Abstract
Background The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013. Methods GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically. Findings The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60–80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7% to 7·5% between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred. Interpretation Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts. Funding Bill & Melinda Gates Foundation.
Original language | English (US) |
---|---|
Pages (from-to) | e704-e713 |
Journal | The Lancet Global Health |
Volume | 4 |
Issue number | 10 |
DOIs | |
State | Published - Oct 1 2016 |
Fingerprint
ASJC Scopus subject areas
- Medicine(all)
Cite this
Health in times of uncertainty in the eastern Mediterranean region, 1990–2013 : a systematic analysis for the Global Burden of Disease Study 2013. / Mokdad, Ali H.; Forouzanfar, Mohammad Hossein; Daoud, Farah; El Bcheraoui, Charbel; Moradi-Lakeh, Maziar; Khalil, Ibrahim; Afshin, Ashkan; Tuffaha, Marwa; Charara, Raghid; Barber, Ryan M.; Wagner, Joseph; Cercy, Kelly; Kravitz, Hannah; Coates, Matthew M.; Robinson, Margaret; Estep, Kara; Steiner, Caitlyn; Jaber, Sara; Mokdad, Ali A.; O'Rourke, Kevin F.; Chew, Adrienne; Kim, Pauline; El Razek, Mohamed Magdy Abd; Abdalla, Safa; Abd-Allah, Foad; Abraham, Jerry P.; Abu-Raddad, Laith J.; Abu-Rmeileh, Niveen M.E.; Al-Nehmi, Abdulwahab A.; Akanda, Ali S.; Al Ahmadi, Hanan; Al Khabouri, Mazin J.; Al Lami, Faris H.; Al Rayess, Zulfa A.; Alasfoor, Deena; AlBuhairan, Fadia S.; Aldhahri, Saleh F.; Alghnam, Suliman; Alhabib, Samia; Al-Hamad, Nawal; Ali, Raghib; Ali, Syed Danish; Alkhateeb, Mohammad; AlMazroa, Mohammad A.; Alomari, Mahmoud A.; Al-Raddadi, Rajaa; Alsharif, Ubai; Al-Sheyab, Nihaya; Alsowaidi, Shirina; Al-Thani, Mohamed; Altirkawi, Khalid A.; Amare, Azmeraw T.; Amini, Heresh; Ammar, Walid; Anwari, Palwasha; Asayesh, Hamid; Asghar, Rana; Assabri, Ali M.; Assadi, Reza; Bacha, Umar; Badawi, Alaa; Bakfalouni, Talal; Basulaiman, Mohammed O.; Bazargan-Hejazi, Shahrzad; Bedi, Neeraj; Bhakta, Amit R.; Bhutta, Zulfiqar A.; Bin Abdulhak, Aref A.; Boufous, Soufiane; Bourne, Rupert R.A.; Danawi, Hadi; Das, Jai; Deribew, Amare; Ding, Eric L.; Durrani, Adnan M.; Elshrek, Yousef; Ibrahim, Mohamed E.; Eshrati, Babak; Esteghamati, Alireza; Faghmous, Imad A.D.; Farzadfar, Farshad; Feigl, Andrea B.; Fereshtehnejad, Seyed Mohammad; Filip, Irina; Fischer, Florian; Gankpé, Fortuné G.; Ginawi, Ibrahim; Gishu, Melkamu Dedefo; Gupta, Rahul; Habash, Rami M.; Hafezi-Nejad, Nima; Hamadeh, Randah R.; Hamdouni, Hayet; Hamidi, Samer; Harb, Hilda L.; Hassanvand, Mohammad Sadegh; Hedayati, Mohammad T.; Heydarpour, Pouria; Hsairi, Mohamed; Husseini, Abdullatif; Jahanmehr, Nader; Jha, Vivekanand; Jonas, Jost B.; Karam, Nadim E.; Kasaeian, Amir; Kassa, Nega Assefa; Kaul, Anil; Khader, Yousef; Khalifa, Shams Eldin A.; Khan, Ejaz A.; Khan, Gulfaraz; Khoja, Tawfik; Khosravi, Ardeshir; Kinfu, Yohannes; Defo, Barthelemy Kuate; Balaji, Arjun Lakshmana; Lunevicius, Raimundas; Obermeyer, Carla Makhlouf; Malekzadeh, Reza; Mansourian, Morteza; Marcenes, Wagner; Farid, Habibolah Masoudi; Mehari, Alem; Mehio-Sibai, Abla; Memish, Ziad A.; Mensah, George A.; Mohammad, Karzan A.; Nahas, Ziad; Nasher, Jamal T.; Nawaz, Haseeb; Nejjari, Chakib; Nisar, Muhammad Imran; Omer, Saad B.; Parsaeian, Mahboubeh; Peprah, Emmanuel; Pervaiz, Aslam; Pourmalek, Farshad; Qato, Dima M.; Qorbani, Mostafa; Radfar, Amir; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Sajjad Ur; Rai, Rajesh K.; Rana, Saleem M.; Rao, Sowmya R.; Refaat, Amany H.; Resnikoff, Serge; Roshandel, Gholamreza; Saade, Georges; Saeedi, Mohammad Y.; Sahraian, Mohammad Ali; Saleh, Shadi; Sanchez-Riera, Lidia; Satpathy, Maheswar; Sepanlou, Sadaf G.; Setegn, Tesfaye; Shaheen, Amira; Shahraz, Saeid; Sheikhbahaei, Sara; Shishani, Kawkab; Sliwa, Karen; Tavakkoli, Mohammad; Terkawi, Abdullah S.; Uthman, Olalekan A.; Westerman, Ronny; Younis, Mustafa Z.; El Sayed Zaki, Maysaa; Zannad, Faiez; Roth, Gregory A.; Wang, Haidong; Naghavi, Mohsen; Vos, Theo; Al Rabeeah, Abdullah A.; Lopez, Alan D.; Murray, Christopher J.L.
