‘The contribution of different risk factors to disease burden has changed substantially’

The leading risk factors for global disease burden in 2010 were high blood pressure, tobacco smoking (including second-hand smoking) and alcohol use; 20 years earlier, they were childhood underweight, household pollution from sold fuels and tobacco smoking, including passive smoking.

Globally, 9.5 million lives were lost in 2010 due to high blood pressure, 6.6 million due to smoking, 5 million each because of diet low in fruits and alcohol use. High blood pressure snuffed out 1.4 million lives in South Asia, 1.3 because of tobacco and smoking and 0.8 million each because of diabetes and outdoor air pollution.

While high blood pressure accounted for 7 per cent of global DALYs (disability adjusted life year) — a measure of overall disease burden expressed as the number of years lost due to ill-health, disability or early death — tobacco accounted for 6.3 per cent and alcohol use 5.5 per cent, against 7.9 per cent of childhood underweight, 7 per cent each for household air pollution and smoking respectively.

Worldwide, the contribution of different risk factors to disease burden has changed substantially, with a shift from risks for communicable diseases in children towards those for non-communicable diseases in adults, according to the latest issue of British medical journal The Lancet.

Sanitation risk

Dietary risk factors and physical inactivity collectively accounted for 10 per cent of global DALYs in 2010, with the most prominent dietary risk being diets low in fruits and those high in sodium. Several risks that primarily affected childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water and sanitation accounting for 0.9 per cent of global DALYs in 2010.

However, in most sub-Saharan Africa, childhood underweight, household pollution and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while household pollution was the leading risk in South Africa. The leading risk factors in Eastern Europe, most of Latin America and South sub-Saharan Africa in 2010 was alcohol use; in most of Asia, North Africa and Middle East, and Central Europe it was high blood pressure. Despite declines, tobacco smoking, including second-hand smoke, remained the leading risk factor in the high-income North America and Western Europe.

Air pollution

The analysis found that outdoor air pollution in the form of fine particles is a much more significant public health risk than previously known — contributing annually to over 3.2 million premature deaths worldwide and over 74 million years of healthy life lost. It now ranks among the top global health risk burdens.

The 2010 Global Burden of Disease applies consistent methods to the largest global data base ever assembled to estimate risk of premature mortality and contribution to health burden from a wide variety of risks: smoking, diet, alcohol, HIV/AIDS, household and outdoor air pollutions to name a few. The study covers 187 countries globally.

The new analysis identifies especially high risk levels in the developing countries of Asia where air pollution levels are the highest in the world. It estimates that over 2.1 million premature deaths occurred and 52 million years of healthy life were lost in 2010 due to ambient fine particle air pollution, fully 2/3 of the burden worldwide.

Among other risk factors studied in the survey, outdoor pollution ranked 4th in mortality and health burden in East Asia (China and North Korea) where it contributed to 1.2 million deaths in 2010 and 6th in South Asia (including India, Pakistan, Bangladesh and Sri Lanka), where it contributed to 7,12,000 deaths in 2010.


Redrawing India’s disease mapDecember 19, 2012