Cardiovascular disease (CVD) is the global leading cause of mortality, which caused 19.7 million deaths in 2019, and 38% of premature deaths from non-communicable diseases.
To understand the prevalence of CVD globally, the World Heart Federation (WHF) released the City Heartbeat Index report that assessed the efforts of 50 world cities in tackling the medical challenge.
The Index evaluated the cities through five domains, naming social determinants, physical environment, health risks, health services and governance.
Social determinants are conditions that affect health outcomes in society, from education levels, food and housing insecurity, employment and healthcare access.
When such factors are lagging, they contribute to high CVD risk, causing a decline to cardiovascular health of civic people.
Toronto and Berlin ranked top for the social determinant domain as cities with strong economies, thus they have favourable access to healthcare, employment and food security, preventing the prevalence of chronic heart diseases.
The Index indicated CVD had risk factors, where employment accounted for 76%, obesity stood at 74% and poverty scored 70%.
Non-communicable diseases, such as diabetes scooped 64%, while hypertension scored 59%. This showed a great impact on the risk of chronic heart diseases.
Due to food insecurity, where people do not have the financial freedom to purchase nutritious food; food security scored 42%.
Access to quality healthcare reduces the risk of chronic heart diseases. This means functioning healthcare infrastructure, available medicines and efficient staff services from health workers.
“Patient-centred care prioritises patients’ needs and preferences, fostering collaboration between patients, families, and healthcare providers. By tailoring treatment to individual beliefs and values, it enhances engagement and decision-making, potentially improving cardiovascular outcomes,” said WHF.
For the health services domain, the report showed New York and San Francisco (USA) were tied at the first spot, scoring 91.9% in access to quality healthcare. An interesting one was São Paulo (83.8%) in Brazil, landing the 8th spot for a middle-income city.
The Governance domain entails that the government is responsible for implementing health policies that would ensure that the health cluster is inclusive, affordable and accessible to all social classes.
Here, the Index indicated that London local government scored the highest, with 96.3%, followed by Hong Kong at 90.7%.
“London stands out as the sole city in the study with policies covering all areas relating to health risks measured in this domain. In the realm of healthy diets, London’s mayor implemented advertising restrictions across the entire Transport for London network in 2019, targeting childhood obesity by limiting promotions of unhealthy products,” said the Index.
New York (87.0%) grabbed third place, whereas Mumbai, Nairobi and San Francisco were tied at 10th place, scooping 79.6% out of the total tally.
According to the Index, Nairobi is the only African city displaying all of the attributes required in the governance domain indicator.
Nairobi has developed a Community Health Services Implementation Plan for 2023 to 2027 with a dedicated budget, “which the development of the plan involved engagement with various stakeholders, validated through workshops and consultations”.
Urbanisation is known to be a contributory factor to an increase in risk factors for CVD, among others.
Hence as there are over 55% of people living in cities as of 2022, global CVD prevention would require strategies tailored for urban settings, involving the promotion of healthy behaviours and tackling social determinants of health.
The Star
hope.mafu@inl.co.za