scholarly journals Health impact of substituting red meat by fish: addressing variability in risk-benefit assessments

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S T Thomsen ◽  
W de Boer ◽  
S M Pires ◽  
B Devleesschauwer ◽  
S Fagt ◽  
...  
Keyword(s):  
Public Health ◽  
Health Gain ◽  
Health Impact ◽  
Red Meat ◽  
Disability Adjusted Life Years ◽  
Childbearing Age ◽  
Health Loss ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Public Health Strategies

Abstract Background Sufficient intake of fish and limited red meat intake is commonly encouraged by national dietary guidelines to prevent various lifestyle diseases. One way to fulfill these guidelines would be to substitute red meat by fish. However, quantitative evidence of the public health gain of such substitution is lacking. Moreover, contaminants in these foods may compromise nutritional benefits. We aimed to estimate the health impact of substituting red meat by fish in the Danish diet in a risk-benefit assessment (RBA). Our study can support policy makers in defining evidence-based public health strategies. Methods We quantified the health impact of substituting red meat by fish among Danish adults in terms of Disability-Adjusted Life Years (DALY) using data from a national dietary survey and food monitoring. We investigated the use of probabilistic methods to model variability in individual substitution behaviors and to assess health impact distributions in RBA of food. Results Health impact of the substitution varied largely by the type of fish consumed and by age and sex of the consumer. We estimated that 134 (95% uncertainty interval: 102; 169) DALYs/100,000 could be averted per year if a mix of lean and fatty fish is consumed in the Danish recommended amounts and intake of red meat decreased among Danish adults. The highest benefit was estimated for women in the childbearing age and for men above 50 years of age. However, a small fraction of women were assigned an overall health loss due to methylmercury exposure during pregnancy and the associated adverse effects in unborn children. Conclusions Our study estimated an overall health gain of substituting red meat by fish in the general Danish adult population, while providing insight in the variability in health impact at the level of individual consumers. Our approach can be applied in other RBAs and the results support the need for targeted public health strategies to ensure consumer health and safety. Key messages The health impact of substituting red meat by fish in Danish adults was quantified in terms of disability-adjusted life years (DALYs), while accounting for variability between individuals. We estimated that young women and men above 50 years of age will experience the largest health gain while a small fraction of the women were assigned a health loss due to chemical exposure.

scholarly journals Inequalities in population health loss by multiple deprivation: COVID-19 and pre-pandemic all-cause disability-adjusted life years (DALYs) in Scotland

2021 ◽  
Author(s):  
Grant Mark Andrew Wyper ◽  
Eilidh Fletcher ◽  
Ian Grant ◽  
Oliver Harding ◽  
Maria Teresa de Haro Moro ◽  
...  
Keyword(s):  
Population Health ◽  
Health Inequalities ◽  
Burden Of Disease ◽  
Health Impact ◽  
Disability Adjusted Life Years ◽  
Multiple Deprivation ◽  
Health Loss ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Index Of Inequality

Background: COVID-19 has caused almost unprecedented change across health, education, the economy and social interaction. It is widely understood that the existing mechanisms which shape health inequalities have resulted in COVID-19 outcomes following this same, familiar, pattern. Our aim was to estimate inequalities in the population health impact of COVID-19 in Scotland, measured by disability-adjusted life years (DALYs) in 2020. These were scaled against pre-pandemic inequalities in DALYs combined across all causes, derived from the Scottish Burden of Disease (SBoD) study.Methods: National deaths and daily case data were input into the European Burden of Disease Network consensus model to estimate DALYs. Total Years of Life Lost (YLL) were estimated for each area-based deprivation quintile of the Scottish population. Years Lived with Disability were proportionately distributed to deprivation quintiles, based on YLL estimates. Inequalities were measured by: the range, Relative Index of Inequality (RII), Slope Index of Inequality (SII), and attributable DALYs were estimated by using the least deprived quintile as a reference. Overall, and inequalities in, COVID-19 DALYs were scaled against pre-pandemic estimates of inequalities across all causes from the SBoD study.Results: Marked inequalities were observed across several measures. The SII was 2,048–2,289 COVID-19 DALYs per 100,000 population. The RII was 1.16, meaning that the rate in the most deprived areas was around 58% higher than the mean population rate, with 40% of COVID-19 DALYs attributed to differences in area-based deprivation. Overall DALYs due to COVID-19 ranged from 7–20% of the annual pre-pandemic impact of inequalities in health loss combined across all causes.Conclusion: The substantial population health impact of COVID-19 in Scotland was not shared equally across areas experiencing different levels of deprivation. The extent of inequality due to COVID-19 was similar to averting all annual DALYs due to diabetes. In the wider context of population health loss, overall ill-health and mortality due to COVID-19 was, at most, a fifth of the annual population health loss due to inequalities in multiple deprivation. Implementing effective policy interventions to reduce health inequalities must be at the forefront of plans to recover and improve population health.

