The term risk refers to the degree of probability of the occurrence of a certain event (PEREIRA, 1995). From an epidemiological point of view, the term is used to define the probability that healthy individuals, but exposed to certain factors, acquire a certain disease. Factors that are associated with an increased risk of contracting a disease are called risk factors. On the contrary, there are factors that give the body the ability to protect itself against the acquisition of a certain disease, called protection factors (Inca, 2007).
Importantly, the same factor can be a risk factor for several diseases (for example, smoking, which is a risk factor for several cancers and for cardiovascular and respiratory diseases). Furthermore, several risk factors may be involved in the genesis of the same disease, constituting multiple causal agents. The study of risk factors, isolated or combined, has allowed the establishment of cause/effect relationships between them and certain diseases. Risk factors can be found in the physical environment, be inherited or represent habits or customs specific to a particular social and cultural environment (Inca, 2007).
Common and modifiable risk factors underlie major chronic diseases. These risk factors explain the vast majority of deaths caused by chronic diseases of all ages, in both sexes, in all parts of the world. They include: obesity, sedentary lifestyle, smoking and alcoholism (WHO, 2005).
According to estimates by the World Health Organization (WHO, 2005), every year, at least
• 4.9 million people die from tobacco consumption;
• 2.6 million people die as a result of being overweight or obese;
• 4.4 million people die from high total cholesterol levels;
• 7.1 million people die from high blood pressure.
CNCDs such as cardiovascular diseases, cancer, diabetes, liver cirrhosis, chronic obstructive pulmonary diseases and mental disorders constitute important public health problems, whose risk factors can be classified into three groups: those of a hereditary nature; the environmental and socioeconomic and the behavioral ones. Among the three groups of risk factors, it is of paramount importance to act on behavioral factors, that is, sedentary lifestyle, diet, smoking and alcohol, since they are preventable (BRASIL, 2001a)
Small changes in risk factors in individuals who are at moderate risk can have a huge impact in terms of death and disability. Through disease prevention in large populations, small reductions in blood pressure and blood cholesterol level could achieve health cost savings. If these risk factors were eliminated through lifestyle changes, at least 80% of all heart disease, stroke and type 2 diabetes could be prevented. Furthermore, more than 40% of cancers could be prevented (WHO, 2005).
CNCDs are the result of unhealthy “lifestyles”. It is believed that individuals develop a CNCD as a result of an unruly “lifestyle”; however, individual responsibility can only have full effect in situations where individuals have equal access to healthy living, and are supported to make healthy decisions (WHO, 2005). It is essential to take into account the influence of globalization, industrialization and the media in changing consumption patterns, as well as the fact that women have entered the labor market.
In this sense, it is important to sensitize health plan operators, service providers and beneficiaries to the importance of promoting healthy eating, physical activity and the reduction of tobacco and alcohol, as predominant factors for protecting health and as essential topics to be addressed in health promotion and risk and disease prevention programs, regardless of the health care area to which the operator directs its programs.
References:
World Health Organization. The World health report: 2005: make every mother and child count. World Health Organization, 2005.
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BUSS, P. M. Uma introdução ao conceito de saúde. In: CZERESNIA, D.; FREITAS, C. M. (Org.). Promoção da saúde: conceitos, reflexões e tendências. Rio de Janeiro: Fiocruz, 2003. p.15-38.
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