Health is improving around the world, but 7 out of 10 deaths are now due to noncommunicable diseases, like stroke, diabetes, chronic kidney disease, and drug use disorders, according to a special issue of The Lancet
The Global Burden of Disease, Injuries, and Risk Factors (GBD) 2015 study brought together 1870 experts in 127 countries and territories to analyze 249 causes of death, 315 diseases and injuries, and 79 risk factors occurring between 1990 and 2015.
“Development drives, but does not determine health,” Christopher Murray, MD, DPhil, director of the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, the coordinating center for the GBD collaboration, said in a statement. “We see countries that have improved far faster than can be explained by income, education, or fertility. And we also continue to see countries—including the United States—that are far less healthy than they should be given their resources.”
Since 1980, life expectancy around the world has increased by more than a decade, rising to 69 years for men and 74.8 years for women in 2015. In that time, death rates for HIV/AIDS, malaria, and diarrhea have fallen significantly.
However, while overall life expectancy has risen by a large amount, healthy life expectancy has increased by just 6.1 years. This means that people are living more years with illness and disability. The burden of ill health has shifted away from communicable, maternal, neonatal, and nutritional disorders to disabling noncommunicable diseases, such as drug use disorder (particularly opioids and cocaine), hearing and vision loss, and osteoarthritis. This trend has a huge impact on health systems and the cost of treatment.
The researchers also created the Socio Demographic Index (SDI) to determine what progress would be expected in countries based on their level of development. The index is based on income per capita, educational attainment, and total fertility rate.
The index found that when looking at high SDI regions, North America had the worst healthy life expectancy. Mortality rate for children younger than 5 years was worse than expected in the United States and Canada. Plus, drug use disorders and diabetes cause a disproportionate amount of ill health and early death in America.
The purpose of these analyses was to provide governments and donors with evidence to identify national health challenges and priorities for intervention.
“A key goal, if not the fundamental goal, of a health system is to prolong life, especially healthy life, into old age,” the authors wrote. “To do so, decision makers in health need comprehensive and disaggregated evidence on comparative mortality levels in populations, particularly for causes of death that are largely preventable through political action, either through improving health services or strengthening prevention programs.”