Global burden of disease study2021 updates.pptx

Key updated 2021

1. GLOBAL BURDEN OF DISEASE STUDY Institute for Health Metrics and Evaluation  ( IHME )

2. Plan of Presentation Introduction to GLOBAL BURDEN OF DISEASES STUDY (GBD Study) History and evolution of GBD Study Concept of measuring health loss. GBD 2021 – key findings Comparison of trends from past studies. References

3. What is the GBD ? The Global Burden of Diseases Study (GBD) is the single largest and most detailed scientific effort conducted to quantify levels and trends in health. Led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington . O ver 12,000 researchers from more than 160 countries and territories participated for GBD Study 2021. Estimates are available for 204 countries and territories.

4. Why is it important? To provide comprehensive data on the causes of death and disability globally, which was lacking before. To generate an objective and systematic measure of disease burden using a new metric, the Disability-Adjusted Life Year (DALY), which accounts for both premature mortality and years lived with disability. To uncover and highlight neglected or hidden health issues, such as mental illness and road injuries, that were not adequately captured in existing health statistics. To enable comparisons across regions, time, and populations to guide health policy and resource allocation effectively. To inform global health agendas, especially for low- and middle-income countries where data was sparse or unreliable.

5. 19 EVOLUTION OF GBD STUDY Published in The Lancet in December 2012 New estimates for time series 1990 to 2010 GBD 1990 World Bank commissioned the first GBS Study GBD 2010 GBS 2013 Expanded the data sets and tools.

6. EVOLUTION OF GBD STUDY GBS 1990 The GBD enterprise dates to the early 1990s, when the World Bank commissioned the original GBD study and featured it in the landmark World Development Report 1993: Investing in Health . Co-authored by Dr. Christopher Murray , who went on to become Director of IHME , this GBD study served as the most comprehensive effort up to that point to systematically measure the world’s health problems, generating estimates for 107 diseases and 483 sequelae (nonfatal health consequences related to a disease). It covered eight regions and five age groups with estimates through 1990. Academic papers from GBD 1990 have been cited more than 11,000 times since they were published. GBD work was institutionalized at the World Health Organization (WHO), and the organization continued to update GBD findings. In 1998, the WHO created a Disease Burden Unit , which generated GBD estimates for 2000, 2001, and 2002, publishing the estimates in WHO’s annual World Health Reports.

7. EVOLUTION OF GBD STUDY GBD 2010 The next comprehensive GBD update, the  Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) published new estimates for the complete time series from 1990 to 2010 and an explanation of its methods in  The Lancet  in December 2012. While the earlier work had been conducted mainly by researchers at Harvard and the World Health Organization, GBD 2010 brought together a community of nearly 500 experts from around the world in epidemiology, statistics, and other disciplines. Funded by the Bill & Melinda Gates Foundation , GBD 2010 significantly broadened the scope of previous versions of GBD. Using improved methods for estimating disability weights, GBD 2010 produced estimates for 291 diseases and injuries , 67 risk factors, 1,160 sequelae, 21 regions, 20 age groups, and 187 countries. The policy report  The Global Burden of Disease: Generating Evidence, Guiding Policy  summarizes the GBD 2010 methods and results. In 2013, the World Bank and GBD researchers renewed the fruitful collaboration they began two decades earlier by launching a series of six regional reports based on findings from GBD 2010.

8. EVOLUTION OF GBD STUDY GBD 2013 With IHME as the coordinating center for an international network of GBD contributors, GBD 2013 expanded the methodology, datasets, and tools and presented estimates for more than 300 diseases and injuries , 79 risk factors, and over 2,300 sequelae for 188 countries. It reflected the work of more than 1,000 researchers in more than 100 countries.

9. 19 EVOLUTION OF GBD STUDY Published in The Lancet in September 2017. GBD 2015 Introduced the Socio- demographic index ( SDI) GBD 2016 GBS 2017 Published in November 2018 Generate projections through 2030.

10. EVOLUTION OF GBD STUDY GBD 2015 GBD 2015 marked the first year of production of annual updates of the entire time series of GBD estimates. These more frequent updates provide policymakers and other decision-makers. The 2015 update expanded and introduced the Socio-demographic Index (SDI) , a summary measure that identifies where countries or other geographies sit on the spectrum of development. Expressed on a scale of 0 to 1 , SDI is a composite average of the rankings of the incomes per capita, average educational attainment, and fertility rates of all areas in the GBD study . Estimates were generated for 315 diseases and injuries and 79 risk factors for 195 countries . The study reflected the work of more than 1,800 researchers in more than 120 countries.

