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Analysis Solutions for Prevention and Control of Non-communicable Diseases

Life course approach to prevention and control of non-communicable diseases

BMJ 2019; 364 doi: (Published 28 January 2019) Cite this as: BMJ 2019;364:l257
  1. Bente Mikkelsen, director1,
  2. Julianne Williams, technical officer2,
  3. Ivo Rakovac, programme manager2,
  4. Kremlin Wickramasinghe, technical officer2,
  5. Anselm Hennis, director3,
  6. Hai-Rim Shin, director4,
  7. Mychelle Farmer, director5,
  8. Martin Weber, programme manager1,
  9. Nino Berdzuli, programme manager1,
  10. Carina Borges, programme manager2,
  11. Manfred Huber, coordinator2,
  12. João Breda, head of office2
  1. 1Division of Non-communicable Diseases and Promoting Health through the Life-course, WHO Regional Office for Europe, Copenhagen, Denmark
  2. 2WHO European Office for Prevention and Control of NCDs, Moscow, Russia
  3. 3Department of Noncommunicable Diseases and Mental Health, WHO Pan American Health Organization (PAHO), Washington, DC, USA
  4. 4Division of Noncommunicable Diseases and Health through the Life-course, WHO Western Pacific Region (WPRO), Manila, Philippines
  5. 5NCD Child Governing Council, American Academy of Pediatrics/Society for Adolescent Health and Medicine, Itasca, USA
  1. Correspondence to: B Mikkelsen mikkelsenb{at}

A successful approach to reducing the burden of non-communicable disease requires action at all stages of life, argue Bente Mikkelsen and colleagues

Many of the health problems we encounter in adulthood stem from our experiences early in life—in some cases, even from before we are born.123456789 The major non-communicable diseases (NCDs) (diabetes, cardiovascular diseases, cancer, chronic respiratory diseases, and mental disorders) are often associated with older age groups, but the evidence suggests that they affect people of all ages. Fifteen million deaths attributed to NCDs occur between the ages of 30 and 69 years and people from all age groups are vulnerable to the risk factors that contribute to NCDs.10

NCD prevention is most effective when it targets a problem at its roots. Taking early, appropriate, timely, and collective action1 is important if we are to reduce premature mortality related to NCDs by a third by 2030—a sustainable development goal that has been affirmed through political declarations by heads of states and governments. A life course approach is an inclusive approach that considers the needs of all age groups and addresses NCD prevention and control in its earliest stages and is recommended in the World Health Organization’s global action plan for prevention and control of NCDs.11

The life course approach is underpinned by evidence from a wide range of disciplines showing how NCDs are influenced by early life factors.1213 It provides a comprehensive and sustainable framework for identifying key settings for interventions, knowledge translation, and a systems thinking approach.14 WHO uses the theory as a basis for many of its strategies and recommendations.1567891516171819

In this article we outline how a life course approach can …

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