“Leaving No One Behind” in Sustainable Development Goals

“Leaving No One Behind” In Sustainable Development Goals

Introduction

With the rapid adoption of the Agenda for Sustainable Development across the globe, members of the United Nations pledged to ensure that the proposed initiatives were understood by and worked for every member of society, including the most marginalized groups. To achieve this goal, global targets for the Sustainable Development Goals are adopted at the national and community level with a commitment to involve communities that are furthest from achieving the goals. Many countries also strive to make the Sustainable Development Goals (SDGs) specific and relevant to context by involving local communities to identify priorities and realistic action plans that address their problems (Marmot and Bell 2018, p. 5). As such, “leaving no one behind” is broadly used to illustrate the commitment of the SDGs to include all members of society and prioritize the needs and interests of marginalized communities. The phrase also demonstrates the commitment of United Nations member states to end extreme poverty in all its forms, reducing income and wealth disparities among individuals and groups in society and promoting progressive universalism to promote the well-being of marginalized people. However, despite the desire by UN member states to come up with sustainable development goals that leave no member of the society behind, such initiatives are often faced with challenges.

Among the most common challenges that limit the universality of SDGs is the lack of standard practice or approach to getting community groups to think about how the SDGs apply to their lives. Also, efforts to involve local communities often fail to target the poor and marginalized groups effectively. For instance, SDG 3 aims to ensure healthy lives and promote well-being for all ages. However, some member states lack the sufficient economic capacity to provide quality healthcare services to all community groups, resulting in the exclusion of some marginalized communities. It is also difficult for member states to develop strategies that address core determinants of health and well-being, including socioeconomic determinants, such as education, income, and gender, without interrupting other SDGs. As a result, marginalized groups tend to be more vulnerable to adverse health risks, such as chronic non-communicable diseases that constitute a common cause of death and disability in many regions across the globe (Di Cesare 2019, p. 185). As such, it is important to investigate strategies that could improve member nations’ capacity to leave no one behind in the initiatives laid down to promote the well-being of each member of society. This study, therefore, seeks to investigate key health risks associated with chronic non-communicable diseases and identify the role of global organizations in addressing such risks and ensuring that marginalized groups have access to equitable healthcare services to reduce their vulnerability to such health issues.

Discussion

A common risk factor for the prevalence of chronic non-communicable diseases is the lack of access to affordable healthcare among marginalized communities. Most marginalized communities have limited access to resources, which delays their economic progression. Members of such communities lack the sufficient economic potential to seek medical attention. While the cost of healthcare services continues to increase, such individuals are often forced to forego medical attention due to their incapacity to pay hospital bills. As a result, members of marginalized communities fail to monitor their health, which increases their vulnerability to chronic non-communicable diseases. They also experience an elevated risk of disease progression to advanced stages and a consequent increase in mortality rates. In addition to the ever-growing cost of healthcare services, inequalities in the geographic distribution of medical facility limits access to healthcare services by community members. For example, based on current demographic trends in the United States, most hospitals are located in cities and densely populated regions, with only a small number in rural regions. As a result, a hospital in a rural area is estimated to serve more people than those in cities (Iglehart 2018, p. 473). As a result, people in rural regions lack access to healthcare facilities which makes it hard for early detection of chronic noncommunicable diseases to facilitate treatment. Eventually, the prevalence of chronic non-communicable diseases among people in rural areas is associated with a lack of equitable access to healthcare.

Poor environmental conditions also constitute a critical risk factor for chronic non-communicable diseases. Due to industrial activities taking place in the contemporary world, the rate of pollution continues to rise. As a result, the prevalence of pollution-related health conditions continues to expand among many regions across the globe. While any member of society can experience negative health implications of pollution, they are observed to be more prevalent among the poor. A study conducted by Cooper, Green, and Knibbs (2019) asserted that low-income, racial and ethnic minorities are more likely to live in areas where they face environmental risks, which explains their high vulnerability to chronic non-communicable diseases. For example, due to economic limitations, such individuals fail to establish their homes in regions with high environmental quality. As a result, they live in pollution-prone areas, such as slums, where poor air quality combines with contaminated water to cause chronic health conditions. Both short-term and long-term exposure to air and water pollutants have been associated with an increased risk of chronic respiratory infections, heart disease, and various cancers. While disparities have been recorded in the prevalence of such conditions among different ethnicities, contemporary strategies put in place to prevent such issues are blamed for disproportionately excluding certain groups in society.

