Download Global burden of disease module

Survey
yes no Was this document useful for you?
   Thank you for your participation!

* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project

Document related concepts

Onchocerciasis wikipedia , lookup

Neglected tropical diseases wikipedia , lookup

African trypanosomiasis wikipedia , lookup

Pandemic wikipedia , lookup

Eradication of infectious diseases wikipedia , lookup

Syndemic wikipedia , lookup

Transcript
1.
How to use this
module
Introduction 1
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
Partners in Global Health Education
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
GLOBAL
BURDEN OF
DISEASE
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
For more
information about
the authors and
reviewers of this
module, click here
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
How to use this module
Partners in Global Health Education
• This self-directed learning (SDL) module has been designed for
medical and other health care students
• We suggest that you start with the learning outcomes and try to keep
these in mind as you go through the module slide by slide and at
your own pace.
• Print-out the GBD SDL answer sheet. Write your answers to the
questions as best you can before looking at the answers.
• Repeat the module until you have achieved a mark of > 19/23
(>80%).
• You should research any issues that you are unsure about. Look in
your textbooks, access the on-line resources indicated at the end of
the module and discuss with your peers and teachers.
• Finally, enjoy your learning! We hope that this module will be
complement your learning about Global Burden of Disease from
other sources.
I
n
t
r
o
d
u
c
t
i
o
n
1
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
Learning Outcomes
Partners in Global Health Education
By the end of this module, you should be able to :
1. Describe how disease burden is measured, including:
• the definitions of 4 standardised mortality rates and their
limitations
• how DALYs attempt to capture overall disease burden
2. Discuss the rationale behind the Global Burden of Disease project
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
3. Identify in the different world regions:
• the leading diseases
• the leading risks to health
4. Describe the concept of disease transition
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
Introduction
Partners in Global Health Education
This module is
concerned with taking
an overview of
disease or ill health in
the world today. But
how can we measure
disease at the global
level?
The obvious and traditional approach is to measure
overall mortality in different countries. The next slide
shows some of the important, standardised mortality rates
that are universally accepted and have specific definitions.
1.
How to use this
module
Definitions of standard mortality
rates
Introduction 1
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
Infant
Mortality Rate
(IMR)
No. deaths between birth and age 1 year
Perinatal
Mortality Rate
(PMR)
No. deaths from the 28th completed week of
gestation till the end of the 1st week of life
Partners in Global Health Education
X 1000
Total no. live births
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
X 1000
Total no. live & stillbirths
Under five
Mortality Rate
(U5MR)
No. deaths occurring below the age of 5 years
Maternal
Mortality Rate
(MMR)
No. maternal deaths per 100,000 live births
X 1000
Total no. live births
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
What do you think is the current under 5 mortality rate in the
following countries
(number of deaths <5 years / 1000 live births) ?
Britain
6/1,000
burden
7.
Partners in Global Health Education
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
China
37/1,000
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Nigeria
198/1,000
Risks
15.
Sources of
information
Click to Reveal Answers
Pakistan
103/1,000
(Source : Unicef State of the World’s Children 2005)
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Life expectancy
Partners in Global Health Education
• Life expectancy is another common
and useful measure of disease burden
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
• The normal life expectancy is taken as:
– 80 years for males
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
– 82 years for females
Acknowledgment:
http://www.musc.edu/cat
alyst/archive/1999/co
2-11cardiac.htm
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
What do you think is the current average life
expectancy in these countries?
Partners in Global Health Education
Britain
burden
7.
78 years
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
China
71 years
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Nigeria
51 years
Pakistan
61 years
Risks
15.
Sources of
information
Click to Reveal Answers
(Source : Unicef State of the World’s Children 2005)
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
Do we need other estimates of
disease burden?
• Both mortality rates and life
expectancy are useful – but do
not tell us anything about
disease burden in people living
with diseases
• This can best be captured by
trying to assess quality of life
• Another option to express
disease burden is in terms of
loss of productivity
• This is the background to the
Global Burden of Disease
(GBD) project: attempting to
estimate the total burden due
to diseases
Partners in Global Health Education
A man with polio begging for
money
1.
How to use this
module
What is the GBD (1)?
Introduction 1
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
Partners in Global Health Education
There are some 6 billion people in the world,
and hundreds of millions experience disease
or injury each year. Taken as a whole, the
combined pain, suffering, loss of productivity
and unrealised hopes and dreams are our
world’s burden of disease !
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
In other words, the burden of disease is a measurement of the gap between the current
health of a population and an ideal scenario where everyone completes their full life
