Exploding the Myths
Myth: Chronic diseases are a problem of the rich countries.
Fact: Chronic noncommunicable diseases (CNCDs) account for more than half the burden of disease and 80% of deaths in poorer countries, which carry a double disease burden.
Myth: CNCDs are a problem only of the elderly.
Fact: Half of these diseases occur in adults under 70 years of age, and the problems often begin in the young, e.g. obesity.
Myth: CNCDs affect men more than women.
Fact: CNCDs affect women and men almost equally and globally. Heart disease is the leading cause of death in women.
Myth: CNCDs cannot be prevented.
Fact: If the known risk factors are controlled, at least 80% of heart disease, stroke and diabetes and 40% of cancers are preventable; in addition, there are cost-effective interventions available for control
Myth: People with CNCDs are at fault and to be blamed because of their unhealthy lifestyles.
Fact: Individual responsibility, while important, only has full effect where people have equal access to healthy choices. Governments have a crucial role to play in altering the social environment to help make the healthy choice the easy choice.
Myth: "My grandfather smoked and lived to 90 years." "Everyone has to die of something."
Fact: While some people who smoke will live a normal lifespan, the majority will have shorter, poorer-quality lives. And yes, everyone has to die, but death does not need to be slow, painful or premature, as is so often the case with CNCDs.
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CARMEN: |
Collaborative
Action for
Risk Factor Prevention & Effective
Management of
E
NCDs
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A Network for Integrated Prevention & Control of
Chronic Noncommunicable Diseases (CNCDs) in the Americas
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Areas of Action
Newsletters
- Chronic Disease Prevention & Control in the Americas:
English | español
- Informativos, Prevenção e controle doenças:
português
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CARMEN Overview:
English | español
CARMEN Regional Initiatives
CARMEN Policy Observatory
CARMEN School
- Text about
- Policy-Makers' Workshop, El Salvador, 11/2008:
English | español
- Social Marketing: Application & Promoting Healthy Lifestyles, 8/2008, Santiago:
English | español
4th Pan American Congress to Promote Vegetable & Fruit Consumption
- Social Marketing & Healthy Lifestyles, 7–8/2008, Mexico:
English |
español
- Physical Activity Training, 2007, Guatemala:
English | español
- Policy-Makers' Workshop, Eastern Caribbean, 2007:
English | español
- Symposium Report—Lay Health Workers (Health Promoters) Project:
Community Mobilization to Improve Cardiovascular Health in the Americas, 10/2005, Chile:
English | español
- Southern Cone Meeting, 2005: español
English-speaking Caribbean
- CARIDIAB—Caribbean Diabetes Project (part of the Caribbean Chronic Care Collaborative / CCCC, Improving the Quality of Diabetes Care)
English | español
- Caribbean Expert Consultation on Scaling Up Population-Based Screening and Management of CVD and Diabetes, 3/2008 (English only)
- Institutional Response to Diabetes and Its Complications (IRDC): DOTA Caribbean Diabetes Initiative
español
- Central American Diabetes Initiative (CAMDI)
English | español
- Healthy Caribbean 2008: Civil Society, 10/2008, Barbados:
English | español
- Caribbean Private Sector Response, 5/2008, Trinidad & Tabago:
English | español
- Promoting Physical Activity 5/2008, Trinidad & Tabago:
English | español
- Caribbean Expert Consultation on Scaling Up Population-Based Screening and Management of CVD and Diabetes, 3/2008:
English
- Caribbean Lifestyle Intervention CARLI, 2004:
English
- CARLI—Caribbean Lifestyle Intervention Program, 2001:
English
Pan American Cardiovascular Initiative (PACI)
- 1st Round of Guatemalan Community Cardiovascular Health Promoters Receives Diplomas, 6/08: English | español
- Visit to Guatemala project 11/07: English | español
- Awardees' Workshop 5/07: English | español
- Symposium Report—Lay Health Workers (Health Promoters) Project:
Community Mobilization to Improve Cardiovascular Health in the Americas, 10/2005, Chile:
English | español
- Meeting at NIH/NHLBI, 10/04: English
Central American Diabetes Initiative (CAMDI): English | español
Regional Campaign: Let's eat healthy, live well, & get moving Americas!
