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Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance... Full description

Journal Title: Lancet (London England), 2017, Vol.390 (10100), p.1345-1422
Main Author: Gakidou, Emmanuela
Other Authors: Abate, Kalkidan Hassen , Abd-Allah, Foad , Abdulle, Abdishakur M , Adetokunboh, Olatunji , Agrawal, Sutapa , Al-Aly, Ziyad , Ammar, Walid , Asayesh, Hamid , Azzopardi, Peter , Balakrishnan, Kalpana , Barquera, Simon , Barregard, Lars , Battle, Katherine E , Bennett, James R , Berhe, Derbew Fikadu , Catalá-López, Ferrán , Cercy, Kelly , Dandona, Rakhi , Davletov, Kairat , Dharmaratne, Samath D , Ding, Eric L , Duncan, Bruce Bartholow , El-Khatib, Ziad Ziad , Erskine, Holly E , Esteghamati, Alireza , Farinha, Carla Sofia e Sa , Fullman, Nancy , Furtado, Joao M , Gemechu, Bikila Lencha , Gopalani, Sameer Vali , Handal, Alexis J , Hankey, Graeme J , Horita, Nobuyuki , Jackson, Maria Delores , Johansson, Lars R K , Kahsay, Amaha , Karema, Corine Kakizi , Katikireddi, Srinivasa Vittal , Keiyoro, Peter Njenga , Kiadaliri, Aliasghar Ahmad , Kim, Yun Jin , Kopec, Jacek A , Kyu, Hmwe H , Lalloo, Ratilal , Lee, Paul H , Leigh, James , Li, Yichong , Liu, Patrick , Lopez, Alan D , Lotufo, Paulo A , Lunevicius, Raimundas , Magdy Abd El Razek, Hassan , Mantovani, Lorenzo G , Matzopoulos, Richard , McAlinden, Colm , Mehndiratta, Man Mohan , Melaku, Yohannes Adama , Millear, Anoushka , Mohammed, Kedir Endris , Montico, Marcella , Morawska, Lidia , Musa, Kamarul Imran , Natarajan, Gopalakrishnan , Noubiap, Jean Jacques N , Olagunju, Tinuke Oluwasefunmi , Olusanya, Jacob Olusegun , Panda-Jonas, Songhomitra , Pandian, Jeyaraj D , Papachristou, Christina , Piradov, Michael A , Plass, Dietrich , Pourmalek, Farshad , Reiner, Robert C , Ribeiro, Antonio L , Sadat, Nafis , Safi, Sare , Sanchez-Niño, Maria Dolores , Shaddick, Gavin , Shamsipour, Mansour , Shariful Islam, Sheikh Mohammed , Shen, Jiabin , Shiferaw, Mekonnen Sisay , Smith, David L , Strub, Bryan , Tarekegn, Yihunie L , Tegegne, Teketo Kassaw , Tehrani-Banihashemi, Arash , Thankappan, Kavumpurathu Raman , Thrift, Amanda G , Torre, Anna , Uneke, Chigozie Jesse , Varughese, Santosh , Venkateswaran, Vidhya , Venketasubramanian, Narayanaswamy , Violante, Francesco S , Yakob, Bereket , Yan, Lijing L , Yimam, Hassen Hamid , Zavala-Arciniega, Luis
Format: Electronic Article Electronic Article
Language: English
Subjects:
Age
Men
st
VDP
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Ltd
ID: ISSN: 0140-6736
Zum Text:
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recordid: cdi_wageningen_narcis_oai_library_wur_nl_wurpubs_531189
title: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
format: Article
creator:
  • Gakidou, Emmanuela
  • Abate, Kalkidan Hassen
  • Abd-Allah, Foad
  • Abdulle, Abdishakur M
  • Adetokunboh, Olatunji
  • Agrawal, Sutapa
  • Al-Aly, Ziyad
  • Ammar, Walid
  • Asayesh, Hamid
  • Azzopardi, Peter
  • Balakrishnan, Kalpana
  • Barquera, Simon
  • Barregard, Lars
  • Battle, Katherine E
  • Bennett, James R
  • Berhe, Derbew Fikadu
  • Catalá-López, Ferrán
  • Cercy, Kelly
  • Dandona, Rakhi
  • Davletov, Kairat
  • Dharmaratne, Samath D
  • Ding, Eric L
  • Duncan, Bruce Bartholow
  • El-Khatib, Ziad Ziad
  • Erskine, Holly E
  • Esteghamati, Alireza
  • Farinha, Carla Sofia e Sa
  • Fullman, Nancy
  • Furtado, Joao M
  • Gemechu, Bikila Lencha
  • Gopalani, Sameer Vali
  • Handal, Alexis J
  • Hankey, Graeme J
  • Horita, Nobuyuki
  • Jackson, Maria Delores
  • Johansson, Lars R K
  • Kahsay, Amaha
  • Karema, Corine Kakizi
  • Katikireddi, Srinivasa Vittal
  • Keiyoro, Peter Njenga
  • Kiadaliri, Aliasghar Ahmad
  • Kim, Yun Jin
  • Kopec, Jacek A
  • Kyu, Hmwe H
  • Lalloo, Ratilal
  • Lee, Paul H
  • Leigh, James
  • Li, Yichong
  • Liu, Patrick
  • Lopez, Alan D
  • Lotufo, Paulo A
  • Lunevicius, Raimundas
  • Magdy Abd El Razek, Hassan
  • Mantovani, Lorenzo G
  • Matzopoulos, Richard
  • McAlinden, Colm
  • Mehndiratta, Man Mohan
  • Melaku, Yohannes Adama
  • Millear, Anoushka
  • Mohammed, Kedir Endris
  • Montico, Marcella
  • Morawska, Lidia
  • Musa, Kamarul Imran
  • Natarajan, Gopalakrishnan
  • Noubiap, Jean Jacques N
  • Olagunju, Tinuke Oluwasefunmi
  • Olusanya, Jacob Olusegun
  • Panda-Jonas, Songhomitra
  • Pandian, Jeyaraj D
  • Papachristou, Christina
  • Piradov, Michael A
  • Plass, Dietrich
  • Pourmalek, Farshad
  • Reiner, Robert C
  • Ribeiro, Antonio L
  • Sadat, Nafis
  • Safi, Sare
  • Sanchez-Niño, Maria Dolores
  • Shaddick, Gavin
  • Shamsipour, Mansour
  • Shariful Islam, Sheikh Mohammed
  • Shen, Jiabin
  • Shiferaw, Mekonnen Sisay
  • Smith, David L
  • Strub, Bryan
  • Tarekegn, Yihunie L
  • Tegegne, Teketo Kassaw
  • Tehrani-Banihashemi, Arash
  • Thankappan, Kavumpurathu Raman
  • Thrift, Amanda G
  • Torre, Anna
