The state of the world’s health

Improvements in sanitation, immunisations, indoor air quality, and nutrition have enabled children in poor countries to live longer over the past 25 years, according to a new scientific analysis of more than 300 diseases and injuries in 195 countries and territories.

However, such progress is threatened by increasing numbers of people suffering serious health challenges related to obesity, high blood sugar, and alcohol and drug abuse. These and other significant health findings are being published in a dedicated issue of The Lancet as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). The study draws on the work of more than 1,800 collaborators in over 120 countries.

"Development drives, but does not solely determine health," said Dr. Christopher Murray, Director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle, the coordinating center for the GBD enterprise.

Globally, life expectancy increased from about 62 years to nearly 72 from 1980 to 2015, with several nations in sub-Saharan Africa rebounding from high death rates due to HIV/AIDS. Child deaths are falling fast, as are illnesses related to infectious diseases. But each country has its own specific challenges and improvements, from fewer suicides in France, to lower death rates on Nigerian roadways, to a reduction in asthma-related deaths in Indonesia.

In much of the world, giving birth is safer for mothers and newborns than it has been over the past 25 years. The number of maternal deaths globally dropped by roughly 29% since 1990, and the ratio of maternal deaths fell 30%, from 282 per 100,000 live births in 1990 to 196 in 2015.

However, 24 countries still have what population health experts consider high rates of maternal mortality, more than 400 deaths per 100,000. These include Central African Republic (1,074 deaths per 100,000), Afghanistan (789 per 100,000), and Sierra Leone (696 per 100,000).

Such levels of maternal deaths underscore the need for reproductive health improvements in those three nations and other countries that are far behind the United Nations' goal to have fewer than 70 deaths per 100,000 live births by 2030.

Areas for improvement include increased access to family planning, better routine reproductive health care, and improved data collection systems.

The top five causes of death in Bangladesh in 2015 were cerebrovascular disease which caused 16% of all deaths, ischemic heart disease, Chronic Obstructive Pulmonary Disease (COPD), diabetes and lower respiratory infection.

The overall life expectancy of females in Bangladesh increased to 72.5 years in 2015 from 68.7 years in 2005. Conjointly, life expectancy of males increased from 65.7 years in 2005 to 68.5 years in 2015.

The study's other findings include many important indicators in health that can guide country-specific plans.

"Policymakers in all nations can use this study to align spending to target the things that will make their communities healthier faster," said Dr. Charles SheyWiysonge, a GBD collaborator from South Africa who serves as a Professor of Clinical Epidemiology at the Faculty of Medicine and Health Sciences, Stellenbosch University, in Cape Town.