In: The Lancet Global Health, Vol. 4, No. 10, 01.10.2016, p. e704-e713.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Health in times of uncertainty in the eastern Mediterranean region, 1990–2013
T2 - a systematic analysis for the Global Burden of Disease Study 2013
AU - Mokdad, Ali H.
AU - Forouzanfar, Mohammad Hossein
AU - Daoud, Farah
AU - El Bcheraoui, Charbel
AU - Moradi-Lakeh, Maziar
AU - Khalil, Ibrahim
AU - Afshin, Ashkan
AU - Tuffaha, Marwa
AU - Charara, Raghid
AU - Barber, Ryan M.
AU - Wagner, Joseph
AU - Cercy, Kelly
AU - Kravitz, Hannah
AU - Coates, Matthew M.
AU - Robinson, Margaret
AU - Estep, Kara
AU - Steiner, Caitlyn
AU - Jaber, Sara
AU - Mokdad, Ali A.
AU - O'Rourke, Kevin F.
AU - Chew, Adrienne
AU - Kim, Pauline
AU - El Razek, Mohamed Magdy Abd
AU - Abdalla, Safa
AU - Abd-Allah, Foad
AU - Abraham, Jerry P.
AU - Abu-Raddad, Laith J.
AU - Abu-Rmeileh, Niveen M.E.
AU - Al-Nehmi, Abdulwahab A.
AU - Akanda, Ali S.
AU - Al Ahmadi, Hanan
AU - Al Khabouri, Mazin J.
AU - Al Lami, Faris H.
AU - Al Rayess, Zulfa A.
AU - Alasfoor, Deena
AU - AlBuhairan, Fadia S.
AU - Aldhahri, Saleh F.
AU - Alghnam, Suliman
AU - Alhabib, Samia
AU - Al-Hamad, Nawal
AU - Ali, Raghib
AU - Ali, Syed Danish
AU - Alkhateeb, Mohammad
AU - AlMazroa, Mohammad A.
AU - Alomari, Mahmoud A.
AU - Al-Raddadi, Rajaa
AU - Alsharif, Ubai
AU - Al-Sheyab, Nihaya
AU - Alsowaidi, Shirina
AU - Al-Thani, Mohamed
AU - Altirkawi, Khalid A.
AU - Amare, Azmeraw T.
AU - Amini, Heresh
AU - Ammar, Walid
AU - Anwari, Palwasha
AU - Asayesh, Hamid
AU - Asghar, Rana
AU - Assabri, Ali M.
AU - Assadi, Reza
AU - Bacha, Umar
AU - Badawi, Alaa
AU - Bakfalouni, Talal
AU - Basulaiman, Mohammed O.
AU - Bazargan-Hejazi, Shahrzad
AU - Bedi, Neeraj
AU - Bhakta, Amit R.
AU - Bhutta, Zulfiqar A.
AU - Bin Abdulhak, Aref A.
AU - Boufous, Soufiane
AU - Bourne, Rupert R.A.
AU - Danawi, Hadi
AU - Das, Jai
AU - Deribew, Amare
AU - Ding, Eric L.
AU - Durrani, Adnan M.
AU - Elshrek, Yousef
AU - Ibrahim, Mohamed E.
