The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3•5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.

No abstract

Background: This study aimed to examine the longitudinal contributions of four political and socioeconomic factors to the increase in life expectancy in less developed countries (LDCs) between 1970 and 2004.

BackgroundThe impact of global warming on population health is a growing concern and has been widely discussed. The issue of heat stress disorders and consequent productivity reduction among workers has not yet been widely addressed. Taiwan is an island straddling the Tropic of Cancer in the West Pacific and has both subtropical and tropical climates. As of 2008, the economy of Taiwan accounts for 1.1% of the world gross domestic product at purchasing power parity and is listed as 19th in the world and eighth in Asia, according to International Monetary Fund data.ObjectiveThe aim of this paper is to identify occupations at risk and the potential health impacts of heat on workers in Taiwan.DesignHistorical data relating to meteorology, population, the labour force and economy were obtained from publicly available databases from the Taiwanese government.ResultsHot seasons with an average maximum temperature above 30°C and relative humidity above 74%, lasting for four to six months from May to October, pose health threats to construction, farming and fishery workers. In particular, populations of ageing farmers and physically overloaded construction workers are the two most vulnerable worker categories in which high temperature impacts on health and productivity.ConclusionsCurrently, regulations and preventive actions for heat relief are difficult to enforce for several reasons, including lack of equipment for measuring environmental conditions, lack of awareness of potential hazards and strict time constraints imposed on workers. There is an urgent need to systematically and comprehensively assess the impact of a warming climate on workers’ health and productivity to provide effective prevention strategies for a better working and living environment in Taiwan.

BackgroundGovernance of a country may have widespread effects on the health of its population, yet little is known about the effect of governance on child mortality in a country that is undergoing urbanization, economic development, and disease control.MethodsWe obtained indicators of six dimensions of governance (perceptions of voice and accountability, political stability and absence of violence, government effectiveness, regulatory quality, rule of law, and control of corruption) and national under-5 mortality rates for 149 countries between 1996 and 2010. We applied a semi-parametric generalized additive mixed model to examine associations after controlling for the effects of development factors (urbanization level and economy), disease control factors (hygienic conditions and vaccination rates), health expenditures, air quality, and time.ResultsGovernance, development, and disease control showed clear inverse relations with the under-5 mortality rate (p<0.001). Per unit increases in governance, development, and disease control factors, the child mortality rate had a 0.901-, 0.823-, and 0.922-fold decrease, respectively, at fixed levels of the other two factors.ConclusionsIn the effort to reduce the global under-5 mortality rate, addressing a country's need for better governance is as important as improvements in development and disease control.