Massive Shifts in the World Health Landscape -- MEDICA - World Forum for Medicine

Massive Shifts in the World Health Landscape

Photo: World Health

The GBD 2010 reveals shifts in health trends
around the world since 1990;
© zerla

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 is making us sick rather than what is 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.

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.

"We are finding that very few people are walking around with perfect health and that, as people age, they accumulate health conditions," said Doctor Christopher Murray, Director of the Institute for Health Metrics and Evaluation at the University of Washington. "At an individual level, this means we should recalibrate what life will be like for us in our 70s and 80s. It also has profound implications for health systems as they set priorities."

The scientists set out to completely overhaul the Global Burden of Disease process first created in the early 1990s by Doctors Murray and Alan Lopez, Head of the School of Population Health at the University of Queensland.

Researchers gathered more data than had ever been amassed for a health study. Using vital registration systems, surveys, censuses, and a meta-analysis of all available randomized controlled trials, they set up a database covering everything from AIDS to zinc deficiency. They created a set of criteria to decide which data should be included in the final analysis and which should not. If a study was not rigorous or was too specific to one place and one time to be broadly applicable, it was excluded. New analytical tools were developed to fill gaps in the data for countries where information is sparse.

"While the GBD Study 2010 offers significant epidemiologic findings that will shape policy debates worldwide, it also limns the gaps in existing disease epidemiology knowledge and offers new ways to improve public health data collection and assessment," said Doctor Paul Farmer, Chair of the Department of Global Health and Social Medicine at Harvard Medical School. "Murray and his colleagues draw not only on their own research, which is well known and has been cited extensively over the past two decades, but also on the work of philosophers, ethicists, economists, and others whose perspectives are too often neglected in epidemiology. A broad audience — from public health authorities to funders and policymakers — will benefit from this impressive contribution to the epidemiologic evidence base."; Source: Institute for Health Metrics and Evaluation