Global health risks: progress and challenges

Global health risks: progress and challenges

WHO is about to publish a "Global Health Risk" report, identifying the global and regional disease and death burdens associated with 24 health risks. These risk factors range from environmental risks such as exposure to indoor solid fuel smoke to metabolic risks such as high blood pressure. The report shows that five major risk factors (children ’s underweight, unsafe sex, alcohol use, unsafe drinking water and sanitation, and high blood pressure) account for one-quarter of deaths worldwide, and account for disability-adjusted life years One fifth of the total. As long as the impact of these five risk factors is reduced, the global average life expectancy can be extended by nearly five years.

The report describes the changing risk factor characteristics of developing countries. Global health risks are evolving. As the fertility rate of women continues to decline and the number of young people suffering from infectious diseases decreases, the age structure of the population changes, and the number of elderly people is increasing. At the same time, physical activity, diet, alcohol and tobacco consumption patterns have changed. Now, low-income countries and middle-income countries face not only the burden of communicable diseases, but also the burden of chronic non-communicable diseases.

Understanding the impact of health risks is important for designing and conducting targeted prevention efforts. However, it is difficult to find and explain the evidence of risk factors and their causal relationship with disease and disability, so it is difficult to analyze risk factors. Risk assessment is limited by epidemiological knowledge and information on the role of global risk factors. To assess the severity of risks, you must first obtain evidence that shows the diseases caused by each risk, then quantify the scale of damage caused by each risk factor, and finally evaluate each risk faced by the global population.

Some risk factors are easier to assess. For example, the impact of physiological risks (such as high body mass index or lack of vitamins) can be measured more accurately, and the consequences of disease on individuals can be investigated. But diet, environment and behavioral risk factors are more difficult to measure accurately. If these risks cannot be accurately measured, it is more difficult to analyze the relationship between exposure and morbidity. Because it is difficult to obtain epidemiological evidence for dietary, environmental, and behavioral risk factors, these risk factors are generally not considered in comparative risk assessments. If these factors are included, the estimates of the disease burden caused by these risks may be less reliable than those that are more easily measured. The resulting set of risk factor estimates will lack precise comparability and must be interpreted carefully Just fine.

Not all risk factors are easy to measure. In addition, it has been confirmed that some risk factors are easier to intervene, while some risk factors are more difficult to intervene. To ensure that all risk factors are treated uniformly, we estimate the burden of each risk factor by comparing the actual situation with the assumption that the risk factor exposure is at an ideal level. For some risk factors (such as lack of micronutrients), effective policies can be implemented to ensure adequate nutrition in a low-cost environment. Achieving the ideal level of exposure is feasible and affordable. But for risk factors such as high body mass index, there are not many effective interventions. In today's society, the average body mass index of some isolated people has reached the ideal level, but reaching the national average body mass index is still a difficult task.

Because it is difficult to find and interpret the evidence of various risk factors and their causal relationship with population diseases and disabilities, it is difficult to assess and interpret the health effects of risk factors. The comparative risk assessment framework used in the Global Health Risk report is the most comprehensive interdisciplinary effort made by the international community to address these challenges. [1] The report ’s findings and information on interventions, costs, and benefits provide a reliable basis for policy action. The report also lists some risk factors that require further research (underweight and lack of physical activity, etc.) in order to develop effective interventions.

The health burden data for various risk factors is being comprehensively revised and updated under the global research project on disease, injury and burden of risk factors. [2] This new study will quantify the impact of risk factors in 1990 and 2005 to analyze the exposure and impact trends of risk factors, which will study more risk factors such as salt intake, folic acid deficiency and intimate partners Violence, etc. As more epidemiological evidence is collected, comparative risk assessment methods will continue to evolve.