Over the past 20 years, we may have gotten better at inoculating young children against disease, but we've become far less judicious about our waistlines, according to data from a comprehensive disease study released this week.
The Global Burden of Disease Study, published in the Lancet, is the most detailed study of its kind to date, and it's also a treasure trove of data about causes of death worldwide.
One of the graphs compiled by the Institute for Health Metrics and Evaluation provides a revealing look at the changing ranks of causes of death between 1990 to 2010.
The most noticeable is HIV/AIDS, which shot up to the sixth-leading cause of death after it was first recognized in 1981. Deaths from measles have dropped off dramatically, as have those from childhood infections and malnutrition.
That's partly thanks to worldwide efforts in childhood health, such as vaccines, vitamin supplements, antibiotics and better obstetrical care, according to Alan D. Lopez, the dean of the school of population health at the University of Queensland in Australia, who worked on the Global Burden of Disease study.
“There have been very, very big payoffs in all the investments made to improve child survival,” Lopez told The Washington Post.
But the prevalence of certain cancers, such as liver and colo-rectal, has increased, as have non-communicable diseases induced by our modern fast-food and inactivity habits, such as diabetes and heart disease.
Four out of every five people with diabetes now live in developing countries, according to 2010 research by the International Diabetes Federation, as over time diets have shifted from traditional foods to processed foods, sugar, and highly saturated fats. According to World Health Organization estimates, India and China will lose $900 billion in national income between 2005 and 2015 to diabetes and cardiovascular disease. The trend has sparked fears that the spread of multinational companies into emerging markets -- such as Nestle's foray into the Amazon and Unilever's door-to-door salesmen in India -- will further cause these so-called "lifestyle" diseases to wreak havoc in areas beyond wealthy, Western countries.
There's also another striking chart that looks at the top causes of death by region of the world, which can be filtered by either 1990 or 2010. (I've pasted a screenshot for 2010 below, but it's worth exploring the interactive version, too). Although people everywhere still mainly die of heart disease, stroke and respiratory issues, things get more diverse as you move down the list.
First, the chart shows the major difference development makes in eradicating deadly communicable diseases: Diarrhea, malaria and tuberculosis are all still very likely to kill people living in Central sub-Saharan Africa, for example, but not Europeans or Latin Americans.
Then there are the region-specific killers: melanoma ranks highest for people who live in Australasia, alcohol use for Eastern Europeans and drug use for "high-income North Americans."
"Self-harm" seems to be the cause of death that knows no income boundaries, posing a top-10 threat to everyone from the "high-income Asia Pacific" to Eastern Europe to South Asia. "Interpersonal violence" rises to number four in Tropical and Central Latin America, as anyone who reads news about drug cartels might have predicted.
There's another view of the rate of deaths by region on this chart:
The good news, as my colleague David Brown reports, is that people are living longer.
As health-care economists lament, however, people spend many of those years living with disability, leaving us with the problem of not only how we're dying, but in what state we're living.
"Where for every year of life expectancy added since 1990, about 91/2 months is time in good health," Brown found.
“We may or we may not know the ways we can reduce those problems,” Joshua A. Salomon of the Harvard School of Public Health, one of the project leaders, told the Post. “But the study should prompt us to think hard about what are the major causes of disability today, and what are the possible solutions that can accelerate progress against them.”