HIV prevalence over time is a critical metric for understanding the effectiveness of programs aiming to prevent HIV. Prevalence is often measured using surveillance of clinic patients, which can lead to selection bias: clinics located in areas of high HIV prevalence are often the first to be monitored by the surveillance systems, distorting the estimated HIV prevalence based on clinic data. To help understand the impact of selection bias on the estimation of HIV prevalence trends, researchers compared the efficacy of two approaches for handling selection bias.
The United States spends more than any other country on health care, but US life expectancy at birth ranked 40th for males and 39th for females globally in 2010. To help understand this poor national performance, as well as the large disparities seen in life expectancy across communities, researchers estimated age-specific mortality rates for males and females by US county from 1985 to 2010.
Obesity and lack of physical activity are associated with several chronic conditions, such as heart disease and diabetes, increased health care costs, and premature death. Since different local governments have pursued different approaches to address both risks, levels of obesity and physical activity are likely to vary substantially across counties. To understand local trends in physical activity and obesity that would help identify successful and less successful strategies, researchers examined county-level changes in physical activity and obesity between 2001 and 2011.
To better inform national health policy, it is critical to understand the major health problems in the United States and how they are changing over time. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), researchers compared health outcomes in the US with those of the 34 countries in the Organization for Economic Co-operation and Development (OECD).
Violence against women is a phenomenon that persists in all countries. However, documenting the magnitude of violence against women and producing reliable comparative data to guide policy and monitor progress has been difficult.
An estimated 6% of global infant deaths are attributable to congenital anomalies, of which 92% occur in low-income and middle-income countries (LMICs). Some of the conditions can be treated by specialized surgical procedures that have been frequently provided through established vertical programs. This study aims to quantify the burden of congenital anomalies in LMICs that could be averted should the surgical programs be scaled up to 100% coverage.
China has seen striking declines in child mortality and an increase in life expectancy due to rapid demographic and epidemiological changes in the past few decades, yet dietary risks, tobacco use, and the rise of non-communicable diseases such as cancer pose risks to continued improvements in health.
Our study is the first to quantify the effect of these biases. We analyse multiple surveys per country or territory and show how the estimated share of the household expenditure devoted to health (i.e. health expenditure share) would have varied if survey instruments with different characteristics had been employed. Our contribution makes it possible for analysts to compare health expenditure share estimates across surveys.
The Global Burden of Disease (GBD) 2010 study produced comparable estimates of the burden of 291 diseases and injuries in 1990, 2005, and 2010. This article reports on the global burden of untreated caries, severe periodontitis, and severe tooth loss in 2010 and compares those figures with new estimates for 1990.
Dengue is a systemic viral infection transmitted between humans by Aedes mosquitoes. Here we undertake an exhaustive assembly of known records of dengue occurrence worldwide, and use a formal modeling framework to map the global distribution of dengue risk. We then pair the resulting risk map with detailed longitudinal information from dengue cohort studies and population surfaces to infer the public health burden of dengue in 2010.
Hypertension is an important and modifiable risk factor for cardiovascular disease and mortality. We estimate trends in prevalence, awareness, treatment, and control of hypertension in US counties using data from the National Health and Nutrition Examination Survey (NHANES) in five two-year waves from 1999–2008 including 26,349 adults aged 30 years and older and from the Behavioral Risk Factor Surveillance System (BRFSS) from 1997–2009 including 1,283,722 adults aged 30 years and older.
It is perhaps surprising to state that we have an extremely poor knowledge of the global distribution of the vast majority of infectious diseases. Here we argue that this information gulf has serious implications for global public health surveillance and that too little attention is given to spatial epidemiology in international preparedness planning.
The United Kingdom has provided universal health care and public health programming for more than six decades. To guide future policymaking in the UK, it is important to analyze trends in population health over time. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), researchers examined three critical questions: what are the patterns of health loss in the UK, what are the leading preventable risks that explain some of those patterns, and how do UK outcomes compare to a set of comparable countries in the European Union (EU) and elsewhere in 1990 and 2010.
These findings suggest that greater reductions in malaria morbidity and health gains for children may be achieved with ITNs and IRS combined beyond the protection offered by IRS or ITNs alone.
The primary aim of this review was to evaluate the state of knowledge of the geographical distribution of all infectious diseases of clinical significance to humans.
Measuring the survival of human immunodeficiency virus–infected adult patients enrolled in antiretroviral therapy (ART) programs is complicated by short observation periods and loss to follow-up. We synthesized data from treatment cohorts in sub-Saharan Africa to estimate survival over 5 years after initiation of ART.
The prevalence of ever smoking and current smoking, smoking initiation, and exposure to second-hand smoking decreased over time. Overall, willingness to stop smoking, supporting smoking bans, and receiving information about the dangers of smoking increased over time.
Healthy life expectancy, or HALE, is a measure of average population health summarizing both mortality and non‐fatal outcomes. HALE is used for comparisons of health across countries or for measuring change over time. These comparisons can shed light on key questions about how morbidity worsens or improves as mortality declines.
Measurement of the global burden of disease using disability‐adjusted life years (DALYs) requires disability weights that measure health losses for all non‐fatal consequences of disease and injury. There has been vigorous debate over the definition and measurement of these weights. The primary objective was a comprehensive re‐estimation of disability weights through a large‐scale, population‐based, empirical investigation in which judgments about health loss associated with many causes were elicited from the general public in diverse communities. This is a marked improvement over previous efforts, which relied solely upon judgments from a small group of health professionals.
In this paper, results on years lost due to premature mortality (YLLs) and years lived with disability (YLDs) are combined to examine the overall burden of disease across 291 diseases and injuries by country for the period 1990 to 2010.
The goal of this research was to estimate deaths and years of lives lost (YLLs) by age, sex, and region for 235 causes at two points in time – 1990 and 2010. This information can be used to better inform global efforts to assess whether society is or is not making progress in reducing the burden of premature – and especially avoidable – mortality.
The goal of this study is to calculate what proportion of deaths or disability‐adjusted life years (DALYs) can be attributed to specific risk factors, holding other independent factors unchanged. Quantification of the disease burden caused by different risks informs prevention by identifying which risks make the greatest contribution to poor health. No complete revision of global burden of disease caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time.
Individuals, households, and health systems devote enormous resources to curing, preventing, and eliminating non‐fatal, disabling health conditions. Therefore, it is essential that some form of measuring and tracking non‐fatal burdens be available for policy and planning purposes.
The number of deaths in each age and sex group for countries, regions, and the world is a critical starting point for assessing the Global Burden of Disease (GBD). A careful estimation of deaths and mortality rates by age and sex is essential to assess progress, improve health, and extend the lives of people around the world. Information about mortality rates and causes of death at different ages, especially premature mortality, is also an important impetus for public policy action.
Between 1990 and 2010, the U.S ranking in neonatal mortality slipped from 29th to 45th among countries globally. Our objective is to measure the extent to which trends and subnational variation in early neonatal mortality reflect differences in the prevalence of risk factors (gestational age and birth weight) compared to differences in clinical care.