Projections of Global Mortality and Burden of Disease from 2002 to 2030

Evidence and Information for Policy Cluster, World Health Organization, Geneva, Switzerland.
PLoS Medicine (Impact Factor: 14). 12/2006; 3(11):e442. DOI: 10.1371/journal.pmed.0030442
Source: PubMed

ABSTRACT Global and regional projections of mortality and burden of disease by cause for the years 2000, 2010, and 2030 were published by Murray and Lopez in 1996 as part of the Global Burden of Disease project. These projections, which are based on 1990 data, continue to be widely quoted, although they are substantially outdated; in particular, they substantially underestimated the spread of HIV/AIDS. To address the widespread demand for information on likely future trends in global health, and thereby to support international health policy and priority setting, we have prepared new projections of mortality and burden of disease to 2030 starting from World Health Organization estimates of mortality and burden of disease for 2002. This paper describes the methods, assumptions, input data, and results.
Relatively simple models were used to project future health trends under three scenarios-baseline, optimistic, and pessimistic-based largely on projections of economic and social development, and using the historically observed relationships of these with cause-specific mortality rates. Data inputs have been updated to take account of the greater availability of death registration data and the latest available projections for HIV/AIDS, income, human capital, tobacco smoking, body mass index, and other inputs. In all three scenarios there is a dramatic shift in the distribution of deaths from younger to older ages and from communicable, maternal, perinatal, and nutritional causes to noncommunicable disease causes. The risk of death for children younger than 5 y is projected to fall by nearly 50% in the baseline scenario between 2002 and 2030. The proportion of deaths due to noncommunicable disease is projected to rise from 59% in 2002 to 69% in 2030. Global HIV/AIDS deaths are projected to rise from 2.8 million in 2002 to 6.5 million in 2030 under the baseline scenario, which assumes coverage with antiretroviral drugs reaches 80% by 2012. Under the optimistic scenario, which also assumes increased prevention activity, HIV/AIDS deaths are projected to drop to 3.7 million in 2030. Total tobacco-attributable deaths are projected to rise from 5.4 million in 2005 to 6.4 million in 2015 and 8.3 million in 2030 under our baseline scenario. Tobacco is projected to kill 50% more people in 2015 than HIV/AIDS, and to be responsible for 10% of all deaths globally. The three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depressive disorders, and ischaemic heart disease in the baseline and pessimistic scenarios. Road traffic accidents are the fourth leading cause in the baseline scenario, and the third leading cause ahead of ischaemic heart disease in the optimistic scenario. Under the baseline scenario, HIV/AIDS becomes the leading cause of burden of disease in middle- and low-income countries by 2015.
These projections represent a set of three visions of the future for population health, based on certain explicit assumptions. Despite the wide uncertainty ranges around future projections, they enable us to appreciate better the implications for health and health policy of currently observed trends, and the likely impact of fairly certain future trends, such as the ageing of the population, the continued spread of HIV/AIDS in many regions, and the continuation of the epidemiological transition in developing countries. The results depend strongly on the assumption that future mortality trends in poor countries will have a relationship to economic and social development similar to those that have occurred in the higher-income countries.

