GBD 2015: Exposure to air pollution rose; Deaths on roads fell, but years gained are compromised by disability
The Institute of Health Metrics and Evaluation’s Global Burden of Disease 2015 supports the urgent need to address air pollution and road injuries. Despite remaining the 8th leading cause of death worldwide compared to 1990, deaths due to road injuries have fallen, but years of life lost (YLLs) and disability adjusted life years (DALYs) have risen. Exposure to air pollution has also increased.
The Institute of Health Metrics and Evaluation, the Lancet, and the World Bank launched the Global Burden of Disease 2015 study at the George Washington University in Washington, DC on October 7, 2016. The study depicts an epidemiological transition – overall, life expectancy is increasing as fewer people are dying of communicable diseases and nutritional diseases. However, years gained through a decrease in premature death have been compromised by disability.
Road traffic injuries are part of this transition. “It is something to celebrate when you see every single cause of death going down – even road traffic accidents, which many of us thought were going up,” said Ariel Pablos-Mendez from USAID. IHME data shows road traffic injuries have experienced a -13.8 percent change between 1990 and 2015. Nonetheless, they remain the 8th leading cause of death. Additionally, they have caused more disability adjusted life years (DALYs), going from the 11th leading cause to the 9th, as well as years of life lost (YLLs), climbing from the 10th leading cause to the 8th. “When examining the list of leading causes of YLLs in 1990 and 2015, it is clear that communicable diseases and neonatal disorders still exact a heavy toll on human health. Along with road injuries, such causes of death accounted for seven of the leading 10 causes of YLLs in 2015. Because these health problems tend to impact younger people (unlike non-communicable diseases, which are more likely to affect adults), the total amount of lost life they cause is immense,’ the report stated.
Like other main causes of YLLs, roads disproportionately impact youth, as the leading cause of death for those age 15-29. The Global Burden of Disease 2015 shows that the toll extends to males ages 15-49, ranking as the third leading cause of death, comprising 10.98% of total deaths.
The epidemic on our roads led to the United Nations Sustainable Development Goal target 3.6, to “halve the number of global deaths and injuries from road traffic accidents” by 2020. The Global Burden of Disease 2015 study points to this target as one of many playing an important role in the health goal of the Sustainable Development Goals. The study provides independent measurements to monitor progress towards this goal, as well as other UN Sustainable Development Goals.
Air pollution, another key player in the UN Sustainable Development Goals, is also included in the study. The study shows that we are exposed to more air pollution in 2015 than we were in 1990. “From a population health standpoint, the most pressing targets for intervention are those risk factors that cause the largest burden of disease and are increasing rapidly.” Air pollution is named as one of those risk factors.
The Global Burden of Disease 2015 links the increase in exposure to ambient air pollution to increased development, and recognizes that with development comes an unequal distribution of health. Road crashes and air pollution are prime examples, as low-income individuals are disproportionately affected by the consequences of each. “We want to expand the quantification of risk to cover social determinants of health. We expect to see progress towards this in the next few years,” said Chris Murray of IHME. This comprehensive approach represents the key message of the Global Burden of Disease 2015. “It’s about action, agency, and accountability,” said Richard Horton of The Lancet. The GBD aims to put data in the hands of policymakers, to create a more equitable, healthier world.