By Dr Tahir Aris

1. Conference on Non-Communicable
Diseases (NCDs)
26-27 March 2013
NCDs in Malaysia – A Rising Trend
National Health and Morbidity Survey
2011
Tahir A1 & Noor Ani A1
1Institute for Public Health, Ministry of Health Malaysia
NATIONAL HEALTH AND MORBIDITY
SURVEY 2011
(NHMS 4)

2. NHMS 2011 Methodology
 Target Population:
 cover the residence in the non institutional living quarters
(LQ)
 Sampling Frame:
 used the National Household Sampling Frame made up of
Enumeration Blocks (EBs) derived from the Population
and Housing Census, Malaysia (2010)
 Sampling Design:
 Multistage Random Sampling (28 strata)
 Stage 1: PSU (EB): 794
 Stage 2: SSU (LQ): 9528
 All individual in LQ were selected
Field Achievement
 Sample size: based on core topics (Health Care
Demands) for analysis up to State (urban/rural): 9,528 LQ
 Minimum sample size: 680 respondents/strata
(DE=2.5, prev: 23%)
• Success rate (LQ): 88.2%
• Average indiv/LQ: 4.1

3. 1500000 1000000 500000 0 500000 1000000 1500000
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75+
Female
Estimated NHMS 2011 Census 2010
Male
Population Pyramid : Comparison Estimated NHMS
2011 & Malaysian Population (Census 2010)
FINDINGS:
1. DIABETES MELLITUS
2. HYPERTENSION
3. HYPERCHOLESTEROLEMIA
4. OVERWEIGHT AND OBESITY
5. VEGETABLES AND FRUIT INTAKE
15/4/2013 6

4. DIABETES MELLITUS
NON-COMMUNICABLE DISEASES
DEFINITION
• Total diabetes:
Number of subjects with known diabetes plus subjects with Undiagnosed Diabetes
• Known Diabetes Mellitus: self reported by subject with confirm diagnosed by
medical personnel.
• Undiagnosed Diabetes: Fasting capillary blood glucose  6.1 mmol /L or Random
Blood Glucose  11.2 mmol /L (tested using validated tool: Cardio Check®), among
people previously not known to have diabetes.
• Impaired Fasting Glucose: Fasting capillary blood glucose 5.6 to < 6.1 mmol/L
(tested using validated tool: Cardio Check®), among people previously not known
to have diabetes.

5. PREVALENCE OF DIABETES, ≥ 18 YEARS, NHMS III (2006)
AND NHMS 2011
11.6
15.2
7 7.2
4.5
8
4.2
4.9
0
2
4
6
8
10
12
14
16
2006 2011
PREVALENCE(%)
DIABETES
KNOWN DM
UNDIAGNOSED DIABETES
IMPAIRED FBS
PREVALENCE OF DIABETES, ≥ 30 YEARS, NHMS II
(1996) NHMS III (2006) AND NHMS 2011
8.3
14.9
20.8
6.5
9.5
10.7
1.8
5.4
10.1
4.3 4.7
5.3
0
5
10
15
20
25
1996 2006 2011
PREVALENCE(%)
DIABETES
KNOWN DM
UNDIAGNOSED DIABETES
IMPAIRED FBS

6. PREVALENCE OF DIABETES BY STATE, ≥ 18 YEARS, NHMS
2011
13.4
22.5
19.7
17.1
22
16.7
15
16.2
24.8
16.5
11.6
9
12.3 11.3
8.8
15.2
0
5
10
15
20
25
30
35
PREVALENCE(%)
PREVALENCE OF DIABETES BY STRATA, ≥ 18 YEARS,
NHMS 2011
15.1
15.6
7.3
7
7.8
8.5
5.1
4.3
0 2 4 6 8 10 12 14 16 18
Urban
Rural
PREVALENCE (%)
IMPAIRED FBS
UNDIAGNOSED DIABETES
KNOWN DM
DIABETES