AU - Eshrati, Babak
AU - Esteghamati, Alireza
AU - Faghmous, Imad A.D.
AU - Farzadfar, Farshad
AU - Feigl, Andrea B.
AU - Fereshtehnejad, Seyed Mohammad
AU - Filip, Irina
AU - Fischer, Florian
AU - Gankpé, Fortuné G.
AU - Ginawi, Ibrahim
AU - Gishu, Melkamu Dedefo
AU - Gupta, Rahul
AU - Habash, Rami M.
AU - Hafezi-Nejad, Nima
AU - Hamadeh, Randah R.
AU - Hamdouni, Hayet
AU - Hamidi, Samer
AU - Harb, Hilda L.
AU - Hassanvand, Mohammad Sadegh
AU - Hedayati, Mohammad T.
AU - Heydarpour, Pouria
AU - Hsairi, Mohamed
AU - Husseini, Abdullatif
AU - Jahanmehr, Nader
AU - Jha, Vivekanand
AU - Jonas, Jost B.
AU - Karam, Nadim E.
AU - Kasaeian, Amir
AU - Kassa, Nega Assefa
AU - Kaul, Anil
AU - Khader, Yousef
AU - Khalifa, Shams Eldin A.
AU - Khan, Ejaz A.
AU - Khan, Gulfaraz
AU - Khoja, Tawfik
AU - Khosravi, Ardeshir
AU - Kinfu, Yohannes
AU - Defo, Barthelemy Kuate
AU - Balaji, Arjun Lakshmana
AU - Lunevicius, Raimundas
AU - Obermeyer, Carla Makhlouf
AU - Malekzadeh, Reza
AU - Mansourian, Morteza
AU - Marcenes, Wagner
AU - Farid, Habibolah Masoudi
AU - Mehari, Alem
AU - Mehio-Sibai, Abla
AU - Memish, Ziad A.
AU - Mensah, George A.
AU - Mohammad, Karzan A.
AU - Nahas, Ziad
AU - Nasher, Jamal T.
AU - Nawaz, Haseeb
AU - Nejjari, Chakib
AU - Nisar, Muhammad Imran
AU - Omer, Saad B.
AU - Parsaeian, Mahboubeh
AU - Peprah, Emmanuel
AU - Pervaiz, Aslam
AU - Pourmalek, Farshad
AU - Qato, Dima M.
AU - Qorbani, Mostafa
AU - Radfar, Amir
AU - Rafay, Anwar
AU - Rahimi, Kazem
AU - Rahimi-Movaghar, Vafa
AU - Rahman, Sajjad Ur
AU - Rai, Rajesh K.
AU - Rana, Saleem M.
AU - Rao, Sowmya R.
AU - Refaat, Amany H.
AU - Resnikoff, Serge
AU - Roshandel, Gholamreza
AU - Saade, Georges
AU - Saeedi, Mohammad Y.
AU - Sahraian, Mohammad Ali
AU - Saleh, Shadi
AU - Sanchez-Riera, Lidia
AU - Satpathy, Maheswar
AU - Sepanlou, Sadaf G.
AU - Setegn, Tesfaye
AU - Shaheen, Amira
AU - Shahraz, Saeid
AU - Sheikhbahaei, Sara
AU - Shishani, Kawkab
AU - Sliwa, Karen
AU - Tavakkoli, Mohammad
AU - Terkawi, Abdullah S.
AU - Uthman, Olalekan A.
AU - Westerman, Ronny
AU - Younis, Mustafa Z.
AU - El Sayed Zaki, Maysaa
AU - Zannad, Faiez
AU - Roth, Gregory A.
AU - Wang, Haidong
AU - Naghavi, Mohsen
AU - Vos, Theo
AU - Al Rabeeah, Abdullah A.
AU - Lopez, Alan D.
AU - Murray, Christopher J.L.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013. Methods GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically. Findings The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60–80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7% to 7·5% between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred. Interpretation Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts. Funding Bill & Melinda Gates Foundation.
AB - Background The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013. Methods GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically. Findings The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60–80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7% to 7·5% between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred. Interpretation Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts. Funding Bill & Melinda Gates Foundation.
UR - http://www.scopus.com/inward/record.url?scp=84991783943&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84991783943&partnerID=8YFLogxK
U2 - 10.1016/S2214-109X(16)30168-1
DO - 10.1016/S2214-109X(16)30168-1
M3 - Article
C2 - 27568068
AN - SCOPUS:84991783943
VL - 4
SP - e704-e713
JO - The Lancet Global Health
JF - The Lancet Global Health
SN - 2214-109X
IS - 10
ER -