You can’t fight an enemy you can’t see: improving data on NCDs

Existing data on the incidence and spread of non-communicable diseases (NCDs) in both Australia and Indonesia suffers from significant gaps – depriving health policymakers of important evidence.

Lead researchers Dr Ansariadi from Universitas Hasanuddin and Dr Peter Azzopardi and Karly Cini from the Murdoch Children’s Research Institute aimed to identify these gaps, and produced a comprehensive NCD framework that will inform policy in both countries. This framework builds on previous work and incorporates new knowledge around what NCDs are and how and why they strike.

Globally, up to 70 per cent of deaths are caused by largely preventable NCDs representing a complex group of conditions characterised by chronicity and non-transmissibility. NCDs are now the leading cause of early death and disability in Australia and Indonesia.

Previously, NCDs were limited to cardiovascular diseases, stroke, diabetes and cancer, but we now recognise that other important conditions such as mental disorders must be included. Many NCDs are preventable through modifying lifestyle habits such as diet, exercise and smoking, and can be disrupted through early detection and treatment of health risks such as obesity and depression.

The importance of early detection and treatment is another key development in our understanding of NCDs. Whereas in the past adolescents have been overlooked when approaching NCDs, but we now know that many habits and conditions that cause later-life NCDs arise during adolescence, making this a vital stage for prevention. Better understanding about how this phase of the life-course relates to NCDs is central to overcoming this global challenge.

Often education at the individual level is promoted as being meaningful in creating change, however most NCD risk factors are socially-located within lifestyle habits such as smoking and diet which is where policy and regulations have a leading role to play.

As lead researcher Dr Ansariadi highlights, ‘Indonesia has a huge problem with smoking, which really requires government action at the national level’.

Collective action and shared responsibility – from individuals, the community and government – will make the biggest difference moving forward.

One implication of this new emphasis on taking a more comprehensive view of NCDs, including across the life course, is recognition of the significant gaps in current data sources – which means that policy suffers. This is where a stronger reporting framework comes in.

Built around this, the AIC health project focused on three key aspects; building a comprehensive NCD reporting framework, mapping existing data sets against this framework, and developing an NCD profile for both Australia and Indonesia with respect to their own unique challenges. Further information about the methodology behind the project, as well as the findings, can be found in the policy briefs ‘Towards a Comprehensive NCD Reporting Framework for Australia’ and ‘Towards a Comprehensive NCD Reporting Framework for Indonesia’, or in the colourful factsheets found below this article.

Findings and recommendations included:

• current data systems in Australia and Indonesia measure some NCDs, but not all. High quality data is key to providing the evidence needed to properly respond to the NCD epidemic. This research suggests that there is a significant need to build upon current data, and to provide better access to integrated data on NCD outcomes, risk factors and determinants for researchers, educators, healthcare providers, service planners, policy makers and decision makers.
• the focus of health policy needs to be broadened to include conditions such as musculoskeletal disorders, neurological disease (including dementia), chronic skin conditions, vision and hearing defects, endocrine disorders, gynaecological conditions and poor mental health.
• subnational policy is needed to better address the health concerns of Indigenous Australians who have a distinct risk and incidence profile when it comes to NCDs; in general for these communities, NCDs occur earlier in the life-course and to greater severity. This shows that there is a distinct policy context for NCDs among the Aboriginal and Torres Strait Islander communities, and that there are unique opportunities for response.
• similarly, inequalities are evident across Indonesia; the rate of NCDs and their risk factors vary subnationally, along socio-economic and geographic lines. While Indonesian data sources do account for wealth index and geographical variation, there is potential for greater analysis of geographic diversity and how this impacts the NCD profile across Indonesia.
• inter-country collaboration aimed at improving data collection methods would be beneficial. One area of strength in Australia, for example, is its cancer registry, and this could represent a learning opportunity for Indonesia.

Full reports and summary infographics

Indonesia summary infographic – English

Indonesia summary infographic – Bahasa Indonesia

Indonesia full report (English only)

Australia full report (English only)

Australia summary infographic (English only)