Institute For Health Metrics And Evaluation Research Articles

Burden of Ischemic Heart Diseases among US States from 1990-2019.

Ischemic Heart Disease (IHD) is a leading cause of global mortality, including in the United States. Understanding the burden of IHD in the United States is crucial for informed decision-making and targeted interventions aimed at reducing morbidity and mortality associated with this leading cause of death. This study aimed to understand the burden of IHD, identify gender disparities and risk factors, explore the relationship between socioeconomic growth and IHD, and analyze risk factor distribution across the states of the United States. This study utilized data from the Global Burden of Diseases Study 2019, which provided comprehensive information on IHD from 1990 to 2019. Data related to IHD from these years were extracted using a query tool from the Institute for Health Metrics and Evaluation (IHME) website. The study assessed the relationship between IHD and socioeconomic development using the Socio-demographic Index (SDI) and measured the overall impact of IHD using Disability-adjusted Life Years (DALYs), considering premature death and disability. Additionally, the study analyzed the burden of IHD attributed to six main risk factors. Data analysis involved comparing prevalence, mortality, SDI, DALYs, attributable burden, and risk estimation among the states. Between 1990 and 2019, there was an improvement in socioeconomic development in all states. Age-standardized rates of disease burden for IHD decreased by 50% [ASDR 3278.3 to 1629.4 (95% UI: 1539.9-1712.3) per 100,000] with the most significant decline observed in Minnesota. Males had higher burden rates than females in all states, and the southeast region had the highest mortality rates. The prevalence of IHD showed a declining trend, with approximately 8.9 million cases (95% UI: 8.0 million to 9.8 million) in 2019, representing a 37.1% decrease in the Age-standardized Prevalence Rate (ASPR) from 1990. Metabolic risks were the leading contributors to the disease burden, accounting for 50% of cases, with Mississippi having the highest attributable risk. Arkansas had the highest attributable risk for high cholesterol and smoking. Conversely, Minnesota had the lowest burden of IHD among all the states. This study highlights variations in the burden of IHD across US states and emphasizes the need for tailored prevention programs to address specific risk factors and gender differences. Understanding the trend in IHD may inform policymakers and healthcare professionals in effectively allocating resources to reduce the burden of IHD and improve national health outcomes.

Addressing Regional Health Disparities: Estonia’s Approach to Burden of Disease Studies

Abstract Background Estonia, a small country defined by NUTS2 regions, faces challenges in assessing health disparities across its different counties when using global health data such as the Global Burden of Disease (GBD). Recognizing this limitation, Estonia initiated independent burden of disease studies in Estonia since 2013, with the findings being biennially published through the health statistics database of the National Institute for Health Development. The objective of this research is to assess the strengths and limitations inherent in various methods when calculating the years of life lost due to premature mortality (YLLs). Methods The approach to assess the burden of disease in Estonia differs somewhat from the Global Burden of Disease (GBD) methodology. One key distinction lies in our utilization of a national life expectancy table and our presentation of results at the LAU1 regional level. These burden of disease studies utilize region-specific life tables supplied by Statistics Estonia, categorized by county and gender, to compute Years of Life Lost (YLLs), offering an opportunity to pinpoint and tackle regional health issues. Results Since the calculation of YLL (Years of Life Lost) in these past studies has relied upon Estonia’s regionalized life tables, categorized by county and gender, the results exhibit substantial disparities when juxtaposed with the Global Burden of Disease study conducted by the Institute for Health Metrics and Evaluation (IHME). Conclusions This research aims to delve deeper into these variations, examining the challenges related to methodology, the availability, and the quality of data, and most importantly, knowledge translation. Our own burden of disease studies empowers us to formulate informed policy recommendations precisely tailored to the distinctive needs of each county, thereby facilitating targeted interventions, and driving improvements in overall public health outcomes.

Heterogeneous courses of cardiovascular disease incidence in Europe 2000-2019 – what are the causes?