  • Source
    • "Both obesity and mental health problems represent important public health challenges (Mathers and Loncar, 2006). In 2008 approximately 1.5 billion adults were overweight globally, of whom more than 200 million men and nearly 300 million women were obese, as shown by the World Health Organization's (WHO) numbers (World Health Organization, 2011). "
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine the longitudinal relationship between psychological distress and body mass index (BMI) changes over a period of five and ten years. Data were used from the Dutch, prospective, population based Doetinchem Cohort study over the period 1995/1999 until 2005/2009 (N=5,504). Psychological distress was assessed using the Mental Health Inventory (MHI-5). BMI (kg/m(2)) was calculated from measured body height and body weight. GEE analyses were used to examine the relationship between psychological distress at baseline and BMI change, and the development of overweight over five years. Linear and logistic regression analyses were used to examine these relations over ten years. Psychological distress predicted an extra overall increase in BMI of 0.14 kg/m(2)- (95%CI 0.03-0.25) over five years and an increase of 0.18 kg/m(2) (95%CI 0.01-0.35) over ten years, when comparing psychological distressed participants to psychologically healthy participants. This was especially the case among persons with normal weight (five years; B=0.26 kg/m(2), 95%CI=0.12-0.40 / ten years; B=0.32 kg/m(2) 95%CI=0.11-0.53) and moderate overweight (five years: B=0.18 kg/m(2), 95%CI=0.02-0.35) at baseline. Psychological distress did not predict the development of overweight five and ten years later. The results in this study indicated that psychological distress predicted an increased risk in gaining weight, but did not result in an increased risk for developing overweight. Copyright © 2015. Published by Elsevier Inc.
    Preventive Medicine 04/2015; 77. DOI:10.1016/j.ypmed.2015.04.020 · 2.93 Impact Factor
  • Source
    • "Low back pain is recognized as one of the main causes for burden of disease despite that back pain is without attributable deaths (Lim et al., 2012). Mental disorders also contribute considerably to years lived with disability (Mathers and Loncar, 2006). By 2030, unipolar depressive disorder is, e.g. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background The aim of this study was to investigate the associations between sickness absence due to back pain or depressive episode with future all-cause and diagnosis-specific disability pension, while adjusting for comorbidity and socio-demographics, for all and stratifying for sex.Method In total, 4,823,069 individuals aged 16–64 years, living in Sweden at the end of 2004, not on old-age or disability pension in 2005 and without ongoing sickness absence at the turn of 2004/2005 formed the study population. Crude and adjusted hazard ratios (HRs) for all-cause and diagnosis-specific disability pension (2006–2010) in relation to diagnosis-specific sickness absence with sickness benefits paid by the Social Insurance Agency were estimated using Cox regression.ResultsThe HR for all-cause disability pension was 7.52 (7.25–7.52) in individuals with an incident sick-leave spell due to back pain, compared to individuals without sickness absence in 2005 in the fully adjusted (socio-demographics and comorbidity) model. The fully adjusted (multivariate) HRs for diagnosis-specific disability pension were musculoskeletal diagnoses 23.87 (22.75–25.04), mental 2.49 (2.27–2.73) or all other diagnoses, 3.44 (3.17–3.75). In individuals with an incident sick-leave spell due to a depressive episode in 2005, the multivariate adjusted HR for all-cause disability pension was 12.87 (12.42–13.35), while the multivariate HRs for disability pension due to musculoskeletal diagnoses were 4.39 (3.89–4.96), for mental diagnoses 25.32 (24.29–26.38) and for all other somatic diagnoses 3.44 (3.09–3.82). Men who were sickness absent due to a depressive episode had a higher HR for disability pension compared to women.Conclusion Results indicate that sickness absence due to a depressive episode or back pain is a strong risk factor for a future disability pension due to mental, musculoskeletal or other somatic diagnoses.
    European journal of pain (London, England) 02/2015; DOI:10.1002/ejp.661 · 3.22 Impact Factor
  • Source
    • "While substantial research has demonstrated the potential for preventing the adverse outcomes of type 2 diabetes [1], the increase in the number of people with diabetes (PWD) has outpaced the response of health systems [2] [3]. This incongruity is particularly marked in low and middle income countries (LMIC) where 80% of deaths from diabetes occur [4]. The estimated adult prevalence of diabetes in Guyana was 15.5% in 2011 [5] and in 2008 diabetes was the fourth leading cause of death [6]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background. Type 2 diabetes is the fourth leading cause of death in Guyana, South America. A complex, interprofessional, quality improvement intervention to improve foot and diabetes care was rolled out in two phases. Methods & Findings. Phase 1: Establishment of an Interprofessional Diabetic Foot Center (DFC) of Excellence to improve foot care and reduce diabetes-related amputations at the national referral hospital. Phase 2: Regionalization to cover 90% of the Guyanese population and expansion to include improved management of diabetes and hypertension. Fourteen key opinion leaders were educated and 340 health care professionals from 97 facilities trained. Eight centers for the evaluation and treatment of foot ulcers were established and 7567 people with diabetes evaluated. 3452 participants had foot screening and 48% were deemed high risk; 10% of these had undocumented foot ulcers. There was a 68% reduction in rate of major amputations (í µí±ƒ < 0.0001); below knee amputations were decreased by 80%, while above knee amputations were unchanged. An increased association of diabetes with women (F/M = 2.09) and increased risk of major amputation in men [odds ratio 2.16 (95% CI 1.83, 2.56)] were documented. Conclusions. This intervention improved foot care with reduction in major amputations sustained over 5 years.
    International Journal of Endocrinology 01/2015; 2015. DOI:10.1155/2015/920124 · 1.52 Impact Factor
Show more

Preview (2 Sources)

Available from