11. EVOLUTION OF GBD STUDY GBD 2016 GBD 2016, was published in a special issue of  The Lancet  in September 2017 and included the second annual report on the Sustainable Development Goal (SDG) indicators. The study included 333 diseases and injuries , 84 risk factors , 23 age groups , estimated for a total of 774 locations , and was produced with the participation of 2,518 collaborators from 133 countries and three territories. Articles using GBD 2016 results to focus on specific topics followed, including studies of  death and disability related to alcohol use ,  US disease burden at the state level , and  global mortality from firearms . GBD 2017 GBD 2017 was published i n November 2018 and provided for the first time an independent estimation of population, for each of 195 countries and territories and the globe, using a standardized as well as a comprehensive update on fertility. Mortality and life expectancy estimates were extended back to 1950 , and new causes were added to the fatal and non-fatal cause lists, for a total of 359 diseases and injuries .   One new risk factor , bullying victimization , and 80 new risk-outcome pairs were also added. More SDG indicators were examined, and forecasting methods were used to generate projections through 2030 and assess the pace of change needed to attain the SDGs. Produced with the input of 3,676 collaborators.

12. 19 EVOLUTION OF GBD STUDY Published in 2024. Shows life expectancy drop due to COVID-19. GBD 2019 In October 2020, it was  published in  The Lancet GBD 2021 GBS 2023 ( ongoing ; not yet a consolidated full release. )

13. EVOLUTION OF GBD STUDY GBD 2019 In October 2020 , GBD 2019 was  published in  The Lancet , and expanded to include 204 countries and territories , for a total of 990 locations at the most detailed level. Subnational estimates were added for five new countries (Italy, Nigeria, Pakistan, the Philippines, and Poland). Ten new causes were added to the fatal and non-fatal estimates, amounting to 369 diseases and injuries . Two new risk factors ( high and low non-optimal temperatures ). Over 5,000 collaborators in 152 countries and territories contributed to this work. GBD 2021 GBD 2021 provides a first-ever look at the magnitude of the COVID-19 pandemic and its ripple effects across health conditions. In addition to COVID-19 and related outcomes, this year also included a new risk factor (nitrogen dioxide pollution) , resulting in a total of 371 diseases and injuries , and 88 risk factors . Estimates are available for 204 countries and territories , with a total of 983 locations at the most detailed level. It is a work of nearly 12,000 collaborators in 163 countries and territories.

14. Who works on the GBD study? A Scientific Council, a Management Team, a Core Analytic Team, and a robust network of global Collaborators . Over 16,500 Collaborators in the Network. GBD Collaborators include researchers, scientists, university professors, policymakers, government health officials, staff of non-governmental organizations and nonprofit organizations, and professionals implementing public health programs or interventions.  Collaborators in India for the  Global Burden of Disease (GBD) Study 2021  include the Indian Council of Medical Research (ICMR), the Public Health Foundation of India (PHFI) and a vast network of researchers, experts, and institutions across India.

15. Which locations are studied in the GBD? SUPER REGIONS ( 7) REGIONS ( 21 ) SUB NATIONAL LEVELS ( for 14 countries)

16. The seven GBD super-regions are grouped based on cause of death patterns. The 7 GBD super-regions are 1) Central Europe, Eastern Europe, and Central Asia 2) High-income 3) Latin America and Caribbean 4) North Africa and Middle East 5) South Asia 6) Southeast Asia, East Asia, and Oceania 7) Sub-Sa SUPER REGIONS ( 7)

17. REGIONS ( 21 ) REGIONS ( 21 )

18. SUB NATIONAL LEVELS (14 countries )

19. Measurement of Burden of Disease? Health-Adjusted Life Years (HALYs) The population health summary measures typically used in estimates of the burden of disease. They measure the combined effects of mortality and morbidity in populations , allowing for comparisons  across illnesses or interventions as well as between populations. Average number of years a citizens can expect to live in full health. Two common approaches to measuring HALYs are  Quality Adjusted Life Years (QALY) Disability Adjusted Life Years (DALY)

20. Disability Adjusted Life Years (DALY) DALYs are currently the most common methods used for estimating burden of disease and measure of overall disease burden. Conceptually, one DALY is the equivalent of losing one year in good health because of either  premature death  or  disease or disability . One DALY represents one lost year of healthy life. DALYs for a disease or health condition are the sum of -years of life lost to due to premature mortality (YLLs) and - the years lived with a disability (YLDs) due to prevalent cases of the disease or health condition in a population.

