Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
Background: The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global...
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| Online Access: | http://dx.doi.org/10.1016/S2214-109X(16)30168-1 http://www.sciencedirect.com/science/article/pii/S2214109X16301681 http://hdl.handle.net/10576/4893 |
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| author | Mokdad, Ali H |
| author2 | Forouzanfar, Mohammad Hossein Daoud, Farah El Bcheraoui, Charbel Moradi-Lakeh, Maziar Khalil, Ibrahim Afshin, Ashkan Tuffaha, Marwa Charara, Raghid Barber, Ryan M Wagner, Joseph Cercy, Kelly Kravitz, Hannah Coates, Matthew M Robinson, Margaret Estep, Kara Steiner, Caitlyn Jaber, Sara Mokdad, Ali A O'Rourke, Kevin F Chew, Adrienne Kim, Pauline El Razek, Mohamed Magdy Abd Abdalla, Safa Abd-Allah, Foad Abraham, Jerry P Abu-Raddad, Laith J Abu-Rmeileh, Niveen M E Al-Nehmi, Abdulwahab A Akanda, Ali S Al Ahmadi, Hanan Al Khabouri, Mazin J Al Lami, Faris H Al Rayess, Zulfa A Alasfoor, Deena AlBuhairan, Fadia S Aldhahri, Saleh F Alghnam, Suliman Alhabib, Samia Al-Hamad, Nawal Ali, Raghib Ali, Syed Danish Alkhateeb, Mohammad AlMazroa, Mohammad A Alomari, Mahmoud A Al-Raddadi, Rajaa Alsharif, Ubai Al-Sheyab, Nihaya Alsowaidi, Shirina Al-Thani, Mohamed Altirkawi, Khalid A Amare, Azmeraw T Amini, Heresh Ammar, Walid Anwari, Palwasha Asayesh, Hamid Asghar, Rana Assabri, Ali M Assadi, Reza Bacha, Umar Badawi, Alaa Bakfalouni, Talal Basulaiman, Mohammed O Bazargan-Hejazi, Shahrzad Bedi, Neeraj Bhakta, Amit R Bhutta, Zulfiqar A Bin Abdulhak, Aref A Boufous, Soufiane Bourne, Rupert R A Danawi, Hadi Das, Jai Deribew, Amare Ding, Eric L Durrani, Adnan M Elshrek, Yousef Ibrahim, Mohamed E Eshrati, Babak Esteghamati, Alireza Faghmous, Imad A D Farzadfar, Farshad Feigl, Andrea B Fereshtehnejad, Seyed-Mohammad Filip, Irina Fischer, Florian Gankpé, Fortuné G Ginawi, Ibrahim Gishu, Melkamu Dedefo Gupta, Rahul Habash, Rami M Hafezi-Nejad, Nima Hamadeh, Randah R Hamdouni, Hayet Hamidi, Samer Harb, Hilda L Hassanvand, Mohammad Sadegh Hedayati, Mohammad T Heydarpour, Pouria Hsairi, Mohamed Husseini, Abdullatif Jahanmehr, Nader Jha, Vivekanand Jonas, Jost B Karam, Nadim E Kasaeian, Amir Kassa, Nega Assefa Kaul, Anil Khader, Yousef Khalifa, Shams Eldin A Khan, Ejaz A Khan, Gulfaraz Khoja, Tawfik Khosravi, Ardeshir Kinfu, Yohannes Defo, Barthelemy Kuate Balaji, Arjun Lakshmana Lunevicius, Raimundas Obermeyer, Carla Makhlouf Malekzadeh, Reza Mansourian, Morteza Marcenes, Wagner Farid, Habibolah Masoudi Mehari, Alem Mehio-Sibai, Abla Memish, Ziad A Mensah, George A Mohammad, Karzan A Nahas, Ziad Nasher, Jamal T Nawaz, Haseeb Nejjari, Chakib Nisar, Muhammad Imran Omer, Saad B Parsaeian, Mahboubeh Peprah, Emmanuel K Pervaiz, Aslam Pourmalek, Farshad Qato, Dima M Qorbani, Mostafa Radfar, Amir Rafay, Anwar Rahimi, Kazem Rahimi-Movaghar, Vafa Rahman, Sajjad Ur Rai, Rajesh K Rana, Saleem M Rao, Sowmya R Refaat, Amany H Resnikoff, Serge Roshandel, Gholamreza Saade, Georges Saeedi, Mohammad Y Sahraian, Mohammad Ali Saleh, Shadi Sanchez-Riera, Lidia Satpathy, Maheswar Sepanlou, Sadaf G Setegn, Tesfaye Shaheen, Amira Shahraz, Saeid Sheikhbahaei, Sara Shishani, Kawkab Sliwa, Karen Tavakkoli, Mohammad Terkawi, Abdullah S Uthman, Olalekan A Westerman, Ronny Younis, Mustafa Z El Sayed Zaki, Maysaa Zannad, Faiez Roth, Gregory A Wang, Haidong Naghavi, Mohsen Vos, Theo Al Rabeeah, Abdullah A Lopez, Alan D Murray, Christopher J L |