scholarly journals Inequalities in population health loss by multiple deprivation: COVID-19 and pre-pandemic all-cause disability-adjusted life years (DALYs) in Scotland

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Grant M. A. Wyper ◽  
Eilidh Fletcher ◽  
Ian Grant ◽  
Oliver Harding ◽  
Maria Teresa de Haro Moro ◽  
...  
Keyword(s):  
Population Health ◽  
Health Inequalities ◽  
Burden Of Disease ◽  
Health Impact ◽  
Disability Adjusted Life Years ◽  
Multiple Deprivation ◽  
Health Loss ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Index Of Inequality

Abstract Background COVID-19 has caused almost unprecedented change across health, education, the economy and social interaction. It is widely understood that the existing mechanisms which shape health inequalities have resulted in COVID-19 outcomes following this same, familiar, pattern. Our aim was to estimate inequalities in the population health impact of COVID-19 in Scotland, measured by disability-adjusted life years (DALYs) in 2020. Our secondary aim was to scale overall, and inequalities in, COVID-19 DALYs against the level of pre-pandemic inequalities in all-cause DALYs, derived from the Scottish Burden of Disease (SBoD) study. Methods National deaths and daily case data were input into the European Burden of Disease Network consensus model to estimate DALYs. Total Years of Life Lost (YLL) were estimated for each area-based deprivation quintile of the Scottish population. Years Lived with Disability were proportionately distributed to deprivation quintiles, based on YLL estimates. Inequalities were measured by: the range, Relative Index of Inequality (RII), Slope Index of Inequality (SII), and attributable DALYs were estimated by using the least deprived quintile as a reference. Results Marked inequalities were observed across several measures. The SII range was 2048 to 2289 COVID-19 DALYs per 100,000 population. The rate in the most deprived areas was around 58% higher than the mean population rate (RII = 1.16), with 40% of COVID-19 DALYs attributed to differences in area-based deprivation. Overall DALYs due to COVID-19 ranged from 7 to 20% of the annual pre-pandemic impact of inequalities in health loss combined across all causes. Conclusion The substantial population health impact of COVID-19 in Scotland was not shared equally across areas experiencing different levels of deprivation. The extent of inequality due to COVID-19 was similar to averting all annual DALYs due to diabetes. In the wider context of population health loss, overall ill-health and mortality due to COVID-19 was, at most, a fifth of the annual population health loss due to inequalities in multiple deprivation. Implementing effective policy interventions to reduce health inequalities must be at the forefront of plans to recover and improve population health.

Identifying Public Health Problems

2018 ◽  
Author(s):  
Scott Burris ◽  
Micah L. Berman ◽  
Matthew Penn, and ◽  
Tara Ramanathan Holiday
Keyword(s):  
Public Health ◽  
Health Problems ◽  
Health Priorities ◽  
Disability Adjusted Life Years ◽  
Quality Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Study Designs ◽  
Quality Adjusted Life

Chapter 5 discusses the use of epidemiology to identify the source of public health problems and inform policymaking. It uses a case study to illustrate how researchers, policymakers, and practitioners detect diseases, identify their sources, determine the extent of an outbreak, and prevent new infections. The chapter also defines key measures in epidemiology that can indicate public health priorities, including morbidity and mortality, years of potential life lost, and measures of lifetime impacts, including disability-adjusted life years and quality-adjusted life years. Finally, the chapter reviews epidemiological study designs, differentiating between experimental and observational studies, to show how to interpret data and identify limitations.

scholarly journals Control of snakebite envenoming: A mathematical modeling study

