Greenspace mitigates the global disease and economic burdens of non-communicable diseases

Hepatitis B virus (HBV) infection remains a significant global public health challenge, contributing to both hepatic and extrahepatic disease burdens. This study aims to estimate the global disease and economic burden of HBV-attributable noncommunicable diseases (NCDs). The study included hepatic NCDs (cirrhosis and other chronic liver diseases [CCLDs] and hepatocellular carcinoma [HCC]) and nonhepatic NCDs (NHNCDs). Nine NHNCDs were identified by integrating the Global Burden of Disease Study (GBD) 2021 database cause list with narrative reviews from January 1, 2013, to May 31, 2024. The economic impacts of HBV-attributable NCDs in 159 countries were estimated and projected to 2035 using a cost-of-illness approach, encompassing healthcare costs and productivity losses due to mortality. Country-specific data were sourced from public and global databases. In 2021, the global HBV-attributable age-standardized incidence rates (ASIRs) and disability-adjusted life-years (DALYs) rates (ASDRs) were: hepatic CCLDs (61.51 and 161.92/100 000 persons), HCC (2.37 and 65.36/100 000 persons), and NHNCDs (7.75 and 33.04/100 000 persons). The global economic cost of HBV-attributable NCDs was conservatively estimated at $40.99 billion in 2021, including $37.42 billion in healthcare costs and $3.57 billion in productivity losses, equivalent to 0.027% of global GDP. Of the healthcare costs, 55.5% ($20.78 billion) were borne by the public healthcare providers, 13.2% ($4.94 billion) by the private healthcare providers, and 31.3% ($11.71 billion) by patients' out-of-pocket spending. If current trends persist, the global economic costs were projected to increase from $42.94 billion (0.028% of global GDP) in 2022 to $83.74 billion (0.035% of global GDP) in 2035, with a cumulative cost $847.10 billion (0.031% of global GDP) over this period. Central and Western Sub-Saharan Africa would bear the heaviest HBV-attributable NCDs costs relative to GDP, while the Caribbean and Latin America would experience the most rapid growth of economic impact. The economic burden of HBV-attributable NCDs is projected to increase over the next decade and disproportionately affect resource-limited settings. Targeted and sustained efforts will be essential to mitigate widening health and economic disparities.

BackgroundHematologic malignancies (HM) impose substantial healthcare and productivity-related costs globally. However, disparities in economic impact across regions and countries remain insufficiently explored. This study aimed to evaluate the global, regional, and national economic burden of HM and its subtypes (leukemia, non-Hodgkin lymphoma, multiple myeloma, and Hodgkin lymphoma) from 1990 to 2021, with projections to 2050.MethodsData from the Global Burden of Disease 2021 study were utilized to estimate the economic burden of HM using the value of a statistical life year (VSLY) approach, based on disability-adjusted life years (DALYs). Decomposition analysis was conducted to identify drivers of economic burden, including population growth and aging. Future trends were modeled using the Bayesian Age-Period-Cohort (BAPC) model, and comparisons of economic burden were made across countries by income levels.ResultsIn 2021, the global economic burden of HM reached $1.516 trillion, a 52.8% increase from $992 billion in 1990. This represented approximately 1% of the global GDP, with high-income countries (HICs) bearing the largest share of 2.17% of GDP, compared to 0.58% in lower-middle-income countries (LMICs). The United States had the highest national burden at $417.42 billion (95% UI: $389.49–$435.80 billion), followed by China $133.84 billion (95% UI: $98.63–$166.21 billion), $113.03 billion (95% UI: $101.62–$122.88 billion), and Japan $88.30 billion (95% UI: $85.65–$90.24 billion). By 2050, the global burden is projected to decline to $1.249 trillion, driven by healthcare advancements in HICs, but with a rising burden in upper-middle-income countries (UMICs), which are expected to account for 48.1% of the global burden. China is projected to lead globally with $421.65 billion (95% UI: $314.68–$1,495.35 billion), followed by India ($123.8 billion), while the United States is expected to decline to $101.6 billion. Subtype-specific analysis revealed that Leukemia accounted for the largest proportion of the burden in 2021 ($651 billion, 42.9%), followed by NHL ($492 billion, 32.5%), multiple myeloma ($278.17 billion, 100.5%), and Hodgkin lymphoma ($43.84 billion, 21%).ConclusionsThe economic burden of HM has increased significantly, with marked disparities across regions and income levels. By 2050, the burden is expected to shift from high- to middle-income countries. Investments in early diagnosis, affordable treatments, and healthcare improvements are essential to reduce the burden and address inequities.

Global and regional projections of the economic burden of Alzheimer's disease and related dementias from 2019 to 2050: A value of statistical life approach.

