Institute of Health Metrics and Evaluation

Seattle, WA, United States

Institute of Health Metrics and Evaluation

Seattle, WA, United States
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Kinge J.M.,Norwegian Institute of Public Health | Kinge J.M.,University of Oslo | Saelensminde K.,Norwegian Directorate of Health | Dieleman J.,Institute of Health Metrics and Evaluation | And 3 more authors.
Health Policy | Year: 2016

We explore the correlation between disease specific estimates of economic losses and the burden of disease. This is based on data for Norway in 2013 from the Global Burden of Disease (GBD) project and the Norwegian Directorate of Health. The diagnostic categories were equivalent to the ICD-10 chapters. Mental disorders topped the list of the costliest conditions in Norway in 2013, and musculoskeletal disorders caused the highest production loss, while neoplasms caused the greatest burden in terms of DALYs. There was a positive and significant association between economic losses and burden of disease. Neoplasms, circulatory diseases, mental and musculoskeletal disorders all contributed to large health care expenditures. Non-fatal conditions with a high prevalence in working populations, like musculoskeletal and mental disorders, caused the largest production loss, while fatal conditions such as neoplasms and circulatory disease did not, since they occur mostly at old age. The magnitude of the production loss varied with the estimation method. The estimations presented in this study did not include reductions in future consumption, by net-recipients, due to premature deaths. Non-fatal diseases are thus even more burdensome, relative to fatal diseases, than the production loss in this study suggests. Hence, ignoring production losses may underestimate the economic losses from chronic diseases in countries with an epidemiological profile similar to Norway. © 2017 Elsevier B.V.


Nasari M.M.,Environmental Health Science and Research Bureau | Szyszkowicz M.,Environmental Health Science and Research Bureau | Chen H.,Public Health Ontario | Crouse D.,Environmental Health Science and Research Bureau | And 17 more authors.
Air Quality, Atmosphere and Health | Year: 2016

The effectiveness of regulatory actions designed to improve air quality is often assessed by predicting changes in public health resulting from their implementation. Risk of premature mortality from long-term exposure to ambient air pollution is the single most important contributor to such assessments and is estimated from observational studies generally assuming a log-linear, no-threshold association between ambient concentrations and death. There has been only limited assessment of this assumption in part because of a lack of methods to estimate the shape of the exposure-response function in very large study populations. In this paper, we propose a new class of variable coefficient risk functions capable of capturing a variety of potentially non-linear associations which are suitable for health impact assessment. We construct the class by defining transformations of concentration as the product of either a linear or log-linear function of concentration multiplied by a logistic weighting function. These risk functions can be estimated using hazard regression survival models with currently available computer software and can accommodate large population-based cohorts which are increasingly being used for this purpose. We illustrate our modeling approach with two large cohort studies of long-term concentrations of ambient air pollution and mortality: the American Cancer Society Cancer Prevention Study II (CPS II) cohort and the Canadian Census Health and Environment Cohort (CanCHEC). We then estimate the number of deaths attributable to changes in fine particulate matter concentrations over the 2000 to 2010 time period in both Canada and the USA using both linear and non-linear hazard function models. © 2016 The Author(s)


PubMed | Institute of Health Metrics and Evaluation, University of Washington, University of Ottawa, Seoul National University and 8 more.
Type: Journal Article | Journal: Air quality, atmosphere, & health | Year: 2016

The effectiveness of regulatory actions designed to improve air quality is often assessed by predicting changes in public health resulting from their implementation. Risk of premature mortality from long-term exposure to ambient air pollution is the single most important contributor to such assessments and is estimated from observational studies generally assuming a log-linear, no-threshold association between ambient concentrations and death. There has been only limited assessment of this assumption in part because of a lack of methods to estimate the shape of the exposure-response function in very large study populations. In this paper, we propose a new class of variable coefficient risk functions capable of capturing a variety of potentially non-linear associations which are suitable for health impact assessment. We construct the class by defining transformations of concentration as the product of either a linear or log-linear function of concentration multiplied by a logistic weighting function. These risk functions can be estimated using hazard regression survival models with currently available computer software and can accommodate large population-based cohorts which are increasingly being used for this purpose. We illustrate our modeling approach with two large cohort studies of long-term concentrations of ambient air pollution and mortality: the American Cancer Society Cancer Prevention Study II (CPS II) cohort and the Canadian Census Health and Environment Cohort (CanCHEC). We then estimate the number of deaths attributable to changes in fine particulate matter concentrations over the 2000 to 2010 time period in both Canada and the USA using both linear and non-linear hazard function models.


