Lecture 27 GBD project (DALYS) Flashcards
Why should we worry about setting priorities?
Lack of resources, evidence based outcomes, opportunity cost, difficult to compare outcomes, individual vs population needs
What is opportunity cost?
A decision will benefit some and create a loss for others. We previously chose decisions that would be greater for a larger portion of the population but this results in inequities, so we should start focusing on marginalised groups
Why is it difficult to compare outcomes?
Because the impact of disabilities on a persons life is hard to measure, and data from healthcare systems only includes individuals who have interacted with the systems
What are reasons for the creation of GBD?
Data about diseases were incomplete, data on non fatal diseases was largely unavailable, lobbying groups distort the importance of diseases, diseases needed to be judged based on the same set of conditions to allocate resources fairly
What are the aims of the GBD?
To create a systemic approach for determining the importance of diseases (aids in setting health service and interventions, helps identify at risk groups) and to take into account non fatal diseases. Measured using DALYS = YLL + YLD
Whats is DALYs?
A measure of disease based on the combination of years of life lost (compared to average life expectancy) and years of life lived with disease
What does YLL represent?
It takes into account the years of life lost to the average life expectancy and also the number of deaths in a year
What does YLD represent?
The number of non fatal outcomes, the average life expectancy of those with non fatal outcomes and the disability weight (a year lived with a disability is measured between 0-1)
What is group 1 diseases?
Communicable diseases
What is group 3 diseases?
Injuries
What is group 2 diseases?
Non Communicable diseases
What are the global changes in DALYS patterns?
There are more non communicable diseases present on the top 10 diseases globally, and mental disorders have made the list. HIV/AIDS remains a problematic communicable disease
What are the DALYs for high income countries?
Non communicable diseases and injuries are predominant
What are the DALYs for low income countries?
High contribution of perinatal, nutritional and communicable diseases.
What are the changes in projected life expectancy globally?
All life expectancies are increasing, however the inequities are not changing
What are the global trends for type 1 diseases?
All communicable diseases are lowering, except for HIV/AIDS which is increasing
What are the global trends for type 2 diseases?
All non communicable diseases are increasing
What are the global trends for type 3 diseases?
Injuries are increasing
What are the major gains of the DALY approach?
Drew attention to the hidden burden of mental health issues and injuries as major public health problems, Recognizes non communicable diseases as an increasing problem in middle and low income countries (its not just a high income country problem)
What are challenged in using DALYS to quantify the burden of disability?
Who should decide the disease burdens, whether one set of disease burdens should be applied globally, how the social and physical environments affect disability experience
What are the MAJOR challenges in using DALYs to quantify the burden of disability?
Disability weights are considered to be the same as the severity of the disease and do not take into account the individuals social position and location, it represents people with disabilities as a burden
Which model does the GBD use?
It uses the medical model, where 1. disabled people are defined by their illness 2. the disease the individuals problem 3. makes disabled people seem like they need care 4. THE DISABLED PERSON IS THE PROBLEM< NOT SOCIETY 5. Control resides within professionals 6. Treatment options are only provided by helpers
How should disability be seen as?
It should not be seen as an individual problem but be seen as a social issue caused by policies, practices, attitudes and environment.
What does the social model focus on?
Focuses on ridding society of barriers to disabled people, instead of treating the illness.