7. PREVALENCE OF DIABETES BY AGE GROUP,
≥ 18 YEARS, NHMS 2011
2.1
4.9 5.3
9.4
10.9
17.6
20.6
26.7
31.6
36.2
36.6
30.3
31.9
0
0.8 0.8
2.6
3.4
7.6
9.1
15.1
17.9
23.1
25.5
20.3
19.4
2.1
4.1
4.5
6.8 7.5
10
11.4
11.6
13.7
13.1
11
10.1
12.5
4.1
3.5 4.4
5.2
5.5
4.6
6.2
6.1 5.1
4.3
5.7
4.7
5.1
0
5
10
15
20
25
30
35
40
18-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+
PREVALENCE(%)
DIABETES
KNOWN DM
UNDIAGNOSED DIABETES
IMPAIRED FBS
PREVALENCE OF DIABETES BY SEX, ≥ 18
YEARS, NHMS 2011
15.8
14.6
7
7.5
8.8
7.1
5.1
4.7
0 2 4 6 8 10 12 14 16 18
Male
Female
PREVALENCE (%)
IMPAIRED FBS
UNDIAGNOSED DIABETES
KNOWN DM
DIABETES

8. PREVALENCE OF DIABETES BY ETHNICITY, ≥ 18 YEARS,
NHMS 2011
17
13.9
24.9
9.3
7
7.9
7
14.4
3.2
1.6
9
6.8
10.5
6.1
5.4
5.7
4.3
4.9
3.9
2.6
0 5 10 15 20 25 30
Malay
Chinese
Indians
Other Bumis
Others
PREVALENCE (%)
IMPAIRED FBS
UNDIAGNOSED DIABETES
KNOWN DM
DIABETES
PREVALENCE OF DIABETES BY ETHNICITY, ≥ 18 YEARS,
NHMS 2011
17
13.9
24.9
9.3
7
0
5
10
15
20
25
30
Malays Chinese indians Other Bumiputeras Others
PREVALENCE(%)

9. Burden of Diabetes in Malaysia: Trends & Projections
by 2020 (Adults age 18 years and above)
HYPERTENSION
NON-COMMUNICABLE DISEASES

10. DEFINITION
• Hypertension
Respondents recording diastolic blood pressure (DBP) of ≥ 90
mm Hg and/or systolic blood pressure of ≥ 140 mm Hg
• Known hypertension
self reported by subject with confirmed diagnosis by medical
personnel
• Undiagnosed hypertension
average BP reading of SBP ≥140 mm Hg and / or DBP ≥ 90 mm
Hg (using validated tool: Omron HEM 907) among
respondents previously not known to be hypertensive
• Total hypertension
Known + undiagnosed hypertension
32.2
32.7
0
5
10
15
20
25
30
35
2006 2011
PREVALENCE(%)
PREVALENCE OF HYPERTENSION, ≥18 YEARS,
NHMS III (2006), NHMS 2011

11. 32.7
12.8
19.8
0
5
10
15
20
25
30
35
40
Overall Known Hpt Undiagnosed Hpt
PREVALENCE(%)PREVALENCE OF HYPERTENSION, KNOWN HYPERTENSION
AND UNDIAGNOSED HYPERTENSION, ≥18 YEARS, NHMS
2011
36.4
38.2
27.9
32.8
34.1
29.9
28.4
42.9
41.1
28.7
26.8
29.1
40.5
27.1
22.5
32.7
0
5
10
15
20
25
30
35
40
45
50
PREVALENCE(%)
PREVALENCE OF HYPERTENSION BY STATE ≥ 18 YEARS,
NHMS 2011

12. 18.8
22.7
12.2
14.7
30.9
37.4
0 5 10 15 20 25 30 35 40
Urban
Rural
PREVALENCE OF HYPERTENSION, KNOWN HPT AND
UNDIAGNOSED HPT BY STRATA, ≥ 18 YEARS, NHMS
2011
Hypertension
Known hpt
Undiagnosed hpt
PREVALENCE (%)
30.99
37.48
0
5
10
15
20
25
30
35
40
45
Urban Rural
STRATA
PREVALENCE HYPERTENSION BY STRATA, ≥18 YEARS, NHMS 2011

