Chronic diseases and failures in public health ‘fueled’ Covid deaths


Na study published today in The Lancet, experts reveal that increasing exposure to major factors risk factors (including hypertension, high blood sugar and high cholesterol), combined with the increase in disease deaths cardiovascular in some countries, “it suggests that the world may be approaching a tipping point in gains in average life expectancy”.

The conclusions are from the Global Burden of Disease Study (GBD), which involves experts working at more than 1,100 universities, research centers and government agencies in 152 countries and providing a new look at how countries have been prepared in terms of health for the pandemic of covid-19 and establish the true scale of the challenge represented by the new threats of pandemic.

The work of the GBD has served to support health policies in several countries, as well as to provide scientific information to international organizations such as the World Bank or the World Health Organization (WHO).

The authors emphasize that the promise of disease prevention through actions or government incentives that lead to healthier behavior and access to health resources is not having the same results worldwide.

“The majority of factors risk management is preventable and treatable and facethe will bring huge social and economic benefits. We are failing to change harmful health behaviors, particularly those related to the quality of the diet, caloric intake and activity partly due to inadequate public health care and funding policy and behavioral research, “says Christopher Murray of the University of Washington (USA), who led the work.

The study stresses that several factors risk factors and non-communicable diseases, including obesity, diabetes and diseases cardiovascular, are associated with an increased risk of serious illness and death from covid-19, and highlights the importance ofncia From factors for the final result.

“Diseases not only interact biologically, they also interact with factors social. It takes a action urgent to address the coexistence of chronic diseases, social inequalities and covid-19 “, defends Murray, referring to the interaction of several epidemics that exacerbate the disease burden in already overburdened populations and that increase their vulnerability.

The authors emphasize that there is a late recognition of the importance ofncia from social and economic development to general health and point to the need for a much broader approach that pays more attention “to all drivers of the population’s health”.

“Given the overwhelming impact of social and economic development on health progress, intensifying policies and strategies that stimulate economic growth, expand access to education and improve the condition of women must be our priority collective“says Murray.

According to the study, although the overall healthy life expectancy – the number of years a person can expect to live in good health – has steadily increased (by more than 6.5 years) between 1990 and 2019, it has not grown as much as the expectation of overall life in 198 of the 204 countries assessed in this study and people are living “more years with health problems”.

Disability, more than early death, has become an increasing share of the global disease burden, rising from 21% in 1990 to more than a third (34%) in 2019, he points out.

In 11 countries – including Singapore, Islândia, Norway, Ireland, Australia, New Zealândia and Qatar – more than half of all health losses (measured by disability adjusted life years – Components) are due to problems caused by non-communicable diseases and injuries.

Global health efforts to fight disease infeciosas and addressing antenatal care have been successful in improving the health of children under the age of 10 in the past few decades (with the overall disease burden falling by around 55%), “but this was not matched by a similar response in groups of older age “, underline the experts.

According to the study, the top 10 contributors to the increase in health losses worldwide in the past 30 years include six causes that affect older adults widely: heart disease ischemic, diabetes, stroke, chronic kidney disease, lung cancer and age-related hearing loss.

In addition, four causes are common from adolescence to old age – HIV / AIDS, the problems musculoskeletal, low back pain and depressive disorders.

Those in charge recall that the increase in health problems “threatens to overburden ill-equipped health systems to deal with the chronic conditions associated with the growth and aging of populations”.

They also indicate that, in the past decade, developing countries have achieved “impressive health gains”, largely “as a result of successful efforts against infectious, maternal and neonatal“but they stress that the health systems of these countries” are not well equipped to deal with the growing burden of noncommunicable diseases – which rose from about one third of the overall disease burden in 1990 to almost two thirds in 2019 “.

In addition, they point out, “while deaths from infectious diseases have dropped substantially in developing countries, deaths from noncommunicable diseases are on the rise.”

In contrast, “health improvements have started to stagnate in most developed countries and have even reversed in several countries, particularly in the United States, where the age-standardized rate of health loss has increased by almost 3% in the past decade.”

The authors believe that the reasons for this lack of progress may include increasing rates of obesity, as well as decreasing the potential to reduce smoking and to make further improvements in the coverage of treatments for hypertension and high cholesterol, which will be necessary to maintain reducing deaths from disease cardiovascular.

The study coordinator recalls that, with a rapidly aging global population, “looking for health services to deal with problems disabling and chronic conditions, which increase with age, will require higher levels of funding, strong political commitment, responsibility supported by better data and a coordinated global effort that prioritizes the most vulnerable. “

The study notes that over the past decade “there have been particularly large and worrying increases (more than 0.5% per year worldwide) in exposure to several highly preventable risks” – obesity, high blood sugar, use of alcohol and drug use – which are contributing to the growing burden of noncommunicable diseases.

“The biggest cumulative health impact comes from the notable increase in metabolic risks (Index of Body Mass [IMC] high, high blood sugar levels, hypertension and high cholesterol), which have risen 1.5% per year since 2010 “, explain the authors, stressing that among the main risks of non-communicable diseases, only smoking has decreased substantially.

The study also states that the impact of factors risk also varies widely across regions: In much of Latin America, Asia and Europe, hypertension, high blood sugar, IMC smoking and tobacco use are the major contributors to health problems, while in Oceânia the main risks are malnutrition and air pollution.

The most striking differences are in the Africa Sub-Saharan, which is dominated by malnutrition.

“Simply providing information about the harms of these risks is not enough”, says co-author Emmanuela Gakidou, adding: “Since individual choices are influenced by financial considerations, education and availability of alternatives, governments must collaborate globally on initiatives to make behavior as healthy as possible for everyone.”

“And, drawing lessons from decades of tobacco control, when there is a great risk to the health of the population, such as obesity, it may be necessary to action concerted government system through regulation, taxation and subsidies “, he stresses.

In an editorial accompanying the study in The Lancet magazine, the warning is still left: “Unless structural inequalities rooted in society are tackled and a more liberal approach to immigration policies is adopted, communities will not be protected from future infectious outbreaks and the health of the population will not achieve the gains that global health advocates seek “.

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