Integrated multisectoral non-communicable disease prevention and control in China: A review of agencies and policies

T he epidemic of non-communicable diseases (NCDs) has become a global threat to human life, health, and sustainable development, particularly in low-and middle-income countries [1].In 2017, NCDs accounted for 73.4% of all deaths worldwide and 89.5% for China [2].The most common NCDs, eg, cardiovascular diseases (CVD), cancer, chronic respiratory diseases, and diabetes, are preventable.Mental disorders have recently been added to the list of major NCDs.NCDs are caused by diverse and pervasive risk factors through complex causal pathways.They are social, cultural, and economic factors at the distal level, environmental and behavioral factors at the intermediate level, and metabolic and genetic determinants at the proximal level.The prevalence rates of most NCD risk factors are on the rise in China [3], posing a challenge to China' s health system.Population aging in China has exacerbated the situation with a continuing increase in the incidence of NCDs [3,4].Given the complexities of NCDs, the World Health Organization (WHO) has called for coordinated, comprehensive, and integrated strategies to contain the NCD epidemic [5].The integrated strategies for the NCD prevention date back to Finnish efforts begun in 1972, which sought to develop comprehensive health policies that were implemented in non-health sectors [6].The concept has evolved, through the 1978 Alma-Ata Declaration and the 1986 Ottawa Charter, into the Health in All Policies (HiAP) in 2006 during the Finnish European Union presidency.Later updates include the Adelaide Statement and the Integrated multisectoral noncommunicable disease prevention and control in China: A review of agencies and policies