1.3 Socio-demographic risk factors
Social structures, socio-economics and demography implicitly impact on health and well-being, including the development of NCDs. These social determinants are unevenly distributed, caused by the unequal distribution of money, power and resources throughout local communities, countries and the world.52 Socio-economic improvement is the primary driver for NCDs, together with other factors like governance, education policies, welfare policies and employment opportunity and security.53 The socio-economy shapes the health status of individuals through behavioural and metabolic risk factors.52
1.4 Health transition
1.4.1 Figure 1: Health transition in Myanmar
Health transition is basically composed of a demographic transition and an epidemiologic transition (Figure 1). Demographic transition occurs as a result of dynamic changes from high fertility and mortality rates to lower rates in a population, thus increasing the proportion of elderly in a population and increasing their life expectancy. Most developing countries, including Myanmar, have a young population, and have started the demographic transition.
Epidemiologic transition refers to the process that the pattern of mortality and disease is changing.54 The disease pattern has globally shifted from contagious diseases to non-communicable diseases
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Globalization impacts the health status of the country, and is a determinant for NCDs.57 For instance, Myanmar was isolated from the western world for more than five decades, and when the new government came to power in 2011 it opened up for trade liberalization, and engaged economically with the rest of world. Despite the benefits of economic growth, consequences of trade liberalization, unhealthy foods such as carbonated drinks, junk foods and tobacco, were rapidly introduced to replace traditional healthy foods and behavioural