  • Uneke, Chigozie Jesse
  • Varughese, Santosh
  • Venkateswaran, Vidhya
  • Venketasubramanian, Narayanaswamy
  • Violante, Francesco S
  • Yakob, Bereket
  • Yan, Lijing L
  • Yimam, Hassen Hamid
  • Zavala-Arciniega, Luis
subjects:
  • 11 Medical And Health Sciences
  • 3112 Neurosciences
  • 3121 Internal medicine
  • 3142 Public health care science
  • Adjusted Life Years
  • Adolescent
  • Adult
  • Age
  • Aged
  • Aged, 80 and over
  • Aging
  • Air Pollution
  • Air Pollution - statistics & numerical data
  • Alcohol
  • ards
  • Article
  • Birth weight
  • Birthweight
  • Blood
  • Blood pressure
  • Body Mass Index
  • Börn
  • Cardiometabolic risk
  • Causation
  • Cause of Death
  • Cause of Death - trends
  • Chair Nutrition and Disease
  • Charities
  • Child
  • Child, Preschool
  • Children
  • chinese population
  • Clusters
  • Communicable Diseases
  • Communicable Diseases - mortality
  • Community medicine
  • Community medicine, Social medicine: 801
  • Comparative analysis
  • cost
  • Counting methods
  • countries
  • deaths
  • Diet
  • Disabled Persons
  • Disabled Persons - statistics & numerical data
  • Disease
  • Disease prevention
  • Domestic violence
  • Dánarmein
  • Dánartíðni
  • Ecological risk assessment
  • environmental
  • Environmental assessment
  • Environmental exposure
  • Environmental Health
  • Environmental Health - statistics & numerical data
  • Epidemiology
  • Exposure
  • Factors de risc en les malalties
  • Fasting
  • Fatalities
  • Female
  • Folkhälsovetenskap
  • Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
  • Fæðingarþyngd
  • General & Internal
  • General & Internal Medicine
  • Gestation
  • Global Burden of Disease
  • Global Burden of Disease - statistics & numerical data
  • Global disease burden
  • Global Health
  • global hälsa
  • Glucose
  • Glucose blood level
  • Health
  • Health and Welfare
  • Health care science
  • Health policy
  • Health risk assessment
  • Health risks
  • Health Sciences
  • Health sciences: 800
  • Health surveillance
  • Heilbrigðisstefna
  • Heilbrigðisvísindi
  • Heilsufar
  • Helsefag
  • Helsefag: 800
  • HNE Nutrition and Disease
  • HNE Voeding en Ziekte
  • Humans
  • Hypertension
  • Háþrýstingur
  • Hälsa och välfärd
  • Hälsovetenskap
  • Hälsovetenskaper
  • Indoor air pollution
  • Infant
  • Infant, Newborn
  • Injuries
  • Journal Article
  • Karlar
  • Kidney diseases
  • Konur
  • Life Expectancy
  • Life Sciences & Biomedicine
  • Lífsgæði
  • Líkamsþyngdarstuðull
  • Lýðheilsa
  • Male
  • Malnutrition
  • Medical and Health Sciences
  • Medical disciplines
  • Medical disciplines: 700
  • Medical research
  • Medicin och hälsovetenskap
  • Medicine
  • Medicine (all)
  • Medicine, Experimental
  • Medisinske Fag
  • Medisinske Fag: 700
  • Men
  • Metabolic Diseases
  • Metabolic Diseases - mortality
  • Metabolism
  • Meðganga
  • Middle Aged
  • Mortality
  • Newborn
  • Noncommunicable Diseases
  • Noncommunicable Diseases - mortality
  • numerical data
  • Nutrition and Disease
  • Næringarskortur
  • obesity prevention
  • Occupational Diseases
  • Occupational Diseases - mortality
  • occupational health
  • Outdoor air quality
  • over
  • Population
  • Population growth
  • precautionary principle
  • Pregnancy
  • Premature birth
  • Preschool
  • Public Health
  • Public Health, Global Health, Social Medicine and Epidemiology
  • Quality
  • Quality of life
  • Quality-Adjusted Life Years
  • Regional analysis
  • Reykingar
  • Risk analysis
  • Risk Assessment
  • Risk exposure
  • Risk factors
  • Risk factors in diseases
  • Salut
  • Samfunnsmedisin
  • Samfunnsmedisin, sosialmedisin: 801
  • Science & Technology
  • Sex Distribution
  • Smoking
  • Smoking - mortality
  • Social Medicine
  • socialmedicin och epidemiologi
  • sosialmedisin
  • st
  • statistics
  • statistics & numerical data
  • Systolic blood pressure
  • Terveystiede
  • Tobacco
  • Trends
  • VDP
  • VLAG
  • Voeding en Ziekte
  • Water Supply
  • Water Supply - standards
  • Water Supply - statistics & numerical data
  • Women
  • World health
  • Young Adult
  • Áhættugreining
ispartof: Lancet (London, England), 2017, Vol.390 (10100), p.1345-1422
description: The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 cou
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
  • 1474-547X
url: Link


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titleGlobal, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
sourceAlma/SFX Local Collection
