School of Management, University of Liverpool, Liverpool L69 3BX, UK.
J Public Health (Oxf). 2012 Aug;34(3):430-7. doi: 10.1093/pubmed/fds005. Epub 2012 Mar 2.
The aim of this study was to quantify and compare the burden of disease attributable to five major lifestyle-related risk factors in a UK Primary Care Trust (Wirral) using World Health Organizations' (WHO) comparative risk assessment (CRA) methodology to demonstrate its practical utility for informing local policy initiatives.
WHO CRA methodology was adopted using exposure data from a local lifestyle survey, disease risk factor relationships published by the WHO and local mortality data to calculate risk factor attributable deaths and years of life lost (YLL).
Smoking remains by far the leading cause of deaths followed by overweight and obesity and low fruit and vegetable intake. Alcohol ranked last by number of deaths, but second by YLL indicating its high contribution to deaths at younger ages.
We have demonstrated the utility of WHO CRA methodology to influence health-related policy-making at a local level. Primary prevention should remain high on the agenda of government initiatives to reduce the future burden of ill health. Future research in this area could look at more in-depth national data to cover a wider range of risk factors addressing some of the methodological and data shortcomings identified in this study.
本研究旨在使用世界卫生组织(WHO)的相对风险评估(CRA)方法量化和比较英国初级保健信托基金会( Wirral )中五种主要与生活方式相关的风险因素的疾病负担,以展示其为当地政策举措提供信息的实用价值。
采用 WHO CRA 方法,使用当地生活方式调查的暴露数据、WHO 发布的疾病风险因素关系以及当地死亡率数据,计算风险因素归因死亡人数和生命损失年数(YLL)。
吸烟仍然是导致死亡的主要原因,其次是超重和肥胖以及水果和蔬菜摄入量低。酒精在死亡人数方面排名最后,但在 YLL 方面排名第二,表明其对年轻人的死亡贡献较高。
我们已经证明了 WHO CRA 方法在影响当地健康相关政策制定方面的实用性。初级预防应继续成为政府减少未来健康不良负担的议程上的首要事项。该领域的未来研究可以使用更深入的全国数据来涵盖更广泛的风险因素,以解决本研究中确定的一些方法和数据缺陷。