13. 8.1
11.8
14.3
22.2
27.2
35.8
44
51.6
61
68.7
74.1
72.8
73.4
1
2 3
4.2
7.4
11.6
17.3
24.6
30
37.9
39.5 40.8 42
7.1 9.9
11.3
17.9
19.8
24.2
26.7
27
31
30.7
34.7
32 31.3
0
10
20
30
40
50
60
70
80
18-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+
PREVALENCE(%) PREVALENCE OF HYPERTENSION, KNOWN HPT AND
UNDIAGNOSED HPT BY AGE GROUP, NHMS 2011
Hypertension 2011
Known Hpt 2011
Newly Hpt 2011
21.8
17.8
11.9
13.8
33.7
31.6
0 5 10 15 20 25 30 35 40
Male
Female
PREVALENCE OF HYPERTENSION, KNOWN HPT,
UNDIAGNOSED HPT BY SEX, ≥ 18 YEARS, NHMS 2011
Hypertension
Known Hpt
Undiagnosed hpt
PREVALENCE (%)

14. 21.8
17.8
0.0
5.0
10.0
15.0
20.0
25.0
Male Female
PREVALENCE UNDIAGNOSED HYPERTENSION BY SEX,
≥18 YEARS, NHMS 2011
20.6
18.3
17.9
23.6
16
13.4
14
12.7
12.9
4.8
34
32.3
30.6
36.4
20.9
0 5 10 15 20 25 30 35 40
Malays
Chinese
Indians
Other Bumiputras
Others
PREVALENCE (%)
Hypertension
Known Hpt
Undiagnosed Hpt
PREVALENCE (%)
PREVALENCE OF HYPERTENSION, KNOWN HPT, UNDIAGNOSED
HPT BY ETHNICITY, ≥ 18 YEARS, NHMS 2011

15. Burden of Hypertension in Malaysia: Trends &
Projections by 2020 (Adults age 18 years and above)
HYPERCHOLESTROLEMIA
NON-COMMUNICABLE DISEASES

16. DEFINITION
A respondent is said to have desirable total cholesterol when level is below
5.2 mmol/L, and high total cholesterol when total cholesterol level equals and
above 5.2 mmol/L (ATP III, 2001).
• Known hypercholesterolemia:
Self-reported by respondents with confirmed diagnosis by a Doctor or Medical
personnel.
• Undiagnosed hypercholesterolemia:
total cholesterol level equals and above 5.2 mmol/L among respondents previously
not known to have hypercholesterolemia.
• Total hypercholesterolemia:
Respondents with known hypercholesterolemia plus newly diagnosed
hypercholesterolemia.
PREVALANCE OF HYPERCHOLESTROLEMIA ≥ 18
YEARS, NHMS III (2006) AND NHMS 2011
20.7
35.1
0
5
10
15
20
25
30
35
40
2006 2011
PREVALENCE(%)

17. 35.1
8.4
26.6
0
5
10
15
20
25
30
35
40
Overall Known Hyperchol Undiagnosed Hyperchol
PREVALENCE(%)
PREVALENCE OF HYPERCHOLESTROLEMIA, KNOWN
HYPERCHOLESTROLEMIA AND UNDIAGNOSED
HYPERCHOLESTROLEMIA , ≥18 YEARS, NHMS 2011
PREVALENCE OF HYPERCHOLESTROLEMIA BY STATE, ≥ 18
YEARS, NHMS 2011
37.7
43.4
33.8
35.9
39.7
31.7 32.7
45 45.1
31.9
34.9
31.1
33.5
29.4
33.3
35.1
0
10
20
30
40
50
60
PREVALENCE(%)