CNCD Surveillance
- Improving Cancer Information in the Americas (Quito, 4/09)
English | español
- CNCD Surveillance, Andean Countries (Quito, 4/09)
English | español
- STEPS Stroke, the STEPwise Approach to Stroke Surveillance: English | español | português
- PanAmerican STEPS, the PAHO/WHO Stepwise Approach to Chronic Noncommunicable Disease Risk-Factor Surveillance: English | español
- CNCD Surveillance, MERCOSUR Countries, Brazil, 2008:
English | español
- Vancouver Meeting 2008 (MERCOSUR countries): English | español
CARMEN Meetings & Events Directory
CARMEN Documents
PAHO & WHO Resolutions on Chronic Disease
- Regional Strategy and Plan of Action for Cervical Cancer Prevention and Control (PAHO Resolution CD48.R10 2008)
English | español
- Regional Strategy on an Integrated Approach to the Prevention and Control of Chronic Diseases Including Diet, Physical Activity, and Health (PAHO Resolution, CD47-17 2006):
English | español
Executive Summary: English | español
Abstract: The Strategy is comprehensive, requiring a combination of interventions for the population and individuals. It is integrated, spanning prevention and control strategies focusing on the major chronic diseases and cross-cutting risk factors (especially physical activity, tobacco, and alcohol). Finally, it is intersectoral, because most of the major determinants of the chronic disease burden lie outside the health sector.
- Health Promotion (PAHO Resolution CD47-16, 2006):
English | español
- Regional Strategy and Plan of Action on Nutrition in Health and Development, 2006–2015
(PAHO Resolution CD47-18, 2006): English | español
- Cancer Prevention and Control (World Health Assembly Resolution WHA58.22, 2005):
English | español
- Global Strategy on Diet, Physical Activity, and Health (World Health Assembly Resolution WHA57.17, 2004):
English | español
- WHO Framework Convention for Tobacco Control (World Health Assembly Resolution WHA56.1, 2003):
English |
español
- Public Health Response to Chronic Diseases (PAHO Resolution CSP26/15, 2002):
English | español
- Cardiovascular Disease, especially Hypertension (PAHO Resolution CD42.R9, 2000;
pp. 16–19): English | español
- Prevention and Control of Noncommunicable Diseases (World Health Assembly Resolution WHA53.17, 2000)
English | español
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Activities in the Countries: Introduction
What is the CARMEN Network?
CARMEN is an initiative of the Pan American Health Organization and aims to improve the health status of the populations in the Americas by reducing risk factors associated with noncommunicable diseases (NCDs).
This is attained through the development, implementation, and evaluation of policies, social mobilization and community-based interventions, epidemiological surveillance of NCD risk conditions, and preventive health-care services.
What are the CARMEN strategies?
The interventions developed within the framework of CARMEN imply the definition of a population space (site, be it provincial or national) and the implementation of actions aimed at preventing risk factors for noncommunicable diseases. This involves implementing strategies such as integrated prevention, promotion of health equity, and demonstrative effect.
- Integrated Prevention
CARMEN advocates for integrated prevention as a central strategic component that simultaneously reduces multiple NCD risk factors at different levels. For practical purposes, an integrated intervention is one that includes the following:
- Simultaneous prevention and reduction of a set of risk factors common to major NCDs.
- Simultaneous use of community resources and health services.
- Combined and balanced efforts for preventive health care and general health promotion, to enable communities to become active participants in decisions concerning their health.
- Strategic consensus-building among different stakeholders—such as governmental, non-governmental, and private sector organizations—in an effort to increase cooperation and responsiveness to population needs.
- Promotion of Health Equity
Traditionally, chronic diseases have been related to high socioeconomic levels; but currently, there exists sufficient evidence to indicate that this relation has been inverted. Evidence clearly shows that the risk for some NCDs, such as cardiovascular diseases and certain forms of cancers, are higher at low socioeconomic levels, with an apparent increase of this trend in recent years.
Prevention strategies should consider such underlying influences on health inequalities as education, income distribution, public safety, housing, work environment, employment, social networks, and transportation, among others. It is important that strategies be aimed at reducing overall population risk while simultaneously reducing the gap among different population groups. In many instances, this requires redesigning and evaluating interventions of well-documented efficacy. It also entails identifying and paying special attention to key population groups, such as indigenous peoples, new urban migrants, and women.
- Demonstrative Effect
Interventions are first introduced in a demonstration area, so that acceptability and effectiveness can be measured in a given context. It is feasible to conduct evaluations by monitoring the impact of NCD risk factors, morbidity, and mortality.
In this context, the demonstrative effect measures whether the risk factors and mortality from corresponding noncommunicable diseases have been modified, and whether the observed changes have occurred within a logical time sequence with regard to the interventions. For practical purposes, it is necessary to
- have a basal measurement that allows for later comparisons;
- have a surveillance system of mortality and risk factors; and
- make systematic collections of information related to the intervention, in order to evaluate its development.
Partnerships with academic centers are highly encouraged in order to strengthen evaluation and participation in international research training activities.
Useful Links
WHO Links
Alliances and Networks
Partners & Collaborating Centers
- CEDETES: Center for the Development & Evaluation of Policies & Technology in Public Health, Colombia (site in Spanish)
- Centers for Disease Control & Prevention (CDC), USA:
English | español
- NHLBI: National Heart, Lung & Blood Institute, National Institutes of Health, USA
- Prevention Research Center (PRC), St. Louis University
- Public Health Agency of Canada (PHAC):
English | français
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