Abstract Background Data from the Global Burden of Disease (GBD) project distributed by the Institute for health metrics and evaluation (IHME) include incidence and prevalence data for almost all countries in the world. In course of own research, the data on cardiovascular disease (CVD) incidence in Western European countries were analysed and revealed great variation in the course of CVD incidence, that is difficult to interpret. We want to present the different courses of CVD incidence for selected countries and discuss possible reasons for this diversity with the audience. Methods GBD data on CVD incidence and mortality for 25 European countries from 2000-2019 for men and women were to graphically display courses of CVD incidence for visual analysis. Results The course of CVD incidence in Western Europe is country-specific - and, within a country, even sex-specific. Yet, in many countries besides the Baltic states and Czechia, CVD incidence reaches a minimum in 2010, increasing afterwards again. Different patterns of incident courses were visible: a) wave-shaped courses which increase e.g. in Austria, Belgium, France and in males in Finland only, but decrease for both sexes Germany, Norway, Portugal and Poland, and in males in Denmark b) u-shaped courses in Spain, Great Britain, France, Italy, and for Finnish and Dutch females c) linearly increasing for both sexes in Czechia, the Baltic states and in Swiss males d) linearly decreasing for women Norway, Belgium, Denmark and Austria. Conclusions The patterns of CVD incidence in Europe are multitude and country-specific even between sexes, reaching a minimum in 2010 in most countries. The validity of analyses combining these different patterns for regional analyses of CVD incidence such as in GBD reports do not take account for this diversity. Unless these differences can be explained by country-specific prevention or risk factor profile, the validity of data on CVD incidence seems to be limited. Key messages • CVD incidence in Europe between 2000 and 2019 is country-specific changing and very heterogeneous. • Analyses summarizing data for (Western/Eastern) Europe will miss this heterogeneity and might come to invalid conclusions regarding the development of CVD incidence.

Impact of air pollution on mortality: Geo-epidemiological study in French-speaking Africa

According to the World Health Organization, air pollution is responsible for 90 % of deaths in Africa. However, limited data on exposure to air pollution is available, and studies are rare, particularly in French-speaking Africa. This study aims to investigate the impact of air pollution on mortality in 12 French-speaking African countries (Algeria, Burkina Faso, Burundi, Cameroon, Guinea, Ivory Coast, Madagascar, Mali, Morocco, Democratic Republic of Congo, Senegal, Tunisia). Using data from the Institute for Health Metrics and Evaluation (IHME), annual concentrations of the PM2.5 pollutant from different cities were integrated into a spatial interpolation model (IDW) at the scale of each country. The interpolation was validated using cross-validation models. For each of the considered cardiorespiratory diseases (LRI, stroke, COPD, IHD), the attributable mortality fraction was estimated using literature data and population exposure calculated using demographic data from each country. Large variations in ambient PM2.5 concentration between the 12 countries are observed, with concentrations ranging from 1.76 μg/m3 in Morocco to 64.99 μg/m3 in Cameroon. Concentrations are higher in West Africa than in Central or North Africa. In 2019, 136 457 deaths attributable to air pollution were recorded in the 12 countries: 40.8 % from ischemic heart disease, 38.5 % from stroke, 13.2 % from lower respiratory infections and 7.5 % from chronic obstructive pulmonary disease. Our model allowed us to obtain a spatial distribution and the number of deaths related to air pollution. However, the estimation of the health impact from air pollution could be improved by more systematic and comprehensive local exposure assessments from a robust air quality monitoring system.

The evaluation of pneumoconiosis by risk factors gender and age groups in Turkiye, in 1990-2021: incidence, prevalence, deaths, and disability-adjusted life years