Lack of sufficient health literacy among communities is also a risk factor for chronic non-communicable diseases. Despite current initiatives put in place by public health departments in many countries, some community groups do not understand behaviours and lifestyles that increase their vulnerability to chronic non-communicable diseases. As a result, such individuals continue to engage in unhealthy practices, increasing the risk of contracting adverse health conditions. For example, while diabetes remains a common cause of death in contemporary society, many people lack sufficient knowledge regarding practices that increase the risk of contracting the disease. They continue to engage in activities such as smoking, alcohol abuse, and excessive intake of cholesterol and sugary products. Although health illiteracy is a major issue among many communities, it is observed to be more common among poor and marginalized groups. According to Jansen et al. (2018), low health literacy is commonly associated with individuals who have limited education, lower income, and non-native English speakers. Due to insufficient access to education and healthcare services, less fortunate members of society demonstrate poor knowledge of healthy lifestyle practices, early signs and symptoms of various chronic conditions, and poor ability to take preventive medicine to promote well-being and avoid contracting diseases. On that account, health illiteracy constitutes a common risk factor for developing chronic non-communicable diseases among poor and marginalized communities.

Genetics has also been observed to influence vulnerability to chronic non-communicable diseases among the poor and marginalized societal groups. As ethnicities demonstrate a varying predisposition to certain health conditions, the prevalence of certain chronic diseases among communities is associated with their genetic makeup. Some marginalized communities demonstrate genetic susceptibility to chronic conditions, which increases the risk of developing certain diseases due to one or more gene mutations in their lineage. For instance, due to their genetic predisposition to obesity and insulin resistance, African Americans have an elevated risk of contracting type 2 diabetes (Chan et al. 2018, p. 178). Due to inefficient health monitoring strategies, the prevalence of certain chronic conditions among ethnicities continues to expand. Also, due to economic incapacity to seek personalized care services, individuals in marginalized communities fail to adopt preventive methods to keep them safe from chronic diseases despite their genetic susceptibility. They lack sufficient capacity to implement lifestyle changes that could increase their resilience to such conditions. For instance, although African Americans’ vulnerability to type 2 diabetes is intensified by certain components of the physical environment, such as transportation, neighbourhood safety, and healthy food, they have limited financial ability to choose between such factors. Adverse social factors also interfere with their emotional health, intensifying their genetic predisposition to the condition.

Drug and substance abuse, mental health challenges, and HIV/AIDS increase vulnerability to chronic noncommunicable diseases among minority groups. Due to emotional deprivation that results from poor living conditions, many members of marginalized communities end up engaging in drug and substance abuse as their coping strategy. As a result, such individuals experience a high risk of developing chronic non-communicable diseases. For example, smoking is observed to trigger lung and throat cancer, while alcohol abuse raises blood pressure to unhealthy levels to cause hypertension and heart disease (Lariscy 2019, p. 100349). Due to their multiple economic and social challenges, psychological health problems also thrive among marginal communities. Consequently, such individuals experience a high risk of developing stress-related chronic conditions. For instance, due to anxiety that results from poverty, less fortunate members of society are likely to develop a stress-related eating disorder, such as binge eating, which increases their vulnerability to obesity and the associated chronic health conditions. In addition to psychological health complications and drug abuse, the prevalence of chronic non-communicable diseases among marginalized and less fortunate members of society is intensified by HIV. According to Ngoma and Mayimbo (2017), individuals in poor and marginalized communities are three times more likely to contract HIV. Since the disease weakens the body’s immune system, it increases the victim’s susceptibility to chronic conditions. For instance, people with HIV are at a high risk of developing a chronic obstructive pulmonary condition and ischemic heart disease (Singhvi, Bon, and Morris 2019, p. 359). On that account, sustainable development goals instituted to control the prevalence of chronic non-communicable health conditions ought to include regulating the spread of HIV/AIDS among poor and marginalized communities.