2021 ◽  
Vol 15 (8) ◽  
pp. e0009711
Author(s):  
Shuaibu Ahijo Abdullahi ◽  
Abdulrazaq Garba Habib ◽  
Nafiu Hussaini
Keyword(s):  
Public Health ◽  
Cost Effectiveness ◽  
Control Strategies ◽  
Real Data ◽  
Disability Adjusted Life Years ◽  
Health Awareness ◽  
Data Set ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The Impact

A mathematical model is designed to assess the impact of some interventional strategies for curtailing the burden of snakebite envenoming in a community. The model is fitted with real data set. Numerical simulations have shown that public health awareness of the susceptible individuals on snakebite preventive measures could reduce the number of envenoming and prevent deaths and disabilities in the population. The simulations further revealed that if at least fifty percent of snakebite envenoming patients receive early treatment with antivenom a substantial number of deaths will be averted. Furthermore, it is shown using optimal control that combining public health awareness and antivenom treatment averts the highest number of snakebite induced deaths and disability adjusted life years in the study area. To choose the best strategy amidst limited resources in the study area, cost effectiveness analysis in terms of incremental cost effectiveness ratio is performed. It has been established that the control efforts of combining public health awareness of the susceptible individuals and antivenom treatment for victims of snakebite envenoming is the most cost effective strategy. Approximately the sum of US$72,548 is needed to avert 117 deaths or 2,739 disability adjusted life years that are recorded within 21 months in the study area. Thus, the combination of these two control strategies is recommended.

Warum ist die „Anzahl vorzeitiger Todesfälle durch Umweltexpositionen“ nicht angemessen quantifizierbar?

2019 ◽  
Vol 81 (02) ◽  
pp. 144-149
Author(s):  
Peter Morfeld ◽  
Thomas Erren
Keyword(s):  
Public Health ◽  
Burden Of Disease ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years

ZusammenfassungIn epidemiologischen Studien und deren Anwendung bei Schadstoffregulierungen (z. B. durch WHO, USA, EU) werden Wirkungen von Umweltexpositionen auf Bevölkerungen („Burden Of Disease“, „Krankheitslast“) oft mittels der verursachten „Anzahl vorzeitiger Todesfälle“, d. h. der durch die Exposition zeitlich vorverlagerten Todesfälle, quantifiziert. Ein aktuelles Beispiel ist die Studie von Schneider et al. zu Krankheitslasten durch Stickstoffdioxid (NO2)-Exposition in Deutschland, durchgeführt im Auftrag des Umweltbundesamtes. Die Autoren ermittelten den Anteil der durch die Exposition verursachten vorzeitigen Todesfälle mittels der „Attributablen Fraktion“ (AF). Gleichwohl können die wahren Zahlen vorzeitiger Todesfälle durch NO2 viel größer oder kleiner sein. Tatsächlich hatten Robins und Greenland bereits 1989 gezeigt, dass der AF-Ansatz nicht angemessen ist. Trotz der weitreichenden Bedeutung für Epidemiologie und Public Health wurde ihre wegweisende Arbeit nicht adäquat berücksichtigt, möglicherweise aufgrund der anspruchsvollen mathematischen Argumentation. Unser Beitrag erläutert – mit einfachen Methoden – unbeachtete aber bedeutende Fallstricke. Wir empfehlen, auf das Konzept der „Anzahl vorzeitiger Todesfälle“ zu verzichten und stattdessen die durch die Exposition verlorene Lebenszeit anzugeben, berechnet pro Person. Diese sollte aber nicht für unterschiedliche Todesursachen (Erkrankungen) und/oder Altersverteilungen aufgeschlüsselt werden. Wir zeigen zudem, dass „Disability Adjusted Life Years“ (DALY) kein angemessenes Maß sind, um Expositionswirkungen in der Bevölkerung zu bewerten.

scholarly journals Disability-adjusted life years associated with population ageing in China, 1990-2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruotong Li ◽  
Xunjie Cheng ◽  
David C. Schwebel ◽  
Yang Yang ◽  
Peishan Ning ◽  
...  
Keyword(s):  
Control Strategies ◽  
Population Ageing ◽  
Chronic Obstructive ◽  
Years Of Life Lost ◽  
Disability Adjusted Life Years ◽  
Obstructive Pulmonary Disease ◽  
Health Loss ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The Government