Micha R.,Harvard University | Micha R.,Agricultural University of Athens | Khatibzadeh S.,Harvard University | Shi P.,Harvard University | And 7 more authors.
BMJ (Online) | Year: 2014

Objectives: To quantify global consumption of key dietary fats and oils by country, age, and sex in 1990 and 2010. Design: Data were identified, obtained, and assessed among adults in 16 age- and sex-specific groups from dietary surveys worldwide on saturated, omega 6, seafood omega 3, plant omega 3, and trans fats, and dietary cholesterol. We included 266 surveys in adults (83% nationally representative) comprising 1 630 069 unique individuals, representing 113 of 187 countries and 82% of the global population. A multilevel hierarchical Bayesian model accounted for differences in national and regional levels of missing data, measurement incomparability, study representativeness, and sampling and modelling uncertainty. Setting and population: Global adult population, by age, sex, country, and time. Results: In 2010, global saturated fat consumption was 9.4%E (95%UI=9.2 to 9.5); country-specific intakes varied dramatically from 2.3 to 27.5%E; in 75 of 187 countries representing 61.8% of the world's adult population, the mean intake was <10%E. Country-specific omega 6 consumption ranged from 1.2 to 12.5%E (global mean=5.9%E); corresponding range was 0.2 to 6.5%E (1.4%E) for trans fat; 97 to 440 mg/day (228 mg/day) for dietary cholesterol; 5 to 3,886 mg/day (163 mg/day) for seafood omega 3; and <100 to 5,542 mg/day (1,371 mg/day) for plant omega 3. Countries representing 52.4% of the global population had national mean intakes for omega 6 fat ≥5%E; corresponding proportions meeting optimal intakes were 0.6% for trans fat (≤0.5%E); 87.6% for dietary cholesterol (<300 mg/day); 18.9% for seafood omega 3 fat (≥250 mg/day); and 43.9% for plant omega 3 fat (≥1,100 mg/day). Trans fat intakes were generally higher at younger ages; and dietary cholesterol and seafood omega 3 fats generally higher at older ages. Intakes were similar by sex. Between 1990 and 2010, global saturated fat, dietary cholesterol, and trans fat intakes remained stable, while omega 6, seafood omega 3, and plant omega 3 fat intakes each increased. Conclusions: These novel global data on dietary fats and oils identify dramatic diversity across nations and inform policies and priorities for improving global health.


PubMed | Agricultural University of Athens, Institute of Health Metrics and Evaluation, Harvard University, Tufts University and Imperial College London
Type: Journal Article | Journal: PloS one | Year: 2015

Sugar-sweetened beverages (SSBs), fruit juice, and milk are components of diet of major public health interest. To-date, assessment of their global distributions and health impacts has been limited by insufficient comparable and reliable data by country, age, and sex.To quantify global, regional, and national levels of SSB, fruit juice, and milk intake by age and sex in adults over age 20 in 2010.We identified, obtained, and assessed data on intakes of these beverages in adults, by age and sex, from 193 nationally- or subnationally-representative diet surveys worldwide, representing over half the worlds population. We also extracted data relevant to milk, fruit juice, and SSB availability for 187 countries from annual food balance information collected by the United Nations Food and Agriculture Organization. We developed a hierarchical Bayesian model to account for measurement incomparability, study representativeness, and sampling and modeling uncertainty, and to combine and harmonize nationally representative dietary survey data and food availability data.In 2010, global average intakes were 0.58 (95%UI: 0.37, 0.89) 8 oz servings/day for SSBs, 0.16 (0.10, 0.26) for fruit juice, and 0.57 (0.39, 0.83) for milk. There was significant heterogeneity in consumption of each beverage by region and age. Intakes of SSB were highest in the Caribbean (1.9 servings/day; 1.2, 3.0); fruit juice consumption was highest in Australia and New Zealand (0.66; 0.35, 1.13); and milk intake was highest in Central Latin America and parts of Europe (1.06; 0.68, 1.59). Intakes of all three beverages were lowest in East Asia and Oceania. Globally and within regions, SSB consumption was highest in younger adults; fruit juice consumption showed little relation with age; and milk intakes were highest in older adults.Our analysis highlights the enormous spectrum of beverage intakes worldwide, by country, age, and sex. These data are valuable for highlighting gaps in dietary surveillance, determining the impacts of these beverages on global health, and targeting dietary policy.


