserved.Chronic diseases•4 main chronic diseases (NCD) 1) Cardiovascular 3) Pulmonary Disease2) Cancer 4) Diabetes •4 behaviors underlie each of these diseases1) Smoking 3) Physical Health2)Nutrition 4) Excessive Alcohol•Lead to 1/3 of pre m ature deaths worldwide•7/10 deaths/yr in US are from chronic diseaseChronic Disease1) Develops and persists over a long period of time 2) Treatments may be initiatedSigns and symptoms may resolve3) Pathophysiology may not go away4) Susceptibility to pathophysiology is always presentHow do assess disease?•CDC’s Mission is to collaborate to create the expertise, information, and tools that people and communities need to protect their health – through health promotion, prevention of disease, injury and disability, and preparedness for new health threats. •Everything from physical activity to anthraxWhat does CDC do?•Wide variety of surveillance research•Tracking population levels of disease over time•Relevant to physical activity and –Tracks US population levels of disease, mortality, and risk factors–Monitors behaviors of people in USA (including physical activity)Epidemiological ConceptsDisease and Health•Epidemiology is the study of the patterns, relationships, risk factors, and effects of health and disease conditions in defined populations.•Disease- abnormal, reduced, or lost structure or function of cells, organs, or systems of the body –can be defined according to _________________•Health–Opposite or absence of disease? –State of mental, physical, and social well-being •not merely the absence of disease or illness the cause OR symptomsMorbidity and Mortality•Mortality–Deaths–A mortality rate is : deaths over a period of time dividid by the total population of interestMorbidity and MortalityMorbidity: state of being diseased/unhealthy - Incidence of illness over a period of time –Can have multiple co-morbiditiesRisk Factor•Risk Factors: Factors associated with an increased risk of disease –i.e. High cholesterol & cardiovascular disease •Identified from correlation between the presence of the factor and subsequent development of the disease.•Examples–Osteoporosis–Diabetes–Breast CancerModifiable and non-modifiableChanging the risk factor changes the risk for diseaseRisk Factors and Disease ProgressionAll Risk Factors Optimal>1 Risk Factor Not Optimal>1 Risk Factor Elevated1 Major Risk Factor>2 Major Risk FactorsDiseaseExample: CVDBerry, et al NEJM 2012CVD: Disease of the heart and blood vesselsExample: CVDCVD: Disease of the heart and blood vesselsPhysical activity and healthThe idea physical activity is important for health is not new:–China ~2500 BC: Exercises modeled after the movement of animals (Hua T’o), “medical gymnastics”Image: ~3rd Century BCPhysical activity and healthThe idea physical activity is important for health is not new:–Greece (460-370 BC)- “All parts of the body, which have a function, if used in moderation and exercised in labours in which each is accustomed, become thereby healthy, well-developed and age more slowly, but if unused and left idle they become liable to disease, defective in growth and age quickly” •HippocratesPhysical activity and healthThe idea physical activity is important for health is not new:–India ~500 AD: Post-Classical Yoga – practices to rejuvenate the body and prolong its lifeThe First Empirical Evidence: Health Benefits of Physical Activity•Occupational physical activity–Morris et al., 1953•Location: London•Bus transport employees•Compared drivers to fare collectors (conductors)Morris et al., 1953Cases of Coronary Heart DiseaseConductors 31Drivers 80Prevalence of children 6 to 19 years of age who attained sufficient moderate to vigorous physical activity to meet public health recommendations (≥60 minutes per day on 5 or more of the 7 days preceding the survey), by sex and age (National Health and Nutrition Examination Survey: 2003–2004). Go A S et al. Circulation. 2014;129:e28-e292Copyright © American Heart Association, Inc. All rights reserved.Minutes of moderate to vigorous physical activity: NHANES 2003-20046-11 20-29 40-49 70+020406080100120MalesFemalesTroiano et al., MSSE 2008MIN/dayAge groupDecrease in percentage of children walking to school, Australia1988–2008 No Leisure-Time Physical Activity Trend ChartSummary•Chronic disease rates are rising at epidemic proportions•Many diseases are related to 4 major behaviors•Evidence has existed since 1950’s about role of PA and health •Major health organizations have begun to recognize the relationship between physical activity and disease risk•However, our population is still not active