Aims: The aim of this study was to evaluate the incidence and prevalence of pneumoconiosis, pneumoconiosis-related disability-adjusted life years (DALY) score, deaths and risk factors by gender and year in Türkiye. Methods: In this study, the estimation data prepared by the Institute for Health Metrics and Evaluation (IHME) for Türkiye in the global burden of disease study covering the years 1990-2021 were used. Descriptive statistics are given as mean and standard deviation. Comparisons according to gender were made with Independent Samples t test. The relationships between numerical variables were analyzed by Pearson correlation coefficient (r). Results: A total of 1755 pneumoconiosis-related deaths occurred in Türkiye between 1990 and 2021. Of the deaths, 687 (39%) were due to silicosis, 489 (28%) to coal worker pneumoconiosis, 451 (26%) to asbestosis and 128 (7%) to other pneumoconiosis. Of those who died, 1619 (92%) were men. The DALY score, incidence and prevalence are also higher in men. The most common risk factor affecting men is silica exposure, while for women it is asbestos exposure. After 2016, incidence and prevalence are decreasing. Conclusion: Pneumoconiosis is more fatal in men and in the 65-80 age group. The effects of the disease vary across countries and even regions within the same country. It is important to take these differences into account in future research on pneumoconiosis. Regulation of working environments in sectors known to cause the disease will both ensure that people are less affected by an important occupational disease and prevent loss of workforce.

Fallacy of attributing the U.S. firearm mortality epidemic to mental health.

Annual global data on mental disorders prevalence and firearm death rates for 2000-2019, enables the U.S. to be compared with comparable counties for these metrics. The Institute for Health Metrics and Evaluation (IHME) Global Health Burden data were used to compare the prevalence of mental disorders with overall, homicide and suicide firearm death rates including homicides and suicides, in high sociodemographic (SDI) countries. Overall and in none of the nine major categories of mental disorders did the U.S. have a statistically-significant higher rate than any of 40 other high SDI countries during 2019, the last year of available data. During the same year, the U.S. had a statistically-significant higher rate of all deaths, homicides, and suicides by firearm (all p<<0.001) than all other 40 high SDI countries. Suicides accounted for most of the firearm death rate differences between the U.S. and other high SDI countries, and yet the prevalence of mental health disorders associated with suicide were not significantly difference between the U.S. and other high SDI countries. Mental disorder prevalence in the U.S. is similar in all major categories to its 40 comparable sociodemographic countries, including mental health disorders primarily associated with suicide. It cannot therefore explain the country's strikingly higher firearm death rate, including suicide. Reducing firearm prevalence, which is correlated with the country's firearm death rate, is a logical solution that has been applied by other countries.

Impacts of socioeconomic and environmental factors on neoplasms incidence rates using machine learning and GIS: a cross-sectional study in Iran

Neoplasm is an umbrella term used to describe either benign or malignant conditions. The correlations between socioeconomic and environmental factors and the occurrence of new-onset of neoplasms have already been demonstrated in a body of research. Nevertheless, few studies have specifically dealt with the nature of relationship, significance of risk factors, and geographic variation of them, particularly in low- and middle-income communities. This study, thus, set out to (1) analyze spatiotemporal variations of the age-adjusted incidence rate (AAIR) of neoplasms in Iran throughout five time periods, (2) investigate relationships between a collection of environmental and socioeconomic indicators and the AAIR of neoplasms all over the country, and (3) evaluate geographical alterations in their relative importance. Our cross-sectional study design was based on county-level data from 2010 to 2020. AAIR of neoplasms data was acquired from the Institute for Health Metrics and Evaluation (IHME). HotSpot analyses and Anselin Local Moran's I indices were deployed to precisely identify AAIR of neoplasms high- and low-risk clusters. Multi-scale geographically weight regression (MGWR) analysis was worked out to evaluate the association between each explanatory variable and the AAIR of neoplasms. Utilizing random forests (RF), we also examined the relationships between environmental (e.g., UV index and PM2.5 concentration) and socioeconomic (e.g., Gini coefficient and literacy rate) factors and AAIR of neoplasms. AAIR of neoplasms displayed a significant increasing trend over the study period. According to the MGWR, the only factor that significantly varied spatially and was associated with the AAIR of neoplasms in Iran was the UV index. A good accuracy RF model was confirmed for both training and testing data with correlation coefficients R2 greater than 0.91 and 0.92, respectively. UV index and Gini coefficient ranked the highest variables in the prediction of AAIR of neoplasms, based on the relative influence of each variable. More research using machine learning approaches taking the advantages of considering all possible determinants is required to assess health strategies outcomes and properly formulate policy planning.

Infective Endocarditis in North Africa and the Middle East, 1990‒2019: Updates from the Global Burden of Disease Study 2019.