creatorGakidou, Emmanuela ; Abate, Kalkidan Hassen ; Abd-Allah, Foad ; Abdulle, Abdishakur M ; Adetokunboh, Olatunji ; Agrawal, Sutapa ; Al-Aly, Ziyad ; Ammar, Walid ; Asayesh, Hamid ; Azzopardi, Peter ; Balakrishnan, Kalpana ; Barquera, Simon ; Barregard, Lars ; Battle, Katherine E ; Bennett, James R ; Berhe, Derbew Fikadu ; Catalá-López, Ferrán ; Cercy, Kelly ; Dandona, Rakhi ; Davletov, Kairat ; Dharmaratne, Samath D ; Ding, Eric L ; Duncan, Bruce Bartholow ; El-Khatib, Ziad Ziad ; Erskine, Holly E ; Esteghamati, Alireza ; Farinha, Carla Sofia e Sa ; Fullman, Nancy ; Furtado, Joao M ; Gemechu, Bikila Lencha ; Gopalani, Sameer Vali ; Handal, Alexis J ; Hankey, Graeme J ; Horita, Nobuyuki ; Jackson, Maria Delores ; Johansson, Lars R K ; Kahsay, Amaha ; Karema, Corine Kakizi ; Katikireddi, Srinivasa Vittal ; Keiyoro, Peter Njenga ; Kiadaliri, Aliasghar Ahmad ; Kim, Yun Jin ; Kopec, Jacek A ; Kyu, Hmwe H ; Lalloo, Ratilal ; Lee, Paul H ; Leigh, James ; Li, Yichong ; Liu, Patrick ; Lopez, Alan D ; Lotufo, Paulo A ; Lunevicius, Raimundas ; Magdy Abd El Razek, Hassan ; Mantovani, Lorenzo G ; Matzopoulos, Richard ; McAlinden, Colm ; Mehndiratta, Man Mohan ; Melaku, Yohannes Adama ; Millear, Anoushka ; Mohammed, Kedir Endris ; Montico, Marcella ; Morawska, Lidia ; Musa, Kamarul Imran ; Natarajan, Gopalakrishnan ; Noubiap, Jean Jacques N ; Olagunju, Tinuke Oluwasefunmi ; Olusanya, Jacob Olusegun ; Panda-Jonas, Songhomitra ; Pandian, Jeyaraj D ; Papachristou, Christina ; Piradov, Michael A ; Plass, Dietrich ; Pourmalek, Farshad ; Reiner, Robert C ; Ribeiro, Antonio L ; Sadat, Nafis ; Safi, Sare ; Sanchez-Niño, Maria Dolores ; Shaddick, Gavin ; Shamsipour, Mansour ; Shariful Islam, Sheikh Mohammed ; Shen, Jiabin ; Shiferaw, Mekonnen Sisay ; Smith, David L ; Strub, Bryan ; Tarekegn, Yihunie L ; Tegegne, Teketo Kassaw ; Tehrani-Banihashemi, Arash ; Thankappan, Kavumpurathu Raman ; Thrift, Amanda G ; Torre, Anna ; Uneke, Chigozie Jesse ; Varughese, Santosh ; Venkateswaran, Vidhya ; Venketasubramanian, Narayanaswamy ; Violante, Francesco S ; Yakob, Bereket ; Yan, Lijing L ; Yimam, Hassen Hamid ; Zavala-Arciniega, Luis
creatorcontribGakidou, Emmanuela ; Abate, Kalkidan Hassen ; Abd-Allah, Foad ; Abdulle, Abdishakur M ; Adetokunboh, Olatunji ; Agrawal, Sutapa ; Al-Aly, Ziyad ; Ammar, Walid ; Asayesh, Hamid ; Azzopardi, Peter ; Balakrishnan, Kalpana ; Barquera, Simon ; Barregard, Lars ; Battle, Katherine E ; Bennett, James R ; Berhe, Derbew Fikadu ; Catalá-López, Ferrán ; Cercy, Kelly ; Dandona, Rakhi ; Davletov, Kairat ; Dharmaratne, Samath D ; Ding, Eric L ; Duncan, Bruce Bartholow ; El-Khatib, Ziad Ziad ; Erskine, Holly E ; Esteghamati, Alireza ; Farinha, Carla Sofia e Sa ; Fullman, Nancy ; Furtado, Joao M ; Gemechu, Bikila Lencha ; Gopalani, Sameer Vali ; Handal, Alexis J ; Hankey, Graeme J ; Horita, Nobuyuki ; Jackson, Maria Delores ; Johansson, Lars R K ; Kahsay, Amaha ; Karema, Corine Kakizi ; Katikireddi, Srinivasa Vittal ; Keiyoro, Peter Njenga ; Kiadaliri, Aliasghar Ahmad ; Kim, Yun Jin ; Kopec, Jacek A ; Kyu, Hmwe H ; Lalloo, Ratilal ; Lee, Paul H ; Leigh, James ; Li, Yichong ; Liu, Patrick ; Lopez, Alan D ; Lotufo, Paulo A ; Lunevicius, Raimundas ; Magdy Abd El Razek, Hassan ; Mantovani, Lorenzo G ; Matzopoulos, Richard ; McAlinden, Colm ; Mehndiratta, Man Mohan ; Melaku, Yohannes Adama ; Millear, Anoushka ; Mohammed, Kedir Endris ; Montico, Marcella ; Morawska, Lidia ; Musa, Kamarul Imran ; Natarajan, Gopalakrishnan ; Noubiap, Jean Jacques N ; Olagunju, Tinuke Oluwasefunmi ; Olusanya, Jacob Olusegun ; Panda-Jonas, Songhomitra ; Pandian, Jeyaraj D ; Papachristou, Christina ; Piradov, Michael A ; Plass, Dietrich ; Pourmalek, Farshad ; Reiner, Robert C ; Ribeiro, Antonio L ; Sadat, Nafis ; Safi, Sare ; Sanchez-Niño, Maria Dolores ; Shaddick, Gavin ; Shamsipour, Mansour ; Shariful Islam, Sheikh Mohammed ; Shen, Jiabin ; Shiferaw, Mekonnen Sisay ; Smith, David L ; Strub, Bryan ; Tarekegn, Yihunie L ; Tegegne, Teketo Kassaw ; Tehrani-Banihashemi, Arash ; Thankappan, Kavumpurathu Raman ; Thrift, Amanda G ; Torre, Anna ; Uneke, Chigozie Jesse ; Varughese, Santosh ; Venkateswaran, Vidhya ; Venketasubramanian, Narayanaswamy ; Violante, Francesco S ; Yakob, Bereket ; Yan, Lijing L ; Yimam, Hassen Hamid ; Zavala-Arciniega, Luis ; GBD 2016 Risk Factors Collaborators ; Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri ; Göteborgs universitet ; Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för arbets-och miljömedicin ; Gothenburg University ; Sahlgrenska Academy ; Sahlgrenska akademin ; Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics ; Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
descriptionThe Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9·3% (6·9–11·6) decline in deaths and a 10·8% (8·3–13·1) decrease in DALYs at the global level, while population ageing accounts for 14·9% (12·7–17·5) of deaths and 6·2% (3·9–8·7) of DALYs, and population growth for 12·4% (10·1–14·9) of deaths and 12·4% (10·1–14·9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27·3% (24·9–29·7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade. The Bill & Melinda Gates Foundation, Bloomberg Philanthropies.
