PHM-Exch> Global health Risks - Mortality and burden of disease attributable to selected major risks

[Claudio Schuftan]

From: Vern Weitzel <vern.weitzel at gmail.com>
crosposted from: "[health-vn discussion group]" <health-vn at anu.edu.au>

From:   Ruggiero, Mrs. Ana Lucia (WDC) <ruglucia at PAHO.ORG>
     EQUIDAD at LISTSERV.PAHO.ORG



*Global health Risks*

*Mortality and burden of disease attributable to selected major risks


*World Health Organization – December 2009*

*
*Available online PDF [70p.] at:
http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf



“…………The leading global risks for mortality in the world are high blood
pressure (responsible for 13% of deaths globally), tobacco use (9%),
high blood glucose (6%), physical inactivity (6%), and overweight and
obesity (5%). These risks are responsible for raising the risk of
chronic diseases such as heart disease, diabetes and cancers. They
affect countries across all income groups: high, middle and low.


The leading global risks for burden of disease as measured in
disability-adjusted life years (DALYs) are underweight (6% of global
DALYs) and unsafe sex (5%), followed by alcohol use (5%) and unsafe
water, sanitation and hygiene (4%). Three of these risks particularly
affect populations in low-income countries, especially in the regions of
South-East Asia and sub-Saharan Africa. The fourth risk – alcohol use –
shows a unique geographic and sex pat­tern, with its burden highest for
men in Africa, in middle-income countries in the Americas and in some
high-income countries.



This report uses a comprehensive framework for studying health risks
developed for The world health report 2002, which presented estimates
for the year 2000. The report provides an update for the year 2004 for
24 global risk factors. It uses updated information from WHO programmes
and scien­tific studies for both exposure data and the causal
associations of risk exposure to disease and injury outcomes. The burden
of disease attributable to risk factors is measured in terms of lost
years of healthy life using the metric of the disability-adjusted life
year. The DALY combines years of life lost due to premature death with
years of healthy life lost due to illness and disability.


Although there are many possible definitions of “health risk”, it is
defined in this report as “a factor that raises the probability of
adverse health outcomes”. The number of such factors is countless and
the report does not attempt to be comprehensive. For example, some
important risks associated with exposure to infectious disease agents or
with antimicrobial resistance are not included. The report focuses on
selected risk factors which have global spread, for which data are
available to estimate population exposures or distributions, and for
which the means to reduce them are known.



Five leading risk factors identified in this report (*/childhood
underweight, unsafe sex, alcohol use, unsafe water and sanitation, and
high blood pressure/*) are responsible for one quarter of all deaths in
the world, and one fifth of all DALYs. Reducing exposure to these risk
factors would increase global life expectancy by nearly 5 years.



Eight risk factors (*/alcohol use, tobacco use, high blood pressure,
high body mass index, high cholesterol, high blood glucose, low fruit
and vegetable intake, and physical inactivity)/* account for 61% of
cardiovascular deaths. Combined, these same risk factors account for
over three quarters of ischaemic heart disease: the leading cause of
death worldwide. Although these major risk factors are usually
asso­ciated with high-income countries, over 84% of the total global
burden of disease they cause occurs in low- and middle-income countries.
Reducing expo­sure to these eight risk factors would increase global
life expectancy by almost 5 years………….”
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