Infective endocarditis (IE), a severe and economically impactful condition, lacks substantial epidemiological data in the North Africa and Middle East (NAME) region. This study focused on analyzing the trends and burden of IE in NAME from 1990 to 2019, taking into account factors like age, gender, and socio-demographic index (SDI). The Global Burden of Disease data from 1990 to 2019 was retrieved from the Institute for Health Metrics and Evaluation (IHME) website. Between 1990 and 2019, the age-standardized rates (ASR) for IE incidence increased by 59%, and prevalence and years lived with disability (YLDs) rose by 12% and 9%, respectively, while the ASRs for deaths, disability-adjusted life years (DALYs), and years of life lost (YLLs) saw reductions of 22%, 34%, and 34% in the NAME region. Death rates among children under five declined by 72%. Gender and the SDI did not significantly influence these changes. Saudi Arabia witnessed the most significant increase in ASR of IE incidence since 1990, while Turkey had the highest rates in 2019. The year 2019 also saw the highest death rate among those aged 70 and over, with over 91000 DALYs from IE. DALYs decreased by 71.5% for children under five from 1990 to 2019 but remained stable for individuals in their seventies. Jordan showed the most notable decrease in ASRs for deaths, DALYs, and YLLs among children under five. This study highlights the changing epidemiology of IE in the NAME region, recommending the establishment of multidisciplinary IE registries, antibiotic prophylaxis guidelines for healthcare-associated IE, and strategies to control antimicrobial resistance as key mitigation measures.

Health status in selected post-communist European countries: a comparative study between Poland and Albania.

The aim of this analysis was to compare selected health status indicators of the Albanian and Polish populations, pertinent to two former communist countries in Central and Eastern Europe (CEE). This analysis was based on the estimates related to the Global Burden of Disease (GBD) 2019 study, reported by the Institute for Health Metrics and Evaluation (IHME). For Poland, IHME uses data mainly from the Central Statistical Office of Poland, whereas for Albania the information is based on the reports from the National Institute of Statistics. In 2019, life expectancy at birth was slightly higher in Albania compared to Poland (78.5 years vs. 78.1 years, respectively). Mortality rate from noncommunicable diseases was similar in both countries (about 520 deaths per 100,000 population). In 2019, the main risk factor for the overall mortality in both countries was the high systolic blood pressure. In Albania, high systolic blood pressure accounted for almost 32% of deaths from all causes, whereas in Poland it accounted for only 21% of all deaths. The second main risk factor in Albania concerned the dietary factors which were responsible for almost one in four deaths. In Poland, the second main risk factor for all-cause mortality concerned tobacco which was responsible for one in five deaths. The third leading risk factor in Albania was tobacco (responsible for one in five deaths), whereas in Poland it concerned the dietary risks (responsible for about 19% of the all-cause mortality). This analysis provides useful information about the current health status of two populations pertinent to the former Communist Bloc in CEE. While health indicators can provide important information about the differences in health status between populations, it is important to interpret these indicators in the context of the specific challenges and limitations facing each country.

The quality of care index for low back pain: a systematic analysis of the global burden of disease study 1990–2017

Background. Low back pain is one of the major causes of morbidity worldwide. Studies on low back pain quality of care are limited. This study aimed to evaluate the quality of care of low back pain worldwide and compare gender, age, and socioeconomic groups.Methods. This study used GBD data from 1990 to 2017 from the Institute for Health Metrics and Evaluation (IHME) website. Extracted data included low back pain incidence, prevalence, disability-adjusted life years (DALYs), and years lived with disability (YLDs). DALYs to prevalence ratio and prevalence to incidence ratio were calculated and used in the principal component analysis (PCA) to make a proxy of the quality-of-care index (QCI). Age groups, genders, and countries with different socioeconomic statuses regarding low back pain care quality from 1990 to 2017 were compared.ResultsThe proxy of QCI showed a slight decrease from 36.44 in 1990 to 35.20 in 2017. High- and upper-middle-income countries showed a decrease in the quality of care from 43.17 to 41.57 and from 36.37 to 36.00, respectively, from 1990 to 2017. On the other hand, low and low-middle-income countries improved, from a proxy of QCI of 20.99 to 27.89 and 27.74 to 29.36, respectively.Conclusion. Despite improvements in the quality of care for low back pain in low and lower-middle-income countries between 1990 and 2017, there is still a large gap between these countries and higher-income countries. Continued steps must be taken to reduce healthcare barriers in these countries.