identifier
0ISSN: 0140-6736
1ISSN: 1474-547X
2EISSN: 1474-547X
3DOI: 10.1016/S0140-6736(17)32366-8
4PMID: 28919119
languageeng
publisherEngland: Elsevier Ltd
subject
ispartofLancet (London, England), 2017, Vol.390 (10100), p.1345-1422
rights
02017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
1info:eu-repo/semantics/restrictedAccess
2Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.
3COPYRIGHT 2017 Elsevier B.V.
4Copyright Elsevier Limited Sep 16, 2017
5info:eu-repo/semantics/openAccess
6cc by (c) Antó i Boqué et al., 2017 info:eu-repo/semantics/openAccess http://creativecommons.org/licenses/by/3.0/es/
72017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license 2017
8Wageningen University & Research
lds50peer_reviewed
oafree_for_read
citedbyFETCH-LOGICAL-12859t-51aa37cce39196f724bcfe6510dba1e83cb254e231b8a1eef5afde1e6118edf03
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search
creatorcontrib
0Gakidou, Emmanuela
1Abate, Kalkidan Hassen
2Abd-Allah, Foad
3Abdulle, Abdishakur M
4Adetokunboh, Olatunji
5Agrawal, Sutapa
6Al-Aly, Ziyad
7Ammar, Walid
8Asayesh, Hamid
9Azzopardi, Peter
10Balakrishnan, Kalpana
11Barquera, Simon
12Barregard, Lars
13Battle, Katherine E
14Bennett, James R
15Berhe, Derbew Fikadu
16Catalá-López, Ferrán
17Cercy, Kelly
18Dandona, Rakhi
19Davletov, Kairat
20Dharmaratne, Samath D
21Ding, Eric L
22Duncan, Bruce Bartholow
23El-Khatib, Ziad Ziad
24Erskine, Holly E
25Esteghamati, Alireza
26Farinha, Carla Sofia e Sa
27Fullman, Nancy
28Furtado, Joao M
29Gemechu, Bikila Lencha
30Gopalani, Sameer Vali
31Handal, Alexis J
32Hankey, Graeme J
33Horita, Nobuyuki
34Jackson, Maria Delores
35Johansson, Lars R K
36Kahsay, Amaha
37Karema, Corine Kakizi
38Katikireddi, Srinivasa Vittal
39Keiyoro, Peter Njenga
40Kiadaliri, Aliasghar Ahmad
41Kim, Yun Jin
42Kopec, Jacek A
43Kyu, Hmwe H
44Lalloo, Ratilal
45Lee, Paul H
46Leigh, James
47Li, Yichong
48Liu, Patrick
49Lopez, Alan D
50Lotufo, Paulo A
51Lunevicius, Raimundas
52Magdy Abd El Razek, Hassan
53Mantovani, Lorenzo G
54Matzopoulos, Richard
55McAlinden, Colm
56Mehndiratta, Man Mohan
57Melaku, Yohannes Adama
58Millear, Anoushka
59Mohammed, Kedir Endris
60Montico, Marcella
61Morawska, Lidia
62Musa, Kamarul Imran
63Natarajan, Gopalakrishnan
64Noubiap, Jean Jacques N
65Olagunju, Tinuke Oluwasefunmi
66Olusanya, Jacob Olusegun
67Panda-Jonas, Songhomitra
68Pandian, Jeyaraj D
69Papachristou, Christina
70Piradov, Michael A
71Plass, Dietrich
72Pourmalek, Farshad
73Reiner, Robert C
74Ribeiro, Antonio L
75Sadat, Nafis
76Safi, Sare
77Sanchez-Niño, Maria Dolores
78Shaddick, Gavin
79Shamsipour, Mansour
80Shariful Islam, Sheikh Mohammed
81Shen, Jiabin
82Shiferaw, Mekonnen Sisay
83Smith, David L
84Strub, Bryan
85Tarekegn, Yihunie L
86Tegegne, Teketo Kassaw
87Tehrani-Banihashemi, Arash
88Thankappan, Kavumpurathu Raman
89Thrift, Amanda G
90Torre, Anna
91Uneke, Chigozie Jesse
92Varughese, Santosh
93Venkateswaran, Vidhya
94Venketasubramanian, Narayanaswamy
95Violante, Francesco S
96Yakob, Bereket
97Yan, Lijing L
98Yimam, Hassen Hamid
99Zavala-Arciniega, Luis
100GBD 2016 Risk Factors Collaborators
101Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri
102Göteborgs universitet
103Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för arbets-och miljömedicin
104Gothenburg University
105Sahlgrenska Academy
106Sahlgrenska akademin
107Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
108Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
title
0Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
1Lancet (London, England)
addtitleLancet
descriptionThe Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9·3% (6·9–11·6) decline in deaths and a 10·8% (8·3–13·1) decrease in DALYs at the global level, while population ageing accounts for 14·9% (12·7–17·5) of deaths and 6·2% (3·9–8·7) of DALYs, and population growth for 12·4% (10·1–14·9) of deaths and 12·4% (10·1–14·9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27·3% (24·9–29·7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade. The Bill & Melinda Gates Foundation, Bloomberg Philanthropies.
