A comparative risk assessment of health burden attributable to modifiable risk factors in Thailand, 2009: a systematic analysis

Abstract

BackgroundThe prevalence of non-communicable diseases in Thailand has been steadily increasing over the past 10 years. Reliable and comparable evidence on burden attributable to preventable risk factors is necessary for priority setting of health interventions. The objective of this study was to estimate the contribution of major modifiable risk factors to burden of disease in Thailand in 2009. MethodsWe followed the Comparative Risk Assessment of the Global Burden of Disease methodology and obtained data on risk exposure from the National Health Examination Survey. Data on the number of cause-specific deaths and incidences were derived from the 2009 Thai Burden of Disease Study. Sensitivity analysis was undertaken to account for uncertainty in the burden estimates. FindingsIn 2009, tobacco smoking accounted for 50 710 deaths (95% uncertainty interval 50 310–50 924), followed by 42 133 deaths attributed to high blood pressure (41 841–42 155), 28 795 attributed to high cholesterol (28 209–28 815), 26 014 attributed to high body-mass index (BMI; 25 707–26 082), and 22 672 attributed to alcohol use (22 617–22 685). Almost 30% (27·03% [95% uncertainty interval 27·02–27·09]) of the total disability-adjusted life-years (DALYs) in males were attributable to harmful effects of alcohol drinking and smoking and around 17% (16·98% [16·88–17·00]) of DALYs in females were attributable to high BMI, high blood pressure, and high blood cholesterol. Most of the burden attributable to each modifiable risk factor exposure was due to cancer, cardiovascular diseases, mental disorders, diabetes, and chronic respiratory diseases. InterpretationAlthough the prevalence of smoking is declining, obesity and the harmful use of alcohol have been steadily increasing over the past 10 years. The efforts to reduce burden from preventable risk factors must be increased. FundingThai Health Promotion Foundation (ThaiHealth) and National Health Security Office.