British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7DQ, UK.
J Public Health (Oxf). 2017 Dec 1;39(4):698-703. doi: 10.1093/pubmed/fdx008.
Non-communicable diseases (NCDs) have slowly risen to the top of the global health agenda and the reduction of premature NCD mortality was recently enshrined in Target 3.4 of the UN Sustainable Development Goals. The unequal global distribution of NCDs is inadequately captured by the most commonly cited statistics.
We analyzed 'WHO Global Health Estimates' mortality data to calculate the relative burden of NCDs for each World Bank income group, including the 'risk of premature NCD death' based on methods in the WHO Global Status Report. We included all deaths from cardiovascular disease, all cancers, respiratory diseases and diabetes in people aged 30-69 years.
Developing countries experience 82% of absolute global premature NCD mortality, but they also contain 82% of the world's population. Examining relative risk shows that individuals in developing countries face a 1.5 times higher risk of premature NCD death than people living in high-income countries. Premature NCD death rates are highest in lower middle-income countries.
Although numbers of deaths are useful to describe the absolute burden of NCD mortality by country type, the inequitable distribution of premature NCD mortality for individuals is more appropriately conveyed with relative risk.
非传染性疾病(NCDs)逐渐成为全球卫生议程的首要议题,最近将减少 NCD 过早死亡率纳入联合国可持续发展目标的目标 3.4。最常引用的统计数据不能充分反映 NCD 在全球的不平等分布情况。
我们分析了“世卫组织全球卫生估计”死亡率数据,以计算每个世界银行收入组的 NCD 相对负担,包括根据世卫组织全球状况报告中的方法计算的“NCD 过早死亡风险”。我们将 30-69 岁人群中的心血管疾病、所有癌症、呼吸道疾病和糖尿病导致的所有死亡都包括在内。
发展中国家承担着全球 82%的 NCD 过早死亡绝对人数,但却容纳了全球 82%的人口。从相对风险来看,发展中国家的人面临 NCD 过早死亡的风险比高收入国家的人高 1.5 倍。NCD 过早死亡率最高的是中低收入国家。
尽管死亡人数有助于按国家类型描述 NCD 死亡率的绝对负担,但个体 NCD 过早死亡率的不平等分布情况更适合用相对风险来表示。