subject
011 Medical And Health Sciences
13112 Neurosciences
23121 Internal medicine
33142 Public health care science
4Adjusted Life Years
5Adolescent
6Adult
7Age
8Aged
9Aged, 80 and over
10Aging
11Air Pollution
12Air Pollution - statistics & numerical data
13Alcohol
14ards
15Article
16Birth weight
17Birthweight
18Blood
19Blood pressure
20Body Mass Index
21Börn
22Cardiometabolic risk
23Causation
24Cause of Death
25Cause of Death - trends
26Chair Nutrition and Disease
27Charities
28Child
29Child, Preschool
30Children
31chinese population
32Clusters
33Communicable Diseases
34Communicable Diseases - mortality
35Community medicine
36Community medicine, Social medicine: 801
37Comparative analysis
38cost
39Counting methods
40countries
41deaths
42Diet
43Disabled Persons
44Disabled Persons - statistics & numerical data
45Disease
46Disease prevention
47Domestic violence
48Dánarmein
49Dánartíðni
50Ecological risk assessment
51environmental
52Environmental assessment
53Environmental exposure
54Environmental Health
55Environmental Health - statistics & numerical data
56Epidemiology
57Exposure
58Factors de risc en les malalties
59Fasting
60Fatalities
61Female
62Folkhälsovetenskap
63Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
64Fæðingarþyngd
65General & Internal
66General & Internal Medicine
67Gestation
68Global Burden of Disease
69Global Burden of Disease - statistics & numerical data
70Global disease burden
71Global Health
72global hälsa
73Glucose
74Glucose blood level
75Health
76Health and Welfare
77Health care science
78Health policy
79Health risk assessment
80Health risks
81Health Sciences
82Health sciences: 800
83Health surveillance
84Heilbrigðisstefna
85Heilbrigðisvísindi
86Heilsufar
87Helsefag
88Helsefag: 800
89HNE Nutrition and Disease
90HNE Voeding en Ziekte
91Humans
92Hypertension
93Háþrýstingur
94Hälsa och välfärd
95Hälsovetenskap
96Hälsovetenskaper
97Indoor air pollution
98Infant
99Infant, Newborn
100Injuries
101Journal Article
102Karlar
103Kidney diseases
104Konur
105Life Expectancy
106Life Sciences & Biomedicine
107Lífsgæði
108Líkamsþyngdarstuðull
109Lýðheilsa
110Male
111Malnutrition
112Medical and Health Sciences
113Medical disciplines
114Medical disciplines: 700
115Medical research
116Medicin och hälsovetenskap
117Medicine
118Medicine (all)
119Medicine, Experimental
120Medisinske Fag
121Medisinske Fag: 700
122Men
123Metabolic Diseases
124Metabolic Diseases - mortality
125Metabolism
126Meðganga
127Middle Aged
128Mortality
129Newborn
130Noncommunicable Diseases
131Noncommunicable Diseases - mortality
132numerical data
133Nutrition and Disease
134Næringarskortur
135obesity prevention
136Occupational Diseases
137Occupational Diseases - mortality
138occupational health
139Outdoor air quality
140over
141Population
142Population growth
143precautionary principle
144Pregnancy
145Premature birth
146Preschool
147Public Health
148Public Health, Global Health, Social Medicine and Epidemiology
149Quality
150Quality of life
151Quality-Adjusted Life Years
152Regional analysis
153Reykingar
154Risk analysis
155Risk Assessment
156Risk exposure
157Risk factors
158Risk factors in diseases
159Salut
160Samfunnsmedisin
161Samfunnsmedisin, sosialmedisin: 801
162Science & Technology
163Sex Distribution
164Smoking
165Smoking - mortality
166Social Medicine
167socialmedicin och epidemiologi
168sosialmedisin
169st
170statistics
171statistics & numerical data
172Systolic blood pressure
173Terveystiede
174Tobacco
175Trends
176VDP
177VLAG
178Voeding en Ziekte
179Water Supply
180Water Supply - standards
181Water Supply - statistics & numerical data
182Women
183World health
184Young Adult
185Áhættugreining
issn
00140-6736
11474-547X
21474-547X
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startdate20170916
enddate20170916
creator
0Gakidou, Emmanuela
1Abate, Kalkidan Hassen
2Abd-Allah, Foad
3Abdulle, Abdishakur M
4Adetokunboh, Olatunji
5Agrawal, Sutapa
6Al-Aly, Ziyad
7Ammar, Walid
8Asayesh, Hamid
9Azzopardi, Peter
10Balakrishnan, Kalpana
11Barquera, Simon
12Barregard, Lars
13Battle, Katherine E
14Bennett, James R
15Berhe, Derbew Fikadu
16Catalá-López, Ferrán
17Cercy, Kelly
18Dandona, Rakhi
19Davletov, Kairat
20Dharmaratne, Samath D
21Ding, Eric L
22Duncan, Bruce Bartholow
23El-Khatib, Ziad Ziad
24Erskine, Holly E
25Esteghamati, Alireza
26Farinha, Carla Sofia e Sa
27Fullman, Nancy
28Furtado, Joao M
29Gemechu, Bikila Lencha
30Gopalani, Sameer Vali
31Handal, Alexis J
32Hankey, Graeme J
33Horita, Nobuyuki
34Jackson, Maria Delores
35Johansson, Lars R K
36Kahsay, Amaha
37Karema, Corine Kakizi
38Katikireddi, Srinivasa Vittal
39Keiyoro, Peter Njenga
