“What ails you isn’t what kills you”

By Joy Portella

The global health sector is obsessed with what kills people. Most studies, not to mention disease advocacy groups, proclaim the death tolls of cancer or HIV/AIDS or malaria. But not many studies talk about what makes people sick.

That’s unfortunate because the fastest growing health problem isn’t death – it’s sickness. As mortality rates decline and people live longer, even in poor parts of the world, those longer lives become riddled with ailments that render us unable to move, see or hear clearly.

The shifting patterns and causes of sickness were detailed this week in The Lancet. The study, which was conducted by an international consortium of researchers led by Minerva Strategies’ client the Institute for Health Metrics and Evaluation (IHME), looks closely at a health measurement called years lived with disability, or YLDs. YLDs are the number of years that people live with some kind of illness or disability. Another way to think of it is the number of years that people are alive but not in good health.

The study revealed that, between 1990 and 2013, YLDs increased globally from 537.6 million in 1990 to 764.8 million in 2013. Against this backdrop of increasing years of ill health, a few facts stuck out for me:

  • What ails isn’t what kills you. Most of the world’s YLDs are caused by diseases or injuries that would be overlooked by many health studies because they are not major killers. I’m talking about ailments like neck and back pains, anxiety, and migraines. Yet these are the health problems that cause most of the world’s suffering. For example, the global disease burdens of both low back pain and depression have increased more than 50% since 1990.
  • We’re all in the same boat. In 2013, low back pain was the number one cause of YLDS among men in the US, Mexico, India, Ukraine, and many other countries in the world. In almost every country, the study shows that a toxic mix of a small set of diseases and injuries is causing enormous amounts of suffering. Of course there are exceptions. In South Africa, for example, the scourge of HIV/AIDS outweighs every other cause of YLDs. But by and large, the whole world is battling the same set of health-compromising ailments, and many health systems are not well-armed for the fight.
  • Diabetes is scaring the hell out of me. Among American women, diabetes increased 112% as a cause of YLDs in the past 3+ decades. It increases 201% among women in Brazil, 144% in China, and 120% in South Africa. Around the world, this disease’s meteoric rise as a cause of sickness and disability is startling. If there’s anything to make you eat right and exercise it’s this: If you don’t, diabetes is going to make you sick. And unlike many causes of sickness, it could also kill you. An IHME-led study from December 2014 revealed that diabetes was the world’s #9 killer in 2013.

There’s a lot more in this fascinating report but I’ll leave it to data-lovers to check it out here.