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Global Burden of Diseases

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Global Burden of Diseases

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  1. GLOBAL BURDEN OF DISEASES (GBD)

  2. GBDs Definition:a comprehensive regional and global assessment of mortalityand disability from diseases and injuries and their risk factors. • GBDs:refers to health problems: -that transcend national borders and -that are best addressed through cooperative actions and solutions

  3. Disability Adjusted Life Years (DALYs) • DALYs: was developed by Murray and Lopezin1997 to measure the burden of diseases and the cost-effectiveness of interventions. • They used this indicator in their first extensive study conducted globally on the occurrence of all major diseases and the impact on disability and mortality in human populations.

  4. Disability Adjusted Life Years (DALYs) • The study was done in collaboration between the Harvard University, School of Public Health, the World Bank and the WHO. • The World Bank and the WHO were the first to use the DALY metric to compare the burden of diseases in different regions of the world.

  5. Disability Adjusted Life Years (DALYs Disability Adjusted Life Years: a comprehensive indicator which includes loss of healthy years due to disability and pre-mature death. • It is the sum of years of life lost (YLLs) due to premature death and Years Lived with Disability (YLD) for each age group and sex. • The basis of the DALYs measure is a golden standard, the “Most desirable life”.

  6. DALYs Calculations • Most desirable life: is defined as living in a ‘completely healthy state’ until death, at age around 80 years. • Perfect health is represented by ‘1’ and deathby ‘0’on the DALY diagram. • For each premature death the number of years lost is counted up to 82.5 years for females and 80 years for males(highest life expectancy).

  7. DALYs Calculations • Example- If a man dies at the age of 20 years, 60 years are lost (Years of Life Lost) due to premature death. • Injuries and diseases not only cause death, but also time periods with morbidity and disability. • Disability:measured in length of years and severity.

  8. DALYs Calculations Severity weights: are given by panel of experts for each disabling condition on a scale from ‘1’ to ‘0’. Example: Weighted severity for Schizophreniawas given a of loss of 0.8and Common cold 0.007. • The severity weightis then multiplied by the average timea person is suffering from the disability of each disease.

  9. DALYs Calculations • Years lost due to premature death or disability is also given different values at different ages. Age Weights: DALY calculation as age weight is obtained from a scale where the value of a year lost rises steeplyfrom ‘0’ at birth to a maximum at 25 yearsof age, and decreases progressively in older ages.

  10. Table 1. Burden of diseases as DALYs lost per 1000 population

  11. Table 2. Percentage Distribution of Age at Death by Region, 2004.

  12. Table 3. Major causes of death, world-wide, 2000 and 2010

  13. Table 4. Ten Top Causes of Death in Low-income Countries 2012

  14. Table 5. Ten Top Causes of Death in Lower-Middle Income Countries,2012

  15. Table 6. Ten Top Causes of Death in Upper-Middle Income Countries, 2012.

  16. Table 7. Ten Top Causes of Death in High-Income Countries, 2012.

  17. Summary of Deaths Across the Globe • Imagine a diverse group of 1000 individuals representative of women, men and childrenfrom all over the globe, who died. • Of these 1000 people, 138would have come from high-income countries, 414 from middle-income countries and 447 from low-income countries.

  18. Summary of Deaths Across the Globe IN High-Income Countries (HICs): • More than 2/3of the people live above 70 years. • Predominantly die of chronic diseases; (CVD, COLDs, Cancers, diabetes or dementia). In Middle-Income Countries (MICs): • Nearly half of the people live to the age of 70. • Chronic diseases are major killers, just as HICs. • Unlike in HICs, lower respiratory infections, TB and road traffic accidents also are leading causes of death.

  19. Summary of Deaths Across the Globe In Low-Income Countries: • Less than ¼ of all people reach the age of 70. • Over 1/3 of all deaths are in children less than 14 years of age. • People mainly die of infectious diseases; LRTIs, HIV/AIDS, TB and malaria. • Complications of pregnancy and child birth continue to be leading causes of death, of both infants and mothers.

  20. Risk Factors • Most common risk factors are tobacco, high blood pressure, alcohol, overweight/obesity, physical inactivity and cholesterol. Tobacco Use: • Single most cause of preventable death globally. • A factor for 6 of 8 major global causes of death. • Expected to kill more people than any other single disease by 2020.

  21. Risk Factors • Tobacco use causes more than 3/4 of CVDs. • Over 100 million people died from use in the twentieth century • About 70% of tobacco use is low-income countries Hypertension: • Responsible for 13% of deaths world- wide. • Over 26%adults who had hypertension globally in 2000 are expected to be 30% by 2020.

  22. Risk Factors • Globally about 2 billion people consume alcohol; with increasing intake in developing countries . • Highest burden (97%) in Latin America and the Caribbean and lowest in the Middle East Crescent (0.4%), and India (1.7%). • Alcohol is estimated to cause 20-30% of esophageal cancer, liver disease, epilepsy, homicides and other intentional injuries.

  23. Risk Factors Global Alcohol Use Disorder Problem: • Globally >125 million people have alcohol disorders. • Major cause of global disability of males and accounts for 1/3 of the male neuropsychiatric disease burden. • Prevalence in 2003 at 1.7% contributed 4%GBD. • In 2003, 18.5% of people 18 years and older in USA suffered from alcohol dependence.

  24. Risk Factors Over weight and Obesity: • Third leading cause of death in the US, costing the society an estimated $ 185 billion annually. • life styles of the ‘West’ are being imported and adopted by the developing nations, as the globalization is moving at high speed. • As people become wealthier, life styles such as tobacco use, alcohol abuse, physical inactivity, and obesity occur, leading to chronic diseases.

  25. Risk Factors • 66% of Americans are overweight and 30% obese. • Globally, there are more than 1 billion over weight adults and at least 300 million of them are obese. • Wealth is also increasing in developing countries. • The WHO predicts there will be 23 million overweight adults in the world by 2015 and more than 700 million of them will be obese.

  26. Risk Factors Physical Inactivity: • Estimated to cause 2 million deaths globally. • Globally, it is a causal factor in 10-16% of cases each of breast cancer, colon cancer, and diabetes and 22% IHD. • The risk of getting CVD increases by 1.5 times in people who do not follow minimum physical activity recommendation.

  27. Risk Factors Cholesterol: • Levels beyond the optimum contribute to about 2/3 of the globe CVDs. • World wide, 4.4 million of deaths are related to hyperlipidemia, which is responsible for 32% of stroke and 56% of Ischemic Heart Disease.

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