Estimates of global and regional potential health gains from reducing multiple major risk factors

Ezzati, Majid, Vander Hoorn, Stephen, Rodgers, Anthony, Lopez, Alan D., Mathers, Colin D. and Murray, Christopher J. L. (2003) Estimates of global and regional potential health gains from reducing multiple major risk factors. Lancet, 362 9380: 271-280. doi:10.1016/S0140-6736(03)13968-2

Author Ezzati, Majid
Vander Hoorn, Stephen
Rodgers, Anthony
Lopez, Alan D.
Mathers, Colin D.
Murray, Christopher J. L.
Title Estimates of global and regional potential health gains from reducing multiple major risk factors
Journal name Lancet   Check publisher's open access policy
ISSN 0140-6736
Publication date 2003-07-26
Sub-type Article (original research)
DOI 10.1016/S0140-6736(03)13968-2
Open Access Status Not yet assessed
Volume 362
Issue 9380
Start page 271
End page 280
Total pages 10
Editor Richard Horton
Place of publication London, England
Publisher The Lancet Publishing Group
Language eng
Subject C1
730299 Public health not elsewhere classified
111706 Epidemiology
111716 Preventive Medicine
111799 Public Health and Health Services not elsewhere classified
Abstract Background Estimates of the disease burden due to multiple risk factors can show the potential gain from combined preventive measures. But few such investigations have been attempted, and none on a global scale. Our aim was to estimate the potential health benefits from removal of multiple major risk factors. Methods We assessed the burden of disease and injury attributable to the joint effects of 20 selected leading risk factors in 14 epidemiological subregions of the world. We estimated population attributable fractions, defined as the proportional reduction in disease or mortality that would occur if exposure to a risk factor were reduced to an alternative level, from data for risk factor prevalence and hazard size. For every disease, we estimated joint population attributable fractions, for multiple risk factors, by age and sex, from the direct contributions of individual risk factors. To obtain the direct hazards, we reviewed publications and re-analysed cohort data to account for that part of hazard that is mediated through other risks. Results Globally, an estimated 47% of premature deaths and 39% of total disease burden in 2000 resulted from the joint effects of the risk factors considered. These risks caused a substantial proportion of important diseases, including diarrhoea (92%-94%), lower respiratory infections (55-62%), lung cancer (72%), chronic obstructive pulmonary disease (60%), ischaemic heart disease (83-89%), and stroke (70-76%). Removal of these risks would have increased global healthy life expectancy by 9.3 years (17%) ranging from 4.4 years (6%) in the developed countries of the western Pacific to 16.1 years (43%) in parts of sub-Saharan Africa. Interpretation Removal of major risk factors would not only increase healthy life expectancy in every region, but also reduce some of the differences between regions, The potential for disease prevention and health gain from tackling major known risks simultaneously would be substantial.
Keyword Coronary Heart-disease
Life Expectancy
Medicine, General & Internal
Q-Index Code C1

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Created: Wed, 15 Aug 2007, 05:35:10 EST