expectancy in full health.
The Global Burden of Disease project attempts to measure this total disease burden.
I
n
t
r
o
d
u
c
t
i
o
n
1
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
What is the GBD (2) ?
Partners in Global Health Education
• The GBD study is a collaboration between the WHO, the World Bank and
the Harvard School of Public Health.
• GBD is a measure of the amount of disease, disability, and death in the
world today. It is a product of complex and interwoven demographic,
economic, social, political, religious and environmental factors. It refers to
the collective impact of disease on the world population.
• Disease burden can be attributed to either specific diseases (e.g. HIV,
TB, obesity, diabetes) and also risks for ill health (unsafe sex,
overcrowding, smoking, excess cholesterol). Therefore, the measurement
of GBD allows us to address preventable diseases in each region of the
world - how much of risks to health could be avoided in future years.
• An important development of this project was a single indicator of total
disease burden – the DALY.
I
n
t
r
o
d
u
c
t
i
o
n
1
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Disability-Adjusted Life Years
(DALYs)
Partners in Global Health Education
DALY= YLL + YLD
Years of Lost Life (due to premature mortality)
Years Lost to Disability (due to injury or illness)
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
The DALY is the internationally-accepted measure of death and disability and is
increasingly cited as a powerful tool for decision makers in international health.
It is the sum of the number of years lost to premature mortality and the number of
productive years lost to disability. One DALY is equivalent to one lost year of healthy life.
Calculation of DALYs is based on the assumption that everyone in the world has a right to
the best life expectancy in the world. The only differences in the rating of a death or
disability should be due to age and sex and not to income, culture, location or social
class.
It’s attractiveness lies in the fact that it combines information about mortality and
morbidity in a single number. DALY allows the losses due to disability and the losses due
to premature death to be expressed in the same unit. Hence, DALYs facilitate
comparisons of different health states or health outcomes.
I
n
t
r
o
d
u
c
t
i
o
n
1
1.
Sample “DALY” calculations for a
disease
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
Partners in Global Health Education
Example A:
• 100,000 children are stricken for 1 week with a disease with a disability
weighting* of 0.3; 2% die at 1 year old.
• DALYs
= YLL + YLD
= (2000 X 80) + (100,000 X 7/365 X 0.3)
= 160,000 + 575
= 160,600
Example B:
• 100,000 adults are stricken for 2 years with a disease with disability weighting* of
0.6; 20% die at age 80 years.
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
•
DALYs
= YLL + YLD
= (20,000 x 2) + (100,000 x 2 x 0.6)
= 40,000 + 120,000
= 160,000
*There are STANDARDISED DISABILITY RATINGS for various conditions
e.g deafness= 0.33, Down syndrome=0.5, Diarrhoea=0.12
I
n
t
r
o
d
u
c
t
i
o
n
1
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
Why are DALYs important?
Partners in Global Health Education
DALYs attempt to provide an appropriate, balanced attention to the effects
of non-fatal as well as fatal diseases on overall health. In the absence of
such assessments, conditions which cause decrements in function but
not mortality tend to be neglected.
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
DALYs help to inform debates on priorities for health service delivery,
research and planning. For example, DALYs can be used to:
• Compare the health of one population with another – and allow decision
makers to focus on health systems with the worst performance
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
• Compare the health of the same population at different points in time
• Compare the health of subgroups within a population - to identify health
inequalities
I
n
t
r
o
d
u
c
t
i
o
n
1
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
DALYs attempt to capture the
overall disease burden
Partners in Global Health Education
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
QALYs*
Prevalence
Incidence
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
Mortality rates
• Maternal
• Infant
• Perinatal
• Under five
• Overall
DALYS
*Quality Adjusted Life Years (QALYs) = Number of fully healthy years lost to a
particular disease or risk factor
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
End of Section 1
Partners in Global Health Education
Well done!
You have come to the end of the first section.
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
We suggest that you answer Questions 1 and then 2 to assess your
learning so far. Please remember to write your answers on the mark
sheet before looking at the correct answers!
i
z
1
1.
How to use this
module
Question 1: Mark the following statements as either
true or false on your answer sheet. Then click to
reveal the answers.
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
deaths in the 1st year of life, according to the total
6.
Measures of disease
number of live and stillbirths
Partners in Global Health Education
Click for the
correct answer
a)
The Infant Mortality Rate (IMR) expresses the number of
a
burden
7.
Global burden of
b)
The Perinatal Mortality Rate (PMR) expresses the deaths
disease
in infants delivered in the last trimester of pregnancy until
8.
DALYs
the end of the age of 1 month according to the total
9.
Section 1 Quiz
number of live and stillbirths
10.
Classification of
c)
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
In the absence of adverse effects on health, men are
b
c
expected to live for 80 years
d)
DALYs capture the number of healthy years lost to
disability
e)
The calculation of DALYs involves an index of the
disability attributed to specific diseases
d
e
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Classification of countries
Partners in Global Health Education
