Noncommunicable diseases are not just about lifestyle
As a doctor, I’ve become very good at telling people to take care of their health. Eat less salt. Avoid too much sugar. Exercise. Stop smoking. Have your blood pressure checked.
But after years of saying these things, I’ve also started asking a harder question: What happens when people know what they should do, but the conditions around them make it difficult to do it?
A mother may know that healthier food is better, but when money is tight, she’ll choose what can feed her family for the day. A worker may want to exercise, but after hours of commuting and a full day at work, there may be little time or energy left. Someone may know that high blood pressure is dangerous and still go untreated because the health facility is far away or the medicines they need aren’t always available.
I saw this while working as an island doctor.
I remember an elderly patient from one of the farthest barangays who suffered a heart attack after years of uncontrolled hypertension. I had been visiting him monthly, but when his condition worsened, getting him out became difficult. No vehicle could reach their area, so his family and neighbors carried him in a duyan to the nearest passable road. It took roughly two hours on foot, with two or three people taking turns carrying him.
His story isn’t isolated. Across the country, these gaps show up in our health statistics. In 2025, ischemic heart disease remained the country’s leading cause of death, followed by neoplasms and cerebrovascular diseases.
Behind those numbers are people who have lived with high blood pressure for years. Some develop complications. Others reach the hospital only after a stroke or heart attack.
Many noncommunicable diseases (NCDs) and their complications can be prevented or delayed when risk factors are addressed and people receive timely, continuous care. But prevention is not simply a matter of telling people what to do. It also depends on whether they have a realistic opportunity to do it.
The country has already passed laws and adopted policies to address many of these risks. But passing a law isn’t enough. It still has to be funded and carried out where people live.
A policy on paper means little to someone who still cannot access screening, receive preventive care before complications occur, or get the prescribed medicine to control their blood pressure.
Prevention is easy to overlook because there is no patient to point to and say, “This is the stroke we prevented.” Sometimes it’s simply helping a young person avoid smoking, or making healthier choices a little easier for people.
The real measure of prevention is not only how many people we reached, but how many remained healthy, avoided complications, or lived longer without preventable disability.
This is where political will matters. It’s easy to launch a campaign or pass a resolution. The harder part is making sure the work continues when the attention has moved on. Are the medicines still available? Do health workers still have what they need? Is there funding to sustain the program? Are services actually reaching the people who need them? And when the people who started it leave, does someone else carry it forward? Some of these efforts may take years before we see their full effect.
I’ve seen how much people can endure. But we should be careful about calling it resilience when some of what people endure could have been prevented.
The harder part is ensuring people can actually access the care and support that keep them healthy.
Because NCDs are not just about lifestyle.
They are also about whether people can make healthier choices and get the care they need when they need it.
RAYMOND MARTIN CORPUS,
raymondmartin.corpus@bicol.doh.gov.ph