Chapter28 - Musculoskeletal twin studies

Global Burden of Infectious Diseases

Tackling the global disease burden is paramount in the context of the burgeoning epidemic of communicable and non-communicable diseases, especially in low- and middle-income countries. While most high-income countries have successfully implemented cost-effective interventions to tackle their burden of non-communicable diseases, low- and middle-income countries have to prioritise cost-effective interventions to tackle the multiple burden of communicable and non-communicable diseases and to strengthen their efforts to effectively address other key issues of public health concern. The irony is that while low- and middle-income countries carry the heaviest burden of disease, such countries have a minor share of the total global health spending, yet their economies are severely challenged and their populations are the most affected by poverty which has a negative impact on health. This chapter gives a critical overview on the following topics: What is International Public Health? Epidemiology and the burden of diseases; Understanding the magnitude of the disease burden.

BackgroundGlobally, herpes simplex virus (HSV)-2 and -1 infections contribute to a large disease burden, but their full economic consequences remain unclear. This study aims to estimate the global economic impact of genital HSV-2 and HSV-1 infection and its consequences for people with genital ulcer disease, neonatal herpes, and human immunodeficiency virus (HIV) infection attributable to HSV-2.MethodsUsing a societal perspective, the economic burden was calculated at the country level and presented by World Health Organization (WHO) regions and World-Bank income levels. The disease burden was obtained from previously published global disease burden studies in 2016 and disaggregated for 194 countries. Estimates of healthcare resource utilisation were sourced from a literature review, and online interviews were conducted with 20 experts from all 6 WHO regions. Relevant costs were obtained from the literature and estimated in 2016 international dollars (I$).ResultsBoth genital HSV-2 (I$31·2 billion) and HSV-1 (I$4·0 billion) infections and their consequences were estimated to cost I$35·3 billion globally in 2016. The major economic burden was from the Americas and Western Pacific regions combined, accounting for almost two-thirds of the global burden (I$20·8 billion). High- and upper-middle-income countries bore a large proportion of the economic burden (76·6% or I$27·0 billion). Costs were driven by the large number of HSV-2 recurrences; however, even assuming conservatively that people with symptomatic herpes have on average only one episode a year, global costs were estimated at I$16·5 billion.ConclusionsThe global costs of genital HSV infection and its consequences are substantial. HSV prevention interventions have the potential to avert a large economic burden in addition to disease burden; thus, efforts to accelerate HSV vaccine development are crucial.

The World Health Organization has reported that mental illness is a leading cause of Disability Adjusted Life Years (DALYs) worldwide. One in four people will develop some kind of mental illness at some point in their lives. Today depression alone ranks 2nd as the cause of DALYs in the age category 15 – 44 years for both sexes (working populations in most countries). Fewer than 25 % of those afflicted have access to effective treatment worldwide and in more than half the countries of the world there is one psychiatrist available for every 200,000 people. By 2030, depression will be the second highest cause of disease burden in middle income countries and the third highest in low income countries. (Victoria Riemer (October 19, 2011). Mental Health Atlas 2011 in Media Center WHO. Retrieved June 15, 2012, fromwww.who.int/mediacentre/news/releases/2010/mental_disabilities_20100916/en/index.html At the World Economic Forum convened in September 2011, comparisons were provided across Non-Communicable Diseases to provide a picture of the impact of the global economic health burden. Mental health costs are the largest single source; larger than cardiovascular disease, chronic respiratory disease, cancer, or diabetes. Mental illness alone will account for more than half of the projected total economic burden from NCDs over the next two decades and 35% of the global lost output. The global cost of mental illness in 2010 was approximately 2.5 T. with a projected increase to 6 T. by 2030. Considering that those with mental illness are at high risk for developing cardiovascular disease, respiratory disease, and diabetes, and vice versa, the true costs of mental illness must be even higher. (Bloom, D.T; Caliero, ET; et.al. (Sept, 2011) The Global Economic Burden of Non-Communicable Diseases in A Report by the World Economic Forum and the Harvard School of Public Health, Retrieved, June 15, 2012.) These mental health realities directly impact the ability of businesses to operate competitively and -- where hazardous operations are daily considerations -- safely. What further complicates responding to the business impact of this health problem is the lack of available research on incidents, near hits attributable to distractability caused by mental/relational problems. The evidence that workers arrive at work with mental illness or distractible frame of mind related to family members or loved ones afflicted with mental health problems is obscure. These issues by definition remain hidden and unidentified and therefore are elusive to normal research that identifies the impact on the workplace of other disease burden.

