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SUMMARY - World Health Organization

SUMMARY . global burden OF DISEASE AND INJUR Y SERIES. THE global . burden OF DISEASE. A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. EDITED BY. CHRISTOPHER]. L. MURRAY. HARVARD UNIVERSITY. BOSTON, MA, USA. tt.' . ~ lijIo,~W. ~ :I ~. ~ 'I~~. 1ff World Health World . Organization BANK. HARVARD SCHOOL OF. PUBLIC Health . PUBLISHED BY THE HARVARD SCHOOL OF PUBLIC Health ON BEHALF OF. THE World Health Organization AND THE World BANK. DISTRIBUTED BY HARVARD UNIVERSITY PRESS. CONTENT S. INTR O D U CT I O N I. 1. THE GBD ' s A P P RO AC H TO MEASU RIN G HEA LTH STATUS 6.

The Global Burden of Disease study (GBD) has involved an estimated forty person-yearsof effort. An extraordinarily large volume of data-on483 separate sequelae of 107 diseases and injuries, and 14 million death cenificates--hasbeen subjected to rigorous analysis using both newly developed and well­ established methods. Volume I, The Global ...

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1 SUMMARY . global burden OF DISEASE AND INJUR Y SERIES. THE global . burden OF DISEASE. A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. EDITED BY. CHRISTOPHER]. L. MURRAY. HARVARD UNIVERSITY. BOSTON, MA, USA. tt.' . ~ lijIo,~W. ~ :I ~. ~ 'I~~. 1ff World Health World . Organization BANK. HARVARD SCHOOL OF. PUBLIC Health . PUBLISHED BY THE HARVARD SCHOOL OF PUBLIC Health ON BEHALF OF. THE World Health Organization AND THE World BANK. DISTRIBUTED BY HARVARD UNIVERSITY PRESS. CONTENT S. INTR O D U CT I O N I. 1. THE GBD ' s A P P RO AC H TO MEASU RIN G HEA LTH STATUS 6.

2 2. How T HE WOR LD D I ES T O DAY 14. ISBN : 0-9655466-0-8 3. DI SABILIT Y: T HE I N VIS I BLE BUR D E N 20. Library of Congress Cataloging-in -Publication (CIP) Data applied for. 4. TH E G LO BAL B URD E N O F DI S EA S E I N 1990. S. RI S K F ACTO R S F OR DEATH AN D DISAB I LI T Y 27. 6. LOO K I NG AH EAD: TH E HE A LTH OF THE WOR LD IN 2020 3I. 7. FROM THE S E RI ES 40. T able of Co ntents for Volum e I 40. List o f Ann ex T ables 41. global H ealth Statistics: Samp le tabl e fro m Volume 11 4 2- The G lo ba l Bu rden of D isease and Inju ry Series 43. This booklet is a SUMMARY of the The global burden of Disease: A.

3 Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in I990 and Projected to 2020, edited by Christopher ].L. Murray and Alan D. Lopez, published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank and distributed by Harvard University Press. It also contains examples of the detailed information on the epidemiology of 240 conditions around the World published in global Health Statistics: A Compendium of Th e Glob al burden of Disease Study and the The Glob al Burd en of Disease a nd Incidence, Prevalence and Mortality Estimates for Over 200 Conditions, by global Health Statistics would no t have been possible with out the financial support Christopher Murray and Alan D.

4 Lopez, published by the Harvard of the Edna McConnell C lark Foundation , the Rocke feller Foundation , the World School of Public Health on behalf of the World Health Organization and the Bank a nd the WHO Ad H oc Comm ittee o n H ealth Research Relating to Future World Bank and distributed by Harvard University Press. Interv ent ion Option s. This SUMMARY has been prepared by Phyllida Brown . The preparation and printing of the SUMMARY were made possible through a grant from the Eli Lilly Foundation and Harvard Medical International. Copyright 1996 World Health Organization . All rights reserved. "Publication of the global burden of Disease and Injury Series marks the transition to a new era.