| author2_role | author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| author_facet | Mokdad, Ali H Forouzanfar, Mohammad Hossein Daoud, Farah El Bcheraoui, Charbel Moradi-Lakeh, Maziar Khalil, Ibrahim Afshin, Ashkan Tuffaha, Marwa Charara, Raghid Barber, Ryan M Wagner, Joseph Cercy, Kelly Kravitz, Hannah Coates, Matthew M Robinson, Margaret Estep, Kara Steiner, Caitlyn Jaber, Sara Mokdad, Ali A O'Rourke, Kevin F Chew, Adrienne Kim, Pauline El Razek, Mohamed Magdy Abd Abdalla, Safa Abd-Allah, Foad Abraham, Jerry P Abu-Raddad, Laith J Abu-Rmeileh, Niveen M E Al-Nehmi, Abdulwahab A Akanda, Ali S Al Ahmadi, Hanan Al Khabouri, Mazin J Al Lami, Faris H Al Rayess, Zulfa A Alasfoor, Deena AlBuhairan, Fadia S Aldhahri, Saleh F Alghnam, Suliman Alhabib, Samia Al-Hamad, Nawal Ali, Raghib Ali, Syed Danish Alkhateeb, Mohammad AlMazroa, Mohammad A Alomari, Mahmoud A Al-Raddadi, Rajaa Alsharif, Ubai Al-Sheyab, Nihaya Alsowaidi, Shirina Al-Thani, Mohamed Altirkawi, Khalid A Amare, Azmeraw T Amini, Heresh Ammar, Walid Anwari, Palwasha Asayesh, Hamid Asghar, Rana Assabri, Ali M Assadi, Reza Bacha, Umar Badawi, Alaa Bakfalouni, Talal Basulaiman, Mohammed O Bazargan-Hejazi, Shahrzad Bedi, Neeraj Bhakta, Amit R Bhutta, Zulfiqar A Bin Abdulhak, Aref A Boufous, Soufiane Bourne, Rupert R A Danawi, Hadi Das, Jai Deribew, Amare Ding, Eric L Durrani, Adnan M Elshrek, Yousef Ibrahim, Mohamed E Eshrati, Babak Esteghamati, Alireza Faghmous, Imad A D Farzadfar, Farshad Feigl, Andrea B Fereshtehnejad, Seyed-Mohammad Filip, Irina Fischer, Florian Gankpé, Fortuné G Ginawi, Ibrahim Gishu, Melkamu Dedefo Gupta, Rahul Habash, Rami M Hafezi-Nejad, Nima Hamadeh, Randah R Hamdouni, Hayet Hamidi, Samer Harb, Hilda L Hassanvand, Mohammad Sadegh Hedayati, Mohammad T Heydarpour, Pouria Hsairi, Mohamed Husseini, Abdullatif Jahanmehr, Nader Jha, Vivekanand Jonas, Jost B Karam, Nadim E Kasaeian, Amir Kassa, Nega Assefa Kaul, Anil Khader, Yousef Khalifa, Shams Eldin A Khan, Ejaz A Khan, Gulfaraz Khoja, Tawfik Khosravi, Ardeshir Kinfu, Yohannes Defo, Barthelemy Kuate Balaji, Arjun Lakshmana Lunevicius, Raimundas Obermeyer, Carla Makhlouf Malekzadeh, Reza Mansourian, Morteza Marcenes, Wagner Farid, Habibolah Masoudi Mehari, Alem Mehio-Sibai, Abla Memish, Ziad A Mensah, George A Mohammad, Karzan A Nahas, Ziad Nasher, Jamal T Nawaz, Haseeb Nejjari, Chakib Nisar, Muhammad Imran Omer, Saad B Parsaeian, Mahboubeh Peprah, Emmanuel K Pervaiz, Aslam Pourmalek, Farshad Qato, Dima M Qorbani, Mostafa Radfar, Amir Rafay, Anwar Rahimi, Kazem Rahimi-Movaghar, Vafa Rahman, Sajjad Ur Rai, Rajesh K Rana, Saleem M Rao, Sowmya R Refaat, Amany H Resnikoff, Serge Roshandel, Gholamreza Saade, Georges Saeedi, Mohammad Y Sahraian, Mohammad Ali Saleh, Shadi Sanchez-Riera, Lidia Satpathy, Maheswar Sepanlou, Sadaf G Setegn, Tesfaye Shaheen, Amira Shahraz, Saeid Sheikhbahaei, Sara Shishani, Kawkab Sliwa, Karen Tavakkoli, Mohammad Terkawi, Abdullah S Uthman, Olalekan A Westerman, Ronny Younis, Mustafa Z El Sayed Zaki, Maysaa Zannad, Faiez Roth, Gregory A Wang, Haidong Naghavi, Mohsen Vos, Theo Al Rabeeah, Abdullah A Lopez, Alan D Murray, Christopher J L |
