Non-communicable diseases (NCDs) account for 71% of all annual deaths, totaling 41 million people worldwide. The development and progression of these diseases are highly related to the environment and lifestyle choices, among which physical inactivity and excess malnutrition stand out. Currently, in Chile, there is no evidence at the regional and local level on the impact of physical activity and healthy nutrition plans and interventions on health promotion, prevention, and timely treatment of NCDs. The following protocol delineates the URO/FOCOS (Universidad Regional de O\'Higgins/FOrtaleciendo COmunidades Saludables- Regional University of O\'Higgins/Strengthening Healthy Communities) study, which will assess pilot community intervention strategies using a participatory action research approach by identifying barriers and facilitators on the practice of physical activity and healthy eating habits. In this project, the community from the O\'Higgins region will be involved throughout the entire research process to develop strategies that promote regular physical activity and healthy eating practices. We propose three interrelated strategies: (1) Participatory Action Research, (2) Community interventions for promoting physical activity and healthy nutrition practices, and (3) health education. The URO/FOCOS study offers a unique opportunity in the O\'Higgins region to develop participatory strategies and interventions based on the community\'s needs and motivations with regard to physical activity and healthy eating habits. We believe these strategies will help to improve the community\'s overall health through effective changes in their decision and preferences toward a more active lifestyle and healthier nutrition practices.

The COVID-19 pandemic and its prevention policies have taken a toll on Canadians, and certain subgroups may have been disproportionately affected, including those with non-communicable diseases (NCDs; e.g., heart and lung disease) due to their risk of COVID-19 complications and women due to excess domestic workload associated with traditional caregiver roles during the pandemic.
We investigated the impacts of COVID-19 on mental health, lifestyle habits, and access to healthcare among Canadians with NCDs compared to those without, and the extent to which women with NCDs were disproportionately affected.
As part of the iCARE study ( www.icarestudy.com ), data from eight cross-sectional Canadian representative samples (total n = 24,028) was collected via online surveys between June 4, 2020 to February 2, 2022 and analyzed using general linear models.
A total of 45.6% (n = 10,570) of survey respondents indicated having at least one physician-diagnosed NCD, the most common of which were hypertension (24.3%), chronic lung disease (13.3%) and diabetes (12.0%). In fully adjusted models, those with NCDs were 1.18-1.24 times more likely to report feeling lonely, irritable/frustrated, and angry \'to a great extent\' compared to those without (p\'s < 0.001). Similarly, those with NCDs were 1.22-1.24 times more likely to report worse eating and drinking habits and cancelling medical appointments/avoiding the emergency department compared to those without (p\'s < 0.001). Moreover, although there were no sex differences in access to medical care, women with NCDs were more likely to report feeling anxious and depressed, and report drinking less alcohol, compared to men with NCDs (p\'s < 0.01).
Results suggest that people with NCDs in general and women in general have been disproportionately more impacted by the pandemic, and that women with NCDs have suffered greater psychological distress (i.e., feeling anxious, depressed) compared to men, and men with NCDs reported having increased their alcohol consumption more since the start of COVID-19 compared to women. Findings point to potential intervention targets among people with NCDs (e.g., prioritizing access to medical care during a pandemic, increasing social support for this population and mental health support).

