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This discussion focuses on the concept of disease burden, which you will learn about in-depth in Chapter 3 of the eText attached. 

For this discussion, in addition to Chapter 3,  please refer to the “Global burden of 87 risk factors in 204 countries and territories” article provided in the Module 2 Learning Resources folder.  Read the article summary and peruse the article.

This is a one-page perusal of both articles to answer the three questions below. 

1) What information presented in this article was most surprising to you about disease burden?

2) Why was that information surprising?

3) In your own words, explain how disease burden is measured and how it is used to define global health.

Global Health Metrics

www.thelancet.com Vol 396 October 17, 2020 1223

Global burden of 87 risk factors in 204 countries and
territories, 1990–2019: a systematic analysis for the Global
Burden of Disease Study 2019
GBD 2019 Risk Factors Collaborators*

Summary
Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on
human health are important to identify where public health is making progress and in which cases current efforts are
inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and
comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease.

Methods GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs),
and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level,
regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors
(eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps.
(1) We included 560 risk–outcome pairs that met criteria for convincing or probable evidence on the basis of research
studies. 12 risk–outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk–outcome pairs for
risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function
of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, an

Courtesy of Mark Tuschman.

Skolnik, Richard. Global Health 101, Jones & Bartlett Learning, LLC, 2019. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/indianatech-ebooks/detail.action?docID=5894023.
Created from indianatech-ebooks on 2022-09-15 00:20:57.

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CHAPTER 3
The Global Burden of Disease

LEARNING OBJECTIVES

By the end of this chapter, the reader will be able to do the
following:

â–  Discuss the concepts of health-adjusted life expectancy
(HALE), disability-adjusted life years (DALYs), and the
burden of disease

â–  Describe the leading causes of disability, deaths, and
DALYs by region, country income group, age, and sex

â–  Describe the leading risk factors for disability, deaths, and
DALYs by region, country income group, age, and sex

â–  Discuss the demographic and epidemiologic transitions

Skolnik, Richard. Global Health 101, Jones & Bartlett Learning, LLC, 2019. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/indianatech-ebooks/detail.action?docID=5894023.
Created from indianatech-ebooks on 2022-09-15 00:20:57.

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P
â–¶ Vignettes

rincess is a 3-year-old girl who lives near the town of
Kenema in Sierra Leone. Although Sierra Leone has made

some progress in reducing young child death, the country remains
very poor, still suffers from the ravages of its earlier civil war, and
continues to have a very weak health system. Access to safe
water and sanitation and good knowledge of hygiene are also
limited. The burden of malaria has gone down, but the disease is
still very prevalent. What are the leading causes of death for
young children like Princess? What are the most important risk
factors for those causes? Is there good evidence about what can
be done in cost-effective and fair ways to reduce the burden of
deaths among young children in Sierra Leone and similar
countries?

Aisha is a 50-year-old woman who lives in the northern part of
Nigeria. She is from a lower middle-class family, in an area that is
still quite poor. Aisha has been feeling unwell and recently visited
the outpatient clinic at the regional hospital. The check-up and
tests the doctors carried out indicated that she has high blood
pressure, high cholesterol, and diabetes. The doctors prescribed
medicines for her to reduce her blood pressure and cholesterol
and another drug

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