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Save lives, stop juvenile drinking in Kenya

By Komu Mwati | December 9th 2015 at 12:00:00 GMT +0300

It is the festive season again and alcohol misuse incidences among teenagers are set to rise. However, reports of underage drinking, while exciting moral indignation, rarely interrogates the more insidious effects of alcohol abuse on youth; the heightened risk of developing Non Communicable Diseases (NCDs) and the socio-economic effects.

Alcohol, along with tobacco use, unhealthy diets and physical inactivity, are among the four major NCD risk factors indicated by the World Health Organization (WHO).

'"NCDs are a major public health concern, with significant social and economic implications in terms of health care needs, lost productivity and premature death. NCDs are thus a serious setback to our attainment of social, health and economic targets," says Joseph Kibachio, Head of NCD Control Unit at the Ministry of Health.

Daniel Ngugi Mwai, an economist at the University of Nairobi, estimates that NCDs reduce household income by 28.64 per cent compared to the 13.63 per cent reduction for general ailments and are 51.35 per cent more likely to incur catastrophic expenditures. The odds of impoverishment are 48.97 per cent higher in households where a member has an NCD compared to those that have a member suffering from a general illness.

WHOs NCD Progress Monitor Report 2015, using data from the 2012 all-cause mortality rates estimates that 27 per cent of all Kenyan deaths result from NCDs. This statistic rises to 87 per cent of all deaths in the high-income countries of Europe, America and Australia.

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"While malaria, TB and HIV, all infectious diseases, are leading causes of morbidity (inability) and mortality (death) in Kenya, NCDs are quickly becoming more prevalent, begetting the double burden of NCDs," says Dr Kibachio.

This is correlated by the Kenya National Bureau of Statistics' (KNBS) latest Economic Survey report (2014) which indicates that Cancers, aneamia, accidents, and cardiovascular diseases were the leading causes of death among Kenyans in 2013. These diseases claimed 36,187 lives; 18.6 per cent of all deaths that year, while the many who survived continue being a direct social and economic burden on society.

Alcohol increases cancer risks in organs and tissues associated with the upper digestive tract and respiratory tracts, the liver, the colon and the breast. The International Agency for Research on Cancer (IARC), a WHO affiliate, has reliably established that Acetaldehyde, the initial product in alcohol metabolism is a carcinogen- cancer causing agent. The risk of digestive tract cancers among youth who drink and eat processed meats is higher- IARC has raised an alert over red and processed meats as carcinogenic. Youth who drink are also big consumers of processed foods.

On a different front, research by Harold S. Ballard, a US haematologist has established that alcohol triggers the production of defective red blood cells in the body, leading to anaemia. This is an oxygen deficiency condition caused by the inability or low capacity of red blood cells to distribute oxygen to other cells. Alcohol interferes with the metabolism of rare minerals like folic acid that are necessary in the production of red blood cells.

Anaemia, an NCD, is a leading cause of death in Kenya. Young women should be aware of the risks: anemia is associated with Pre-term Deliveries, Stillbirths, Miscarriages, and Sudden Infant Death Syndrome. Globally, anaemia accounts for 20 per cent of all maternal deaths.

Intentional and unintentional accidents are a major heath concern in Kenya. Gladwell Gathecha, Head of Violence and Injury Prevention Unit at the Ministry of Health, has some chilling statistics: 70 per cent of all injuries in Kenya result from either assault or road traffic crashes, with assault taking the lion share- 42 per cent. Alcohol abuse is a major risk factor for these health conditions.

The Kenya National Transport and Safety Authority (NTSA) on its part recognizes the role of alcohol in road accidents and has initiated media campaigns against drunk driving. Statistics from NTSA indicate that between January 1, 2015 and 26 October 2015, 2,430 have died through road accidents while 3,732 have been seriously injured; unable to work and a strain on resources.

Alcohol use among young people is a sporadic yet intense affair- binge-drinking. Research by the American College of Cardiology has shown that binge-drinking is a significant risk factor in cardiovascular disease later in life. It impairs cell function within the endothelium (cells lining internal body spaces) of blood vessels. This is a precursor to atherosclerosis, the hardening of the blood arteries, which causes strokes.

NCDs have their genesis in modifiable lifestyle behaviors that people pick as they grow up. The consequences of unhealthy lifestyles will only manifest later in life. Premature death from NCDs is therefore a choice; needless. Most NCDs take time to develop; middle and old life afflictions have their genesis in youth. This has profound implications: attitude change among the youth holds the best chance of preventing NCDs.

The Ministry of Health has issued a National Strategy for the Prevention and Control of Non-Communicable Diseases. Linkages between social ills like under-age drinking and NCDs need to be made more firmly so that more resources are allocated to advocacy initiatives that counter unhealthy lifestyle behaviour. While authorities will no doubt feel pressured to balance economics and social welfare, alcohol advertising needs to be revisited. Attaching heroism and patriotism to alcohol consumption as advertisers do, works against the government's constitutional goal of ensuring health to all Kenyans.

Action against underage drinking now will relieve the country of the burden of lost income through immature death and unnecessary health costs that will be expended on survivors later in life.

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