Mod 3

• Global Burden of Disease
• Epidemiology


  The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems
• Health Categories Used to Report GBD

  • Disability Adjusted Life Years (DALYs)
  • Years Lived with Disability (YLD)
  • Years of Life Lost (YLL)
• Reflecting on Racial and Ethnic Differences in Death Rates
• Disability Adjusted Life Years (DALYs)

  A measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death
• Years Lived with Disability (YLD)

  Years of healthy life lost due to disability
• Years of Life Lost (YLL)

  Years of life lost due to premature mortality
• GBD Timeline
• Comparing Death Rates to DALYs
• Comparing High SDI and Low SDI Countries
• Burden of Communicable Diseases
• Communicable Diseases: Human Immunodeficiency Virus (HIV)
• Canadian Aboriginal AIDS Network
• Other Group 1 Conditions

  • Nutritional Conditions
  • Maternal Conditions
  • Neonatal Health
• Cardiovascular Disease (CVD)
• Common non-communicable diseases


  • Cardiovascular disease (CVD)
  • Cancer
  • Mental illness
• Injuries


  Health category that accounts for the smallest portion of all deaths
• Injuries have different rates between different age, sex, and geographic areas
• Millennium Development Goals (MDG)

  Developed by the UN to improve the Global Burden of Disease
• Sustainable Development Goals (SDG)

  Developed by the UN to improve the Global Burden of Disease
• Epidemiology


  Comprehensive understanding of factors that are detrimental to health, and how these factors vary across populations
• Global Burden of Disease (GBD)


  Measure of total health loss from hundreds of diseases and injuries (and their risk factors) that provides insight into the health status of different populations throughout the world
• GBD is a critical measure of global health
• Health categories used to report GBD


  • Communicable diseases, and maternal, neonatal, and nutritional conditions
  • Non-communicable diseases
  • Injuries
• Communicable, maternal, neonatal, perinatal, and nutritional disorders

  Represent 2 out of every 10 deaths that occur globally, largely in low-income populations due to inadequate access to healthcare
• Non-Communicable Diseases (NCDs)


  Account for about 7 out of 10 deaths globally, responsible for 41% of deaths in low SDI regions and 88% in high SDI regions
• Injuries


  Represent roughly 1 in 10 deaths that occur globally, with the largest difference between the sexes (12% of overall male deaths and 6% of female deaths in 2019)
• In Canada, 10,957 men and 6,414 women died as a result of injury in 2015
• In Canada, First Nations, Inuit, and Metis populations are 3.5, 3.2, and 2.7 times more likely to die by injury than the general population
• Socio-Demographic Index (SDI)


  Takes into account the income per person, educational attainment, and fertility rate
• Disability Adjusted Life Years (DALY)

  Measure of overall disease burden, expressed as the cumulative number of years lost due to ill-health, disability, or early death
• Years Lived with Disability (YLD)

  Incorporates disability into a single measure of burden, multiplying the number of years a person has a condition that affects their quality of life by a weighting factor between 0 and 1
• Years of Life Lost (YLL)

  Measure of premature mortality, placing more weight on illnesses that result in early mortality
• The Institute for Health Metrics and Evaluation (IHME) created an interactive GBD Compare Tool to analyze global health trends from 1990 to present
• How have the global DALYs of each disease changed from 2005 to 2019?

  • HIV - Decreased
  • Depression - Increased
  • Tuberculosis - Decreased
  • Malaria - Decreased
  • Ischemic Heart Disease - Increased
• From 1990 to 2019, the percentage for DALYs/100,000 for non-communicable diseases significantly increased, while the DALYs/100,000 for communicable diseases decreased, and injuries remained third, but all three categories experienced a decrease in DALYs/100,000
• Non-communicable diseases surpassed communicable diseases in DALY rankings in 1993
• Diseases (blue) significantly increased, while the DALYs/100,000 for communicable diseases (red) decreased. Injuries (green) remained third. However, all three categories experienced a decrease in DALYs/100,000.
• In terms of DALYs/100,000 non-communicable diseases surpassed communicable diseases in 1993
• Ischemic Heart Disease (IHD) has a large death rate (16.7% of total deaths) but a smaller proportion of the DALYs (7.19% of total DALYs)

  IHD is often characterized by an acute life-threatening episode, creating a smaller DALY score