40Kiadaliri, Aliasghar Ahmad
41Kim, Yun Jin
42Kopec, Jacek A
43Kyu, Hmwe H
44Lalloo, Ratilal
45Lee, Paul H
46Leigh, James
47Li, Yichong
48Liu, Patrick
49Lopez, Alan D
50Lotufo, Paulo A
51Lunevicius, Raimundas
52Magdy Abd El Razek, Hassan
53Mantovani, Lorenzo G
54Matzopoulos, Richard
55McAlinden, Colm
56Mehndiratta, Man Mohan
57Melaku, Yohannes Adama
58Millear, Anoushka
59Mohammed, Kedir Endris
60Montico, Marcella
61Morawska, Lidia
62Musa, Kamarul Imran
63Natarajan, Gopalakrishnan
64Noubiap, Jean Jacques N
65Olagunju, Tinuke Oluwasefunmi
66Olusanya, Jacob Olusegun
67Panda-Jonas, Songhomitra
68Pandian, Jeyaraj D
69Papachristou, Christina
70Piradov, Michael A
71Plass, Dietrich
72Pourmalek, Farshad
73Reiner, Robert C
74Ribeiro, Antonio L
75Sadat, Nafis
76Safi, Sare
77Sanchez-Niño, Maria Dolores
78Shaddick, Gavin
79Shamsipour, Mansour
80Shariful Islam, Sheikh Mohammed
81Shen, Jiabin
82Shiferaw, Mekonnen Sisay
83Smith, David L
84Strub, Bryan
85Tarekegn, Yihunie L
86Tegegne, Teketo Kassaw
87Tehrani-Banihashemi, Arash
88Thankappan, Kavumpurathu Raman
89Thrift, Amanda G
90Torre, Anna
91Uneke, Chigozie Jesse
92Varughese, Santosh
93Venkateswaran, Vidhya
94Venketasubramanian, Narayanaswamy
95Violante, Francesco S
96Yakob, Bereket
97Yan, Lijing L
98Yimam, Hassen Hamid
99Zavala-Arciniega, Luis
general
0Elsevier Ltd
1Elsevier B.V
2Elsevier Limited
3Elsevier
4Lancet Publishing Group
5Karolinska university; Dalarna University
6Elsevier BV
7Elsevier Science Inc
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creationdate20170916
titleGlobal, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
authorGakidou, Emmanuela ; Abate, Kalkidan Hassen ; Abd-Allah, Foad ; Abdulle, Abdishakur M ; Adetokunboh, Olatunji ; Agrawal, Sutapa ; Al-Aly, Ziyad ; Ammar, Walid ; Asayesh, Hamid ; Azzopardi, Peter ; Balakrishnan, Kalpana ; Barquera, Simon ; Barregard, Lars ; Battle, Katherine E ; Bennett, James R ; Berhe, Derbew Fikadu ; Catalá-López, Ferrán ; Cercy, Kelly ; Dandona, Rakhi ; Davletov, Kairat ; Dharmaratne, Samath D ; Ding, Eric L ; Duncan, Bruce Bartholow ; El-Khatib, Ziad Ziad ; Erskine, Holly E ; Esteghamati, Alireza ; Farinha, Carla Sofia e Sa ; Fullman, Nancy ; Furtado, Joao M ; Gemechu, Bikila Lencha ; Gopalani, Sameer Vali ; Handal, Alexis J ; Hankey, Graeme J ; Horita, Nobuyuki ; Jackson, Maria Delores ; Johansson, Lars R K ; Kahsay, Amaha ; Karema, Corine Kakizi ; Katikireddi, Srinivasa Vittal ; Keiyoro, Peter Njenga ; Kiadaliri, Aliasghar Ahmad ; Kim, Yun Jin ; Kopec, Jacek A ; Kyu, Hmwe H ; Lalloo, Ratilal ; Lee, Paul H ; Leigh, James ; Li, Yichong ; Liu, Patrick ; Lopez, Alan D ; Lotufo, Paulo A ; Lunevicius, Raimundas ; Magdy Abd El Razek, Hassan ; Mantovani, Lorenzo G ; Matzopoulos, Richard ; McAlinden, Colm ; Mehndiratta, Man Mohan ; Melaku, Yohannes Adama ; Millear, Anoushka ; Mohammed, Kedir Endris ; Montico, Marcella ; Morawska, Lidia ; Musa, Kamarul Imran ; Natarajan, Gopalakrishnan ; Noubiap, Jean Jacques N ; Olagunju, Tinuke Oluwasefunmi ; Olusanya, Jacob Olusegun ; Panda-Jonas, Songhomitra ; Pandian, Jeyaraj D ; Papachristou, Christina ; Piradov, Michael A ; Plass, Dietrich ; Pourmalek, Farshad ; Reiner, Robert C ; Ribeiro, Antonio L ; Sadat, Nafis ; Safi, Sare ; Sanchez-Niño, Maria Dolores ; Shaddick, Gavin ; Shamsipour, Mansour ; Shariful Islam, Sheikh Mohammed ; Shen, Jiabin ; Shiferaw, Mekonnen Sisay ; Smith, David L ; Strub, Bryan ; Tarekegn, Yihunie L ; Tegegne, Teketo Kassaw ; Tehrani-Banihashemi, Arash ; Thankappan, Kavumpurathu Raman ; Thrift, Amanda G ; Torre, Anna ; Uneke, Chigozie Jesse ; Varughese, Santosh ; Venkateswaran, Vidhya ; Venketasubramanian, Narayanaswamy ; Violante, Francesco S ; Yakob, Bereket ; Yan, Lijing L ; Yimam, Hassen Hamid ; Zavala-Arciniega, Luis
facets
frbrtype5
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rsrctypearticles
prefilterarticles
languageeng
creationdate2017
topic
011 Medical And Health Sciences
13112 Neurosciences
23121 Internal medicine
33142 Public health care science
4Adjusted Life Years
5Adolescent
6Adult
7Age
8Aged
9Aged, 80 and over
10Aging
11Air Pollution
12Air Pollution - statistics & numerical data
13Alcohol
14ards
15Article
16Birth weight
17Birthweight
18Blood
19Blood pressure
20Body Mass Index
21Börn
22Cardiometabolic risk
23Causation
24Cause of Death
25Cause of Death - trends
26Chair Nutrition and Disease
27Charities
28Child
29Child, Preschool
30Children
31chinese population
32Clusters
33Communicable Diseases
34Communicable Diseases - mortality
35Community medicine
36Community medicine, Social medicine: 801
37Comparative analysis
38cost
39Counting methods
