“Non-communicable disease”. Let’s retire this phrase. Isn’t it counterproductive to Public Health?

Sitting here on the tail end of another awesome ASLM conference https://www.lifestylemedicine.org.au/conference/program/, I find myself again reacting to public health concept “Communicable disease” (spread by infectious agents) vs “Non-communicable” disease as I find it binary, polarised, disempowering and counterproductive to our efforts to live healthier.

I react because of the possible implications of the latter term. If something is “non-communicable” then we aren’t spreading, encouraging, allowing, promoting this condition are we? The factors causing the epidemic of type 2 diabetes are mainly non communicable, no?

“No” I argue. But do you agree? The way I see it, whenever we promote sweets as a reward for eating healthy food to children, or a Friday beer session as a reward for a hard week’s work, or a G and T as the deserved treat at the end of a stressful day, we are spreading the “you deserve this” meme. We are communicating and transmitting a message. We are trafficking in communicable harmful beliefs, and we are promoting all sorts of “non communicable” conditions.

Furthermore, so many of the conditions have a transmissible component through vertical and horizontal gut microbiome transmission (families share the gut microbiome, mothers pass down their microbiome (gut/skin) during childbirth. We are now well aware of the gut-brain, gut-nerve, gut-joint axes (amongst others) and the importance of a healthy mouth microbiome in preventing cardiovascular disease. We transmit our microbiomes, and we exchange bits of them with our pets.

Add to this the component of epigenetic signalling (which is partially genetically passed down, and partially modulated by the gut-biome) and suddenly we question whether we are really passive in perpetuating society’s chronic diseases.

And don’t get me started on how we transmit ideas that we are individuals with rights, rather than an interconnected colony of humans. The latter idea, intrinsic to the gentler cultures, is a weird concept to us Western Lifestylers.

Suffice it to say, I think we should broaden the term “communicable conditions” and thereby share a bit more responsibility for our part in promoting and transmitting the upstream determinants of lifestyle disease, starting with our language. (Owning up to my hypocrisy here.. I feel very certain about this, and that’s a problem… ). To me this is about more helpful ways of thinking about taking collective responsibility for our health and health inequality.