The articles of this issue of the Brazilian Journal of Epidemiology are the result of efforts to estimate and analyze the burden of disease in Brazil and in its states.
National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (i.e., amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardized cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015.
The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world. The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden.
Regional variation in cardiovascular mortality is well-known but county-level estimates for all major cardiovascular conditions have not been produced.
Heart failure is a major cause of disease burden in sub-Saharan Africa (SSA). There is an urgent need for better strategies for heart failure management in this region. However, there is little information on the capacity to diagnose and treat heart failure in SSA. We aim to provide a better understanding of the capacity to diagnose and treat heart failure in Kenya and Uganda to inform policy planning and interventions.
Examining life expectancy by county allows for tracking geographic disparities over time and assessing factors related to these disparities. This information is potentially useful for policymakers, clinicians, and researchers seeking to reduce disparities and increase longevity.
Development assistance for health targets younger more than older age groups, relative to their disease burden. This disparity increased between 1990 and 2013. There are several potential causes for the disparity increase. We investigated the benefits from development assistance for health by age group.
Adolescence and emerging adulthood form a critical time period for the achievement of optimal health and nutrition across all stages of the life course. The results of this study paint a less than ideal picture of current young people's nutrition, suggesting dual burdens of underweight and high body-mass index in many countries and variable improvements in micronutrient deficiencies across geographical regions.
Estimates of future spending can be beneficial for policymakers and planners, and can identify financing gaps. In this study, we estimate future gross domestic product (GDP), all-sector government spending, and health spending disaggregated by source, and we compare expected future spending to potential future spending.
In this study, we further explore global health financing trends and examine how the sources of funds used, types of services purchased, and development assistance for health disbursed change with economic development.
The burden of premature death and health loss from end-stage renal disease (ESRD) is well described. Less is known regarding the burden of cardiovascular disease attributable to reduced glomerular filtration rate (GFR). We estimated the prevalence of reduced GFR for 188 countries at six time points from 1990 to 2013.
Exposure to ambient air pollution increases morbidity and mortality, and is a leading contributor to global disease burden. We explored spatial and temporal trends in mortality and burden of disease attributable to ambient air pollution from 1990 to 2015 at global, regional, and country levels.
The scale-up of tobacco control, especially after the adoption of the Framework Convention for Tobacco Control, is a major public health success story. Nonetheless, smoking remains a leading risk for early death and disability worldwide, and therefore continues to require sustained political commitment. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) offers a robust platform through which global, regional, and national progress toward achieving smoking-related targets can be assessed.
Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health. This study quantifies and describes levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion.
Professional skilled care has shown to be one of the most promising strategies to reduce maternal mortality, and in-facility deliveries are a cost-effective way to ensure safe births. We examined the characteristics of women who had a delivery in a health facility and determinants of the decision to bypass a closer facility and travel to a distant one.
Although preventable, tetanus still claims tens of thousands of deaths each year. The patterns and distribution of mortality from tetanus have not been well characterized. We identified the global, regional, and national levels and trends of mortality from neonatal and non-neonatal tetanus based on the results from the Global Burden of Disease study 2015.
The Global Burden of Disease 2015 study aims to use all available data of sufficient quality to generate reliable and valid prevalence, incidence, and disability-adjusted life year (DALY) estimates of oral conditions for the period of 1990 to 2015. Since death as a direct result of oral diseases is rare, DALY estimates were based on years lived with disability, which are estimated only on those persons with unmet need for dental care.
Cancer is a leading cause of morbidity and mortality in the United States and results in a high economic burden. Our objective of this study was to estimate age-standardized mortality rates by US county from 29 cancers.
The purpose of this study was to identify factors associated with contraceptive use among women in need living in the poorest areas in five Mesoamerican countries: Guatemala, Honduras, Nicaragua, Panama and State of Chiapas (Mexico).
The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR.
Elevated systolic blood pressure (SBP) is a leading global health risk. Quantifying the levels of SBP is important to guide prevention policies and interventions.
A recent report by the Institute for Health Metrics and Evaluation (IHME) highlights that mental health receives little attention despite being a major cause of disease burden. This paper extends previous assessments of development assistance for mental health (DAMH) in two significant ways; first by contrasting DAMH against that for other disease categories, and second by benchmarking allocated development assistance against the core disease burden metric (disability-adjusted life year) as estimated by the Global Burden of Disease Study.
US health care spending has continued to increase, and now accounts for more than 17% of the US economy. Despite the size and growth of this spending, little is known about how spending on each condition varies by age and across time.
Health care spending on children in the United States continues to rise, yet little is known about how this spending varies by condition, age and sex group, and type of care, nor how these patterns have changed over time.
According to GBD analyses, the rise of NCD is in part due to increased life expectancy due to reduced premature mortality from communicable, child, and maternal illnesses, but preventable risk factors also contribute and present targets for NCD control efforts.