| author_role | author |
| dc.creator.none.fl_str_mv | Mokdad, Ali H Forouzanfar, Mohammad Hossein Daoud, Farah El Bcheraoui, Charbel Moradi-Lakeh, Maziar Khalil, Ibrahim Afshin, Ashkan Tuffaha, Marwa Charara, Raghid Barber, Ryan M Wagner, Joseph Cercy, Kelly Kravitz, Hannah Coates, Matthew M Robinson, Margaret Estep, Kara Steiner, Caitlyn Jaber, Sara Mokdad, Ali A O'Rourke, Kevin F Chew, Adrienne Kim, Pauline El Razek, Mohamed Magdy Abd Abdalla, Safa Abd-Allah, Foad Abraham, Jerry P Abu-Raddad, Laith J Abu-Rmeileh, Niveen M E Al-Nehmi, Abdulwahab A Akanda, Ali S Al Ahmadi, Hanan Al Khabouri, Mazin J Al Lami, Faris H Al Rayess, Zulfa A Alasfoor, Deena AlBuhairan, Fadia S Aldhahri, Saleh F Alghnam, Suliman Alhabib, Samia Al-Hamad, Nawal Ali, Raghib Ali, Syed Danish Alkhateeb, Mohammad AlMazroa, Mohammad A Alomari, Mahmoud A Al-Raddadi, Rajaa Alsharif, Ubai Al-Sheyab, Nihaya Alsowaidi, Shirina Al-Thani, Mohamed Altirkawi, Khalid A Amare, Azmeraw T Amini, Heresh Ammar, Walid Anwari, Palwasha Asayesh, Hamid Asghar, Rana Assabri, Ali M Assadi, Reza Bacha, Umar Badawi, Alaa Bakfalouni, Talal Basulaiman, Mohammed O Bazargan-Hejazi, Shahrzad Bedi, Neeraj Bhakta, Amit R Bhutta, Zulfiqar A Bin Abdulhak, Aref A Boufous, Soufiane Bourne, Rupert R A Danawi, Hadi Das, Jai Deribew, Amare Ding, Eric L Durrani, Adnan M Elshrek, Yousef Ibrahim, Mohamed E Eshrati, Babak Esteghamati, Alireza Faghmous, Imad A D Farzadfar, Farshad Feigl, Andrea B Fereshtehnejad, Seyed-Mohammad Filip, Irina Fischer, Florian Gankpé, Fortuné G Ginawi, Ibrahim Gishu, Melkamu Dedefo Gupta, Rahul Habash, Rami M Hafezi-Nejad, Nima Hamadeh, Randah R Hamdouni, Hayet Hamidi, Samer Harb, Hilda L Hassanvand, Mohammad Sadegh Hedayati, Mohammad T Heydarpour, Pouria Hsairi, Mohamed Husseini, Abdullatif Jahanmehr, Nader Jha, Vivekanand Jonas, Jost B Karam, Nadim E Kasaeian, Amir Kassa, Nega Assefa Kaul, Anil Khader, Yousef Khalifa, Shams Eldin A Khan, Ejaz A Khan, Gulfaraz Khoja, Tawfik Khosravi, Ardeshir Kinfu, Yohannes Defo, Barthelemy Kuate Balaji, Arjun Lakshmana Lunevicius, Raimundas Obermeyer, Carla Makhlouf Malekzadeh, Reza Mansourian, Morteza Marcenes, Wagner Farid, Habibolah Masoudi Mehari, Alem Mehio-Sibai, Abla Memish, Ziad A Mensah, George A Mohammad, Karzan A Nahas, Ziad Nasher, Jamal T Nawaz, Haseeb Nejjari, Chakib Nisar, Muhammad Imran Omer, Saad B Parsaeian, Mahboubeh Peprah, Emmanuel K Pervaiz, Aslam Pourmalek, Farshad Qato, Dima M Qorbani, Mostafa Radfar, Amir Rafay, Anwar Rahimi, Kazem Rahimi-Movaghar, Vafa Rahman, Sajjad Ur Rai, Rajesh K Rana, Saleem M Rao, Sowmya R Refaat, Amany H Resnikoff, Serge Roshandel, Gholamreza Saade, Georges Saeedi, Mohammad Y Sahraian, Mohammad Ali Saleh, Shadi Sanchez-Riera, Lidia Satpathy, Maheswar Sepanlou, Sadaf G Setegn, Tesfaye Shaheen, Amira Shahraz, Saeid Sheikhbahaei, Sara Shishani, Kawkab Sliwa, Karen Tavakkoli, Mohammad Terkawi, Abdullah S Uthman, Olalekan A Westerman, Ronny Younis, Mustafa Z El Sayed Zaki, Maysaa Zannad, Faiez Roth, Gregory A Wang, Haidong Naghavi, Mohsen Vos, Theo Al Rabeeah, Abdullah A Lopez, Alan D Murray, Christopher J L |