Abstract Background The Chinese population has aged significantly in the last few decades. Comprehensive health losses including both fatal and non-fatal health outcomes associated with ageing in China have not been detailed. Methods Based on freely accessible disability adjusted life years (DALYs) estimated by the Global Burden of Diseases (GBD) 2017, we adopted a robust decomposition method that ascribes changes in DALYs in any given country across two time points to changes resulting from three sources: population size, age structure, and age-specific DALYs rate per 100,000 population. Using the method, we calculated DALYs associated with population ageing in China from 1990 to 2017 and examined the counteraction between the effects of DALYs rate change and population ageing. This method extends previous work through attributing the change in DALYs to the three sources. Results Population ageing was associated with 92.8 million DALYs between 1990 and 2017 in China, of which 65.8% (61.1 million) were years of life lost (YLLs). Males had comparatively more DALYs associated with population ageing than females in the study period. The five leading causes of DALYs associated with population ageing between 1990 and 2017 were stroke (23.6 million), chronic obstructive pulmonary disease (COPD) (18.3 million), ischemic heart disease (13.0 million), tracheal, bronchus, and lung cancer (6.1 million) and liver cancer (5.0 million). Between 1990 and 2017, changes in DALYs associated with age-specific DALY rate reductions far exceeded those related to population ageing (− 196.2 million versus 92.8 million); 57.5% (− 112.8 million) of DALYs were caused by decreases in rates attributed to 84 modifiable risk factors. Conclusion Population ageing was associated with growing health loss in China from 1990 to 2017. Despite the recent progress in alleviating health loss associated with population ageing, the government should encourage scientific research on effective and affordable prevention and control strategies and should consider investment in resources to implement strategies nationwide to address the future challenge of population ageing.

scholarly journals Population health, economics and ethics in the age of COVID-19

2020 ◽  
Vol 5 (7) ◽  
pp. e003259 ◽  
Author(s):  
Sanjay G Reddy
Keyword(s):  
Public Health ◽  
Population Health ◽  
Disability Adjusted Life Years ◽  
Quality Adjusted Life Years ◽  
Health Measures ◽  
Balanced Approach ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Aggregate Population ◽  
Quality Adjusted Life

Are the steps that have been taken to arrest the spread of COVID-19 justifiable? Specifically, are they likely to have improved public health understood according to widely used aggregate population health measures, such as Quality Adjusted Life Years (QALYs) and Disability Adjusted Life Years (DALYs) as much or more than alternatives? This is a reasonable question, since such measures have been promoted extensively in global and national health policy by influential actors, and they have become almost synonymous with quantification of public health. If the steps taken against COVID-19 did not meet this test, then either the measures or the policies must be re-evaluated. There are indications that policies against COVID-19 may have been unbalanced and therefore not optimal. A balanced approach to protecting population health should be proportionate in its effects across distinct health concerns at a moment, across populations over time and across populations over space. These criteria provide a guide to designing and implementing policies that diminish harm from COVID-19 while also providing due attention to other threats to aggregate population health. They should shape future policies in response to this pandemic and others.

scholarly journals Antidepressants and public health in Iceland

2004 ◽  
Vol 184 (2) ◽  
pp. 157-162 ◽  
Author(s):  
Tómas Helgason ◽  
Helgi Tómasson ◽  
Tómas Zoëga
Keyword(s):  
Public Health ◽  
Depressive Disorders ◽  
Hospital Admissions ◽  
Adult Population ◽  
Health Impact ◽  
The Public ◽  
Admission Rates ◽  
Outpatient Visits ◽  
Disability Adjusted Life ◽  
Life Years

BackgroundMajor depressive disorder is the second leading cause of disability-adjusted life-years in developed regions of the world and antidepressants are the third-ranking therapy class worldwide.AimsTo test the public health impact of the escalating sales of antidepressants.MethodNationwide data from Iceland are used as an example to study the effect of sales of antidepressants on suicide, disability, hospital admissions and outpatient visits.ResultsSales of antidepressants increased from 8.4 daily defined doses per 1000 inhabitants per day in 1975 to 72.7 in 2000, which is a user prevalence of 8.7% for the adult population. Suicide rates fluctuated during 1950–2000 but did not show any definite trend. Rates for outpatient visits increased slightly over the period 1989–2000 and admission rates increased even more. The prevalence of disability due to depressive and anxiety disorders has not decreased over the past 25 years.ConclusionsThe dramatic increase in the sales of antidepressants has not had any marked impact on the selected public health measures. Obviously, better treatment for depressive disorders is still needed in order to reduce the burden caused by them.