A comparative study of life-years lost attributable to air particulate matter in Asia-Pacific and European countries

Air particulate matter (PM) and its harmful effects on human health are of great concern globally due to all-cause and cause-specific mortality impacts across different population groups. While Europe has made significant progress in reducing particulate air pollution-related mortality through innovative technologies and policies, many countries in Asia-Pacific region still rely on high-polluting technologies and have yet to implement effective policies to address this issue, resulting in higher levels of mortality due to air pollution in the region. This study has three aims related to quantifying life-years lost (LYL) attributable to PM, and further separated into ambient PM and household air pollution (HAP): (1) to investigate LYL by causes of death; (2) to compare LYL between Asia-Pacific (APAC) and Europe; and (3) to assess LYL across different socio-demographic index (SDI) countries. The data used come from the Institute for Health Metrics and Evaluation (IHME) and Health Effects Institute (HEI). Our results show that average LYL due to PM in APAC was greater than in Europe, with some Pacific island countries particularly affected by the exposure to HAP. Three quarters of LYL came from premature deaths by ischemic heart disease and stroke, in both continents. There were significant differences between SDI groups for causes of death due to ambient PM and HAP. Our findings call for urgent improvement of clean air to reduce indoor and outdoor air pollution-related mortality in the APAC region.

Burden of Cardiovascular Diseases in Nepal from 1990 to 2019: The Global Burden of Disease Study, 2019.

Cardiovascular diseases (CVDs) have emerged as the leading cause of deaths worldwide in 2019. Globally, more than three-quarters of the total deaths due to CVDs occur in low- and middle-income countries like Nepal. Although increasing number of studies is available on the prevalence of CVDs, there is limited evidence presenting a complete picture on the burden of CVDs in Nepal. In this context, this study aims to provide comprehensive picture on the burden of CVDs in the country. This study is based on the Global Burden of Disease (GBD) study 2019, which is a multinational collaborative research covering 204 countries and territories across the world. The estimations made from the study are publicly available in the GBD Compare webpage operated by the Institute for Health Metrics and Evaluation (IHME), University of Washington. This article makes use of those data available on the GBD Compare page of IHME website to present the comprehensive picture of the burden of CVDs in Nepal. Overall, in 2019, there were an estimated 1,214,607 cases, 46,501 deaths, and 1,104,474 disability-adjusted life years (DALYs) due to CVDs in Nepal. The age-standardized mortality rates for CVDs witnessed a marginal reduction from 267.60 per 100,000 population in 1990 to 245.38 per 100,000 population in 2019. The proportion of deaths and DALYs attributable to CVDs increased from 9.77% to 24.04% and from 4.82% to 11.89%, respectively, between 1990 and 2019. Even though there are relatively stable rates of age-standardized prevalence, and mortality, the proportion of deaths and DALYs attributed to CVDs have risen sharply between 1990 and 2019. Besides implementing the preventive measures, the health system also needs to prepare itself for the delivery of long-term care of patients with CVDs which could have significant implications on resources and operations.

The EAT-Lancet Commission's Planetary Health Diet Compared With the Institute for Health Metrics and Evaluation Global Burden of Disease Ecological Data Analysis.

