Global Health: 20 Years Changes Things

Health issues all over the world have shifted to diet and lifestyle as greatest burden

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Twenty years ago, infectious disease in children was the highest risk factor for death and disability in the world. Today, it’s low-nutrient, high sodium diets, alcohol and tobacco.

A recent study looked at risk factors for death, disease and disability in 21 regions across the globe. Findings showed a different world from 20 years ago.

“Overall we’re seeing a growing burden of risk factors that lead to chronic disease in adults, such as cancer, heart disease and diabetes, and a decreasing burden for risks associated with infectious diseases in children,” said Dr. Ezzati.

"Exercise, and eat plenty of fruits and veggies."

Majid Ezzati, PhD, professor in the School of Public Health at Imperial College London in the UK, and Stephen Lim, PhD, associate professor at the Institute for Health Metrics and Evaluation at the University of Washington, were the senior investigators for this study.

Researchers evaluated 67 risk factors for disease and injury in 21 regions all over the world from 1990-2010.

Measures were deaths and disability-adjusted life years (DALYs), years lived with disability (YLD) and years of lost life (YLL).

In 2010, the top three global burden DALYs were:

  1. Diets high in sodium, low in produce and physical inactivity at 10 percent
  2. High blood pressure at 7 percent
  3. Tobacco smoking, including secondhand smoke, at 6 percent
  4. Alcohol use at 6 percent

In 1990, the top three global burden DALYs were:

  1. Underweight children at 8 percent
  2. Household air pollution from indoor heating/cooking fuels at 7 percent
  3. Tobacco smoking, including secondhand smoke, at 6 percent

In 2010, alcohol use was the leading risk factor for all measures in Eastern Europe, most of Latin America and southern sub-Saharan Africa.

High blood pressure was the culprit in Asia, North Africa, central Europe and the Middle East.

Tobacco smoking, including secondhand smoke was the leading risk factor in North America and western Europe.

For Australasia and southern Latin America, as well as North Africa, the Middle East and Oceania, high body mass index was the leading risk factor.

Authors concluded, over the last 20 years there has been a shift in the risk factors for the leading causes of disease. Where it used to be infectious diseases in children, now there are more issues with non-infectious diseases in adults.

Dr. Ezzati said, “The good news is there are lots of things we can do to reduce disease risk. To bring down the burden of high blood pressure, we need to regulate the salt content in food, provide easier access to fresh fruit and vegetables and strengthen primary healthcare services.”

This study was published in December in The Lancet.

Research was funded by the Bill and Melinda Gates Foundation.

No conflicts of interest were reported.

Reviewed by: 
Review Date: 
December 16, 2012
Last Updated:
April 11, 2013