Renaming non-communicable diseases
Authors: Paul Lincoln
Journal: The Lancet Global Health (2017)

The debate opened up through the Comment by Luke Allen and Andrea Feigl1Allen LN Feigl AB What's in a name? A call to reframe non-communicable diseases.Lancet Glob Health. 2017; 5: e129-e130Summary Full Text Full Text PDF PubMed Scopus (42) Google Scholar is timely and welcomed. The framing of non-communicable diseases (NCDs) has been an ongoing challenge for those working on prevention and one that has not been fully addressed or resolved. NCDs could be much better described, thereby creating a wider understanding, a focus on primary causes, more productive prevention-orientated research and development, and evidence-based social policy. Essentially this is a group of diseases linked by common risk factors, determinants, aetiologies, and pathologies, which can cause a variety of organ and organ system damage. They manifest as multistage diseases that themselves can become risks for multiple morbidities. They are caused by the duration and dosage of exposure to anthropogenic risk factors, usually over several decades. NCDs can theoretically be defined by any stage along the pathway of their distal and proximal causes from the social, environmental, and economic determinants of health to physiological risk factors and the diseases themselves. No overall description is likely to cover the bandwidth of the causes. So the logic would be to define them by their root cause(s). I suggest a more apropriate term "industriogenic" diseases since they are largely caused by the consumption of health-harming products—the vectors of the disease risks being the ready availability and marketing of these products. The term could be criticised for being ideologically framed, but language—as with knowledge—can never be truly objective. Over time science has changed the discourse from a focus on individual-level to population-level causes. The public health world now needs to upgrade its definitions and descriptions: the term NCDs is anachronistic and possibly harmful to the progression of effective and efficient public policy. I declare no competing interests. Renaming non-communicable diseasesThe call by Luke Allen and Andrea Feigl (February, 2017)1 to reframe non-communicable diseases (NCDs) is welcome. The lack of focus on these increasingly important causes of morbidity, impairment, and mortality, with their commensurate increasing consumption of health and societal resources and reduced economic contribution, is inappropriate and damaging for all the reasons Allen and Feigl cogently argue. Few things that are described in the negative as what they are not obtain the understanding or action they deserve. Full-Text PDF Open AccessWhat's in a name? A call to reframe non-communicable diseasesThe 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 study1 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. Full-Text PDF Open Access