It may not come as a big surprise
that our views on health today differ radically from the key issues considered
20 years ago. Although past studies always have reflected the needs of the
zeitgeist they were conducted in, no large-scale studies have considered the
impact of these shifts on the health landscape in total. Now, an international
study covering 302 institutions from 50 countries, has resulted in a triple
issue of The Lancet devoted to discussing
what health is today.
The study was funded by the World
Bank and the Bill and Melinda Gates Foundation, and was a collaborative effort
between the University of Queensland, Harvard School of Public Health, the
Johns Hopkins Bloomberg School of Public Health, the University of Tokyo,
Imperial College London, and the World Health Organization.
During the course of the study
the researchers utilised a wide range of data, including data from surveys,
censuses and registration systems. In addition to that, all randomised
controlled trials were subject to an in-depth meta-analysis. All of this
information was then put into a database that covered a wide range of conditions
from AIDS to zinc deficiencies. The data were then further analysed to see
whether they would fit criteria set by the committee, such as excluding data
that may have been too specific to a time and place. The final findings, which
were developed from statistical modelling, were so widespread that 650 million
estimates were generated for both small and large health challenges.
One of the key interpretations of
the findings indicated that although mortality has decreased, individuals now
appear to live longer but be less healthy. For instance, malnutrition appears
to have decreased by two thirds whereas dietary risk factors and physical
inactivity collectively caused 10% of the disease burden directly or
indirectly. Heart disease, stroke, high blood pressure, smoking and alcohol
were seen as the leading risk factors for premature death or disability.
What is remarkable about this
study is not the findings, as it could be argued that they confirm what many
people already have suspected with regards to modern health, but due to a range
of factors, individuals may not attempt to not change these behaviours to
affect a different outcome.
What intrigues us about the study is the impact it will have
on the research community. Establishing a database of this magnitude has not
been accomplished in the past, and it is bound to illuminate areas where
research is lacking.