Certain commercial determinants of health also regulate the prevalence of chronic non-communicable diseases among communities. Some of the strategies corporations use to maximize their revenues, market share, and market influence cause adverse health implications for certain groups in society, increasing their predisposition to chronic conditions. Many people in contemporary society commonly consume ultra-processed foods and beverages. Such foods often contain many added ingredients and are highly manipulated to suit the organization’s marketing objectives. They are also preferred by many people due to their ease of preparation and increased availability in many regions. However, consumption of such products is observed to have harmful implications on a person’s health and trigger different chronic conditions. Frequent consumption of ultra-processed foods causes an increase in free sugars, saturated fats, and excessive carbohydrates to increase the risk of diet-related conditions such as obesity and diabetes (Rauber et al. 2018, p. 587). Corporations also come up with strategies to encourage members of the public to consume harmful substances such as tobacco and alcohol to maximize their profits. As members of society consume such products, they experience an increased risk of developing certain chronic conditions.

Moreover, corporations expose their employees to adverse working conditions that increase their susceptibility to chronic diseases. People from less fortunate communities seek employment opportunities to improve their living standards. Some employers expose them to adverse working conditions through which they develop chronic conditions that result in physical incapacitation or even death. For example, mining corporations require their workers to extract minerals from the earth’s surface without providing them with safety equipment and insurance. Such employees are exposed to toxins, such as mercury, that trigger chronic cancers (Singh, Tiwari, Mishra, and Kumar 2019, p. 49). Similarly, exploitative production methods adopted by firms reduce the community’s economic potential by extracting huge amounts of resources while offering little compensation to employees. Eventually, the impact of poverty on the prevalence of chronic non-communicable diseases continues to escalate. Also, corporations engage in unhealthy competitive activities; they limit the government’s capacity to raise a sufficient amount of revenue to address the prevalence of chronic conditions. For instance, some companies evade paying taxes to minimize their running expenses. In so doing, such corporations deprive the public sector of much-needed resources, which delays the implementation of public health policies that could reduce the prevalence of chronic non-communicable diseases.

Unhealthy cultural practices also constitute critical risk factors for chronic non-communicable diseases. Culture provides a context through which meaning is gained from the available health information and provides the purpose by which individuals understand their health status and use the available methods to avoid contracting diseases. However, some cultural beliefs and practices limit people’s ability to develop health literacy and adopt healthy practices to keep themselves safe from chronic conditions. Unhealthy cultural beliefs and practices also limit a community’s ability to utilize the available health structures and seek medical interventions whenever disease symptoms are experienced to prevent progression. For instance, some cultures view cancer, and other similar conditions as a punishment from God sent to people who engage in vices. People who practice such cultural beliefs refrain from seeking medical attention and social support networks whenever they begin experiencing symptoms. Asa result, such individuals experience rapid disease progression, which results in high rates of deaths related to chronic non-communicable diseases.

Implications

Global organizations should develop policies to improve access to affordable healthcare among poor and marginalized communities. Despite the promise to improve lives and well-being through sustainable development goals, the level of access to equitable healthcare services needs to be improved. Among the factors that limit access to healthcare among communities include the high costs of medical and health insurance services. Global organizations should, therefore, encourage state innovation and state-level individual mandates, auto-enrollment, and reinsurance to increase the number of individuals covered and stabilize health insurance premiums while reserving the existing patient protection structures. They could also develop policies to address the prevailing shortage of the clinical workforce, especially in rural regions, to stimulate access to healthcare services by residents. Moreover, telehealth and remote patient monitoring structures could be developed to establish a cost-effective and reliable way to expand capacity in the current health system. While applying such policies requires huge funds, global organizations may experience difficulties implementing them. They should, therefore, consider raising member contributions to avoid deficits during the implementation process.