Gout is an inflammatory and metabolic disease characterized by arthritis and elevation of the serum uric acid (SUA) level. More and more studies have shown that high body mass index (BMI) has become one of the most important risk factors for gout. We used the data of gout burden attributed to high body mass index (BMI) from global burden of disease (GBD) study 2019 to provide insights for reducing the global burden of gout. From 1990 to 2019, the prevalence and DALYs of gout caused by high BMI worldwide has been increasing. The burden of gout caused by high BMI is heavier in the elderly male group and regions with high SDI worldwide. Our findings provide evidence for the burden of gout caused by high BMI. Developing a weight management plan and lifestyle habits for groups severely affected by gout will effectively reduce the global disease and economic burden.

Forecasting the Global Economic and Health Burden of COPD From 2025 Through 2050.

BackgroundThe Global Burden of Disease (GBD) studies have transformed global understanding of health risks by producing comprehensive estimates of attributable disease burden, or the current disease that would be eliminated if a risk factor did not exist. Yet many have noted the greater policy significance of avoidable burden, or the future disease that could actually be eliminated if a risk factor were eliminated today. Avoidable risk may be considerably lower than attributable risk if baseline levels of exposure or disease are declining, or if a risk factor carries lagged effects on disease. As global efforts to deliver clean cookstoves accelerate, a temporal estimation of avoidable risk due to household air pollution (HAP) becomes increasingly important, particularly in light of the rapid uptake of modern stoves and ongoing epidemiologic transitions in regions like South and Southeast Asia.Methods and FindingsWe estimate the avoidable burden associated with HAP using International Futures (IFs), an integrated forecasting system that has been used to model future global disease burdens and risk factors. Building on GBD and other estimates, we integrated a detailed HAP exposure estimation and exposure-response model into IFs. We then conducted a counterfactual experiment in which HAP exposure is reduced to theoretical minimum levels in 2015. We evaluated avoidable mortality and DALY reductions for the years 2015 to 2024 relative to a Base Case scenario in which only endogenous changes occurred. We present results by cause and region, looking at impacts on acute lower respiratory infection (ALRI) and four noncommunicable diseases (NCDs). We found that just 2.6% of global DALYs would be averted between 2015 and 2024, compared to 4.5% of global DALYs attributed to HAP in the 2010 GBD study, due in large part to the endogenous tendency towards declining traditional stove usage in the IFs base case forecast. The extent of diminished impact was comparable for ALRI and affected NCDs, though for different reasons. ALRI impacts diminish due to the declining burden of ALRI in the base case forecast, particularly apparent in South Asia and Southeast Asia. Although NCD burdens are rising in regions affected by HAP, the avoidable risk of NCD nonetheless diminishes due to lagged effects. Because the stove transition and the decline of ALRI are proceeding more slowly in Sub-Saharan Africa, avoidable impacts would also be more persistent (3.9% of total DALY due to HAP) compared to South Asia (3.6%) or Southeast Asia (2.5%).ConclusionsOur results illustrate how a temporal dynamic calculation of avoidable risk may yield different estimates, compared to a static attributable risk estimate, of the global and regional burden of disease. Our results suggest a window of rising and falling opportunity for HAP interventions that may have already closed in Southeast Asia and may be closing quickly in South Asia, but may remain open longer in Sub-Saharan Africa. A proper accounting of global health priorities should apply an avoidable risk framework that considers the role of ongoing social, economic and health transitions in constantly altering the disease and risk factor landscape.

Schistosomiasis is a neglected tropical disease that causes a significant global burden. The aim of this study was to report the latest estimates of the global, regional, and national schistosomiasis disease burden and forecast changes in schistosomiasis-related disease burden. This work was based on the 2021 Global Burden of Disease (GBD) study. We analyzed the schistosomiasis data by sex, age in years, and Socio-Demographic Index (SDI) region and country, using Age-Standardized Rates (ASR) for comparisons among different groups. The Estimated Annual Percent Changes (EAPC) analysis was used to evaluate the temporal trend of the disease burden, and the Differential Autoregressive Integrated Moving Average (ARIMA) and Exponential Smoothing (ES) models were used to predict the disease burden from 2022 to 2046. In the GBD 2021 study, it was reported that compared to 1990, the number of deaths has decreased by 74,350, the prevalence number has increased by 1,482,260, and Disability-Adjusted Life Years (DALYs) have decreased by 1,770,436. Additionally, the age-standardized mortality rate (ASMR) has decreased by 0.31 per 100,000 people, with an EAPC of -0.353 (95% CI: -0.361 to -0.344). Similarly, the age-standardized DALYs rate (ASDR) has decreased by 15.45 per 100,000 people (EAPC: -1.56, 95% CI: -1.78 to -1.34), and the age-standardized prevalence rate (ASPR) has decreased by 559.64 per 100,000 people (EAPC: -0.63, 95% CI: -0.95 to -0.31). The regions and countries with the highest disease burden are mostly concentrated in Africa. Despite a general decline in global schistosomiasis burden indicators, the burden of disease has actually increased in high SDI areas. The ARIMA and ES models forecast results show that female mortality and ASMR will decline in the next 25 years, while male mortality and ASMR will remain stable, and other disease indicators will continue to decline. The global schistosomiasis burden has significantly decreased over the past 30 years, but it remains high in African regions and countries, as well as low-SDI areas. Effective cooperation among countries should be strengthened to improve the disease burden in high-burden areas and countries.

