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Global studies show a fatal convergence of the chronic disease COVID-19

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Ongoing modeling studies and multiple analyzes of disease burden in 204 countries and territories show the rate of increase in preventable chronic diseases that increase vulnerability to COVID-19 and the effects that could not stop the pandemic. It reveals no dangerous combination of public health reactions.

The Global Burden of Disease Study 2019, the most comprehensive known study of its kind, yesterday Special problem of LancetExplains the burden of 369 illnesses and injuries in detail and analyzes 286 causes of death and 87 risk factors from 1990 to 2019. The study, led by researchers at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, is designed to be specific. Countries with the highest need for public health intervention.

Deterioration of US health

Researchers have found a disastrous number in the United States, where life expectancy in 2019 is 78.9 years, shorter than 81.3 years in other high-income countries and has not increased since 2010. This is partly due to the increase in deaths from cardiovascular disease. , Up 16.7% from 2010.

In the United States, the number of years in which health can be expected has steadily increased over the past 30 years, and in 2019 it will be 65.2 years, but it is good, following the same income country (67.4 years). Healthy life expectancy is growing slower than life expectancy in the United States and 197 other countries, indicating a worse healthy life expectancy than in 1990.

With a mortality rate of 6.5 per 1,000 live births, the mortality rate of children under the age of 5 in the United States is significantly higher than the average of 4.9 per 1,000 in other high-income countries, at 3.6 per 1,000 in Australia. It’s almost doubled.

Over the last 20 years, deaths in US adults aged 25-29 have increased by 18.7% and deaths aged 30-34 have increased by 15.6%. This is primarily due to increased rates of drug and alcohol use disorders and self-harm. In 2019, 65,700 Americans died from drug overdose. It has increased from 31,800 in 2010 and accounts for more than half of drug overdose worldwide.

In the United States, improved health is reversing in the form of increased health losses due to increased rates of hypertension, hyperglycemia, obesity, slower declines in smoking rates, and increased deaths from drug overdose. Smoking was the number one cause of health loss in 2019 (10% to 20% of health loss in most states and 13% across the country).

Not equipped to treat the growing burden of chronic illness

Globally, the rise in the proportion that has contributed significantly to the increase in health loss over the last 30 years includes ischemic heart disease (up 50% since 1990), diabetes (148%), stroke (32%), and chronic This includes conditions that mainly affect the elderly. Kidney disease (93%), lung cancer (69%), and age-related hearing loss (83%).

Four common conditions in all age groups, including HIV / AIDS (up 128% from 1990), musculoskeletal disorder group (129%), back pain (47%), and depression (61%) The percentage is rising.

Over the last three decades, international efforts to control infectious diseases and improve prenatal care have reduced the burden of illness in children under the age of 10 by about 55%, as well as in older age groups. Efforts have not been very successful.

Low- and middle-income countries have successfully launched efforts to address infectious diseases, maternal and neonatal illnesses, but the authors have written a healthcare system to manage the increasing burden of chronic diseases in these countries. Said it wasn’t in place. One-third of the overall disease burden in 1990 to nearly two-thirds in 2019.

Around the world, disability accounts for an increasing proportion of the disease burden, increasing from 21% of the total burden in 1990 to 34% in 2019. More than half of all health losses in 11 countries (including Australia, Iceland and Ireland) New Zealand, Norway, Singapore and Qatar are currently due to disabilities caused by non-infectious diseases and injuries.

Christopher Murray, MD, Principal Research Author of IHME, said: Lancet news release Increasing disability rates requires a new and more effective approach.

“With the rapid aging of the world’s population, the demand for medical services to address the increasing disability consequences and chronic illnesses with age is higher levels of funding, stronger political commitments and better data. It requires accountability backed by, and prioritized coordinated global efforts. It is the most vulnerable, “Murray said.

“Acute-Chronic Health Emergency”

The authors say that hypertension, obesity, hyperglycemia, elevated rates of abnormal cholesterol levels, and increased mortality from cardiovascular disease in regions such as the United States and the Caribbean suggest life expectancy worldwide. I did. The gain may decrease or tend to decrease.

They observed that no programs were implemented globally to reward promised government disease prevention programs and healthy behavior and improve access to health care. The government needs to enact these types of programs to help people reduce risk factors for illness, which will bring many economic and social benefits, they added.

“It’s not enough to provide information about the harms of these risks,” said IHME co-authors Emmanuela Gakidou, PhD, and MSc in the release. “Given that individual choices are influenced by economic considerations, education and the availability of alternatives, the government will work globally on initiatives to enable healthier behavior for all. is needed.”

Researchers called for urgent action to address chronic disease, social inequality, and the heavy burden of COVID-19 and reduce the country’s vulnerability to future pandemics.

In the release, Richard Houghton, MD, Editor-in-Chief Lancet, COVID-19 is referred to as a “chronic acute health emergency” boosted by social inequality such as poverty, poor access to housing and education, and racial inequality.

“And the chronicity of the current crisis is being ignored in our future crisis,” he said. “Non-communicable diseases have played an important role in promoting the deaths of more than one million people caused by COVID-19 to date, and continue to build health in all countries after the pandemic has subsided. Probably. “

Accompanying Commentary, Lancet The editorial board said, [the Global Burden of Disease study] Unless we address structural inequality deeply rooted in society and adopt a more liberal approach to immigration policy, communities will not be protected from future outbreaks of infectious diseases and population health will be sought by global health advocates. It means not achieving profits. “

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