PHM-Exch> Massive shifts reshape the health landscape worldwide

[Claudio Schuftan]

From: Ruggiero, Mrs. Ana Lucia (WDC) <ruglucia at paho.org>
crossposted from : EQUIDAD at listserv.paho.org


** ** ** ** ** **

>From IHME - William Heisel, ****London******

*Massive shifts reshape the health landscape worldwide*

*Fewer people dying but more live with disability.
Mental health disorders, pain, and injuries hindering people’s health.
Obesity and high blood sugar replacing lack of food as leading risks. *

Data visualizations website: http://bit.ly/TfvD4u ****

GHDx - Global Health Data Exchange website: http://bit.ly/TYSuDQ ****

****LONDON****, December 2012 – Globally, health advances present most
people with a devastating irony: avoid premature death but live longer and
sicker.****

That’s one of the main findings from the Global Burden of Disease Study
2010 (GBD 2010), a collaborative project led by the
*Institute for Health Metrics and Evaluation (IHME) at the University of
Washington. *

The findings are being announced at the Royal Society in ****London**** on
Dec. 14 and published in *The Lancet <http://bit.ly/Zi2omM>,* the first
time the journal has dedicated an entire triple issue to one study. The
seven scientific papers and accompanying commentaries provide a new
platform for assessing the world’s biggest health challenges, and then
finding the best ways to address them.****

The study reveals massive shifts in health trends around the world since
1990, the starting point of the first Global Burden of Disease study. Since
that time, the world has grown considerably older. Where infectious disease
and childhood illnesses related to malnutrition were once the primary
causes of death, now children in many parts of the world – outside of
sub-Saharan Africa – are more likely to live into an unhealthy adulthood
and suffer from eating too much food rather than too little. Lastly, health
burden is increasingly defined by what’s making us sick rather than what’s
killing us. ****

The biggest contributor to the world’s health burden used to be premature
mortality – driven by more than 10 million deaths in children under the age
of 5 – but now the disease burden is caused mostly by chronic diseases and
injuries such as musculoskeletal disorders, mental health conditions, and
injuries. This burden intensifies as people live longer.****

Essentially, what ails you isn’t necessarily what kills you. While the
world has done a tremendous job battling fatal illnesses – especially from
infectious diseases – we are now living with more health problems that
cause a lot of pain, impair our mobility, and prevent us from seeing,
hearing, and thinking clearly.****



*Findings show rapid changes in health outcomes
* ****

The study underscores significant achievements, such as the dramatic drop
in child mortality, which has fallen so quickly that it has beaten every
published prediction. But more work remains. Diseases such as diarrhea due
to rotavirus and measles continue to kill more than 1 million children
under the age of 5 every year, despite effective vaccines against those
diseases.
 ****

While child mortality has decreased, GBD 2010 found a startling 44%
increase in the number of deaths among adults aged 15 to 49 between 1970
and 2010. This is in part because of increases in violence and the ongoing
challenge of HIV/AIDS, which kills 1.5 million people annually.
 ****

Another mixed success is that while the burden of malnutrition has
successfully been cut by two-thirds, poor diets and physical inactivity are
contributing to rising rates of obesity and other lifestyle-related risk
factors, including high blood pressure, tobacco smoking, and harmful
alcohol use. Dietary risk factors and physical inactivity collectively
caused 10% of the disease burden, and the burden due to excess weight and
high blood sugar are rising substantially.
 ****


Disability is causing a greater and greater fraction of the burden of
disease as demographics and epidemiology evolve. Much of this burden is
caused by a relatively small group of ailments. Researchers examined more
than 300 diseases, injuries, and risk factors and found that just 50
distinct causes account for 78% of the global burden. Just 18 of those
account for more than half the burden.


The types of illnesses and injuries causing death and disability are also
changing. While ischemic heart disease and stroke remained the two greatest
causes of death between 1990 and 2010, all the other rankings in the top 10
causes changed. Diseases such as diabetes, lung cancer, and chronic
obstructive pulmonary disease moved up, and diarrhea, lower respiratory
infections, and tuberculosis moved down.****

Falling out of the 10 leading causes between 1990 and 2010
wereprotein-energy malnutrition, the leading cause of starvation. They
were
replaced by lower back pain and road injuries.

*Gap between sub-Saharan Africa and the rest of the world widens*

 ****

The trends identified in GBD 2010 occur across regions with one notable
exception: sub-Saharan **Africa**, where infectious diseases, childhood
illnesses, and maternal causes of death account for as much as 70% of the
burden of disease. By comparison, these conditions account for only
one-third of the burden in South Asia and **Oceania**, and less than 20% in
all other regions. Additionally, while the average age of death throughout
Latin America, Asia, and North Africa increased by more than 25 years
between 1970 and 2010, it rose by less than 10 years in most of sub-Saharan
**Africa**.****

 ****

The data do show modest progress in lowering child mortality, but
communicable and nutritional causes still account for half of premature
deaths in Africa. Nearly as troubling is the rising burden of chronic
illness, such as stroke and heart disease.

 ****

 What have been historically considered “Western ailments” also menace
millions in **Africa**, including the very young. Pain, anxiety, and
depression – which erode quality of life and productivity – are ranked
among the highest causes of years lived with disability throughout
sub-Saharan **Africa**.****

 ****

“African nations have not even begun to confront the consequences of
exploding cases of mental illness, depression, pain, and the enormous
burden of substance abuse that stem from those conditions,”
 ****

*New evidence creates a platform for research and strategic policymaking
 *

GBD 2010 provides the evidence for a range of new research projects and
targeted policy making. It also opens the opportunity for countries to
conduct detailed burden studies of their own populations.****

 ****


The findings from the first GBD study also brought malaria back to the
world stage after years of neglect, spurring the rise in policy attention
that has lowered deaths. Depression had not been framed as a public health
problem until the 1990s when the original GBD study showed its significant
burden.
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