Wah Yun Low PhD, Colin Binns, MBBS, PhD

Industrialization and urbanization have brought about growth in wealth, and an improvement in overall health, including increased life expectancy from 60 years in 1960 to 75 years in 2015. Life expectancy for women in Vietnam is now in excess of 80 years. In Vietnam, the nature of public health problems has changed as it has moved through the epidemiologic transition. The overwhelming burden of acute infectious diseases have been replaced by chronic diseases, including stroke, hypertension, and cancer.

Vietnam, a Southeast Asian nation, is one country that is continuing to experience rapid economic progress and poverty reduction and its effects can be seen in the change in population dynamics, education, and health sectors. The population dynamics is typical of a developing country going through the demographic transition with a changing population pyramid reflecting the declining population growth rate. Vietnam is considered a lower middle–income country with a population of about 90 million (annual population growth of about 1%) and a gross domestic product (GDP) of about US$2000 per capita per year.1 The World Health Organization (WHO) noted that Vietnam has achieved some of the Millennium Development Goals (MDGs), such as reducing the maternal mortality ratio (54 per 100 000 live births), infant mortality rate (11.4 per 1000 live births), and under-5 mortality rate (23.0 per 1000 live births).2 Life expectancy at birth is 70 years for men and 76 years for women. Morbidity and mortality patterns are shifting from communicable to noncommunicable diseases. In 2012, stroke is the leading cause of death, killing 112 600 people, followed by ischemic heart disease (36 500) and chronic obstructive pulmonary disease (25 500).2 Vietnam has also been affected by epidemics and outbreaks of avian influenza, severe acute respiratory syndrome (SARS) and HIV/AIDS, and is actively collaborating with international agencies in combating these emerging diseases. Progress has also been made toward ensuring universal access to HIV prevention, treatment, care, and support, although stigma and discrimination again people living with HIV still exists, and thus hampering access to prevention and healthcare services. Vietnam is recognized by the WHO as being one of the top four countries in delivering value for their “health dollar”, but even so there are health and accessibility disparities between geographic regions in the country.

Most of the articles, covering a range of topics from noncommunicable disease, occupational health, lifestyle, maternal and child health, health expenditure, and aging, in this supplement issue dealt with data drawn from the Chi Linh Health and Demographic Surveillance System (CHILILAB HDSS). The CHILILAB HDSS was set up in 2004, and the only health and demographic surveillance system in Chi Linh district of Hai Duong, a northern province of Vietnam. A detailed description of the methodology has been published elsewhere.3 Tran et al describe the methods used for the 2016 CHILILAB HDSS data collection and the key sociodemographic variables used in the subsamples.4 Furthermore, comparison with previous HDDS survey were also undertaken and found no significant difference in household size and gender composition, but educational and economic level in 2016 seemed to have improved.4 Problems of detection and management of cardiovascular disease still exist. Prevalence of impaired fasting glycaemia was 11.8% and diabetes was 12.1%, and only 16.8% diabetic cases detected in this 2016 study was diagnosed before, thus indicating high unmet needs for detection and managing diabetes found in Chi Linh population.5 Other lifestyle, such as in-home smoking is a problem among Vietnamese population, as this will increase the risk of nonsmokers being exposed to secondhand smoke in their home environment.6 Therefore, there is thus an urgent need to improve the capacity of commune health stations for the prevention and control of noncommunicable diseases, with essential equipment and the availability of medicines.7 Other topics are also discussed in this Supplement Issue, such as the quality of life of the elderly and occupational health of workers. It is hoped that this Supplement Issue will create more awareness of public health issues in Vietnam, and appropriate actions or programs will be implemented in dealing with such issues.

Full-text link:

• http://journals.sagepub.com/doi/full/10.1177/1010539517720328
• https://www.ncbi.nlm.nih.gov/pubmed/28719768

Source: Center for Population Health Sciences (CPHS) – Hanoi University of Public Health