18. PREVALENCE OF HYPERCHOLESTROLEMIA, KNOWN AND
UNDIAGNOSED BY STRATA, ≥ 18 YEARS, NHMS 2011
25.3
30.4
9.1
6.6
34.3
37
0 5 10 15 20 25 30 35 40
Urban
Rural
PREVALENCE (%)
Hypercholestrolemia
Known
Hypercholestrolemia
Undiagnosed
Hypercholestrolemia
PREVALENCE OF HYPERCHOLESTROLEMIA, KNOWN AND
UNDIAGNOSED BY AGE GROUP, ≥ 18 YEARS, NHMS 2011
0.6 1.3 2.5 3.9 5.4
8.7
13.6 15.6
18.7
23.8 22.6 22
17.710.7
16.1
19.9
26.5 29.2
31.9
33.1
35.9 37.3 31.9 34.6 32 36.5
11.3
17.4
22.4
30.4
34.6
40.5
46.7
51.4
55.9 55.7 57.2
53.9
54.2
0
20
40
60
80
100
120
140
18-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+
Hypercholestrolemia
Undiagnosed
Hypercholestrolemia
Known
Hypercholestrolemia
PREVALENCE(%)

19. PREVALENCE OF HYPERCHOLESTROLEMIA, KNOWN AND
UNDIAGNOSED BY SEX, ≥18 YEARS, NHMS 2011
21.5
32
8.6
8.2
30.1
40.2
0 5 10 15 20 25 30 35 40 45
Male
Female
Hypercholestrolemia
Known
Hypercholestrolemia
Undiagnosed
Hypercholestrolemia
PREVALENCE (%)
PREVALENCE OF HYPERCHOLESTROLEMIA BY SEX, ≥18
YEARS, NHMS 2011
30.1
40.2
0
5
10
15
20
25
30
35
40
45
Male Female
PREVALENCE (%)

20. PREVALENCE OF HYPERCHOLESTROLEMIA KNOWN AND
UNDIAGNOSED, BY ETHNICITY, ≥ 18 YEARS, NHMS 2011
PREVALENCE (%)
30.3
22.2
24.1
23.9
23.6
8
11.2
11.3
5.9
1.6
38.4
33.4
35.5
29.8
25.2
0 5 10 15 20 25 30 35 40 45
Malays
Chinese
Indians
Other
Bumiputras
Others
Hypercholestrolemia
Known
Hypercholestrolemia
Undiagnosed
Hypercholestrolemia
33.25
26.17 26.4
25.68
27.07
15
20
25
30
35
40
Malay Chinese Indian Other Bumiputra Others
Prevalence
PREVALENCE UNDIAGNOSED HYPERCHOLESTROLEMIA BY ETHNICITY,
NHMS 2011

21. Burden of Hypercholesterolaemia in Malaysia: Trends
& Projections by 2020 (Adults age 18 years and above)
NUTRITIONAL STATUS
NON-COMMUNICABLE DISEASES

22. DEFINITION
BMI STATUS (CPG 2004)
• Underweight ≤ 18.5
• Normal = 18.5 – 22.9
• Pre-obese = 23.0 – 27.4
• Obese ≥ 27.5
BMI STATUS (WHO 1998)
• Underweight ≤ 18.5
• Normal = 18.5 – 24.9
• Overweight = 25.0 – 29.9
• Obese ≥ 30
• Abdominal obesity (aged > 18
years old) =
- Men ≥ 108
- Women ≥ 80
8.3
31.1
27.2
33.3
8.3
47.2
15.1
29.4
0.0
10.0
20.0
30.0
40.0
50.0
60.0
CPG
2004
WHO
1998
PREVALENCE(%)
NATIONAL PREVALENCE OF NUTRITIONAL
STATUS ≥ 18 YEARS, NHMS 2011
UNDERWEIGHT
NORMAL
OBESITY
PRE-OBESE /
OVERWEIGHT

23. 25.2
8.5 8.3
48.4 47.2
16.6
29.1 29.4
4.4
14 15.1
0
10
20
30
40
50
60
NHMS (1996) NHMS (2006) NHMS (2011)
PREVALENCE(%) NATIONAL PREVALENCE OF NUTRITIONAL
STATUS (WHO, 1998), NHMS II (1996), NHMS
III (2006), NHMS 2011
UNDERWEIGHT
NORMAL
OVERWEIGHT
OBESITY
26.3
33.5
27.2
33.3
0 5 10 15 20 25 30 35 40
OBESITY
OVERWEIGHT
PREVALENCE (%)
PREVALENCE OF NUTRITIONAL STATUS,
≥ 18 YEARS, NHMS III (2006) AND NHMS 2011
(CPG2004)
NHMS 2011
NHMS 2006

