Measuring the health of populations

Over the last two decades, the global health landscape has undergone rapid transformation. People around the world are living longer than ever before, and populations are getting older. Many countries have made remarkable progress in preventing child deaths. As a result, disease burden is increasingly defined by disability as opposed to being dominated by premature mortality. The leading causes of death and disability are shifting from communicable diseases in children to non-communicable diseases in adults. These global trends differ across regions and by level of development. Notably, in sub-Saharan Africa, communicable, maternal, and newborn diseases and nutritional deficiencies continue to dominate. While low- and middle-income countries are tackling this ‘unfinished agenda’ of largely poverty-related diseases, increasingly they also need to prepare their health services for a growing burden of non-communicable diseases and injuries. In high-income countries, health budgets are steadily increasing relative to gross domestic product due to ageing of the population, an ever-expanding array of medical technologies, and greater demands of consumers for healthcare services. For governments and other healthcare providers to be able to respond to these challenges, high-quality comparable data on the size and trends in mortality and morbidity are essential. In 2007, the Bill & Melinda Gates Foundation funded the Global Burden of Diseases, Injuries, and Risk Factors Study 2010, which endeavoured to rethink methods and assumptions underlying population health measurement while making use of the vastly improved health data and computational resources. This chapter describes the methods underlying the Global Burden of Disease (GBD) study.