40countries
41deaths
42Diet
43Disabled Persons
44Disabled Persons - statistics & numerical data
45Disease
46Disease prevention
47Domestic violence
48Dánarmein
49Dánartíðni
50Ecological risk assessment
51environmental
52Environmental assessment
53Environmental exposure
54Environmental Health
55Environmental Health - statistics & numerical data
56Epidemiology
57Exposure
58Factors de risc en les malalties
59Fasting
60Fatalities
61Female
62Folkhälsovetenskap
63Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
64Fæðingarþyngd
65General & Internal
66General & Internal Medicine
67Gestation
68Global Burden of Disease
69Global Burden of Disease - statistics & numerical data
70Global disease burden
71Global Health
72global hälsa
73Glucose
74Glucose blood level
75Health
76Health and Welfare
77Health care science
78Health policy
79Health risk assessment
80Health risks
81Health Sciences
82Health sciences: 800
83Health surveillance
84Heilbrigðisstefna
85Heilbrigðisvísindi
86Heilsufar
87Helsefag
88Helsefag: 800
89HNE Nutrition and Disease
90HNE Voeding en Ziekte
91Humans
92Hypertension
93Háþrýstingur
94Hälsa och välfärd
95Hälsovetenskap
96Hälsovetenskaper
97Indoor air pollution
98Infant
99Infant, Newborn
100Injuries
101Journal Article
102Karlar
103Kidney diseases
104Konur
105Life Expectancy
106Life Sciences & Biomedicine
107Lífsgæði
108Líkamsþyngdarstuðull
109Lýðheilsa
110Male
111Malnutrition
112Medical and Health Sciences
113Medical disciplines
114Medical disciplines: 700
115Medical research
116Medicin och hälsovetenskap
117Medicine
118Medicine (all)
119Medicine, Experimental
120Medisinske Fag
121Medisinske Fag: 700
122Men
123Metabolic Diseases
124Metabolic Diseases - mortality
125Metabolism
126Meðganga
127Middle Aged
128Mortality
129Newborn
130Noncommunicable Diseases
131Noncommunicable Diseases - mortality
132numerical data
133Nutrition and Disease
134Næringarskortur
135obesity prevention
136Occupational Diseases
137Occupational Diseases - mortality
138occupational health
139Outdoor air quality
140over
141Population
142Population growth
143precautionary principle
144Pregnancy
145Premature birth
146Preschool
147Public Health
148Public Health, Global Health, Social Medicine and Epidemiology
149Quality
150Quality of life
151Quality-Adjusted Life Years
152Regional analysis
153Reykingar
154Risk analysis
155Risk Assessment
156Risk exposure
157Risk factors
158Risk factors in diseases
159Salut
160Samfunnsmedisin
161Samfunnsmedisin, sosialmedisin: 801
162Science & Technology
163Sex Distribution
164Smoking
165Smoking - mortality
166Social Medicine
167socialmedicin och epidemiologi
168sosialmedisin
169st
170statistics
171statistics & numerical data
172Systolic blood pressure
173Terveystiede
174Tobacco
175Trends
176VDP
177VLAG
178Voeding en Ziekte
179Water Supply
180Water Supply - standards
181Water Supply - statistics & numerical data
182Women
183World health
184Young Adult
185Áhættugreining
toplevel
0peer_reviewed
1online_resources
creatorcontrib
0Gakidou, Emmanuela
1Abate, Kalkidan Hassen
2Abd-Allah, Foad
3Abdulle, Abdishakur M
4Adetokunboh, Olatunji
5Agrawal, Sutapa
6Al-Aly, Ziyad
7Ammar, Walid
8Asayesh, Hamid
9Azzopardi, Peter
10Balakrishnan, Kalpana
11Barquera, Simon
12Barregard, Lars
13Battle, Katherine E
14Bennett, James R
15Berhe, Derbew Fikadu
16Catalá-López, Ferrán
17Cercy, Kelly
18Dandona, Rakhi
19Davletov, Kairat
20Dharmaratne, Samath D
21Ding, Eric L
22Duncan, Bruce Bartholow
23El-Khatib, Ziad Ziad
24Erskine, Holly E
25Esteghamati, Alireza
26Farinha, Carla Sofia e Sa
27Fullman, Nancy
28Furtado, Joao M
29Gemechu, Bikila Lencha
30Gopalani, Sameer Vali
31Handal, Alexis J
32Hankey, Graeme J
33Horita, Nobuyuki
34Jackson, Maria Delores
35Johansson, Lars R K
36Kahsay, Amaha
37Karema, Corine Kakizi
38Katikireddi, Srinivasa Vittal
39Keiyoro, Peter Njenga
40Kiadaliri, Aliasghar Ahmad
41Kim, Yun Jin
42Kopec, Jacek A
43Kyu, Hmwe H
44Lalloo, Ratilal
45Lee, Paul H
46Leigh, James
47Li, Yichong
48Liu, Patrick
49Lopez, Alan D
50Lotufo, Paulo A
51Lunevicius, Raimundas
52Magdy Abd El Razek, Hassan
53Mantovani, Lorenzo G
54Matzopoulos, Richard
55McAlinden, Colm
56Mehndiratta, Man Mohan
57Melaku, Yohannes Adama
58Millear, Anoushka
59Mohammed, Kedir Endris
60Montico, Marcella
61Morawska, Lidia
62Musa, Kamarul Imran
63Natarajan, Gopalakrishnan
64Noubiap, Jean Jacques N
65Olagunju, Tinuke Oluwasefunmi
66Olusanya, Jacob Olusegun
67Panda-Jonas, Songhomitra
68Pandian, Jeyaraj D
69Papachristou, Christina
70Piradov, Michael A
71Plass, Dietrich
72Pourmalek, Farshad
73Reiner, Robert C
74Ribeiro, Antonio L
75Sadat, Nafis
76Safi, Sare
77Sanchez-Niño, Maria Dolores