24. PREVALENCE OF PRE-OBESE BY STATES,
≥ 18 YEARS, NHMS 2011 (CPG 2004)
33
34.0
35.2
33.7
31.3 32.2
36.3
31.4
29.1
32.3 32.7
34.5
32.4
36.9 36.3
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
PREVALENCE(%)
PREVALENCE OF OBESITY BY STATES,
≥ 18 YEARS, NHMS 2011 (CPG 2004)
29 28.2
29.4 29.3
28.2 28.2
26.9
30.1
34.6
28.2 28.1
21.1
26.7
22.8
27.4
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
PREVALENCE(%)

25. 33.7
32.4
27.3
26.3
0 5 10 15 20 25 30 35 40
Urban
Rural
PREVALENCE (%)
PREVALENCE OF PRE-OBESE/OBESITY BY
STRATA, ≥ 18 YEARS NHMS 2011
OBESITY
PRE-OBESE
16.1
18.5
24.2
28.1
31.1 31.6
35.1
32.6
34.4
30.7
27.7
17.8 16.8
15.7
24.5
26.1
35.4 35.7
41.0
38.6
40.3 39.4 40.2 41.0 40.1
36.9
0
5
10
15
20
25
30
35
40
45
18-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79
PREVALENCE(%)
PREVALENCE OF PRE-OBESE/OBESITY BY AGE
GROUP ≥ 18 YEARS, NHMS 2011
OBESITY
PRE-OBESE

26. 35.80
30.70
24.96
29.61
0.00 5.00 10.00 15.00 20.00 25.00 30.00 35.00 40.00
MALE
FEMALE
PREVALENCE (%)
OBESITY
PRE-OBESE
PREVALENCE OF PRE-OBESE/OBESITY BY SEX
≥ 18 YEARS, NHMS 2011
33.4
35.8
29.8
33.5
28
32
19.7
35.7
25.2
13.8
0 5 10 15 20 25 30 35 40
Malay
Chinese
Indians
Other Bumis
Others
PREVALENCE %
PREVALENCE OF PRE-OBESE/OBESITY BY
ETHNICITY, ≥ 18 YEARS NHMS 2011
OBESITY
PRE-OBESE

27. OBESITY AMONG POPULATION < 18
YEARS
DEFINITION
• Obesity among children is defined as BMI for
age ≥+2SD.

28. PREVALENCE OF OBESITY AMONG CHILDREN
<18 YEARS BY STATES, NHMS 2011
5.5 5.8
6.4
4.7 5
7.2
3.4
9 8.8
7.3
5.5
3.2
8
6.3
7.4
6.1
0
2
4
6
8
10
12
14
PREVALENCE(%)
6.5
5.5
5 5.2 5.4 5.6 5.8 6 6.2 6.4 6.6
Urban
Rural
PREVALENCE %
PREVALENCE OF OBESITY AMONG
CHILDREN < 18 YEARS, BY STRATA ,
NHMS 2011

29. 6.5 6.7
6.3
4.9
0
1
2
3
4
5
6
7
8
0-4 5-9 10-14 15-17
PREVALENCE(%)
PREVALENCE OF OBESITY AMONG CHILDREN
< 18 YEARS BY AGE GROUP, NHMS 2011
7.6
4.6
0
1
2
3
4
5
6
7
8
9
10
Male Female
PREVALENCE(%)
PREVALENCE OF OBESITY AMONG CHILDREN
< 18 YEARS BY SEX, NHMS 2011

30. INTAKE OF FRUITS/VEGETABLES
NON-COMMUNICABLE DISEASES
DEFINITION
• Inadequate intake: Intake of less than 5
servings of fruits and/or vegetables per day
(based on WHO definition for the prevention
of chronic diseases)