21. DALY Contd..

22. DALYs = Years of life lost due to premature mortality (YLL) + Years lived with disability (YLD) YLL = N (number of deaths at age x) x L (standard of life expectancy at age x in years) YLD = I (number of incident cases) x DW (disability weight) x L (average  duration of the case until remission or death in years) DALY Contd..

23. Mortality, life expectancy, and population Fertility forecasts and their implications for population growth Causes of death: examining effects on life expectancy Disease burden: successes and challenges Risk factors driving the global burden of disease Forecasts of disease burden through 2050 KEY FINDINGS OF GBD 2021 REPORT

24. Life expectancy Life expectancy declined in 84% of countries and territories during the COVID-19 pandemic.

25. Mortality While global mortality rates rose sharply amid the COVID-19 pandemic, child mortality continued to fall

26. Annual changes in the global population, 1950–2021 Population growth rates continued to decline during the COVID-19 pandemic.

27. Change in life expectancy by region, 1990–2021 Eastern sub-Saharan Africa saw the largest increase in life expectancy among regions; the region’s biggest gains stemmed from efforts to combat diarrhea, tuberculosis, lower respiratory infections, HIV/AIDS, and measles

28. Fertility forecasts

29. Fertility forecasts and their implications for population growth Most countries will experience below-replacement* levels of fertility by mid-century. Researchers anticipate a massive shifting of births from high-income countries to low-income countries. Populations are expected to contract in areas where fertility is below 2.1 children per person who could give birth. Study incorporated hundreds of new data points from surveys, censuses, and vital and sample registration. *Fertility below replacement levels is defined as fewer than 2.1 children per person who could give birth.

30. Projected fertility rates by country in 2100 Only six countries are projected to experience fertility rates above replacement levels (2.1 children per person who could give birth) by 2100.

31. CAUSES OF DEATH

32. CAUSES OF DEATH ( UPDATES IN GBD 2021)

33. Years of life expectancy gained or lost from leading causes of death globally, 1990–2021 The highest increases in global life expectancy have come from progress against enteric diseases, including diarrhea and typhoid. The largest decreases in life expectancy have come from COVID-19 and COVID-related causes

34. Disease burden Among the top causes of disease burden globally, diarrheal diseases, congenital birth defects, and HIV/AIDS dropped the most in the rankings between 2010 and 2021. COVID-19 was the single leading cause of disease burden in 2021.

35. Disease burden ( UPDATES IN GBD 2021)

36. The largest improvements in healthy life expectancy occurred in countries ranking lowest on the Socio-demographic Index, a measure of income, fertility, and education Change in healthy life expectancy by GBD super-region, 2010–2021

37. Risk factors driving the global burden of disease High blood pressure, smoking, and high blood sugar (high fasting plasma glucose) were the three leading risk factors for early death and poor health worldwide in 2021.

38. Risk factors driving the global burden of disease

39. Top 10 risk factors for disease burden among children vs. older adults globally, 2021 While low birthweight, short gestation, and child underweight were top risk factors for children under age 5 in 2021, risk factors including high blood pressure, high blood sugar, and smoking were leading risk factors among older people

40. Rates of disease burden attributable to high body mass index, high fasting plasma glucose, high blood pressure, smoking, and low birth weight, age-standardized, 2000–2021 Since 2000, disease burden linked to high body mass index and high blood sugar rose by 16% and 8%, respectively, as exposure to these risk factors has grown.

41. Forecasts of disease burden through 2050

42. Leading causes of disease burden worldwide in 2022 versus 2050 Between 2022 and 2050, poor health and early death from communicable, maternal, nutritional, and neonatal diseases will decline, and the burden of non-communicable diseases will rise.

43. THANK YOU….