Massive new study says bad diet, lack of exercise, smoking take their
toll
Although people are living
longer, they are more likely to be sicker as bad diet, lack of exercise,
smoking and other health risks take their toll, according to a massive new
study conducted by the Institute for Health Metrics and Evaluation at the
University of Washington to quantify rends in the world’s health problems.
The report, the Global Burden of
Disease Study, was to be formally released today at the Royal Society in London
and published in The Lancet, which has dedicated an entire triple issue to the
study, conducted by 486 authors from 50 countries, including 26 low- and
middle-income countries.
The global health landscape has
witnessed massive shifts during the 20 years from 1990 to 2010, with fewer
people dying but more with disabilities. Infectious disease and childhood
illnesses related to malnutrition were once the primary causes of death. But
obesity and high blood sugar are replacing lack of food as leading risks.
Children in most parts of the world are more likely to suffer ill health from
eating too much rather than too little, according to the study.
While scientists have done a
tremendous job battling fatal illnesses, more health problems are now caused by
chronic diseases and injuries such as musculoskeletal disorders and mental
health conditions that impair physical and mental wellbeing.
“We’re finding that very few
people are walking around with perfect health and that, as people age, they
accumulate health conditions,” said Dr Christopher Murray, Director of the
Institute for Health Metrics and Evaluation and one of the founders of the
Global Burden of Disease study. “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.”
Some findings:
(i) While child mortality
decreased dramatically by 41 percent (although, despite effective vaccines,
diarrhea and measles continue to kill more than 1 million children below 5
every year), there was a startling 44 percent increase in the number of deaths
among adults aged 15 to 49 between 1970 and 2010. India has recorded a 61.5
percent reduction in child mortality since 1970. Yet it ranks only above
Pakistan (20.3 percent) and Afghanistan (44 percent) amongst all the 8 SAARC
nations (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri
Lanka). However, what is really disconcerting is that India registered a
substantial increase of 35.6 percent in adult mortality, with 2.11 million
young Indian adults in the age group 15-49 years dying before their 50th
birthday in 2010, as compared to 1.56 million in 1970.
This is troubling indeed, and as
much a cause of concern as the significant number of children who die every
year. India also ranked a poor 136th of 187 countries in terms of female life
expectancy (67.5 years) while Japan ranked first at 85.9 years. Among the 30
high-income countries, Republic of Korea recorded the maximum increase of 6.5
years in female life expectancy bringing it to 82.7 years.
(ii) The burden of malnutrition
has been reduced by two-thirds, but dietary risk factors and physical
inactivity together caused 10 percent of the disease burden. Poor diets and
physical inactivity are contributing to rising rates of obesity and other
lifestyle-related risk factors, including high blood pressure, smoking, and
harmful alcohol use.
(iii) The types of illnesses
causing death and disability are changing. While ischemic heart disease and
stroke remained the top two in the list of 10 leading causes of death during
1990-2010, diarrhea, lower respiratory infections, and tuberculosis moved down,
while diabetes, lung cancer and chronic obstructive pulmonary disease moved up
their earlier rankings. Neonatal encephalopathy, an often fatal brain condition
in newborns, and protein-energy malnutrition, the leading cause of starvation,
fell out of the list and were replaced by lower back pain and road injuries.
“We have gone from a world 20
years ago where people weren’t getting enough to eat to a world now where too
much food and unhealthy food – even in developing countries – is making us
sick,” said Dr Majid Ezzati, Chair in Global Environmental Health at Imperial
College London and one of the study’s lead authors.
(iv) Much of the disease burden
is caused by a relatively small group of ailments. After examining more than
300 diseases, injuries and risk factors, researchers found that just 50
distinct causes account for 78 percent of the global burden of disease and a
mere 18 account for more than half the burden.
“If we only could crack the code
on just this small group of illnesses, we could make enormous progress in
improving health,” said Dr Kenji Shibuya, Chair of the Department of Global
Health Policy at the University of Tokyo and one of GBD 2010’s lead authors.
(v) The trends identified in GBD
2010 occur across the world, with the notable exception of sub-Saharan Africa,
where infectious diseases, childhood illnesses, and maternal causes of death
account for as much as 70 percent of the burden of disease—as against only 33
percent of the burden in South Asia and Oceania, and less than 20 percent in
all other regions.
Also, 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.
According to Dr George Mensah,
Visiting Professor at the University of Cape Town and a co-author of GBD 2010,
“Sub-Saharan Africa continues to present a special challenge for a variety of
methodological, geographic, and economic reasons. 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.”
The seven scientific papers and
accompanying commentaries of GBD 2010 provide the evidence for a range of new
research projects and targeted policymaking with a view to find the best ways
to address the world’s biggest health challenges.
“At a time when world economies
are struggling, it is crucial for health systems and global health funders to
know where best to allocate resources,” said Dr Paul Ramsey, Chief Executive
Officer of UW Medicine and Dean of the University Of Washington School Of
Medicine. “I see GBD 2010 as much more than the health data it provides, which
itself is of enormous value. I see it as a management tool for ministers of
health and leaders of health systems to prepare for the specific health
challenges coming their way.”
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