- What is the Local Burden of Disease (LBD) and why is it important?
- What indicators are being mapped by LBD?
- What countries are being mapped by LBD?
- How can I use LBD estimates?
- How do LBD and the Global Burden of Disease (GBD) connect?
- Where are LBD estimates being used?
- How accurate are the local estimates?
- Why use a geospatial approach?
- What is geospatial data?
- Where does LBD get data?
- Where can I find LBD estimates? Can I use them?
- How do I download LBD estimates and maps?
The Local Burden of Disease (LBD) project at the Institute for Health Metrics and Evaluation (IHME) works to produce estimates of what is killing people and making them sick at a granular, local resolution. These estimates allow decision-makers to tailor health responses precisely, making health policy decisions for local areas rather than entire countries. They also help to identify geographic inequities. While global- and national-level estimates have been essential to understanding overarching trends in child mortality, infectious diseases, access to clean water, and other health-related topics, they can hide local variations within national borders.
LBD is estimating and mapping health-related measures that are of high importance in addressing worldwide health inequities and achieving the United Nations Sustainable Development Goals:
- Under-5 mortality
- Child growth failure (stunting, wasting, underweight)
- Child overweight
- Malaria (P.f. and P.v.), in partnership with the Malaria Atlas Project, University of Oxford
- Lower respiratory infections
- Exclusive breastfeeding
- Anemia (in women of reproductive age)
- Lymphatic filariasis
- Ebola and other hemorrhagic fevers
- Educational attainment
- Oral rehydration therapy coverage
- Household air pollution
- Male circumcision
- Pandemic potential of henipavirus, Middle East respiratory syndrome coronavirus, Rift Valley fever, and monkeypox.
- Vaccine coverage
- Water and sanitation
For most indicators, LBD is mapping in stages, focusing first on countries with the highest burden of disease and where changing outcomes can have the most impact. For the first phase of LBD mapping, researchers focus on countries in Africa. Stage two papers map all low- and middle-income countries, and stage three papers are global. Some research – such as the work on malaria or tuberculosis – does not follow this approach, instead mapping either all endemic areas or only those where good-quality data are available.
LBD seeks to improve the geographically fine-grained evidence base for a variety of health conditions. Such estimates will allow decision-makers to target resources and health interventions precisely, so that health policy decisions can be tailored for local areas rather than entire countries. By combining local detail with broad coverage, we provide a tool health officials globally need to make locally informed decisions and, in the process, help all people live longer, healthier lives. The maps and estimates generated by the LBD project are made freely and publicly available to guide the public health efforts of all who wish to use them, from researchers to policymakers.
The LBD project is an extension of the Global Burden of Diseases, Injuries, and Risk Factors (GBD) study. Over time, the goal is to map every factor included in GBD with precise local detail, to support better health around the world.
Maps produced by LBD and partners are in use worldwide for policy design and implementation. The Bill and Melinda Gates Foundation and the World Health Organization use LBD maps to inform policy and strategy. LBD works with thousands of collaborators and makes maps that are freely available to all who wish to use them. For example, UNICEF has integrated LBD results into its Equitable Impact Sensitive Tool (EQUIST), a powerful web-based platform to help decision-makers develop equitable strategies to improve health and nutrition for the most vulnerable children and women. LBD estimates available via EQUIST include neonatal and under-5 mortality, under-5 stunting, and under-5 wasting.
The accuracy of the estimates varies based on the amount of data available in a given location. Uncertainty intervals are provided with all estimates, so anyone accessing the data can see the range of possible values for each area. The LBD team updates estimates for all mapped countries every time a new paper is published on a given theme, and is constantly adding new data sources to our library to maintain the highest possible accuracy.
Using geospatial data gives us the ability to estimate the burden of disease, health patterns, and trends based on a specific location. Geospatial data also give us the ability to estimate geographic inequity and identify the areas most in need of support. Having precise location information can also provide context and help decision-makers identify potential reasons why a disease may be spreading, or where there is a high risk of disease outbreaks. Many of the analyses the LBD team has conducted so far have found large variation in the burden of different health conditions at the subnational level and “hotspots” of mortality or disease within countries that are hidden by national-level estimates.
Geospatial data has a geographic component linking it to a location on the Earth’s surface. This means that the records in a dataset have location information such as longitude and latitude, a street address, city, or ZIP code. Geospatial data can come from GPS tracking, satellite imagery, and geotagging. More information on data used by the LBD project is available on our website.
The LBD team uses a broad set of data sources, including census data, environmental data, national surveys such as those from UNICEF and DHS data from Ministries of Health, and data directly from intervention programs. LBD also works with the GBD Collaborator Network, which includes over 4,000 collaborators from around the world. Individuals in the Collaborator Network review and provide timely feedback related to interpretation of results and/or methodological approaches, as well as provide feedback on data sources used in LBD analysis.
In accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER), all results from IHME’s Local Burden of Disease research, along with comprehensive information on data sources and methods used, are made freely available to the public through the Global Health Data Exchange (GHDx).
The GHDx is a library of health data that can power analyses of local disease burden. It shares data, to the extent allowed by usage agreements, with other researchers and interested parties. Anyone interested in inquiring about the data used by the Local Burden of Disease team – or in sharing data to be used in its analyses – is invited to email us at [email protected].
There are several ways to access data and results produced by the LBD project:
- The LBD section of the Global Health Data Exchange (GHDx). Published LBD studies have records in the GHDx that link to results, methods, data sources, and more, so that researchers interested in examining, replicating, or building upon those projects’ results may do so.
- The research articles (and their accompanying annexes) published in peer-reviewed scientific journals.
- The data visualizations available on IHME’s website.
Anyone interested in inquiring about the data used by the LBD team – or in sharing data to be used in its analyses – is invited to email us at [email protected].
In the future, the LBD team will be making available downloadable maps that may be helpful to researchers, policymakers, advocates, or anyone interested in global health.
The Institute for Health Metrics and Evaluation (IHME) is committed to appropriate protection and management of all information shared with us, and our research is approved by the Institutional Review Board through the University of Washington.