Abstract

Since 1990 and for the first time in the history of human civilization, most newborns have very high chance to live their adult life for more than 65 years and beyond. With the global population experiencing extra years of life, the wellbeing of older adults is paramount. However, if added years are spent in poor health, national health systems will face increased pressure and healthcare expenses. The Global Burden of Diseases, Injuries and Risk Factors 2019 (GBD 2019) used health data from 204 countries (1990-2019) for adults aged more than 70 years old. The report measured health risk factors for diseases, mortality and disability, years of life lost, years lived with disability and disability adjusted life years (DALY) and other trends. In the 20th century communicable diseases were predominant, known as infectious or transmissible diseases. These diseases were the result of viral infections pathogenic biologic agents (chickenpox/shingles, influenza, hepatitis, tuberculosis, HIV/AIDS, Covid-19, etc). But in the 21st century the leading causes of death worldwide change into non communicable diseases, such as heart disease (cardiovascular), cancer, chronic respiratory disease, diabetes, osteoarthritis, Alzheimer’s disease, etc. These diseases represent the emerging global health threats. Traditional risk factors were related to poverty (malnutrition, poor hygiene, malaria) affecting mostly low-income people in developing countries (lack of safe drinking water, poor hygiene, indoor air pollution. etc). Modern risk factors, are connected with modern ways of living in urban areas, caused by technological and industrial developments. The Global Burden of Disease (GBD) with the collection of global data for leading causes, risk factors and attributable deaths cleared misunderstandings of people for the connection of disease and deaths in global scale. GBD in the last 20 years found that the leading risk factors are: high blood pressure (hypertension, heart diseases), tobacco use, high blood glucose (diabetes), overweight-obesity, lack of physical activity, low of fruit and vegetable intake, high cholesterol (cardiovascular diseases), alcohol use, unsafe sex, indoor air pollution and ambient air pollution, vitamin, iron and zinc deficiencies, unsafe water, sanitation and hygiene, etc. Also, in the GBD report (2019), researchers collected data for the leading global risks for burden of disease as measured in disability-adjusted life years (DALYs), a time-based measure that combines years of life lost due to premature mortality and years of life lost due to time lived in states of less than full health, or years of healthy life lost due to disability. The most important risk factors for DALYs were: underweight (malnutrition), high systolic blood pressure, unsafe sex, alcohol use, unsafe water, sanitation and hygiene, high body mass index (BMI), dietary risks, low intake of fruit and vegetables, obesity, physical inactivity, low bone mineral density, kidney dysfunction, etc. This review covers the GBD reports of the last 20 years and the main conclusions. GBDs provided support for the medical authorities to be prepared for the spectrum of attributable health risk factors and the preventative actions to be undertaken from people on the dangers of hazardous lifestyle habits.

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