Micha R.,Tufts University | Khatibzadeh S.,Harvard University | Shi P.,Tufts University | Andrews K.G.,Institute of Health Metrics and Evaluation | And 2 more authors.
BMJ Open | Year: 2015

Objective: To quantify global intakes of key foods related to non-communicable diseases in adults by region (n=21), country (n=187), age and sex, in 1990 and 2010. Design: We searched and obtained individual-level intake data in 16 age/sex groups worldwide from 266 surveys across 113 countries. We combined these data with food balance sheets available in all nations and years. A hierarchical Bayesian model estimated mean food intake and associated uncertainty for each agesex- country-year stratum, accounting for differences in intakes versus availability, survey methods and representativeness, and sampling and modelling uncertainty. Setting/population: Global adult population, by age, sex, country and time. Results: In 2010, global fruit intake was 81.3 g/day (95% uncertainty interval 78.9-83.7), with countryspecific intakes ranging from 19.2-325.1 g/day; in only 2 countries (representing 0.4% of the world's population), mean intakes met recommended targets of ≥300 g/day. Country-specific vegetable intake ranged from 34.6-493.1 g/day (global mean=208.8 g/ day); corresponding values for nuts/seeds were 0.2- 152.7 g/day (8.9 g/day); for whole grains, 1.3- 334.3 g/day (38.4 g/day); for seafood, 6.0-87.6 g/day (27.9 g/day); for red meats, 3.0-124.2 g/day (41.8 g/ day); and for processed meats, 2.5-66.1 g/day (13.7 g/day). Mean national intakes met recommended targets in countries representing 0.4% of the global population for vegetables (≥400 g/day); 9.6% for nuts/seeds (≥4 (28.35 g) servings/week); 7.6% for whole grains (≥2.5 (50 g) servings/day); 4.4% for seafood (≥3.5 (100 g) servings/week); 20.3% for red meats (≤1 (100 g) serving/week); and 38.5% for processed meats (≤1 (50 g) serving/week). Intakes of healthful foods were generally higher and of less healthful foods generally lower at older ages. Intakes were generally similar by sex. Vegetable, seafood and processed meat intakes were stable over time; fruits, nuts/seeds and red meat, increased; and whole grains, decreased. Conclusions: These global dietary data by nation, age and sex identify key challenges and opportunities for optimising diets, informing policies and priorities for improving global health.


Messina J.P.,University of Oxford | Humphreys I.,University of Oxford | Flaxman A.,Institute of Health Metrics and Evaluation | Brown A.,University of Oxford | And 3 more authors.
Hepatology | Year: 2015

Hepatitis C virus (HCV) exhibits high genetic diversity, characterized by regional variations in genotype prevalence. This poses a challenge to the improved development of vaccines and pan-genotypic treatments, which require the consideration of global trends in HCV genotype prevalence. Here we provide the first comprehensive survey of these trends. To approximate national HCV genotype prevalence, studies published between 1989 and 2013 reporting HCV genotypes are reviewed and combined with overall HCV prevalence estimates from the Global Burden of Disease (GBD) project. We also generate regional and global genotype prevalence estimates, inferring data for countries lacking genotype information. We include 1,217 studies in our analysis, representing 117 countries and 90% of the global population. We calculate that HCV genotype 1 is the most prevalent worldwide, comprising 83.4 million cases (46.2% of all HCV cases), approximately one-third of which are in East Asia. Genotype 3 is the next most prevalent globally (54.3 million, 30.1%); genotypes 2, 4, and 6 are responsible for a total 22.8% of all cases; genotype 5 comprises the remaining <1%. While genotypes 1 and 3 dominate in most countries irrespective of economic status, the largest proportions of genotypes 4 and 5 are in lower-income countries. Conclusion: Although genotype 1 is most common worldwide, nongenotype 1 HCV cases-which are less well served by advances in vaccine and drug development-still comprise over half of all HCV cases. Relative genotype proportions are needed to inform healthcare models, which must be geographically tailored to specific countries or regions in order to improve access to new treatments. Genotype surveillance data are needed from many countries to improve estimates of unmet need. © 2014 The Authors.


PubMed | Institute of Health Metrics and Evaluation, Harvard University and Tufts University
Type: Journal Article | Journal: BMJ open | Year: 2015