31. 92.9
94.8
90.1
95.7 93.6
90.9 92.3 93 95.6
89.8 92 95.1 94.7
90.7 94.2
0
20
40
60
80
100
120
Johor
Kedah
Kelantan
Melaka
NegeriSembilan
Pahang
Penang
Perak
Perlis
Selangor
Terengganu
Sabah&WPLabuan
Sarawak
WPKualaLumpur
WPPutrajaya
PREVALENCE%
PREVALENCE OF VEGE/FRUIT INTAKE <5
SERVINGS BY STATE, ≥ 18 YEARS, NHMS 2011
92.5
92.1
94.2
0 20 40 60 80 100
MALAYSIA
Urban
Rural
PREVALENCE (%)
PREVALENCE OF VEGE/FRUIT INTAKE <5
SERVINGS AMONG ADULTS, ≥ 18 YEARS,
NATIONAL AND BY STRATA, NHMS 2011

32. 97.4 95 94.4 91.8 90.6 90.6 91.7 90.4 89 90.1 89.7
93.6 96.2
0
20
40
60
80
100
120
18-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79
PREVALENCE% PREVALENCE OF VEGE/FRUIT INTAKE <5
SERVINGS BY AGE GROUP, ≥ 18 YEARS, NHMS
2011
92.8
92.1
0 10 20 30 40 50 60 70 80 90 100
Male
Female
PREVALENCE %
PREVALENCE OF VEGE/FRUIT INTAKE
<5 SERVINGS BY SEX, ≥ 18 YEARS, NHMS 2011

33. 92.4
90.9
94.8
94.8
92.6
0 10 20 30 40 50 60 70 80 90 100
Malays
Chinese
Indians
Other
Bumis
Others
PREVALENCE %
PREVALENCE OF VEGE/FRUIT INTAKE <5
SERVINGS BY ETHNICITY, ≥ 18 YEARS, NHMS
2011
PHYSICAL ACTIVITY
NON-COMMUNICABLE DISEASES

34. ‘Active’ Physical Activity
Combination of walking, moderate-
intensity or vigorous-intensity activities
achieving a minimum of at least 600
MET-minutes/week.
• IPAQ Short Form ( revised Nov 2005)
DEFINITION
TREND OF ‘ACTIVE’ PHYSICAL ACTIVITY, NHMS III (2006) AND
NHMS 2011
56.3
64.8
0
10
20
30
40
50
60
70
NHMS 2006 NHMS 2011
PREVALENCE(%)

35. PREVALENCE OF ‘ACTIVE’ PHYSICAL ACTIVITY BY STATE,
NHMS 2011
PREVALENCE OF ‘ACTIVE’ PHYSICAL ACTIVITY BY STRATA,
NHMS 2011.

36. PREVALENCE OF ‘ACTIVE’ PHYSICAL ACTIVITY, BY AGE
GROUP, NHMS 2011
PREVALENCE OF ‘ACTIVE’ PHYSICAL ACTIVITY BY SEX, NHMS
2011

37. PREVALENCE OF ‘ACTIVE’ PHYSICAL ACTIVITY, BY ETHNICITY,
NHMS 2011
NON-COMMUNICABLE DISEASES
ALCOHOL

38. DEFINITION
• Alcoholic beverages in this context encompassed any drink
containing ethanol irrespective of its concentration and,
inclusive of those consumed for medical purposes such as
alcoholic tonic
• Non drinker is a respondent who never consume alcoholic
beverages in their life time
• Ever drinker is a respondent who had history of consuming
alcoholic beverages at least once in their life time
• Current drinker is a respondent who still consuming alcoholic
beverages for the past 12 months
• Ex-drinker is a respondent who had stopped drinking
alcoholic beverages for the past 12 months
DEFINITION
• Binge drinking is consumption of ≥ 6 standard drink per-sitting
• Heavy episodic drinking is consumption of ≥ 6 standard drink per-
sitting at least once occasion weekly.
• Low risk drinker is a respondent who consumed alcohol according
to low risk guideline and is generally indicated when the AUDIT
score is between 0 – 7.
• Risky drinker is a respondent who consumed alcohol in excess of
low risk guideline and is generally indicated when the AUDIT score
is between 8 – 19.
• Probable Alcohol Dependence is a respondent who consumed
alcohol beyond the low risk guideline and is generally indicated
when the AUDIT score is 20 or above
Validated tool: Alcohol Use Disorder Identification Test (AUDIT)

