Study: Life Expectancy, Disability Up

WASHINGTON — People are living longer, but they are also living more years in poor health. That’s according to the most thorough look to date at the global burden of disease.

On average, men worldwide can expect to live 67 years; and women, 73, according to the new research in the journal “The Lancet.”    

That’s about a five-year increase over 1990.

The findings are part of a seven-article series looking at global disease and disability, involving nearly 500 researchers in 50 countries.

“All of us in the world of health focus on diseases and often bad news. Actually, the global burden of disease 2010 study broadly presents very good news,” said Richard Horton, “The Lancet’s” editor-in-chief. .

The new research found far fewer people died of measles, tetanus, respiratory and diarrheal diseases in 2010 than in 1990. Overall, deaths from infections, complications from childbirth, and malnutrition fell about 17 percent, to 13.2 million.

Global efforts have focused on reducing HIV/AIDS, tuberculosis and malaria. But these diseases still kill more than a million people per year each, and malaria has actually increased by nearly 20 percent.

“Those three big, big diseases are not just going to go away,” said Mike Cohen, who heads global health research at the University of North Carolina at Chapel Hill.  He was not involved in the studies. He says the report notes declines in HIV/AIDS deaths since 2006. Tuberculosis deaths are down nearly 20 percent as well.

But the research highlights a major transition taking place worldwide, Cohen says.

“As infectious diseases have been better controlled and people live longer, and as their diets change and lifestyles change, the inevitable consequence in health is, you have to deal much more broadly with hypertension, heart disease, (and diabetes),” he said.

In fact, the report found these kinds of non-communicable diseases accounted for more than half of the global burden of disease in 2010, surpassing infections, maternal and childhood ailments, and malnutrition.

For example, in 1990, the top cause of death was childhood underweight. In 2010, that dropped to number eight, and high blood pressure topped the list.

But while people are living longer, they are also spending more time in poor health, says Joshua Salomon, professor of global health at Harvard University and co-author of the section on disability.

“I think in general we’ve been more successful at reducing mortality and less successful at actually addressing chronic disability,” Salomon said.

Physical conditions such as arthritis and back issues, and mental and behavioral problems like depression, anxiety and substance abuse were the top causes of disability.

And while much has changed in global health in the past two decades, one thing has stayed the same: smoking remained a top-three cause of death.