The major diseases that affect people vary markedly in different
world regions. Three major groupings of countries can be defined by
geography, state of economic and demographic development, and
mortality patterns.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
Group I
developing countries with
high mortality
• Sub-Saharan Africa
• South-East Asia
Group II
developing countries with
low mortality
• China
• Latin America
Group III
developed / industrialised
countries
• Europe
• North America
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
Source: WHO World Health report 2002
1.
How to use this
module
Question 2: Where do the major diseases
occur in the world today?
Introduction 1
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
Which country group has the greatest burden of the following
diseases? Write down your answers on the answer sheet, then
review the correct answers on the next slide.
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Partners in Global Health Education
Sources of
information
Diseases
A
Country group
I, II or III?
?
B
Infectious and parasitic
diseases
Cardiovascular diseases
C
Injuries
?
?
1.
How to use this
module
Answer 2: Where do the major diseases
occur in the world today?
Introduction 1
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
Diseases
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
A
Partners in Global Health Education
Country group
Group 1
B
Infectious and parasitic
diseases
Cardiovascular diseases
C
Injuries
Group 1
Group 1
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
All of these diseases occur more commonly in developing
countries with high mortality!!
1.
How to use this
module
What are the major diseases in the
world today?
Introduction 1
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Partners in Global Health Education
This bar diagram shows the sharp contrast in disease burden as well as the pattern of
diseases in the three country groups – with disease burden measured by DALYs. The
diagram shows clearly that the greatest burden for nearly all diseases falls upon
people living in group 1 countries.
Global burden of
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
DALYs (000 000)
disease
Risks
15.
Sources of
information
Group I
Developing
countries +
high mortality
Group II
Developing
countries + low
mortality
Group III
Developed
countries
Source: WHO World Health Report 2002
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
End of Section 2
Partners in Global Health Education
Well done!
You have come to the end of the second section.
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
We suggest that you proceed to answer question 3 to assess your
learning further. Do remember to write your answers on the mark
sheet before looking at the right answer!
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
Question 3: The table shows the % total DALYs for the leading 3
diseases for each group of countries. First write down the group
corresponding to each row on the answer sheet and then click for
correct answer.
Disease
Partners in Global Health Education
Group
burden
7.
HIV/AIDS
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
Lower
Diarrhoel
respiratory disease
infections
Ischaemic
heart
disease
Unipolar
depressive
disorders
Cerebrovascular
disease
Click to reveal
answers
(3a)
9.0
8.2
6.3
-
-
-
I
II
III
(3b)
-
4.1
-
-
5.9
4.7
I
II
III
(3c)
-
-
-
9.4
7.2
6.0
I
II
III
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
Risks rather than specific
diseases
Partners in Global Health Education
• An alternative way of looking at ill health is to consider
risks for disease rather than diseases themselves
• A risk is defined as the probability of an adverse health
outcome or a factor that raises this probability
• A single risk factor may underlie several diseases; e.g.
unsafe sex is a risk for HIV/AIDS, many other sexually
transmitted diseases and teenage pregnancy
• It is often more useful to direct health interventions
against risks rather than specific diseases
• DALYs have been assigned to health risks as well as
diseases
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Global burden of
Relationship between risks to
health and disease burden
Partners in Global Health Education
Factors which threaten health and are widely spread in populations have been identified
in different regions of the world. These risks are strongly related to patterns of living
and particularly to consumption.
The vast majority of threats to health occur more frequently in the poor and in those with
little education and lowly occupations. Therefore, the leading risks to health identified
in developing countries are also the leading health risks at the global level:
Introduction 1
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
•
•
•
•
•
•
Underweight – the leading risk factor for disease and death in the world today.
Particularly affects young children, women during pregnancy and the elderly.
Unsafe sex - the main factor in the spread of HIV/AIDS. > 99% of HIV infections in
Africa are attributable to unsafe sex.
Unsafe water.
Poor sanitation and hygiene - about 2 million deaths from childhood infectious
diarrhoea still occur every year in the developing countries of the world.
Iron deficiency.
In-door smoke. Half of the world’s population is exposed to in-door pollution, mainly
the result of burning solid fuels for cooking and heating. Globally, it is estimated that
36% of all lower respiratory infections and 22% of chronic obstructive pulmonary
disease are associated with in-door pollution.
I
n
t
r
o
d
u
c
t
i
o
n
1
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
What are the major risks to health in the developed world?
Sources of
information
Partners in Global Health Education
Overweight and obesity are important determinants of health which lead to adverse
metabolic changes, including elevated blood pressure, unfavourable cholesterol levels and
increased resistance to insulin. They raise the risk of coronary heart disease, stroke,
diabetes mellitus and many forms of cancer. According to the WHO World Health Report
