All over the world, diseases such as obesity, hypertension and hyperglycemia (high blood sugar) and air pollution are directly related to decreased life expectancy. Together, they all create a perfect storm that now aggravates deaths by Covid- 19.
These were the main results of a study published on Thursday night (15) in the prestigious English scientific journal The Lancet.
In the study, carried out by the University of Washington Institute of Health Assessment and Measurement (IHME), researchers assessed 286 causes of death, 369 diseases and injuries and 87 risk factors in 204 countries and territories across the country. the world.
The data show how the world, in particular public health systems, was not prepared for a pandemic and, worse, as treatable and preventable risk factors, such as obesity and hyperglycemia, have not received due attention from global health programs.
Supported by WHO (World Health Organization), the study that assesses the global burden of disease is carried out annually as a way to analyze what are the main causes of death and loss of quality of life, as well as the change in life expectancy in the last 30 years.
Covid-19’s impact on people’s health will not only be felt in 2020 and 2021, say the researchers, but in the years that follow as well.
Among the factors that aggravated the crisis are the inefficiency of public health to prevent the increase in risk factors, such as national awareness and prevention programs for so-called noncommunicable diseases (obesity, hypertension, diabetes, high cholesterol).
Richard Horton, editor of Lancet magazine, says that the Covid-19 pandemic is not just a pandemic, but several together, called a syndemia. Although cardiovascular diseases and age are the main risk factors associated with the worsening of the condition and death by Covid-19, other factors, such as socioeconomic factors, affect how populations survive the coronavirus health crisis.
“The syndical nature of the threat we face requires not only addressing each affliction but also urgently addressing the underlying social inequalities that affect them, namely poverty, housing, education and race, which are powerful determinants of health.” The editor adds that Covid-19 is an “aggravated chronic health emergency” and its impact on the future is being ignored.
“Noncommunicable diseases have played a critical role in more than a million deaths caused by Covid-19 so far, and will continue to influence the health of all countries after the pandemic is gone.
As we resume our root health systems for diseases like Covid-19, this study on the global burden of morbidity and mortality offers a means of targeting what is the biggest emergency and how it differs between countries. “
For Christopher Murray, director of the IHME and lead author of the study, the increase in life expectancy in the world is a positive indicator when assessing infectious diseases that plagued sub-Saharan African countries until the mid-2000s, such as AIDS and tuberculosis. However, the greatest loss of global life expectancy today is related to risk factors such as cardiovascular disease, unbalanced diets and air pollution.
In part, improvements in neonatal care and maternal care have increased survival and decreased the risk of premature death, especially in children under the age of ten, but the same attention has not been paid to older age groups.
“We are not managing to change unhealthy behaviors, in particular those related to the quality of food and physical activity, in part due to a lack of regulatory attention and funding for research on behavior and public health,” says Murray.
The main differences observed between developed countries and middle or low income nations in relation to risk factors are in the treatment of water and sewage and neonatal and postpartum care. In much of Latin America, in North America, Asia and Europe, hypertension, high cholesterol, overweight and smoking are the main causes of health problems.
In Oceania, malnutrition and air pollution are among the main risks. Sub-Saharan Africa, on the other hand, deals with malnutrition, water pollution and air pollution. Metabolic disease, which combines obesity, diabetes and high cholesterol, is identified as one of the main factors of healthy loss of life in the last 30 years in western Europe and North America.
For Emmanuela Gakidou, researcher and co-author of the IHME study, only the information on risk factors is not enough, it is necessary to act. “The incidence of metabolic disease went from 10.4% in 1990 to 20% in 2019.
Based on lessons learned in smoking control decades, when there is a significant risk to the population’s health, such as obesity, it may be necessary for the government to act through regulation, taxes and subsidies. “
In Brazil, about 55.4% of the population in 2019 is overweight, according to data from Vigitel (Risk Factors Surveillance System for chronic non-communicable diseases), of the Ministry of Health.
Although the first and second leading causes of disease death in the country are vascular diseases (heart and brain, respectively), weight gain takes first place in noncommunicable diseases associated with healthy loss of life.