Combining health and social protection measures to reach the ultra ...

More documents

Recommendations

Info

Decision-making than a quarter of the total disease burden. In contrast, in Latin America and the Caribbean, these diseases accounted for 8% of disease burden. However, this region also had high levels of diabetes and endocrine disorders compared with other regions. Violence was the third leading cause of burden in Latin America and Caribbean countries, but did not reach the top 10 in any other region. HIV/AIDS was the leading cause of burden of disease in sub-Saharan Africa, followed by malaria. Seven other Group I causes also appear in the top 10 causes for this region, with road traffic accidents being the only non-Group I cause. Group I, II, and III causes all appear among the top 10 causes of the disease burden for the Middle East and North Africa. Of particular note, road traffic accidents were the third leading cause and congenital anomalies were the seventh leading cause. Group I causes of disease burden remained dominant in South Asia, and this burden fell particularly on children, but noncommunicable diseases such as IHD, stroke, and chronic obstructive pulmonary disease also featured in the list of top 10 causes. In East Asia and the Pacific, stroke was the leading cause of disease burden in 2001, with IHD in fourth place, although Group I causes such as conditions arising during the perinatal period, TB, lower respiratory infections, and diarrhoeal diseases remained important. Conclusions The analysis presented has confirmed some of the conclusions of the original GBD study about the importance of including nonfatal outcomes in a comprehensive assessment of global population health, and has also confirmed the growing importance of noncommunicable diseases in low- and middle-income countries. However, it has also documented some dramatic changes in population health in some regions since 1990. The key findings include the following: ✜ HIV/AIDS is now the fourth leading cause of the burden of disease globally and the leading cause in sub-Saharan Africa. ✜ In low- and middle-income countries, the epidemiological transition has resulted in a 20% reduction in the per capita disease burden due to Group I causes since 1990. Without the HIV/AIDS epidemic, this reduction would have been closer to 30%. Several of the “traditional” infectious diseases, such as TB and malaria, have not declined, in part because of weak public health services and the increased numbers of people with immune systems weakened by HIV/AIDS. ✜ The per capita disease burden in Europe and Central Asia increased by nearly 40% during 1990–2001, meaning that this region now has worse health than all other regions except South Asia and sub-Saharan Africa. The unexpected increase in the disease burden, and the concomitant reduction in life expectancy, in countries of this region appear to be related to such factors as alcohol abuse, suicide, and violence, which seem to be associated with societies facing social and economic disintegration. The rapidity of these declines has dramatically changed our perceptions of the time frames within which substantial changes in the burden of chronic disease can occur and of the potential for such adverse health trends to occur elsewhere. ✜ Adults under the age of 70 in low- and middle-income countries face a substantially greater risk of death from noncommunicable diseases than adults of the same age in high-income countries. ✜ In Europe and Central Asia, Latin America and the Caribbean, and the Middle East and North Africa, more than 30% of the entire disease burden among male adults age 15 to 44 is attributable to injuries, including road traffic accidents, violence, and self-inflicted injuries. In addition, injury deaths are noticeably higher for women in some parts of Asia and the Middle East and North Africa than in other regions, partly because of high levels of suicide and violence. Combined with higher rates of infant and child mortality for girls, this results in a narrower differential between male and female healthy life expectancy than in any other region. ❏ Alan Lopez is Professor of Medical Statistics and Population Health and Head of the School of Population Health at the University of Queensland. Prior to joining the University in January 2003, he worked at the World Health Organization (WHO) in Geneva, Switzerland, for 22 years where he held a series of technical and senior managerial posts including Chief Epidemiologist in WHO’s Tobacco Control Program (1992–95), Manager of WHO’s Program on Substance Abuse (1996–98), Director of the Epidemiology and Burden of Disease Unit (1999–2001), and Senior Science Advisor to the Director-General (2002). Colin Mathers is Coordinator of the Country Health Information team in the Evidence and Information for Policy Cluster at the World Health Organization (WHO) in Geneva, Switzerland. He is responsible for WHO reassessments of the global burden of disease, and in the development of software tools to support burden of disease analysis at country level. 174 ✜ Global Forum Update on Research for Health Volume 4
