Shifting Patterns of Morbidity and Mortality in the Developing.ppt

Shifting Patterns of Morbidity and Mortality in the Developing World
Calvin L. Wilson MD
Director – Center for Global Health
University of Colorado Denver
Presenter Disclosures
The following personal financial relationships mercial interests relevant to this presentation existed during the past 12 months:
Calvin L. Wilson MD
No relationships to disclose
Objectives
Understand past and current patterns of morbidity and mortality around the world
Discuss the epidemiologic and demographic transitions taking place, and propose some possible determinants of this change
Review potential health system strategies needed to deal with this challenge
Definitions
Levels of development traditionally expressed in economic terms (World Bank), rather than human or system development
Developing countries (“majority world”) – GNI < $4000 (Low e – GNI < $975)
Developed countries (“Western/Industrialized world”) – GNI > $12,000
“Upper Middle e” countries – GNI $4000 - $12,000
Mortality – Global Picture
Cause of Death
USA (2002)
Jordan (2002)
Kazakhstan (2002)
Nepal (2002)
Nigeria (2005)
Cardiovascular Disease
38%
32%
53%
21%
11%
Cancer
23%
14%
13%
7%
4%
Chronic Resp. Disease
8%
3%
4%
5%
3%
Diabetes
3%
1%
1%
2%
1%
Other Chronic Diseases
16%
15%
8%
7%
5%
Communicable, Preventable
6%
19%
8%
49%
69%
Injuries
6%
16%
13%
9%
7%
WHO
Mortality – Global Picture
Cause of Death
High e (2005)
Low e (2003)
Cardiovascular Disease
38%
23%
Cancer
26%
7%
Chronic Resp. Disease
6%
5%
Diabetes
3%
1%
Other Chronic Diseases
14%
7%
Communicable, Preventable
7%
48%
Injuries
6%
9%
WHO
Life Expectancy
LaPorte, Ronald, Epidemiologic Transition, ercourse/
Life ExpectancyExample - Egypt
20
Years
5
Years
LaPorte, Ronald, Epidemiologic Transition, ercourse/
Epidemiologic Transition
Shift from one pattern of morbidity and mortality to another
Transition from diseases of “Developing” world to those “Developed” world
Most clearl