Global organizations could also develop strategies to address environmental pollution and protect marginalized communities from chronic noncommunicable diseases that result from contamination. Sustainable development goals aim at protecting the planet from degradation by managing its natural resources and taking actions to combat global warming and climate change (Caiado et al. 2018, p. 1276). Global organizations should demonstrate their commitment to sustainable development goals by laying down initiatives to combat pollution among member nations. As international forums for building consensus and negotiating agreements, global organizations ought to develop and spearhead initiatives to combat global environmental problems such as greenhouse gas emissions, depletion of the ozone layer, deforestation, and water pollution. They should also develop environmental standards to be adopted by member countries during resource extraction and other industrial activities to regulate the rate of pollution. Due to the prevailing disparities in the prevalence of chronic non-communicable health conditions that result from pollution among different communities, contemporary environmental protection measures are blamed for excluding certain poor and marginalized groups in society. Strategies put in place to protect local communities from adverse implications of pollution need to be refined to accommodate greater equality.

Many people in poor and marginalized communities have been observed to lack sufficient health literacy, which increases their vulnerability to chronic non-communicable diseases. The World Health Organization needs to propose strategies for developing consciously constructed learning opportunities by marginalized members of society to improve their health literacy, knowledge, and life skills that are conducive to individual and community well-being. Such educational opportunities should promote healthy diets and encourage community members to seek medical interventions whenever they experience symptoms of a disease. Eventually, members of communities that adopt unhealthy cultural beliefs and practices could understand the importance of healthcare facilities in preventing and managing chronic conditions. As a core function of public health, the World Health Organization and other global organizations should support governments and local communities to cope with and address health issues that are more prevalent in certain community groups. Such a strategy could be accomplished by establishing healthy public policies to address healthcare issues at a national level, creating supportive environments, and strengthening community action and personal skills to improve health literacy and reduce susceptibility in the long run.

Global organizations could also develop ways to combat genetic predisposition to diseases among marginalized communities. The World Health Organization, in particular, could develop strategies through which member countries could conduct community-based screening for different chronic diseases to allow for early identification and inform management methods. The organization could also offer direct financial and material help to economically challenged countries to improve their capacity to address public health concerns. For instance, the global organization could provide screening equipment to countries and conduct mass campaigns to encourage members of communities within which different chronic conditions are more prevalent to get tested and receive guidelines from health specialists. However, such a strategy may be faced with limitations such as possible discrimination in the administration of the interventions provided, the high cost of gene therapy and medicines required, and variations in prevalence patterns in different regions which could result in a generalization bias. To counter such challenges, the global organization ought to investigate the prevalence of various chronic conditions in different communities and budget estimates to confirm the availability of the required resources.

Global organizations should inform local governments of policies regarding effective ways to control drug abuse. Such strategies could include conducting mass media campaigns to change community norms regarding drug use and alter societal perceptions regarding the prevalence of use. By conducting target-driven mass media campaigns, global organizations could enhance community awareness of the association between drug abuse and chronic non-communicable diseases. As a result, the strategies implemented by global organizations could support current anti-drug campaigns adopted by local governments at the national level. Global organizations could also collaborate with community entities to develop community-centred strategies for reducing the prevalence of chronic and emotional health implications of drug and substance abuse. Such entities could include representatives from community agencies who would work together to specify goals for reducing the prevalence of drug abuse in each community. Since such community entities are more aware of the community dynamics, they could effectively empower community residents and present accurate information regarding other social determinants of health in the region to inform future strategies. Also, global organizations could incorporate health education content in the school curriculum among the affected communities to refine societal perceptions regarding drug abuse and prevent the progression of the current prevalence of chronic conditions to succeeding generations.

