Global, Regional, National, and Subnational Big Data to Inform Health Equity Research: Perspectives from the Global Burden of Disease Study 2017

Abstract

Objectives: Everyone deserves a long and healthy life, but in reality, health outcomes differ across populations. We use results from the Global Burden of Disease Study 2017 (GBD 2017) to report patterns in the burden of diseases, injuries, and risks at the global, regional, national, and subnational level, and by sociodemographic index (SDI), from 1990 to 2017.Design: GBD 2017 undertook a systematic analysis of published studies and available data providing information on prevalence, incidence, remission, and excess mortal­ity. We computed prevalence, incidence, mortality, life expectancy, healthy life expectancy, years of life lost due to prema­ture mortality, years lived with disability, and disability-adjusted life years with 95% uncertainty intervals for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries from 1990 to 2017. We also computed SDI, a summary indicator combining measures of income, education, and fertility.Results: There were wide disparities in the burden of disease by SDI, with smaller burdens in affluent countries and in specific regions within countries. Select diseases and risks, such as drug use disorders, high blood pressure, high body mass index, diet, high fasting plasma glucose, smoking, and alco­hol use disorders warrant increased global attention and indicate a need for greater investment in prevention and treatment across the life course.Conclusions: Policymakers need a com­prehensive picture of what risks and causes result in disability and death. The GBD provides the means to quantify health loss: these findings can be used to examine root causes of disparities and develop pro­grams to improve health and health equity.Ethn Dis. 2019;29(Suppl 1): 159-172; doi:10.18865/ed.29.S1.159.

Reframing implementation science to address inequities in healthcare delivery

“…However, inequities in the delivery of healthcare are a global issue. Ongoing efforts are documenting the magnitude of these healthcare inequities, identifying interventions to improve healthcare delivery, and improving crosscountry communications for better implementation of these interventions for communities in need [84]; e.g., [85,86]. A common challenge in these efforts is finding the balance between a global response to address inequities in healthcare delivery while respecting and understanding the unique systems of care across countries.…”

Strategic Partnerships to Advance Health Equity

“…Mokdad et al demonstrate how the burgeoning health metrics and big data from the Global Burden of Disease Study can inform and help advance health equity research at the global, regional, national, and sub-national levels. 24 Three articles in this journal sup- [25][26][27] Jooma et al caution that the anticipated benefits of genomic research come with the peril that the benefits may not be equitably available to all populations, thus potentially exacerbating health inequities. 25 The authors offer several strategies to help prevent this potential adverse outcome.…”

Reduction of mortality and predictions for acute myocardial infarction, stroke, and heart failure in Brazil until 2030

“…Non-transmissible diseases include chronic respiratory diseases, cancers, diabetes, mental conditions, and diseases of the circulatory system (also referred to as cardiovascular diseases—CVD) 1 , which are responsible for the majority of disabilities 3 and deaths worldwide 3 , 4 . In Brazil, CVD cause 28% of deaths 2 , among which ischemic heart diseases are highlighted as the leading cause, followed by stroke 3 , 5 , 6 . Together, these categories account for 1/3 of global deaths 7 .…”

“…The risk factors for these diseases include the consumption of tobacco 2 , 8 – 12 , arterial hypertension 2 , 5 , 6 , 9 , 12 – 15 , inadequate diet 5 , sedentarism, excessive consumption of alcohol, environmental pollution 1 , 2 , 5 , 9 , the presence of metabolic alterations 16 , high cholesterol 3 , 15 , 17 , diabetes 6 , 8 , 9 , 11 , 13 , and overweight and obesity 2 , 8 , 9 , 11 , 14 , 15 . Regarding the moderate consumption of alcohol, some findings have suggested lower chances of developing CVD, but no causal conclusions were drawn 13 .…”

“…The assessment of these risk factors is very important 6 , along with analysis of health determinants and social iniquities 8 . Nevertheless, health promotion and prevention actions are also essential, along with the monitoring of trends and their dynamics throughout the years 20 , 21 .…”