Transcript Global Burden of Disease

Global Burden of Disease
Cathy Hoelzer, MPH, PA-C
Brief Introduction
World Outreach
Health
“A state of complete
physical, mental, and
social well-being and
not merely the
absence of disease or
infirmity.”
WHO definition of health
Global Health
• Refers to health problems that transcend national
borders
• Refers to health problems that are best addressed by
cooperative actions and solutions
• Why should we be involved?
– Health matters to everyone, not just to those living in
developing countries.
Global Burden of
Disease
• The global burden of disease (GBD) is a
comprehensive regional and global assessment of
mortality and disability from107 diseases and injuries
and ten risk factors.
• Developed in 1990 by the WHO.
• Provides information and projections about disease
burden on a global scale.
For more info see: http://www.who.int/topics/global_burden_of_disease/en/
Why should we care?
• Medical missionaries
have been on the
forefront of health in
developing nations for
100’s of years.
• We can enable others to
live more productive and
fulfilling lives.
Source: www.turnbacktogod.com
What’s the world dying of these days?
THE LEADING CAUSES OF
MORTALITY
Chronic Disease
• CDs responsible for 60% of all deaths in 2005.
• >80% of deaths occurred in low to middle income
countries (LMIC).
• NCDs are killing more people in their prime adult
years.
• Surprising fact:
– TB, HIV, and malaria only account for 10% of the global
deaths.
Number 1 Killer
• Cardiovascular diseases
kill more people each
year than any other.
• In 2004
– CHD killed 7.2 million
people
– Another 5.7 million died
of stroke or another form
of CVD
Major Causes of Death, World, 2004
1
2
3
4
5
6
7
8
9
10
Disease or Injury
Ischemic heart disease
Cerebrovascular disease
Lower respiratory infections
COPD
Diarrheal diseases
HIV/AIDS
Tuberculosis
Trachea, bronchus, lung cancers
Road traffic accidents
Prematurity and low birth weight
Deaths/ % of total
million
deaths
7.2
12.2
5.7
9.7
4.2
7.1
3
5.1
2.2
3.7
2
3.5
2.5
1.5
1.3
2.3
1.3
2.2
1.2
2
Source: The Global Burden of Disease: 2004 update, WHO
Comparison of Global Mortality, 2004
Source: WHO Fact Sheet, Top 10 Causes of Death
Percent distribution of age at death by
region, 2004
Source: Global Burden of Disease, 2004 Update, used by
permission
Most common NCDs
RISK FACTORS
Globalization
• “The increasing interconnectedness of countries and
the openness of borders to ideas, people, commerce,
and financial capital. “ (Lancet, 2003)
• Refers to every aspect of life: cultural, social,
psychological, and political.
• Creates both negative and positive impacts on society
and its health.
From the US to …
Developing Nations
Poor nutrition now affects all parts of the world
China
Tanzania
Bad Habits spreading
Major risk factors
•
•
•
•
•
Tobacco use
High blood pressure
Alcohol
Overweight and obesity, physical inactivity
Cholesterol
Tobacco use
Source: WHO Report on Global Tobacco Epidemic, 2008, used by
permission
Liang Liang smoking since
age 1-1/2
Warning! Warning!
Hypertension
• Responsible for 13% of
deaths world-wide.
• Over 26% of adults in
the world had
hypertension in 2000—
expected to jump to 30%
by 2025.
• 2/3 with HTN live in
developing world.
Adequate Screening
& Treatment
•
•
•
•
Still fairly unattained in much of the world.
Pakistan: >40% of docs prescribed sedatives for HTN!
Africa: control rates as low as 2%.
Saudi Arabia: >60% of physicians and nurses in large
teaching hospital had poor knowledge of basic
techniques of BP measurement.
Hypertension Interventions
•
•
•
•
Use measuring devices properly.
Screen at risk patients.
Educate patients on lifestyle modifications.
Start patients on appropriate and affordable
medications.
• In LMIC:
– Major thrust should focus on primary prevention
incorporating broad population based approach
Alcohol Use
• About 2 billion people consume alcohol.
• Developing countries increasing intake.
• Highest burden in Latin America and Caribbean
(9.7%).
• Lowest in Middle Eastern Crescent (0.4%) and India
(1.7%).
Worldwide Alcohol
Consumption, 2008
The Alcohol Use Disorder
Problem
• Globally:
– In 2003, the prevalence of alcohol use disorders was
estimated at 1.7%.
– Use contributes to 4% of GBD.
• United States:
– 18.5% of the population age 18 and older suffer from
alcohol abuse or dependence
– Cost U.S. society an estimated $185 billion annually.
– Third leading cause of death in the US in 2003.
Interventions
• It is fundamental and good medicine to ask our
patients about alcohol use.
• Many practitioners fail to screen.
–
–
–
–
Lack of time
Think don’t have right training
Embarrassed
Don’t believe it will help
• Numerous trials have shown brief interventions DO
help.
Overweight & Obesity
The World Health Organization predicts there will be 2.3 billion overweight
adults in the world by 2015 and more than 700 million of them will be obese.
Physical Inactivity
• Physical inactivity is estimated to cause 2 million
deaths worldwide annually.
• Globally a causal factor in:
– ~ 10-16% of cases each of breast cancer, colon cancers, and
diabetes
– 22% of ischemic heart disease.
Source: WHO:
http://www.who.int/dietphysicalactivity/publications/facts/pa/en/index.html
Interventions
• Commonwealth Fund:
– When health providers told their patient they were
overweight they were “almost 9 times as likely to believe
their weight was damaging to their health as those who were
not told this.”
• Increasing physical activity is a societal, not just an
individual problem,
• It demands a population-based, multi-sectoral, multidisciplinary, and culturally relevant approach.
Cholesterol
• Suboptimal levels
contribute to ~ 2/3 of the
global CVD risk.
• 4.4 million deaths in
world related to
hyperlipidemia.
• Responsible for 32% of
ischemic stroke and 56%
of IHD.
Interventions
•
•
•
•
Health education
Cooking classes
Kitchen gardens
Community physical
activity events
The many faces of chronic
disease
Face to face with chronic disease - photos and
personal stories. © Copyright World Health
Organization (WHO), 2005. All Rights Reserved.
Illness
Top 4 causes of illness worldwide include:
1. Diarrheal disease
2. Pneumonia and other lower respiratory tract infections
 Except in Africa which has high levels of malaria
3. Injuries
4. Complications of pregnancy
Disability
• More individuals have iron-deficiency anemia than
any other health problem in the world.
• Other very common conditions, with varying levels of
severity, include:
–
–
–
–
–
–
asthma
arthritis
vision and hearing problems
migraine
major depressive episodes
intestinal worms.
Neglected Tropical
Disease
• Comprise 13 parasitic and bacterial infections.
• Over1.4 billion people affected—most of whom live
on less than $1.25 per day.
• NTDs stigmatize, disable, and inhibit individuals from
being able to care for themselves or their families—all
of which promote poverty.
• ~90% of the total NTD disease burden are found in
Africa, Asia and Latin America.
Just 50 cents a day
We can make a
difference
• Medical missionaries are well positioned to help stem
the epidemic of chronic disease and illness.
• We are motivated by Christ’s love to better the health
of our communities and others around the world.
For Christ's love compels us, because we are convinced that one died for all,
and therefore all died. And he died for all, that those who live should no
longer live for themselves but for him who died for them and was raised again.
II Cor 5:14-15
These smiling
faces make all
your sweat and
tears worth it!
Questions?