2002, obesity on it’s own accounts for about 200,000 deaths in the United States of
America and Canada alone, and about 320,000 deaths in the 20 countries of Western
Europe.
Tobacco and excess alcohol consumption are major risks to health in the developed
world. Alcohol was estimated to cause 20-30% of oesophageal cancer, liver disease,
epilepsy, motor vehicle accidents, and homicide worldwide.
The world is living
dangerously, says Dr Gro
Brundtland (Former
Director General, WHO)
either because it has
little choice, which is
often the case among
the poor, or because it is
making the wrong
choices in terms of it’s
consumption and it’s
activities.
I
n
t
r
o
d
u
c
t
i
o
n
1
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Global burden of
The concept of
epidemiological transition
Partners in Global Health Education
As life expectancy increases, the major causes of death
and disability shift from communicable, maternal and
perinatal causes to chronic, non-communicable ones.
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
In the developing world:
• According to the World Health Report 2002, there has been an increase in the
consumption of alcohol and tobacco and an adoption of unhealthy lifestyles
synonymous with a Western life style.
• This has led to an increased incidence of obesity, diabetes mellitus, cardiovascular
diseases and conditions linked to them. Meanwhile, the burden of infectious disease
remains.
• The resultant burden, consequent on the combined impact of communicable and
non-communicable diseases, has been described as a “double whammy”.
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
Health risks in different
world regions
Partners in Global Health Education
• The next 3 slides show the disease burden
(measured by DALYs) attributable to 10 leading
health risks according to country group
• Note how single risks underlie several diseases
and how these relationships differ in different
regions
• Note that the total number of DALYs (x axis) is
much greater in the developing than the
developed worlds
1.
How to use this
module
Burden of disease attributable to 10 selected leading
risk factors, by level of development
Introduction 1
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
Partners in Global Health Education
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Burden of disease attributable to 10 selected leading risk
factors, by level of development
Sources of
information
Source of data: WHO World Health report 2002
1.
How to use this
Burden of disease attributable to 10 selected leading
risk factors, by level of development
Introduction 1
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
Partners in Global Health Education
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
Source of data: WHO World Health report 2002
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
End of Section 3
Partners in Global Health Education
You have come a long way!
This is the last of the sections.
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
For the section just ended, answer Questions 4 - 6 to assess what you
have learnt. It is still required that you put down your answers on the
mark sheet before looking at the right answer!
I
n
t
r
o
d
u
c
t
i
o
n
1
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
Question 4: This picture shows a traditional “three-stone”
kitchen in rural West Africa. Write down:
a) 3 risks to health
b) 4 diseases that can result from these risks
Partners in Global Health Education
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
Click to
reveal
answers
I
n
t
r
o
d
u
c
t
i
o
n
1
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
Partners in Global Health Education
Question 5:
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
Write down 3 risks to
health that are
associated with regular
consumption of the meal
shown.
Click to Reveal Answers
I
n
t
r
o
d
u
c
t
i
o
n
1
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Question 6:
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Partners in Global Health Education
Sources of
information
List 3 diseases that are
associated with the health
risk shown in this
photograph.
Click to Reveal Answers
I
n
t
r
o
d
u
c
t
i
o
n
1
1.
How to use this
module
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
6.
Measures of disease
burden
7.
Global burden of
What strategies can reduce risks to health?
Partners in Global Health Education
“Any health action promotive,
preventive, curative,
or rehabilitative
activity, where the
primary intent is to
improve health.”
Most riskreducing
strategies involve
a component of
behaviour change.
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Risks
15.
Sources of
information
The population
Reduce risks in the
population as a whole
• Legislation, tax, financial
incentives by government
• Health promotion campaigns
• Engineering solutions; e.g. safety
belts in vehicles, provision of piped
water
The individual
Target individuals within
a particular population
• Change health behaviours
of individuals through
personal interaction with a
health provider
1.
How to use this
module
Sources of information
2.
Learning outcomes
3.
Introduction
4.
Definition of terms
5.
Epidemiology
Copy and paste these links into your browser to access these information resources:
6.
Measures of disease
•
The World Health report 2002 – Reducing Risks, Promoting Healthy Life; http://www.who.int/whr/2002/en/
•
Unicef State of the World’s Children 2005; http://www.unicef.org/sowc05/english/
Partners in Global Health Education
burden
7.
Global burden of
disease
8.
DALYs
9.
Section 1 Quiz
10.
Classification of
Other resources:
•
Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ. The Lancet 2002; 360:1347-1360
countries
11.
Section 2 Quiz
12.
Risk factors
13.
Section 3 Quiz
14.
Reducing Health
Selected major risk factors and global and regional burden of disease
•
Regional patterns of disability-free life expectancy and disability-adjusted life expectancy: Global Burden
of Disease Study; Murray CJ, Lopez AD. The Lancet 1997; 349:1347-1352
Risks
15.
Sources of
information