Background This article aimed to compare the EAT-Lancet Commission's "Planetary Health Diet" (PHD) with the Institute for Health Metrics and Evaluation (IHME) Global Burden of Disease Study 1990-2017 (GBD2017) dietary and other risk factor data. In the PHD/GBD comparison, we also intended to show the relevance of a new multiple regression analysis methodology with dietary and non-dietary risk factors (independent variables) for noncommunicable disease (NCD) deaths/100000/year in males and females 15-69 years old from 1990 to 2017 (NCDs, dependent variable). Methods We formatted worldwide GBD2017 dietary risk factors and NCDdata on 1120 worldwide cohorts to obtain 7846 population-weighted cohorts. Each cohort represented about one million people, totaling about 7.8 billion people from 195 countries. With an empirically derived methodology, we compared the PHD animal- and plant-sourced food recommended ranges (kilocalories/day=KC/d) with optimal dietary ranges (KC/d) from GBD cohort data. Using GBD data subsets with low and high animal food consumption cohorts, our new GBD multiple regression formula derivation methodology equated risk factor formula coefficients to their population-attributable risk percents (PAR%s). Results We contrasted PHD recommendations for the available 14 dietary risk factors (KC/dmeans and ranges) with our GBD analysis methodology's optimal ranges for each dietary variable (KC/dmean and range): PHD beef, lamb, and pork mean: 30 KC/d(range: 0-60 KC/d)/GBD processed meat: 8.86 (1.69-16.03)+GBD red meat: 44.52 (20.37-68.68), PHD fish: 40 (0-143)/GBD: 19.68 (3.45-35.90), PHD whole milk or equivalents: 153 (0-306)/GBD: 40.00 (18.89-61.11), PHD poultry: 62 (0-124)/GBD: 56.10 (24.13-88.07), PHD eggs: 19 (0-37)/GBD: 19.42 (9.99-28.86), PHD: saturated oils 96 (0-96)/GBD added saturated fatty acids (SFA): 116.55 (104.04-129.07), PHD all added sugars: 120 (0-120)/GBD sugary beverages: 286.37 (256.99-315.76), PHD tubers or starchy vegetables: 39 (0-78)/GBD potatoes: 84.16 (75.75-92.58)+GBD sweet potatoes: 9.21 (4.05-14.37), PHD fruits: 126 (63-189)/GBD: 63.03 (21.61-113.71), PHD vegetables: 78.32 (9.48-196.14)/GBD: 85.05 (66.75-103.36), PHD nuts: 291 (0-437)/GBD nuts and seeds: 10.97 (5.95-15.98), PHD whole grains: 811 (811/811)/GBD: 56.14 (50.53-61.76), PHD legumes: 284 (0-379)/GBD: 59.93 (45.43-74.43), and total animal foodPHD: (0/400)/GBD: 329.84 (212.49-447.19). Multiple regression low and high animal foodsubsets' (animal foods mean=147.09 KC/d versus animal foods mean=482.00 KC/d) formulas each with 28dietary and non-dietary risk factors (independent variables) accounted for 52.53% and 28.83% of their respective total formula PAR%s with NCDs (dependent variable). Conclusions GBD data modeling supported many but not all the PHD dietary recommendations. GBD data suggested that the amount of consumption of animal foods was the dominant determinate of NCDs of countries globally. Adding to the univariate associations, multiple regression risk factor formulas with risk factor coefficients equated to their PAR%s further elucidated dietary influences on NCDs. This paper and the soon-to-be-released IHME GBD2021 (1990-2021) data should help inform the EAT-Lancet 2.0 Commission's work.

Association between universal health coverage and the disease burden of acute illness and injury at the global level

BackgroundThis study examines the relationship between universal health coverage (UHC) and the burden of emergency diseases at a global level.MethodsData on Disability-Adjusted Life Years (DALYs) from emergency conditions were extracted from the Institute for Health Metrics and Evaluation (IHME) database for the years 2015 and 2019. Data on UHC, measured using two variables 1) coverage of essential health services and 2) proportion of the population spending more than 10% of household income on out-of-pocket health care expenditure, were extracted from the World Bank Database for years preceding our outcome of interest. A linear regression was used to analyze the association between UHC variables and DALYs for emergency diseases, controlling for other variables.ResultsA total of 132 countries were included. The median national coverage of essential health services index was 67.5/100, while the median national prevalence of catastrophic spending in the sample was 6.74% of households. There was a strong significant relationship between health service coverage and the burden of emergency diseases, with an 11.5-point reduction in DALYs of emergency medical diseases (95% CI -9.5, -14.8) for every point increase in the coverage of essential health services index. There was no statistically significant relationship between catastrophic expenditures and the burden of emergency diseases, which may be indicative of inelastic demand in seeking services for health emergencies.ConclusionIncreasing the coverage of essential health services, as measured by the essential health services index, is strongly correlated with a reduction in the burden of emergency conditions. In addition, data affirms that financial protection remains inadequate in many parts of the globe, with large numbers of households experiencing significant economic duress related to seeking healthcare. This evidence supports a strategy of strengthening UHC as a means of combating death and disability from health emergencies, as well as extending protection against impoverishment related to healthcare expenses.

