Lecture 20: GBD

Question 1

Describe the reasons for the Global Burden of Disease (GBD) Project

Answer 1

1. Previously the data on the burden of disease and injury were incomplete and there was 2.
   little information for nonfatal outcomes (mostly mortality) which gave
2. lobby groups a distorted image of what problems are most important.
3. There was no systematic approach to estimate the burden therefore difficult to prioritise/compare diseases.

Question 2

Define Disability Adjusted Life Year (DALY)

Answer 2

A summary measure of population health that combines data on premature mortality and non fatal health outcomes to represent the heath of a particular population as a single number

Question 3

What is the impact of the Global Burden of Disease (GBD) Project

Answer 3

• It aids in setting health and research priorities
• identifies disadvantaged groups therefore helping targetted interventions
• Can track disease burdens over time
• uses one measurement to compare that has both YLL and YLD

Question 4

What is the data required to compute DALYs.

Answer 4

DALY= Years lived with disability + Years of life lost

Question 5

Define the three parts of YLD: represents morbidity by counting years lived with disease

Answer 5

• Number of cases with a non fatal outcomes with the disease.
• The average duration of non fatal outcomes until recovery/death and
• the disability weight representing the severity of the impairment (0-1)

Question 6

Define the three parts of YLL: represents mortality by counting years lost to premature death caused by disease

Answer 6

• Number of deaths from the disease in a year times*

- Years lost per death relative to an ideal age

Question 7

Describe the the leading causes of DALYs globlally and the trend between LMIcs

Answer 7

CVD, Diarrhoea and Neoplasms are leading diseases.
More developed countries have higher average life expectancy and lower fertility rate= demographic transition
In HIc main disease burden is group 2: NCDs while LIc main disease burden is group 1: CD. Fastest increases of DALYs LIMIc

Question 8

What are the three groups of diseases and their global trends

Answer 8

Group 1 : communicable diseases
Gp2: Non communicable disease
Gp 3: Injuries
Gp2 & 3 are expected to rise while gp 1 will decline except for HIV aids which is gonna stay steady.

Question 9

What are the major gains of the DALY approach

Answer 9

1. Drew attention to previously hidden burden of mental health/ injuries as major health problems
2. Recognises NCDs as a major and increasing problem for LIMIc- not just rich countries

Question 10

What are the two major challenges in using DALYS to quantify the burden of disability

Answer 10

1. Disability weights are considered to be the same as the severity of impairment relating to disease but do not take into account the effect of the their SES, access of individuals that might make it more burdensome
2. GBD project potentially represents people with disabilities as a buren

Question 11

What is the ‘Medical’ model of Disability

Answer 11

GBD takes medical model of disability where it is an individual problem defined by the medical condition not societal problem. Promotes the view of disabled person as dependent and needed to be cured/cared for with control by professionals- choices for individual are limited to what is provided by them.

Question 12

What is the ’Social’ model of Disability

Answer 12

Disability is seen as a social issue caused by policies practices attitudes or the environment.
It focuses on ridding societal barriers rather than curing people with impairments