5 1 firmly predict that by the turn of the cent ury the official reporting of Health outcomes in dozens of countries and globally will embody the approach and standards described in this series.". INTRODUCTION. Dean T. [amison, Professor of Public Health , Uniuer- sity of California Los Angeles and Chairman, WHO. Ad Hoc Committee of Health Research Relating to Future Interventi on O ptio ns The next two decades will see dramatic changes in the Health needs of the World 's populations. In the developing regions where four-fifths of the planet's people live, noncommunicable diseases such as depression and heart disease are fast replacing the traditional enemies, such as infectious diseases and malnutrition, as the leading causes of disability and premature death.]

6 By the year 2020, noncommunicable diseases are expected to account for seven out of every ten deaths in the developing regions, compared with less than half today. Injuries, both unintentional and intentional, are also growing in importance, and by 2020 could rival infectious diseases worldwide as a source of ill Health . These changes are expected because of the rapid aging of the developing World 's populations, As a population's birth rate falls, the number of adults relative to children increases, and the population's commonest Health problems become those of adults rather than those of children. In China, some other parts of Asia and Latin America, this so -called "epidemiological transition" is already much further advanced than many public Health specialists appreciate.

7 In all regions the rapidity of change, and the very large absolute numbers involved, will pose serious challenges to Health -care systems and force difficult decisions about the allocation of scarce resources. Yet, until now, many governments have lacked even ktGIOI\IAL GItOUr l NCS. the most basic data they needed to inform debate and to assess priorities o ~::i~~~~~.t=:i::~~~lleb~ .;ru lC). Ewl'lom,n -dt tNl't'hi .. ,If_\11ff. 0 ~ ::t:~~j:~~~~~rn fOrA!). Auuff. r'-')' ..ANCC1'IH IArAI) for public Health . ~=~~~~~~~':i:l:!tErf~ IFSEf 0 ~~~~ ~~i~~~~~SS). CIlfAIn iOl:ult\ln dOhrot'" :AI'5 A(t'iClW ",h-uhu;~ IASSI Now, for the first time, this gap has been filled with a landmark o Aftcinv- ;l tlNDI.

8 Jl'loNtINDI. Wrin Amtriu ,,"It ,ht )' publication. Researchers at the Harvard School of Public Health and the InckIINt>, AtnrfiqllC'l.,incccuuIM(,UCI. C g:~ :~~~: Ch"",ICUNI. ~~~cJt;;:::~C~ ~'b~~: Croinanr nloytfl_I('fICotllC.\tO). World Health Organization , with more than 100 collaborators from around the World , have produced a comprehensive, internally consistent and comparable set of estimates of current patterns of mortality and disability from d isease and injury for all regions of the World , with projections to the year 2020. The global burden of Disease and Injury Series, the ten-volume result of their study, is a unique resource that 2 The global burden of Disease SUMMARY 3.

9 Provides policy -makers with their well advanced, suggesting that public Health policy, with its traditional first comprehensive picture of the Deaths from emphasis on infectious disease, has not kept pace with events. In addition, World 's current and future Health it makes a number of startling individual observations. Just four examples needs . noncommunicable are highlighted here: The researchers involved in this diseases are expected to The burdens of mental illnesses, such as depression, alcohol dependence a m biti o us five -year effo rt and schizophrenia, have been seriously underestimated by traditional developed a new approach to climb from 28.

10 I million approaches that take account only of deaths and not disability. While measuring Health status. Their a year in I990 to psychiatric conditions are responsible for little more than one per cent method quantifies not merely the of deaths, they account for almost 11 per cent of disease burden number of de aths but also the million by 2020-an worldwide. impact of premature death and increase in absolute disability on a population , a nd Adults under the age of 70 in Sub-Saharan Africa today face a higher combines these into a single unit numbers of 77 per cent. probability of death from a noncommunicable disease than adults of of measur ement of the overall the same age in the Established Market Economies.


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