4. Comparative Quantification of Mortality and Burden of Disease Attributable to Selected Risk Factors

Abstract

Reliable and comparable analyses of risks to health are critical for preventing disease and injury. Previous estimates of morbidity and mortality resulting from risk factors have not achieved complete methodological consistency and comparability across risk factors. The aim of this chapter is to present an analysis of mortality and morbidity attributable to 19 major risk factors in a unified framework while acknowledging characteristics specific to individual risk factors.

Data on risk factor exposure and relative risk by age, sex, and region were from the Comparative Risk Assessment project, supplemented with new data sources and epidemiological analyses. Population–attributable fractions for individual and multiple risk factors were applied to cause–specific mortality and disease burden from chapter 3.

Results indicate that those risk factors that affect the poorest regions and populations—such as undernutrition; unsafe water, sanitation, and hygiene; indoor smoke from household use of solid fuels; and unsafe sex—continue to dominate the loss of health worldwide. These are coupled with hazards such as alcohol use, smoking, high blood pressure, high cholesterol, and overweight and obesity that are prevalent worldwide. Globally, an estimated 45 percent of mortality and 36 percent of disease burden were attributable to the joint effects of these 19 selected risk factors. Substantial proportions of some of the leading global diseases (for example, lower respiratory infections, diarrhea, HIV/AIDS, lung cancer, ischemic heart disease, and stroke) were attributable to these 19 selected risk factors. The large global disease burden attributable to the selected risk factors highlights the relevance and importance of prevention policies and programs that reduce risk factor exposure.

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