To quantify global intakes of key foods related to non-communicable diseases in adults by region (n=21), country (n=187), age and sex, in 1990 and 2010.We searched and obtained individual-level intake data in 16 age/sex groups worldwide from 266 surveys across 113 countries. We combined these data with food balance sheets available in all nations and years. A hierarchical Bayesian model estimated mean food intake and associated uncertainty for each age-sex-country-year stratum, accounting for differences in intakes versus availability, survey methods and representativeness, and sampling and modelling uncertainty.Global adult population, by age, sex, country and time.In 2010, global fruit intake was 81.3g/day (95% uncertainty interval 78.9-83.7), with country-specific intakes ranging from 19.2-325.1g/day; in only 2 countries (representing 0.4% of the worlds population), mean intakes met recommended targets of 300g/day. Country-specific vegetable intake ranged from 34.6-493.1g/day (global mean=208.8g/day); corresponding values for nuts/seeds were 0.2-152.7g/day (8.9g/day); for whole grains, 1.3-334.3g/day (38.4g/day); for seafood, 6.0-87.6g/day (27.9g/day); for red meats, 3.0-124.2g/day (41.8g/day); and for processed meats, 2.5-66.1g/day (13.7g/day). Mean national intakes met recommended targets in countries representing 0.4% of the global population for vegetables (400g/day); 9.6% for nuts/seeds (4 (28.35g) servings/week); 7.6% for whole grains (2.5 (50g) servings/day); 4.4% for seafood (3.5 (100g) servings/week); 20.3% for red meats (1 (100g) serving/week); and 38.5% for processed meats (1 (50g) serving/week). Intakes of healthful foods were generally higher and of less healthful foods generally lower at older ages. Intakes were generally similar by sex. Vegetable, seafood and processed meat intakes were stable over time; fruits, nuts/seeds and red meat, increased; and whole grains, decreased.These global dietary data by nation, age and sex identify key challenges and opportunities for optimising diets, informing policies and priorities for improving global health.


Ticked Off! Here's What You Need To Know About Lyme Disease A new study reveals that India will soon outpace its Asian neighbor, China in the context of increasing air pollution levels. U.S.-based Heath Effects Institute, along with the Institute of Health Metrics and Evaluation released a report on Feb. 14, which indicates that 1.1 million premature deaths were encountered in 2015 due to increasing air pollution in India. The same statistic applies for China as well, but the country has taken numerous measures to keep a check on carbon emissions and also to stabilize the level of air particulates in the atmosphere. Michael Brauer, a professor at the University of British Columbia and the lead author of the study, states that this situation is the "perfect storm" for India. The report states that the amount of a fine dust particulate matter known as PM2.5 has risen sharply and is largely responsible for the 1.1 million premature deaths in India. Brauer believes that the country's growing industrialization, along with the rapid growth in population, are behind the rise of PM2.5 in India. Per the report, air pollution took 4.2 million lives prematurely all over the world in 2015, out of which 50 percent of the deaths occurred in China and India. Dan Greenbaum, president of Health Effects Institute stated that problems due to air pollution are on a rise worldwide and the new report states clearly why air pollution can be considered to be a major contributor to premature death. The report also contains the reading of a website on the issue, indicating that around 92 percent of the total world's population resides in areas surrounded by unhealthy air. The surprising fact is that, despite glaring evidence linking air pollution with deaths, there are some ministers who are reluctant to accept the connection. "There is no conclusive data available in the country to establish direct correlation-ship of death exclusively with air pollution," said Anil Madhav Dave, India's environment Minister. While the Indian government has never denied the negative impact of air pollution on human health, it is not supportive of the evidence provided by various studies. The government is reluctant to accept the data, which clearly shows that a link exists between air pollution and mortality. The Indian government is backing its stance by stating that the premature deaths could also be the result of other factors like bad food habits, socio economic status, medical history, immunity and many other aspects. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.


News Article | February 15, 2017
Site: www.technologyreview.com

This is not a distinction any country wants. India’s toxic air is now contributing to nearly 1.1 million deaths a year, and the country is on its way toward standing alone as the site of the deadliest air pollution problem on the planet. We’ve all seen pictures of Chinese cities blanketed in smog, and China’s air pollution has been the world’s worst for years in terms of the number of premature deaths it causes. But it’s now roughly tied with India, and the two countries appear headed in opposite directions, according to a new report on global air quality released Tuesday. The study, a joint effort between the Health Effects Institute in Boston and the Seattle-based Institute of Health Metrics and Evaluation, suggests that since 1990, developed countries like the U.S. and much of Europe have made continued strides in cleaning up their air. And while China has been the poster child for foul air for years, strong government regulation has leveled off its overall deaths attributable to air pollution over the last five years, while the death rate has been on a steady downward trend. Not so for India. From 2010 to 2015, the number of premature deaths caused by air pollution each year has gone from 957,000 to about 1.1 million. While the death rate has remained the same, several factors—including rapid industrialization, a heavy reliance on coal for energy, population growth, and an aging populace that is more vulnerable to the effects of air pollution—have combined to create what one researcher told the New York Times was “the perfect storm for India.” Of course, India is far from the only country that needs to think hard about the detrimental health effects of polluted air as it pursues economic growth. A report in the Guardian on Monday found that air pollution is so bad in many cities that the physical benefits of cycling get erased after just 30 minutes of breathing in the microscopic particles that are the main contributor to air-pollution-related deaths.

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