scholarly journals The estimated disease burden of acute COVID-19 in the Netherlands in 2020, in disability-adjusted life-years

2021 ◽  
Author(s):  
Scott A. McDonald ◽  
Giske R. Lagerweij ◽  
Pieter de Boer ◽  
Hester E. de Melker ◽  
Roan Pijnacker ◽  
...  
Keyword(s):  
Public Health ◽  
The Netherlands ◽  
Disease Burden ◽  
Years Of Life Lost ◽  
Age Group ◽  
Disability Adjusted Life Years ◽  
Health Burden ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Per Capita

Abstract Background. The impact of the COVID-19 pandemic on population health is recognised as being substantial, yet few studies have attempted to quantify to what extent infection causes mild or moderate symptoms only, requires hospital and/or intensive care unit (ICU) admission, results in prolonged and chronic illness, or leads to premature death. Our objectives were to quantify the total disease burden of acute COVID-19 in the Netherlands in 2020 using the disability-adjusted life-years (DALY) measure, and to investigate how disease burden varies between age-groups and occupation categories.Methods. Using standard methods and diverse data sources (registered COVID-19 deaths, hospital and ICU admissions, population-level seroprevalence, mandatory notifications, and the literature) , we estimated the total years of life lost (YLL), years lived with disability (YLD), DALY and DALY per 100,000 population due to COVID-19, excluding its post-acute sequelae, and additionally stratified by 5-year age-group and occupation.Results. The total disease burden in the Netherlands in 2020 due to acute COVID-19 was 273,500 (95% CI: 268,500–278,800) DALY, and the per-capita burden was 1570 (95% CI: 1540–1600) DALY/100,000, of which 99.4% consisted of YLL. The per-capita burden increased steeply with age, starting from the 60-64 years age-group. The per-capita burden by occupation category was highest for healthcare workers and lowest for the catering sector.Conclusions. SARS-CoV-2 infection and associated premature mortality was responsible for a considerable direct health burden in the Netherlands, despite extensive public health measures. Total DALY were much higher than for other high-burden infectious diseases, but lower than the estimated annual burden from coronary heart disease. These findings are valuable for informing public health decision-makers regarding the expected health burden due to COVID-19 among subgroups of the population, and the possible gains from targeted preventative interventions.

Burden of Traumatic Brain Injury in New Zealand: Incidence, Prevalence and Disability-Adjusted Life Years

2015 ◽  
Vol 44 (4) ◽  
pp. 255-261 ◽  
Author(s):  
Braden Te Ao ◽  
Martin Tobias ◽  
Shanthi Ameratunga ◽  
Kathryn McPherson ◽  
Alice Theadom ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
New Zealand ◽  
Brain Injury ◽  
Population Data ◽  
Disability Adjusted Life Years ◽  
Mild Tbi ◽  
Health Loss ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Incidence Prevalence

Objective: The study aimed to estimate the incidence, prevalence and disability-adjusted life years (DALY) for traumatic brain injury (TBI) in New Zealand (NZ) in 2010. Methods: A multi-state life table model was constructed using inputs from the Brain Injury Outcomes New Zealand in the Community study for the first-ever incidence of TBI in a lifetime and its severity distribution, from the NZ Ministry of Health's Mortality Collection for the data on TBI mortality and from Statistics of NZ for the population data. The modeled estimate of prevalence was combined with the disability weights for TBI (by stage and severity level) from the Global Burden of Disease 2010 study to obtain estimates of health loss (DALYs) for TBI. Results: Approximately, 11,300 first-ever incident TBIs occurred in NZ during 2010, with 527,000 New Zealanders estimated to have ever experienced a TBI (prevalent cases). The estimated 20,300 DALYs attributable to TBI accounted for 27% of total injury-related health loss and 2.4% of DALYs from all causes. Of the total DALYs attributable to TBI, 71% resulted from fatal injuries. However, non-fatal outcomes accounted for a substantial share of the burden (29%) with mild TBI making the greater contribution of non-fatal outcomes (56%). Conclusions: The burden of TBI in NZ is substantial, and mild TBI contributes to a major part of non-fatal outcomes.

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