Noncommunicable Diseases: Three Decades Of Global Data Show A Mixture Of Increases And Decreases In Mortality Rates.
Noncommunicable diseases are the leading health concerns of the modern era, accounting for two-thirds of global deaths, half of all disability, and rapidly growing costs. To provide a contemporary overview of the burdens caused by noncommunicable diseases, we compiled mortality data reported by authorities in forty-nine countries for atherosclerotic cardiovascular diseases; diabetes; chronic respiratory diseases; and lung, colon, breast, cervical, liver, and stomach cancers. From 1980 to 2012, on average across all countries, mortality for cardiovascular disease, stomach cancer, and cervical cancer declined, while mortality for diabetes, liver cancer, and female chronic respiratory disease and lung cancer increased. In contrast to the relatively steep cardiovascular and cancer mortality declines observed in high-income countries, mortality for cardiovascular disease and chronic respiratory disease was flat in most low- and middle-income countries, which also experienced increasing breast and colon cancer mortality. These divergent mortality patterns likely reflect differences in timing and magnitude of risk exposures, health care, and policies to counteract the diseases. Improving both the coverage and the accuracy of mortality documentation in populous low- and middle-income countries is a priority, as is the need to rigorously evaluate societal-level interventions. Furthermore, given the complex, chronic, and progressive nature of noncommunicable diseases, policies and programs to prevent and control them need to be multifaceted and long-term, as returns on investment accrue with time.
Mohammed K. Ali (mkali@emory.edu) is an associate professor in the Hubert Department of Global Health, Rollins School of Public Health, at Emory University, in Atlanta, Georgia.
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Lindsay M. Jaacks is a postdoctoral fellow in the Hubert Department of Global Health, Rollins School of Public Health, at Emory University.
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Alysse J. Kowalski is a research associate in the Hubert Department of Global Health, Rollins School of Public Health, at Emory University.
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Karen R. Siegel is an adjunct assistant professor in the Hubert Department of Global Health, Rollins School of Public Health, at Emory University.
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Majid Ezzati is chair in global environmental health in the Faculty of Medicine, School of Public Health, Imperial College London, in the United Kingdom.
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D002318:Cardiovascular Diseases / Q000401:mortality / Q000503:physiopathology; D002908:Chronic Disease / Q000401:mortality*; D003920:Diabetes Mellitus / Q000401:mortality / Q000503:physiopathology; D005260:Female; D014943:Global Health; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends*; D009369:Neoplasms / Q000401:mortality / Q000503:physiopathology; D012140:Respiratory Tract Diseases / Q000401:mortality / Q000503:physiopathology; D013997:Time Factors; D014944:World Health Organization
Chronic Care; Epidemiology; International/global health studies