Jeffrey Bland, PhD, presents a short commentary on the book Epic Measures by Dr. Christopher Murray and the Global Burden of Disease (GBD) work, highlighting a recent Lancet article that reports GBD 2013 results (incidence/prevalence and years lived with disability for 301 conditions across 188 countries, 1990–2013). Bland emphasizes that while mortality has declined, years lived with disability are falling more slowly due to a global rise in chronic non-infectious diseases (diabetes, heart disease, arthritis, renal failure), now spreading into low- and middle-income countries. He argues the solutions will depend less on drugs/surgery and more on personalized lifestyle medicine, endorsing Epic Measures and the GBD findings as important evidence.
Chapters
Epic Measures, a remarkable title for a remarkable book. A book that is really a frame shifter in terms of the way it has us understand the global burden of disease and what's going on really in health, not only just in the United States, but the whole world. This is a book about Dr. Christopher Murray, a remarkable gentleman, medical doctor and also an economist who is by all reports, really one of the world's leaders in public health and has been the spearhead of a Gates foundation funded consortium, a global consortium to try to assemble the first database of accurate information that relates to quality of life years lost due to disability as well as the causes of death in various countries. His point, as described in the book is beyond that of death certificates, is to ask what happens to people as they become chronically ill in terms of their disability or quality of life years lost. And that is a whole different way of looking at health of the world and individual countries. And this particular data that comes from multiple practitioners, multiple experts in the field, actually hundreds of different experts who have assembled and compiled this information is the basis of, for the underpinning of this book. Now, how does that relate to what's just gone on this week? This week, the Lancet magazine. In fact, in all of my years of reading the Lancet, I don't recall ever seeing one issue that is dedicated basically to one article. It's not a special issue. This is a one article issue of the Lancet. And what do you think that article is all about? It's all about the most recent database and association of understanding of this Quality of Life Years Lost and Disability Index. This article which you'll see is basically the substance of this issue. The journal which is entitled Global, Regional and National Incidence Prevalence in Years Lived with disability for 301 acute and chronic diseases and injuries in 188 countries from 1990 to 2013. A systematic analysis of the Global Burden of Disease Study, 2013. This is Tour de force. This is an unbelievably important bit of work. And in this issue is a foldout that goes through all of these countries and graphically defines the disability years life lost as a consequence of different conditions. Those conditions can be as far ranging as death due to war to death due to chronic illnesses like diabetes. And in fact, what is the ultimate takeaway from all of this? If we were to summarize down into a sound bite, which is not fair when we really think of the weight of this information and the extraordinary diversity of conclusion can be derived from it, I think the central, most important kind of sound bite is really discussed in the interpretation of this article. They go on to say aging the world's population is leading to a substantial increase in the number of individual individuals with a sequelae of diseases and injuries. And the years of quality life lost due to disability are declining much more slowly than is the mortality rate in the world. And this is a consequence of the rising tide of chronic metabolic diseases, non infectious diseases, that is cutting across all countries of the world. Not just seen in the developed United States and Canada and Europe, but in the developing world. It's rising at epidemic proportion. These non infectious chronic diseases of diabetes, of heart disease, of arthritis, of renal failure and so forth. And so what we are seeing is an exporting from the western world of these chronic non infectious diseases to the rest of the world, for which there is a lower level of medical technology, lower levels of pharmaceutical science available and a tremendous new rising tide of concern. The solution to these are going to reside not in drugs and surgery, but in personalized lifestyle medicine. And that's the reason that we feel that our personalized Lifestyle Medicine Institute is timely. It's pressing it, it's right at the cornerstone of what is really happening as it pertains to the opportunity to address this particular rising burden of disease in a way that's really going to make a difference. So I urge look at the Lancet and certainly read the book. Epic measures powerful information.