78Shaddick, Gavin
79Shamsipour, Mansour
80Shariful Islam, Sheikh Mohammed
81Shen, Jiabin
82Shiferaw, Mekonnen Sisay
83Smith, David L
84Strub, Bryan
85Tarekegn, Yihunie L
86Tegegne, Teketo Kassaw
87Tehrani-Banihashemi, Arash
88Thankappan, Kavumpurathu Raman
89Thrift, Amanda G
90Torre, Anna
91Uneke, Chigozie Jesse
92Varughese, Santosh
93Venkateswaran, Vidhya
94Venketasubramanian, Narayanaswamy
95Violante, Francesco S
96Yakob, Bereket
97Yan, Lijing L
98Yimam, Hassen Hamid
99Zavala-Arciniega, Luis
100GBD 2016 Risk Factors Collaborators
101Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri
102Göteborgs universitet
103Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för arbets-och miljömedicin
104Gothenburg University
105Sahlgrenska Academy
106Sahlgrenska akademin
107Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
108Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
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86SwePub Articles
87SWEPUB Freely available online
88SWEPUB Lunds universitet
jtitleLancet (London, England)
delivery
delcategoryRemote Search Resource
fulltextfulltext
addata
au
0Gakidou, Emmanuela
1Abate, Kalkidan Hassen
2Abd-Allah, Foad
3Abdulle, Abdishakur M
4Adetokunboh, Olatunji
5Agrawal, Sutapa
6Al-Aly, Ziyad
7Ammar, Walid
8Asayesh, Hamid
9Azzopardi, Peter
10Balakrishnan, Kalpana
11Barquera, Simon
12Barregard, Lars
13Battle, Katherine E
14Bennett, James R
15Berhe, Derbew Fikadu
16Catalá-López, Ferrán
17Cercy, Kelly
18Dandona, Rakhi
19Davletov, Kairat
20Dharmaratne, Samath D
21Ding, Eric L
22Duncan, Bruce Bartholow
23El-Khatib, Ziad Ziad
24Erskine, Holly E
25Esteghamati, Alireza
26Farinha, Carla Sofia e Sa
27Fullman, Nancy
28Furtado, Joao M
29Gemechu, Bikila Lencha
30Gopalani, Sameer Vali
31Handal, Alexis J
32Hankey, Graeme J
33Horita, Nobuyuki
34Jackson, Maria Delores
35Johansson, Lars R K
36Kahsay, Amaha
37Karema, Corine Kakizi
38Katikireddi, Srinivasa Vittal
39Keiyoro, Peter Njenga
40Kiadaliri, Aliasghar Ahmad
41Kim, Yun Jin
42Kopec, Jacek A
43Kyu, Hmwe H
44Lalloo, Ratilal
45Lee, Paul H
46Leigh, James
47Li, Yichong
48Liu, Patrick
49Lopez, Alan D
50Lotufo, Paulo A
51Lunevicius, Raimundas
52Magdy Abd El Razek, Hassan
53Mantovani, Lorenzo G
54Matzopoulos, Richard
55McAlinden, Colm
56Mehndiratta, Man Mohan
57Melaku, Yohannes Adama
58Millear, Anoushka
59Mohammed, Kedir Endris
60Montico, Marcella
61Morawska, Lidia
62Musa, Kamarul Imran
63Natarajan, Gopalakrishnan
64Noubiap, Jean Jacques N
65Olagunju, Tinuke Oluwasefunmi
66Olusanya, Jacob Olusegun
67Panda-Jonas, Songhomitra
68Pandian, Jeyaraj D
69Papachristou, Christina
70Piradov, Michael A
71Plass, Dietrich
72Pourmalek, Farshad
73Reiner, Robert C
74Ribeiro, Antonio L
75Sadat, Nafis
76Safi, Sare
77Sanchez-Niño, Maria Dolores
78Shaddick, Gavin
79Shamsipour, Mansour
80Shariful Islam, Sheikh Mohammed
81Shen, Jiabin
82Shiferaw, Mekonnen Sisay
83Smith, David L
84Strub, Bryan
85Tarekegn, Yihunie L
86Tegegne, Teketo Kassaw
87Tehrani-Banihashemi, Arash
88Thankappan, Kavumpurathu Raman
89Thrift, Amanda G
90Torre, Anna
91Uneke, Chigozie Jesse
92Varughese, Santosh
93Venkateswaran, Vidhya
94Venketasubramanian, Narayanaswamy
95Violante, Francesco S
96Yakob, Bereket
97Yan, Lijing L
98Yimam, Hassen Hamid
99Zavala-Arciniega, Luis
aucorp
0GBD 2016 Risk Factors Collaborators
1Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri
2Göteborgs universitet
3Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för arbets-och miljömedicin
4Gothenburg University
5Sahlgrenska Academy
6Sahlgrenska akademin
7Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
8Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
formatjournal
genrearticle
ristypeJOUR
atitleGlobal, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
jtitleLancet (London, England)
addtitleLancet
date2017-09-16
risdate2017
volume390
issue10100
spage1345
epage1422
pages1345-1422
issn
00140-6736
11474-547X
eissn1474-547X
notes
0The Lancet
1Collaborators listed at the end of the Article
abstractThe Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9·3% (6·9–11·6) decline in deaths and a 10·8% (8·3–13·1) decrease in DALYs at the global level, while population ageing accounts for 14·9% (12·7–17·5) of deaths and 6·2% (3·9–8·7) of DALYs, and population growth for 12·4% (10·1–14·9) of deaths and 12·4% (10·1–14·9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27·3% (24·9–29·7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade. The Bill & Melinda Gates Foundation, Bloomberg Philanthropies.
copEngland
pubElsevier Ltd
pmid28919119
doi10.1016/S0140-6736(17)32366-8
tpages78
oafree_for_read