Global health: longer lives, more lifestyle disease

Credit: CC0 Public Domain

Life expectancy worldwide has jumped by a decade since 1980, rising in 2015 to 69 years for men and nearly 75 for women, according to a comprehensive overview of global health released Thursday.
These extra years came in large measure thanks to a sharp drop in deaths from communicable diseases, especially over the last decade, said the Global Burden of Disease report, published in The Lancet.

08 oct 2016--Despite population increases, combined mortality from HIV/AIDS and tuberculosis—both major killers—fell by more than a quarter, from 3.1 million in 2005 to 2.3 million in 2015.
Over this period, annual deaths due to diarrhoeal diseases decreased by 20 percent.
And malaria mortality plummeted by more than a third, from 1.2 million in 2005 to 730,000 last year.
During that decade, life expectancy went up in 188 of 195 countries and territories.
At the same time, however, non-communicable diseases of all kinds—ranging from cancers to heart disease and stroke—claimed more lives, with the death toll rising from 35 million in 2005 to 39 million in 2015.
"As we live longer, the burden of non-communicable diseases is rising—along with the attendant costs of treatment," Kevin Watkins, head of Save the Children UK, noted in a comment, also in The Lancet.
Many of the diseases on the rise are associated with ageing: cancers, coronary artery disease, cirrhosis of the liver and Alzheimer's, among others.
The paradox is that even as lifespans grow, more people are spending more time in ill health of living with disabilities, the 100-page study found.
Centralising the expertise of nearly 1,900 experts, the report—coordinated by the Institute for Health Metrics and Evaluation at the University of Washington in Seattle—comes at the juncture between two major UN health initiatives.
The Millennium Development Goals (MDGs), set in 2000, set hard targets for reducing child and maternal mortality, and combatting key communicable diseases, by 2015.
A 15-year clock on a new set of Sustainable Development Goals (SDGs)—several of them health related—began running last year.
The report is intended as a benchmark for this new effort.
There have been other major health gains over the last quarter century.
The number of deaths of children under five, for example, dropped by more than 50 percent from 1990 to 2015, to 5.8 million.

National score cards

But that was still well short of the MDG calling for under-five mortality to be slashed by two-thirds.
Had that target been met, another 14 million children would have survived to see their fifth birthday.
There were exceptions to the generally positive trends, many stemming from conflict.
Since 2011, global deaths from war have risen massively due in large part to fighting in Syria, Yemen and Libya.
Male life expectancy in Syria has dropped more than 11 years since the civil war there began.
In 2015, the number of people displaced by armed conflict and disasters reached a record 65 million. Over half of the world's refugees are children.
The report also "graded" countries, indicating whether mortality levels from specific causes were lower or higher than expected, taking into account each nation's income and education levels, as well as fertility rates.
The United States, for example, scored very poorly on coronary heart disease, chronic obstructive pulmonary disease (COPD), and drug abuse.
Many Eastern European countries scored poorly on these, as well as alcohol abuse and stroke.
Western European and East Asian countries, generally speaking, scored highest.