Global economic burden of Chagas disease: a computational simulation model.

Bacterial skin diseases are a category of inflammatory skin conditions caused by bacterial infections, which impose a significant global disease burden. However, they have not been well assessed or predicted on a global scale. It is necessary to update the estimates and forecast future trends of the global burden of bacterial skin diseases to evaluate the impact of past healthcare policies and to provide guidance and information for new national and international healthcare strategies. We aimed to describe the burden and trend of bacterial skin diseases and to predict the burden up to 2045. To achieve this, we employed a cross-sectional analysis based on Global Burden of Disease (GBD) data, utilizing advanced statistical models to quantify trends and forecast future burdens. Data on incidence and disability-adjusted life years (DALYs) of bacterial skin diseases were obtained from Global Burden of Disease 2021. We used average annual percent change (AAPC) by Joinpoint Regression to quantify the temporal trends. We conducted decomposition analysis to understand the contribution of aging, epidemiological changes, and population growth. Bayesian Age-Period-Cohort model was used to predict burden up to 2045. Global incidence rate of bacterial skin diseases increased from 8,988.74 per 100,000 in 1990 to 10,823.88 per 100,000, with AAPC of 0.62% (0.61 ~ 0.63%). The highest incidence rate was in low Socio-demographic Index (SDI) region and population aged < 35. The DALYs rate increased from 20.82 per 100,000 in 1990 to 25.45 per 100,000 in 2021, with AAPC of -0.11% (-0.34 ~ 0.13%). The highest increase of DALYs was in high SDI region and population aged > 85. Among the three evaluated factors of decomposition analysis, the major drivers of incident case rise were population growth, followed by epidemiological changes; the major drivers of DALYs case rise were population growth, followed by aging. The number of incidence cases has increased since 1990, reaching nearly 90million in 2021 and expected to hit 1.2billion in 2045. The incidence rate has also risen. Meanwhile, DALYs showed an upward trend from 1990 to 2005, peaking at 32/100,000, then a downward trend. Our findings align with our initial objectives, demonstrating a significant increase in the global incidence of bacterial skin diseases and highlighting the need for targeted prevention and treatment strategies. The variation in burden across different regions and age groups underscores the importance of tailored public health interventions. Predictive models suggest a continued rise in incidence rates and incident cases through 2045, emphasizing the urgency for action. This study provides a foundation for future research and policy development aimed at reducing the burden of bacterial skin diseases worldwide.

Smoking is a risk factor for low back pain (LBP) and rheumatoid arthritis (RA). We aimed to estimate the global health and economic burden of LBP and RA attributable to smoking. This was a cross-sectional study. The study was conducted in 192 countries and territories. Prevalent cases of LBP and RA were used, extracted from the Global Burden of Diseases, Injuries and Risk Factors Study 2019 data repositories. Smoking-attributable health and economic burden was estimated with the population-attributable fraction method. Smoking-attributable prevalence of LBP and RA and health-care costs were estimated for patients of all ages, whereas years lived with disability (YLDs) and productivity losses due to morbidity were estimated for patients aged 15-84 years. Uncertainty intervals (UIs) of the results were obtained by repeating the analysis with the lower and upper bounds of all input variables. Globally, smoking accounted for 84.5 million (UI = 56.7-120.2 million) prevalent cases of LBP, 1.8 million (UI = 0.5-3.4 million) prevalent cases of RA and 11.3 million (UI = 6.2-18.5 million) YLDs, which represented 1.5% of all-cause YLDs in the working-age population aged 15-84 years in 2019. Health-care costs and productivity losses of smoking-attributable LBP and RA cost the global economy purchasing-power parity $326.0 billion (UI = $184.0-521.4 billion), representing 0.2% of the global gross domestic product. Specifically, smoking accounted for $65.8 billion (UI = $38.0-101.2 billion) in health-care costs world-wide, with more than half [$39.8 billion (UI = $23.1-61.3 billion), 60.6%] borne by the public sector. Smoking also contributed to $260.3 billion (UI = $146.0-420.3 billion) in productivity losses globally. Approximately 60.0% of the global YLDs were observed in middle-income countries, whereas 84.4% of health-care costs and 72.7% of productivity losses were borne by high-income countries. Globally, in 2019, smoking accounted for more than 11.0 million years lived with disability and purchasing-power parity $326.0 billion in economic losses due to low back pain and rheumatoid arthritis. Middle-income countries suffered more morbidity, whereas high-income countries experienced larger economic losses.