Objective: To examine the prospective associations between airflow obstruction (AFO) and risks of major chronic diseases morbidity in Chinese adults. Methods: Samples of this study were from the China Kadoorie Biobank. A total of 486 996 participants aged 30 to 79 years (mean 51.5 years) at the baseline study, were included after excluding those who self-reported of having heart disease, stroke and cancer at baseline. AFO was defined under the Global Initiative on Obstructive Lung Disease (GOLD) criteria and forced expiratory volume per one second in percentage of the expected one (FEV(1)% P). Cox regression models were used to investigate the associations of AFO with incidence rates of ischemic heart disease, cerebrovascular disease and lung cancer after adjusted for potential confounders. Results: Over a period of 7 years through the follow-up program, the incident cases of ischemic heart disease, cerebrovascular disease and lung cancer appeared as 24 644, 36 336 and 3 218, respectively. Compared with people without AFO, the HR (95% CI) of GOLD-1 to GOLD-4 were 0.89 (0.78-1.01), 1.05 (0.98-1.12), 1.29 (1.18-1.40) and 1.65 (1.42-1.91) respectively for ischemic heart disease. The HR (95%CI) of GOLD-1 to GOLD-4 were 0.96 (0.70-1.26), 1.12 (0.96-1.31), 1.38 (1.14-1.65) and 1.48 (1.05-2.02) respectively for lung cancer. No statistically significant differences in the associations between GOLD level and cerebrovascular disease morbidity were found. However, each 10% decrease in FEV(1)% P was associated with 7.2% (95%CI: 6.4%-8.0%), 3.6% (95%CI: 3.0%-4.3%) and 10.5% (95%CI: 8.4%-12.6%) increased the risks of ischemic heart disease, cerebrovascular disease and lung cancer respectively. The results were persistant when stratified by smoking status. Conclusion: Higher degree of AFO seemed to be associated with the risks of ischemic heart disease, cerebrovascular disease and lung cancer morbidity among the Chinese adults.
目的： 在中国成年人中探究气流受限与主要慢性病发病风险的前瞻性关联。 方法： 本研究基于中国慢性病前瞻性研究，剔除基线自报患有心脏病、脑卒中和恶性肿瘤的个体后，共纳入基线时30~79岁（平均51.5岁）的研究对象486 996名。分别以慢性阻塞性肺疾病全球倡议（GOLD）标准和第一秒用力呼气容积占预计值百分比（FEV(1)%P）评价气流受限，使用Cox比例风险回归模型分析气流受限与缺血性心脏病、脑血管病和肺癌发病之间的关联。 结果： 在平均7年的随访期间，缺血性心脏病、脑血管病、肺癌分别新发24 644、36 336、3 218例。与气流正常者相比，GOLD-1至GOLD-4人群的缺血性心脏病发病风险比（HR）值（95%CI）依次为0.89（0.78~1.01）、1.05（0.98~1.12）、1.29（1.18~1.40）和1.65（1.42~1.91）；肺癌发病HR值（95%CI）依次为0.96（0.70~1.26）、1.12（0.96~1.31）、1.38（1.14~1.65）和1.48（1.05~2.02）。未发现GOLD分级与脑血管病发病风险之间存在有统计学意义的关联。FEV(1)%P每下降10%，缺血性心脏病、脑血管病、肺癌风险分别增加7.2%（95%CI：6.4%~8.0%）、3.6%（95%CI：3.0%~4.3%）、10.5%（95%CI：8.4%~12.6%）。按吸烟状态分层分析，上述结果基本不变。 结论： 我国成年人群中气流受限程度越严重，个体缺血性心脏病、脑血管病和肺癌的发病风险越高。.

BACKGROUND: Non-communicable chronic diseases (NCDs) have become the top threat in China. This study aimed to estimate the prevalence of major NCDs among the elderly population in rural areas in southern China and explore its associated social determinants.
METHODS: A multistage cluster random sampling methodology was adopted to select a total of 9245 rural elderly people from 3860 rural households in Guangdong Province. Interviews and physical examinations were performed to collect patient information. Descriptive and logistic regression analyses were conducted to explore factors associated with the presence of major NCDs.
RESULTS: Over one-third (38.5%) of the study population suffered from five major NCDs. The grade of activities of daily living (ADL), mental status, and social relationship of elderly people without NCDs were better than those with NCDs. The major factors associated with the presence of NCDs among the elderly people included age (70-79 years group and 80-89 years group), education level (senior high/technical secondary school and junior college and above), mental status (concentration, enrichment and happy life and memory), relationship with neighbours, activities of daily living (ADL) (being able to climb three floors and bend over), physical activity, marital status (bereft), and living conditions (with offspring and family members).
CONCLUSIONS: The study identified several social determinants associated with the presence of major NCDs. A higher level of family support and physical exercise might contribute to improved physical condition, mental status, and ADL among the elderly people in rural areas in southern China.