Abstract
BackgroundOver the past few decades, economic, political, and social changes have directly and indirectly affected the health of the Mongolian population. To date, no comprehensive analysis has been conducted on the burden of diseases in this country. Thus, we aimed to describe the leading causes of death and disabling conditions and their trends between 1990 and 2019 in the Mongolian population.MethodsWe used the data from the Global Burden of Disease (GBD) 2019 study. In the current study, we examined life expectancy at birth, healthy life expectancy, the 20 leading causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted-life-years (DALYs), and the contribution of major risk factors to DALYs in Mongolia.FindingsThe life expectancy at birth in Mongolia has gradually increased since 1995 and reached 63.8 years for men and 72.7 for women in 2019. The highest increase in the age-standardised death rate between 1990 and 2019 occurred in alcohol use disorders (628.6%; 95% UI 10.0–1109.6) among men, and in liver cancer (129.1%; UI 65.3–222.4) among women. Ischaemic heart disease and stroke showed the highest rates of death, YLLs, and DALYs among both men and women. In 2019, the highest age-standardised rates of DALYs were attributable to high systolic blood pressure and dietary risks.InterpretationAlthough Mongolia saw substantial improvements across many communicable diseases, maternal and neonatal disorders, and under-5 mortality between 1990 and 2019, non-communicable diseases remained leading causes of mortality. The mortality from the most preventable causes such as injury, alcohol use, and dietary risks remain substantially high, suggesting that individual and social efforts are needed to tackle these diseases. Our analyses will support the development of policy priorities and action plans in multiple sectors to improve the overall health of the Mongolian population.FundingBill & Melinda Gates Foundation.
Highlights
Mongolia, located in East Asia with a population of 3.2 million, is the l9th largest and least densely populated country in the world and one-third of the population live in rural areas with a traditional semi-nomadic lifestyle [1]
We examined 20 leading causes of total deaths, years of life lost (YLLs), years lived with disability (YLDs), and DALYs in Mongolia in accordance with the third hierarchical level of classification, which has 169 causes of death
We report all rates as age-standardised rates derived from world population standards that were developed for the Global Burden of Disease (GBD) study, and each point estimate includes 95% uncertainty intervals (UIs)
Summary
Mongolia, located in East Asia with a population of 3.2 million, is the l9th largest and least densely populated country in the world and one-third of the population live in rural areas with a traditional semi-nomadic lifestyle [1]. The current health care system in Mongolia was developed in 1921 under the strong, centrally planned Soviet Union Semashko model, with health-care services fully financed by general government revenues. By 2019, 90.2% of the population was covered by social health insurance [3]. There are four sources of revenue for the health sector: state budget, health insurance fund, out-of-pocket payments, and international aid and loans [2, 3]. As of 2019, 69.7% of the total health expenditure was financed from the state budget, 26.9% from health insurance funds, and 3.5% from other revenues such as out-of-pocket expenses [3]. Over the past few decades, economic, political, and social changes have directly and indirectly affected the health of the Mongolian population. We aimed to describe the leading causes of death and disabling conditions and their trends between 1990 and 2019 in the Mongolian population
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