PHLT611: Special Issues in Public Health – I
Unit 04: International Health: Disease patterns around the world, Regions of the world
according to WHO and their overall health status, effect of climate, politics and society
on health, and International Health Organization, International Regulations.
Disease patterns around the world, Regions of the world according to WHO and their
overall health status
A straightforward way to assess the health status of a population is to focus on mortality – or concepts like
child mortality or life expectancy, which are based on mortality estimates. A focus on mortality, however,
does not take into account that the burden of diseases is not only that they kill people, but that they cause
suffering to people who live with them.he sum of mortality and morbidity is referred to as the ‘burden of
disease’ and can be measured by a metric called ‘Disability Adjusted Life Years‘ (DALYs). DALYs are
measuring lost health and are a standardized metric that allow for direct comparisons of disease burdens of
different diseases across countries, between different populations, and over time. 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.
Premature death and ill health – the global burden of disease
Human potential that is lost due to poor health is immense: The Global Burden of Disease (GBD) project
aims to quantify this loss by estimating the number of healthy life years lost globally. This metric takes into
account both, the human life years lost due to early death and the life years compromised by disease and
disability. It is a massive study that takes into account thousands of datasets to capture the burden of
diseases globally.
55.9 million people died in 2017. If we sum up all life years lost due to premature death – the sum of the
differences between each person’s age of death and their life expectancy at that age – we find that the world
population lost 1.65 billion years of potential life due to premature death in that year. Disease and disability
meant that an additional 853 million years of healthy life years were lost.1
It is hard to get a sense of scale for these enormous numbers. One way to illustrate it is to put it in relation to
the global population, which was 7.53 billion in that year. The global burden of disease, viewed in this way,
sums up to a third of a year lost for each person on the planet.2
The global distribution of the disease burden
The map shows DALYs per 100,000 people of the population. It is thereby measuring the distribution of the
burden of both mortality and morbidity around the world.
,We see that rates across the regions with the best health are below 20,000 DALYs per 100,000 individuals.
In 2017 this is achieved in many European countries, but also in Canada, Israel, South Korea, Taiwan,
Japan, Kuwait, the Maldives, and Australia.
In the worst-off regions, particularly in Sub-Saharan Africa, the rate is higher than 80,000 DALYs per
100,000.
The disease burden by cause
Epidemiologists break the disease burden down into three key categories of disability or disease – and this is
shown in the chart here: non-communicable diseases (NCDs) [in blue]; communicable, maternal, neonatal
and nutritional diseases [in red], and injuries [in grey].
We provide a more detailed breakdown of what sub-categories fall within each of these three groupings in
our Data Quality and Definitions section. We also look at a higher-resolution breakdown within each of
these groupings in the sections which follow.
At a global level, in 2017 more than 60 percent of the burden of disease results from non-communicable
diseases (NCDs), with 28 percent from communicable, maternal, neonatal and nutritional diseases, and just
over 10 percent from injuries.
The chart also shows a notable shift since 1990, when communicable diseases held the highest share at 46
percent.
This shift in burden towards NCDs result from a significant reduction in communicable and preventable
disease as incomes rise and overall health and living standards improve. In high-income nations, NCDs
typically account for more than 80 percent of disease burden. In contrast, communicable diseases to be low,
at less than 5 percent. The opposite is true in low-income nations; communicable disease still accounts for
more than 60 percent across many countries.
, How do different diseases and disabilities contribute towards the burden of disease?
In the two charts here we see the breakdown of the disease burden by cause. One chart shows the absolute
numbers of DALYs by cause while the other presents share of the total DALYs by each cause.
Non-communicable diseases are shown in blue; communicable, maternal, neonatal and nutritional diseases
shown in red; and injuries shown in grey.
At a global level the largest disease burden in 2017 comes from cardiovascular diseases which account for
15 percent of the total. This is followed by cancers (9 percent); neonatal disorders (7 percent); muscoskeletal
disorders (6 percent); and mental and substance use disorders (5 percent).
This attribution varies significantly across the world – these figures and rankings of the disease burden can
be explored by country and region using the ‘change country’ option in the charts.
If we look at a lower-income country (e.g. Congo), we notice that communicable and neonatal diseases rank
much higher. This is in stark contrast to a typical high-income nation (e.g. United States) where no
communicable diseases fall within the top ten. Cardiovascular disease, cancer, muscoskeletal disorders and
mental and substance use disorders form the top four health burdens across many upper-middle and high-
income nations.
A dedicated IHME website provides a very helpful interactive tool to explore all available data on burden of
disease worldwide.