39. PREVALENCE OF CURRENT DRINKER, ≥ 13 YEARS,
NHMS III (2006) AND NHMS 2011
11.1
11.6
0
2
4
6
8
10
12
2006 2011
PREVALENCE(%)
YEAR
PREVALENCE OF CURRENT DRINKER, BINGE DRINKER
AND HEAVY EPISODIC BY STRATA, ≥ 13 YEARS, NHMS 2011
12.6
6.1
1.1
8.9
4.7
0.8
0
2
4
6
8
10
12
14
16
Urban Rural
PREVALENCE(%)
binge drinker
current drinker
heavy episodic
drinker

40. PREVALENCE OF CURRENT DRINKER, BINGE DRINKER AND
HEAVY EPISODIC DRINKER BY AGE GROUP, ≥ 13 YEARS,
NHMS 2011
1.6
6.9
15.7
13.7
14.7 14.3
13.9
12.4
11
9.7 9.8
8.4
5.4
4.9
0.6
3.5
8.3
7
8.3
6.3 6.4 6.7
5
4 4.1
3.7
1.7 1.5
0.3
0.7 1.4
0.9
1.3 1 1.3 1.2 1.5 0.8 1.6
0.5 0.1
0.9
0
2
4
6
8
10
12
14
16
18
10-14
years
15-19
years
20-24
years
25-29
years
30-34
years
35-39
years
40-44
years
45-49
years
50-54
years
55-59
years
60-64
years
65-69
years
70-74
years
75+
years
Current drinker
Binge drinker
Heavy episodic
drinker
PREVALENCE(%)
PREVALENCE OF CURRENT DRINKER, BINGE DRINKER
AND HEAVY EPISODIC BY SEX, ≥ 13 YEARS, NHMS 2011
17.2
9.1
1.9
5.7
2.2
0.20
2
4
6
8
10
12
14
16
18
20
Male Female
PREVALENCE(%)
binge drinker
current drinker
heavy episodic
drinker

41. PREVALENCE OF CURRENT DRINKER, BINGE DRINKER AND
HEAVY EPISODIC DRINKER BY ETHNICITY, ≥ 13 YEARS, NHMS
2011
0.9 0.5
0.1
27.5
12.1
2.4
18.8
8.3
1.1
20.3
12.8
2.2
11.3
6.7
0.90
5
10
15
20
25
30
35
Malay Chinese Indian Other
Bumiputeras
Others
PREVALENCE(%)
Current drinker
Binge drinker
Heavy episodic
drinker
PATTERN OF DRINKING BY RISK, ≥ 13 YEARS, NHMS 2011
35.6
49.2
14.0
1.20
10
20
30
40
50
60
Abstinence Low-risk Risky Probable dependence
PREVALENCE(%)

42. COMPARISON OF ‘DRINKING RISKS’ GLOBAL VS NHMS 2011
Babor & Higgins-Biddle, WHO, 2001
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Global NHMS 2011
40 36
35 49
20
14
5
1
Ex drinker
Low (score : 0 - 7)
Risky (score : 8 - 19)
P. Dependence

43. Conclusion
• Inter-sectoral collaboration with community
participation is an important strategy to curb
the NCD problems. Preventing the primary
risk factors of NCDs, namely tobacco use, poor
diets, harmful use of alcohol and physical
inactivity, is a top priority to reverse the rising
trends in NCDs.
Conclusion

44. “Research is not a luxury, but an essential
tool to facilitate & improve managerial
decision-making”
WHO Technical Series No. 819
It’s Not What You Know,
But What You Do With What You
Know