Excess Global Blood Pressure Associated With Fine Particulate Matter Air Pollution Levels Exceeding World Health Organization Guidelines

Excess Global Blood Pressure Associated With Fine Particulate Matter Air Pollution Levels Exceeding World Health Organization Guidelines

The evaluation of chronic obstructive pulmonary diseases by gender in Turkey: incidence, prevalence, and mortality

Aims: The aim of this study was to evaluate the incidence and prevalence of chronic obstructive pulmonary disease (COPD) and COPD-related deaths by gender in Turkey. Methods: The data used in the study, covering the years 1990-2019, were taken from the estimation data prepared for Turkey within the global burden of disease study by the Institute for Health Metrics and Evaluation (IHME). Mann-Whitney test was applied to compare the variables according to gender. Non-parametric Spearman rank correlation coefficient was calculated to determine the relationships between variables. Results: The difference between the mean ranks of the total number of prevalences, the total number of incidences, and the total number of deaths by gender were statistically significant. A strong and linear association was found between the risk factors and deaths due to COPD. Conclusion: Policies are needed to decrease the risk factors that lead to the development of COPD. The more risk factors can be controlled, the more lives can be saved.

S-31-5: SOCIO-ECONOMIC IMPACT AND BURDEN OF HYPERTENSION IN THE PHILIPPINES PROJECTED IN 2050

Objective: Hypertension has remained the number one cause of cardiovascular death in the Philippines for over three (3) decades. Despite this finding, the burden accounted for by hypertension is investigated to a lesser extent in the country. We performed this study to determine the socio-economic impact and burden of hypertension if Filipinos are affected with uncontrolled high blood pressure and the results projected in the next 30 years. Design and method: Primary data thru interviews and Labor Force Survey were gathered (N = 806). Secondary data were obtained from the following agencies; Philippine Statistics Authority (PSA), Family Income and Expenditure Survey (FIES), National Demographic and Health Survey (NDHS), National Nutrition Survey, Institute for Health Metrics and Evaluation (IHME), United Nations World Population Prospects, and World Health Organization (WHO). Consequently, cost of illness (COI) was calculated using the direct costs, morbidity costs, and mortality costs. Results: Sixty-eight percent (68%) of the respondents were in the active workforce. The majority do not have comorbidities (87%), but those who have hypertensive heart disease, stroke, and kidney problems were the top comorbid conditions. The source of funds for expenses is primarily out-of-pocket (41%). Nearly all patients were not hospitalized (92%) in the past year. The few hospitalized (8%) were mainly due to hypertensive emergency. The impact (% of respondents) of uncontrolled hypertension on productivity at work showed the following; four (4) days missing work (72%) and ten (10) days lost of productivity (63%). The impact (% of respondents) of uncontrolled hypertension on productivity at home showed the following: six (6) days of household suspended (66%), eleven (11) days reduced household work (78%), and five (5) days affected social activity (60%). Hypertension sufferers 40 years and older will get the most significant share of productivity loss due to uncontrolled hypertension. The productivity loss of premature mortality accounts for a 17% of total economic burden in 2020 and this is expected to increase to 20% by 2050. In 2020, about 70% of the total economic burden is accounted for direct &amp; indirect care. In the next 30 years (2020 - 2050), the economic cost of hypertension its present value is expected to increase from Php52.6 billion ($1 billion) in 2020 to Php97.3 billion ($1.8 billion) by 2050. Conclusion: The socio-economic impact of uncontrolled hypertension in the Philippines was enormous. The economic cost of hypertension will almost double in the next 30 years. Both productivity loss and premature mortality will have significant impact on the Philippine economy by 2050.