Decision-making References 1. Bannister J and Hill K. Mortality in China, 1964–2000. Population Studies, 2004, 58 (1): 55–75. 2. Lopez AD, Ahmad O, Guillot M et al. World Mortality in 2000: Life Tables for 191 Countries. Geneva: World Health Organization, 2002. 3. Lopez, AD, Begg S and Bos E. Demographic and epidemiological characteristics of major regions, 1990–2001, pp. 17-44 in Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL (eds.), Global Burden of Disease and Risk Factors. Disease Control Priorities Review, Volume 2, 2006. New York: Oxford University Press and The World Bank (copublication). 4. Lopez AD et al. (Eds). Global Burden of Disease and Risk Factors. Disease Control Priorities Review, Volume 2, 2006. New York: Oxford University Press and The World Bank (co-publication). 5. Mathers CD, Lopez AD and Murray CJL. The Burden of Disease and Mortality by Condition: Data, Methods and Results for 2001, pp. 45-240 in Lopez AD et al. (Eds.), Global Burden of Disease and Risk Factors. Disease Control Priorities Review, 2006, Volume 2. New York: Oxford University Press and The World Bank (co-publication). 6. Murray CJL et al. Modified Logit Life Table System: Principles, Empirical Validation, and Application. Population Studies, 2003, 57 (2): 1–18. 7. Murray CJL and Lopez AD. 1996a. Estimating Causes of Death: New Methods and Global and Regional Applications for 1990. In The Global Burden of Disease (ed.) Murray CJL and Lopez AD, pp. 117-200. Vol. 1 of Global Burden of Disease and Injury Series. Cambridge, MA: Harvard University Press. Murray CJL and Lopez AD. 1996b. Evidence-Based Health Policy: Lessons from the Global Burden of Disease Study. Science, 274 (5288): 740–43. Murray CJL and Lopez AD (eds.). 1996c. The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. Vol. 1 of Global Burden of Disease and Injury Series. Cambridge, MA: Harvard University Press. Murray CJL and Lopez AD. 1997a. Global Mortality, Disability, and the Contribution of Risk Factors: Global Burden of Disease Study. The Lancet, 349 (9063): 1436–42. Murray CJL and Lopez AD. 1997b. Mortality by Cause for Eight Regions of the World: Global Burden of Disease Study. The Lancet, 349 (9061): 1269–76. 8. Mari Bhat PN. Completeness of India’s Sample Registration System: An Assessment Using the General Growth Balance Method. Population Studies, 2002, 56 (2): 119–34. 9. Roglic G et al. The Realistic Burden of Mortality Attributable to Diabetes: Estimates for the Year 2000. Diabetes Care, 2005, 28 (9): 2130-2135. Global Forum Update on Research for Health Volume 4 ✜ 175
Page 1 and 2:
Global Forum Update on Research for
Page 3 and 4:
Editorial Advisory Board: Luis Gabr
Page 5 and 6:
Contents 096 Child immunization: ac
Page 7 and 8:
Introduction Research contributions
Page 9 and 10:
Introduction Type I Type II Type II
Page 11 and 12:
Introduction making), takes account
Page 13 and 14:
Access to health Strengthening heal
Page 15 and 16:
Access to health raising public awa
Page 17 and 18:
Access to health Recent trends in r
Page 19 and 20:
Access to health districts with a p
Page 21 and 22:
Access to health Understanding heal
Page 23 and 24:
Access to health This study investi
Page 25 and 26:
Access to health References continu
Page 27 and 28:
Access to health combining particip
Page 29 and 30:
Access to health 2002 2005 Diff. SU
Page 31 and 32:
Access to health References continu
Page 33 and 34:
Access to health Americans think th
Page 35 and 36:
Access to health threatening and se
Page 37 and 38:
Access to health References 1. Worl
Page 39 and 40:
Access to health Open access to res
Page 41 and 42:
Access to health References 1. Rose
Page 43 and 44:
Access to health national and globa
Page 45 and 46:
Access to health Senior Research Fe
Page 47 and 48:
Access to health ✜ Rights alone a
Page 49 and 50:
Access to health meaningful communi
Page 51 and 52:
Access to health Inequality, margin
Page 53 and 54:
Access to health questions, develop
Page 55 and 56:
Access to health reasonable in abou
Page 57 and 58:
Access to health References 1. Kohn
Page 59 and 60:
Access to health The diverse pathwa
Page 61 and 62:
Access to health 2001, WTO ruled th
Page 63 and 64:
Access to health knowledge and educ
Page 65 and 66:
Access to health References 1. Lee
Page 67 and 68:
Innovation 076 Towards the developm
Page 69 and 70:
Innovation ✜ Creating a viable va
Page 71 and 72:
Innovation Natural sciences and env
Page 73 and 74:
Innovation References 1. Morel C et
Page 75 and 76:
Innovation The changes in internati
Page 77 and 78:
Innovation promoting health in deve
Page 79 and 80:
Innovation efficiently converted in
Page 81 and 82:
Innovation future global health fin
Page 83 and 84:
Innovation References 1. See http:/
Page 85 and 86:
Innovation Health system strengthen
Page 87 and 88:
Innovation Being healthy: the role
Page 89 and 90:
Innovation when much progress and a
Page 91 and 92:
Innovation The role of Knowledge Tr
Page 93 and 94:
Innovation knowledge - the “know
Page 95 and 96:
Research resources 110 Research imp
Page 97 and 98:
Decision-making implemented on a sm
Page 99 and 100:
Research resources 30 27.5 25 20 19
Page 101 and 102:
Research resources poliomyelitis an
Page 103 and 104:
Research resources Nursing research
Page 105 and 106: Research resources utilization are
Page 107 and 108: Research resources The need to deve
Page 109 and 110: Research resources ✜ Health resea
Page 111 and 112: Research resources References 1. Co
Page 113 and 114: Research resources investigated the
Page 115 and 116: Research resources A new landscape
Page 117 and 118: Research resources 13 + 1*- HIV/AID
Page 119 and 120: Research resources References 1. Da
Page 121 and 122: Research resources international le
Page 123 and 124: Research resources Partnership dyna
Page 125 and 126: Research resources that many public
Page 127 and 128: Research resources compounds from m
Page 129 and 130: Research resources References 1. So
Page 131 and 132: Decision-making Delivering evidence
Page 133 and 134: Decision-making Equitable access: g
Page 135 and 136: Decision-making years’ experience
Page 137 and 138: Decision-making Policy-makers Compl
Page 139 and 140: Decision-making interview studies),
Page 141 and 142: Decision-making References 1. Haine
Page 143 and 144: Decision-making reviews in this fie
Page 145 and 146: Decision-making Inequities in healt
Page 147 and 148: Decision-making Deaths Crude death
Page 149 and 150: Decision-making Group I Group II Gr
Page 151 and 152: Decision-making Low- and middle-inc
Page 153 and 154: Decision-making Europe and Central
Page 155: Decision-making Europe and Central
Page 159 and 160: Decision-making irresponsible-to be
Page 161 and 162: Decision-making Several strategies
Page 163: To achieve better health, particula
show all

Combining health and social protection measures to reach the ultra ...

Create successful ePaper yourself

Delete template?

Save as template?