Lahore (Muhammad Yasir) The interaction of COVID-19 with the continued global rise in chronic illness and related risk factors, including obesity, high blood sugar, and outdoor air pollution, over the past 30 years has created a perfect storm, fuelling COVID-19 deaths.
The latest findings from the Global Burden of Disease Study (GBD), published today in The Lancet, provide new insights on how well countries were prepared in terms of underlying health for the COVID-19 pandemic, and set out the true scale of the challenge to protect against further pandemic threats.
The study also reveals that the rise in exposure to key risk factors (including high blood pressure, high blood sugar, high body-mass index [BMI], and elevated cholesterol), combined with rising deaths from cardiovascular disease in some countries (e.g., the USA and the Caribbean), suggests that the world might be approaching a turning point in life expectancy gains.
“Most of these risk factors are preventable and treatable, and tackling them will bring huge social and economic benefits. We are failing to change unhealthy behaviours, particularly those related to diet quality, caloric intake, and physical activity, in part due to inadequate policy attention and funding for public health and behavioural research”, says Professor Christopher Murray, Director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, USA, who led the research.
Several of the risk factors and non-communicable diseases (NCDs) highlighted by the study, including obesity, diabetes, and cardiovascular disease, are associated with increased risk of serious illness and death from COVID-19. But diseases don’t just interact biologically, they also interact with social factors. Urgent action is needed to address the syndemic of chronic diseases, social inequalities, and COVID-19—referring to the interaction of several epidemics that exacerbate the disease burden in populations who are already burdened, and increase their vulnerability.
Dr Richard Horton, Editor-in-Chief of The Lancet, says: “The syndemic nature of the threat we face demands that we not only treat each affliction, but also urgently address the underlying social inequalities that shape them—poverty, housing, education, and race, which are all powerful determinants of health.”
He continues, “COVID-19 is an acute-on-chronic health emergency. And the chronicity of the present crisis is being ignored at our future peril. Non-communicable diseases have played a critical role in driving the more than 1 million deaths caused by COVID-19 to date, and will continue to shape health in every country after the pandemic subsides. As we address how to regenerate our health systems in the wake of COVID-19, this Global Burden of Disease Study offers a means of targeting where the need is greatest, and how it differs between countries”.
The top ten contributors to increasing health loss worldwide over the past 30 years, measured as the largest absolute increases in number of DALYs, include six causes that largely affect older adults—is chaemic heart disease (with numbers of related DALYs increasing by 50% between 1990 and 2019), diabetes (up 148%), stroke (32%), chronic kidney disease (93%), lung cancer (69%), and age-related hearing loss (83%). In addition, four causes are common from teenage years into old age—HIV/AIDS (128%), a group of musculoskeletal disorders (129%), low back pain (47%), and depressive disorders (61%).For example, from 1990 to 2019, the number of DALYs due to is chaemic heart disease rose by more than 400% in the Philippines, while the number of DALYs due to diabetes rose by more than 1000% in the United Arab Emirates. Such increases in ill health threaten to strain health-care systems ill-equipped to handle the chronic conditions associated with growing, ageing populations.