Editorial

From Editor’s Desk… The new year begins with the threat of a new coronavirus variant, according to health experts. A new chapter in the COVID mutation issue has begun in China. The potential of new mutations that could prove to be more contagious or fatal than the currently dominant omicron strain is being considered by specialists as the number of COVID infections in China has skyrocketed since the country loosened its preventative and control procedures. About 250 million individuals in China may have caught COVID-19 in the first days of December, according to an estimate from China’s health officials, as reported by Bloomberg and the Financial Times. A severe omicron pandemic is expected to break out in the next few months, according to a model developed by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine. The model predicts that by March 1, 2023, if strict safeguards are not reinstated, the expected number of new infections every day might reach 4.6 million. Peter Hotez, head of Baylor College of Medicine’s National School of Tropical Medicine in Houston, agrees that the sudden increase in cases in China is likely to lead to the appearance of novel mutations. The vaccine’s efficacy is another crucial factor to consider. New research shows that Chinese vaccinations like Sinovac only prevent 61 percent of deaths and 55 percent of hospitalizations, while vaccines made by Moderna and Pfizer are 90 percent effective against both. Taking into account all of the evidence, it is possible that we may experience another phase of the breakout in the not too distant future. Dr. Khaid Mohammed Alabdulwahhab Editor in Chief

Effects of Senility on Disease Burden: Panel Analysis Using 2010 to 2019 OECD Health Data.

In this study, the geniatric status of OECD (Organisation for Economic Co-operation and Development) countries was measured, and the effects of aging status on disease patterns in each country were quantitatively assessed. A theoretical model explaining the effects was suggested, and the implications were discussed. Data used in this study were the OECD Health Statistics data and WHO Global Burden of Disease data. The values for each country were paired with disability-adjusted life years (DALYs) presented by the WHO and Institute for Health Metrics and Evaluation (IHME). A cross-country panel analysis was conducted to analyze the effects of senility on the burden of disease in OECD countries. Geniatric status had effects on the burden of disease (P = .048). Total health expenditure significantly reduced the burden of disease (P = .001). In the panel model with YLL (Year of Life Lost) as the outcome variable, geniatric status had twice greater effects on the burden of disease than that in the model with DALY (P = .003). In medical insurance-related policies, the characteristics of the disease should be considered. In particular, chronic diseases have not received much attention compared to their risk. However, the disease that actually affects the burden of disease is a disease that becomes chronic and requires long-term treatment rather than a disease with a high fatality rate. And, as a result of this study, the higher the level of resource consumption for treatment in OECD countries, where aging is progressing, the burden of disease was rather reduced. Therefore, if there is institutional support to receive appropriate treatment, it will be possible to reduce the national burden of disease.

Urbanization and health impacts of air pollution in Ukraine: threats and opportunities

The aim to conduct a content analysis of studies on the impacts of air pollution on the urban residents’ health in the world and Ukraine, to show the relationship between urbanization and the selected environmental risk factor, to assess its contribution to the global disease burden for Ukraine minimizing harmful effects.Material and methods: Content analysis of research on the air pollution exposure on the urban residents’ health in the world and Ukraine was used. The Data Visualizations / Institute for Health Metrics and Evaluation (IHME) hub data was used to study the contribution to the global burden of disease. GBD 2019 Cause and Risk Summary.Results: At present, changes in thinking and a synergistic approach are needed to fulfill all the goals of achieving the Sustainable Development Goals, approved, agreed and set by governments around the world, including Ukraine. Important Global Task 3.9 "Significantly reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and poisoning", was not chosen by Ukraine due to a lack of reliable indicators with a proven cause-and-effect relationship with the environmental factor that caused this disorder. Reducing the level of air pollution can significantly reduce the burden of diseases, primarily those caused by heart disease and stroke, lung cancer, and chronic respiratory diseases, including asthma.Conclusions: Policies that encourage investment in cleaner transport, energyefficient homes, electricity generation, industry and better household waste management can reduce key sources of air pollution.