Global Burden of Disease part II Outline for

Global Burden of Disease ’part II’

Outline for today • Brief ‘GBD-repetition’ • Exercise in groups

Diseases and injuries • There are over 300 different diseases and injuries • Different interest groups emphasize different diseases as “major public health problems” • With limited resources which diseases should be given priority?

The GBD answers • • • What are the world’s health problems? Who do they hurt? How much? Where? Why?

The world’s largest catalog of health data • • • 359 diseases and injuries 84 risk factors 23 age groups 1990 to 2017 774 Geographies Available at: http: //www. healthdata. org/us-health & A visualization tool

Traditionally • Public health placed strong emphasis on mortality indicators to map population health • Deaths does not account for diseases that causes disability and pain during life

GBD include non-fatal health outcomes • Including diseases that causes disability and pain during life (non-fatal health outcomes) • Reveal the burden of mental disorders • As well as the burden of non-communicable diseases and injuries in low- and middle income countries.

GBD uses data from multiple sources • GBD uses all available data of sufficient quality to estimate disease burden

The GBD project…. …is constantly improving as new data and methods are available.

DALY (Disability Adjusted Life Years) DALY is a measure on the disease burden that describes ill health in the population by combining information about both mortality and disability

DALY = YLL+ YLD • What specifically is measured is the time (in years) with optimal health that is lost due to: • Premature death (YLL) • Loss of function (disease) (YLD) 11

Comparative Risk Assessment (CRA) • This is a continuation of the GBD project • The challenge is to estimate the influence of risk factors to disease burden

Why include risk factors? • Disease data is focused on curative needs • Risk factors are possible to prevent • Basis for prioritization and planning of health policy measures

Attributable fraction • How much of the disease burden can be avoided if you take away a certain risk factor • Need information about relative risks • This is the same between countries • Prevalence of exposure • Different between countries

Example: High BMI in Sweden • High BMI causes in total: • 200, 165 DALY • Corresponding to 7. 9% of the total burden of disease • This means that 7. 9% of the total burden of disease can be avoided if overweight/obese people decrease their BMI

Key accomplishments of GBD efforts • First comparable measurement of health loss from conditions/ diseases that result in death and those that do not. • Mental illness – Profound impact on health policy • Shed light on the important contribution of NCDs in LMICs and the importance of injuries

Exercise

Aim • Understand how to use health indicators to compare the health situation in men and women and in different countries. • Analytically discuss underlying reasons to potential differences or similarities. • Discuss strategies of how to reduce disease burden.