Unit 04: International Health: Disease patterns around the world, Regions of the world
according to WHO and their overall health status, effect of climate, politics and society
on health, and International Health Organization, International Regulations.
Disease patterns around the world, Regions of the world according to WHO and their
overall health status
A straightforward way to assess the health status of a population is to focus on mortality – or concepts like
child mortality or life expectancy, which are based on mortality estimates. A focus on mortality, however,
does not take into account that the burden of diseases is not only that they kill people, but that they cause
suffering to people who live with them.he sum of mortality and morbidity is referred to as the ‘burden of
disease’ and can be measured by a metric called ‘Disability Adjusted Life Years‘ (DALYs). DALYs are
measuring lost health and are a standardized metric that allow for direct comparisons of disease burdens of
different diseases across countries, between different populations, and over time. 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.
Premature death and ill health – the global burden of disease
Human potential that is lost due to poor health is immense: The Global Burden of Disease (GBD) project
aims to quantify this loss by estimating the number of healthy life years lost globally. This metric takes into
account both, the human life years lost due to early death and the life years compromised by disease and
disability. It is a massive study that takes into account thousands of datasets to capture the burden of
diseases globally.
55.9 million people died in 2017. If we sum up all life years lost due to premature death – the sum of the
differences between each person’s age of death and their life expectancy at that age – we find that the world
population lost 1.65 billion years of potential life due to premature death in that year. Disease and disability
meant that an additional 853 million years of healthy life years were lost.1
It is hard to get a sense of scale for these enormous numbers. One way to illustrate it is to put it in relation to
the global population, which was 7.53 billion in that year. The global burden of disease, viewed in this way,
sums up to a third of a year lost for each person on the planet.2
The global distribution of the disease burden
The map shows DALYs per 100,000 people of the population. It is thereby measuring the distribution of the
burden of both mortality and morbidity around the world.
,We see that rates across the regions with the best health are below 20,000 DALYs per 100,000 individuals.
In 2017 this is achieved in many European countries, but also in Canada, Israel, South Korea, Taiwan,
Japan, Kuwait, the Maldives, and Australia.
In the worst-off regions, particularly in Sub-Saharan Africa, the rate is higher than 80,000 DALYs per
100,000.
The disease burden by cause
Epidemiologists break the disease burden down into three key categories of disability or disease – and this is
shown in the chart here: non-communicable diseases (NCDs) [in blue]; communicable, maternal, neonatal
and nutritional diseases [in red], and injuries [in grey].
We provide a more detailed breakdown of what sub-categories fall within each of these three groupings in
our Data Quality and Definitions section. We also look at a higher-resolution breakdown within each of
these groupings in the sections which follow.
At a global level, in 2017 more than 60 percent of the burden of disease results from non-communicable
diseases (NCDs), with 28 percent from communicable, maternal, neonatal and nutritional diseases, and just
over 10 percent from injuries.
The chart also shows a notable shift since 1990, when communicable diseases held the highest share at 46
percent.
This shift in burden towards NCDs result from a significant reduction in communicable and preventable
disease as incomes rise and overall health and living standards improve. In high-income nations, NCDs
typically account for more than 80 percent of disease burden. In contrast, communicable diseases to be low,
at less than 5 percent. The opposite is true in low-income nations; communicable disease still accounts for
more than 60 percent across many countries.
, How do different diseases and disabilities contribute towards the burden of disease?
In the two charts here we see the breakdown of the disease burden by cause. One chart shows the absolute
numbers of DALYs by cause while the other presents share of the total DALYs by each cause.
Non-communicable diseases are shown in blue; communicable, maternal, neonatal and nutritional diseases
shown in red; and injuries shown in grey.
At a global level the largest disease burden in 2017 comes from cardiovascular diseases which account for
15 percent of the total. This is followed by cancers (9 percent); neonatal disorders (7 percent); muscoskeletal
disorders (6 percent); and mental and substance use disorders (5 percent).
This attribution varies significantly across the world – these figures and rankings of the disease burden can
be explored by country and region using the ‘change country’ option in the charts.
If we look at a lower-income country (e.g. Congo), we notice that communicable and neonatal diseases rank
much higher. This is in stark contrast to a typical high-income nation (e.g. United States) where no
communicable diseases fall within the top ten. Cardiovascular disease, cancer, muscoskeletal disorders and
mental and substance use disorders form the top four health burdens across many upper-middle and high-
income nations.
A dedicated IHME website provides a very helpful interactive tool to explore all available data on burden of
disease worldwide.