Global organizations should also collaborate with local governments to develop standards to be observed by all businesses that produce or sell goods and services within a community. While unhealthy commercial business activities cause adverse health implications to the communities within which they operate, many governments across the globe employ different strategies to discourage the consumption of harmful products by community members. However, local governments lack sufficient capacity to assess the processes involved in producing a certain product, particularly by multinational corporations, making it possible for harmful goods to enter the market. Global organizations should, therefore, collaborate with local governments to investigate the quality of goods availed to a community to manage the prevalence of chronic non-communicable diseases that result from the consumption of such products. Global organizations, such as the United Nations, could develop regulations to control the nature of ingredients used in manufacturing consumer goods. They could also initiate weight and measure regulations and collaborate with the local governments in updating their tax systems to ensure that all businesses pay taxes. Such a strategy could help local governments control unhealthy business practices and raise sufficient revenue to fund public health initiatives.

While there exists an association between a community’s cultural beliefs and the prevalence of chronic non-communicable diseases, global organizations should collaborate with religious organizations, educational institutions, and local governments to discourage unhealthy beliefs and practices among communities. In collaboration with governmental agencies, global health organisations could use community health education initiatives to engage local people in discussions about certain practices that increase their vulnerability to chronic non-communicable diseases and other health conditions. Providing an intensive comprehension of the association between cultural beliefs and health would help local communities make informed health choices to avoid contracting chronic conditions. The global organizations could collaborate with customary personnel, older people, religious leaders, and local health workers to inform the rest of the community regarding health risks associated with certain unhealthy cultural practices they engage in. Such a strategy could help avoid resistance to the presented health recommendations by community members. Moreover, global health organizations could provide recommendations to member countries regarding regulations that could help discourage unhealthy cultural practices and stipulate public health initiatives as proposed by sustainable health goals.

Conclusion

Sustainable development goals are instituted to promote the standards of life, encourage environmental sustainability, and ensure that all people across the globe enjoy peace and prosperity. They are, therefore, guided by the idea of “leaving no one behind” to encourage inclusivity and ensure that all communities benefit from the public health initiatives put in place. Despite the commitment of sustainable development goals to encourage inclusivity and fairness in access to healthcare services, some communities experience increased vulnerability to various chronic non-communicable diseases. Variability of the prevalence of such conditions among marginalized communities is associated with various risk factors, which include lack of access to affordable healthcare, unfavourable environmental conditions, and insufficient health literacy levels among communities. Such groups also experience genetic vulnerability to chronic conditions, which is intensified by other health needs such as emotional health deprivation and HIV/AIDS. Also, various commercial determinants of health increase the community’s susceptibility to chronic diseases. Some products availed by businesses to the market are capable of triggering chronic health conditions. Business organizations also expose their employees to adverse working conditions, which increase their vulnerability to chronic non-communicable health conditions.

Global organizations could respond to the prevailing inconsistencies in the prevalence of chronic diseases by developing policies to improve access to affordable healthcare among poor and marginalized communities. This could be achieved by encouraging state innovation, auto-enrollment, and reinsurance to increase the number of individuals with access to health insurance and stabilize premiums while reserving the existing patient protection structures. Global organizations could also respond to the challenges by developing strategies to address environmental pollution to protect people in local communities from chronic noncommunicable diseases that result from pollution and poor living conditions. They should also develop opportunities for learning through which community members improve their health literacy and develop life skills that are conducive to their health and community well-being. The World Health Organization and other global health organizations could also conduct mass media campaigns to change community norms regarding drug use and alter societal perceptions regarding how drugs can be used as a coping strategy against stress and depression. They should also collaborate with local governments to develop regulatory standards and laws that ensure that the products consumed by community members do not attract any health complications. Moreover, global organizations must collaborate with religious leaders, educators, public health specialists, and local administrative structures to discourage unhealthy cultural practices among local communities.

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