2010-12-31-世界卫生组织-2011_STEPS_Country_report_Niue_124页_1mb

Niue NCD Risk Factors STEPS Report Summary

Core Content

The Niue NCD Risk Factors STEPS Report (May 2013) presents a comprehensive baseline assessment of noncommunicable disease (NCD) risk factors in Niue. Conducted using the WHO STEPwise Approach to NCD Surveillance (STEPS), the survey collected data from all individuals aged 15 years and over, making it a unique and valuable resource for understanding NCD trends in the country.

This report is a collaboration between the Niue Health Department and the World Health Organization (WHO), with expert contributions from several individuals. It includes data from the 2011 Census and provides insights into key NCD risk factors such as tobacco use, alcohol consumption, poor diet, physical inactivity, obesity, high blood pressure, high blood glucose, and high cholesterol.

Main Objectives

• To document the prevalence and magnitude of major modifiable NCD risk factors.
• To compare NCD risk factors across different age groups and between men and women.

Key Findings

Tobacco Use

• 17.7% of the population were current smokers (22.6% of men and 13.0% of women).
• 11.6% of current smokers smoked daily (15.8% of men and 7.6% of women).
• Men started smoking at 17.7 years and women at 22.4 years.
• Manufactured cigarettes were most common among those under 45.

Alcohol Consumption

• 49.3% of the population consumed alcohol in the past 30 days.
• 60.2% of men and 39.1% of women were current drinkers.
• 54.9% of male current drinkers consumed more than 5 standard drinks on a single occasion.
• 31.3% of female current drinkers consumed 4 or more drinks on a single occasion.
• Binge drinking was most common in men aged 35-44 and 45-54, and women aged 35-44.

Diet

• The average consumption of fruits and vegetables was below the recommended five servings per day.
• 92.9% of the population consumed less than five combined servings of fruit and vegetables per day.
• Men consumed 3.3 days of fruits and vegetables per week, while women consumed 3.8 days.
• On days when they consumed fruits and vegetables, the average was 1.1 servings per day.

Physical Activity

• 17.1% of the population reported low levels of physical activity (<600 METminutes per week).
• Men engaged in 38.4 minutes of recreation-related physical activity per day, compared to 21.9 minutes for women.
• Work-related and transport-related physical activity levels were high.

Obesity and Body Composition

• The mean BMI was 31.8 kg/m², indicating a high overall obesity rate.
• 61% of the population was classified as obese (BMI ≥ 30).
• 86.8% of women and 85% of men were overweight (BMI ≥ 25).
• 13.7% of the population had a normal BMI (18.5–24.9).

Blood Pressure

• 33.5% of the population had raised blood pressure (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg, or on medication).
• Raised blood pressure increased with age, with the highest prevalence in women aged 65+.

Blood Glucose

• 38.4% of the population had raised blood glucose (fasting glucose ≥ 6.1 mmol/L or on medication).
• Men had a higher prevalence (42.1%) than women (34.9%).
• Raised blood glucose levels increased with age, with the highest in men aged 65+.

Total Cholesterol

• 34.8% of the population had raised total cholesterol (≥ 5.0 mmol/L or ≥ 190 mg/dL).
• Women had a higher prevalence (36%) than men (33.7%).
• The highest prevalence of raised cholesterol was in men aged 55–64 and women aged 45–54 and 55–64.

Combined Risk Factors

• The population was classified into three risk categories:
  • Low Risk: 0.2% (no risk factors).
  • Moderate Risk: 56% (1–2 risk factors).
  • High Risk: 43.8% (3–5 risk factors).
• 3% of the population had a ≥ 30% risk of a fatal or non-fatal cardiovascular event in the next 10 years.

Key Recommendations

For the Government of Niue

• Provide high-level leadership and follow through on UN Political Declaration commitments.
• Establish a multi-sectoral national commission to oversee the NCD Action Plan with timed targets and indicators.
• Scale up NCD risk factor reduction using this report.
• Earmark funds for ongoing strategy implementation and monitoring.
• Accelerate the implementation of the WHO FCTC.
• Support the Tobacco-Free Pacific initiative by 2025.
• Require health warnings on cigarette packages.
• Consider taxing manufacturers/importers of cigarettes and alcohol to subsidize health services.
• Develop policies to promote healthy food importation.
• Investigate scaling-up fruit and vegetable availability.
• Create physical activity-friendly environments.

For the Niue Health Department (in partnership with NGOs and the community)

• Identify cultural factors contributing to NCD risk and develop culturally acceptable strategies.
• Launch comprehensive anti-smoking campaigns, especially targeting teenagers and young adults.
• Promote fruit and vegetable consumption through policy and public awareness.
• Develop culturally-appropriate programs to encourage daily physical activity, including in workplaces.
• Create public awareness campaigns on the importance of regular monitoring and screening for blood pressure, cholesterol, and blood sugar.
• Increase awareness of NCD risk multipliers from combining the 5 major risk factors.

For Assessing and Managing Absolute CVD Risk

• Support targeted screening and referrals.
• Strengthen the health care system by implementing the Package of Essential NCD interventions in primary health care (PHC).
• Ensure appropriately trained human resources and basic equipment are available at all health care levels.
• Strengthen community-based care for individuals with diagnosed NCDs.

For Surveillance

• Support secondary analysis of the data to identify statistical associations.
• Repeat the STEPS survey every 5 years to build a robust NCD surveillance system.
• Participate in comparative analyses with other Pacific Island Countries (PICs) to identify modifiable risk factors specific to Niue.

Conclusion

The report underscores the prevalence of NCD risk factors in Niue, particularly high blood pressure, raised blood glucose, raised cholesterol, and obesity. It emphasizes the need for primary and secondary prevention and highlights the potential to reduce NCD burden through policy, education, and community engagement. The findings serve as a baseline for future NCD prevention and control efforts and support the development of a national NCD action plan.

Appendices

• Appendix 1: Niue STEPS Survey Questionnaire.
• Appendix 2: Data Book for the Niue STEPS Survey.
• Appendix 3: List of STEPS Survey Field Staff.
• Appendix 4: References.

Figures

• Figure 1: The WHO STEPwise approach to NCD surveillance.
• Figure 2: Sequence of data collection stations at field sites.

Acknowledgements

The report was supported by the Niue Health Department, WHO, AusAID, and the New Zealand Aid Programme. It is a result of collaborative efforts and expert contributions from various stakeholders.