Poverty is not the absolute cause of deaths due to non-communicable diseases

Background: The pathways for development of noncommunicable diseases (NCDs) are sedentary behaviour, common dietary habits of the Western world, tobacco use, stress, and alcoholism among individuals and populations with underlying lack of general and health education. However, some experts have observed that poverty is the primary cause of disability and deaths due to NCDs. This study examines the association of social class and social determinants of health as risk factors for deaths due to NCDs. Subjects and methods: Randomly selected death records of 2,222 (1,385 men and 837 women) decedents, aged 25-64 years at time of death, out of 3,034 death records, were studied by verbal autopsy questionnaires, during 1999-2001 from the records at the Municipal Corporation in Moradabad. All the risk factors were assessed by questionnaires which werecompleted with the help of the victim's spouse and a local treating doctor practising in the concerned field. Social classes were assessed, based on attributes of per capita income, occupation, education, housing, and ownership of consumer luxury items in the household. Poverty was considered if the total family income was <US$300.00 per month. Lack of knowledge on health education about the role of exercise, prudent diet, and adverse effects of tobacco use and alcoholism was studied by the validated questionnaires. Results: This study shows that sedentary behaviour, excess salt intake, and other typical Western dietary habits were significantly more common among decedents belonging to higher social classes 1-3, compared to those within lower social classes 4 and 5. Lack of knowledge regarding health education was significantly more common among decedents in lower social classes, who died more often due to communicable diseases. The study also revealed that deaths associated with diabetes mellitus and due to circulatory diseases were significantly more common among higher social classes 1-3, compared to lower social classes 4 and 5. However, deaths due to malignant diseases and chronic lung diseases were not associated with social class (except the social class of women with breast cancer), but total proportion of deaths due to NCDs including these causes were significantly greater among higher social classes 1-3, compared to lower social classes 4 and 5. The findings indicate that sedentary behaviour, typical Western diet, and excessive salt intake, in conjunction with underlying lack of health education, may be the predisposing factors for deaths among decedents of higher social classes 1-3. Among lower social classes 4 and 5, general lack of health education may have caused more deaths due to communicable diseases, as well as injury and accidents. Conclusions: This study shows that lack of health education appears to be the major cause of deaths due to circulatory diseases and diabetes mellitus among higher social classes 1-3, whereas among lower social classes, this may be the underlying cause of deaths due to communicable diseases. Malignant diseases and chronic lung diseases were common among all social classes. © Nova Science Publishers, Inc.