| dc.date.none.fl_str_mv | 2016-10-17T05:19:43Z 2016-10 |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://dx.doi.org/10.1016/S2214-109X(16)30168-1 Ali H Mokdad, Mohammad Hossein Forouzanfar, Farah Daoud, et al. "Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013", The Lancet Global Health, Volume 4, Issue 10, October 2016, Pages e704-e713, 2214109X http://www.sciencedirect.com/science/article/pii/S2214109X16301681 http://hdl.handle.net/10576/4893 10 4 |
| dc.language.none.fl_str_mv | en |
| dc.publisher.none.fl_str_mv | Elsevier, Ltd |
| dc.rights.none.fl_str_mv | http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Mediterranean region life expectancy Health conditions Cause of death |
| dc.title.none.fl_str_mv | Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | Background: The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013. Methods: GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically. Findings: The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60–80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7% to 7·5% between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred. Interpretation: Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts. Funding: Bill & Melinda Gates Foundation. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | qu_46adc7f86260b6e779bfba036182d8cf |
| identifier_str_mv | Ali H Mokdad, Mohammad Hossein Forouzanfar, Farah Daoud, et al. "Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013", The Lancet Global Health, Volume 4, Issue 10, October 2016, Pages e704-e713, 2214109X 10 4 |
| language_invalid_str_mv | en |
| network_acronym_str | qu |
| network_name_str | Qatar University repository |
| oai_identifier_str | oai:qspace.qu.edu.qa:10576/4893 |
| publishDate | 2016 |
| publisher.none.fl_str_mv | Elsevier, Ltd |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| spelling | Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013Mokdad, Ali HForouzanfar, Mohammad HosseinDaoud, FarahEl Bcheraoui, CharbelMoradi-Lakeh, MaziarKhalil, IbrahimAfshin, AshkanTuffaha, MarwaCharara, RaghidBarber, Ryan MWagner, JosephCercy, KellyKravitz, HannahCoates, Matthew MRobinson, MargaretEstep, KaraSteiner, CaitlynJaber, SaraMokdad, Ali AO'Rourke, Kevin FChew, AdrienneKim, PaulineEl Razek, Mohamed Magdy AbdAbdalla, SafaAbd-Allah, FoadAbraham, Jerry PAbu-Raddad, Laith JAbu-Rmeileh, Niveen M EAl-Nehmi, Abdulwahab AAkanda, Ali SAl Ahmadi, HananAl Khabouri, Mazin JAl Lami, Faris HAl Rayess, Zulfa AAlasfoor, DeenaAlBuhairan, Fadia SAldhahri, Saleh FAlghnam, SulimanAlhabib, SamiaAl-Hamad, NawalAli, RaghibAli, Syed DanishAlkhateeb, MohammadAlMazroa, Mohammad AAlomari, Mahmoud AAl-Raddadi, RajaaAlsharif, UbaiAl-Sheyab, NihayaAlsowaidi, ShirinaAl-Thani, MohamedAltirkawi, Khalid AAmare, Azmeraw TAmini, HereshAmmar, WalidAnwari, PalwashaAsayesh, HamidAsghar, RanaAssabri, Ali MAssadi, RezaBacha, UmarBadawi, AlaaBakfalouni, TalalBasulaiman, Mohammed OBazargan-Hejazi, ShahrzadBedi, NeerajBhakta, Amit RBhutta, Zulfiqar ABin Abdulhak, Aref ABoufous, SoufianeBourne, Rupert R ADanawi, HadiDas, JaiDeribew, AmareDing, Eric LDurrani, Adnan MElshrek, YousefIbrahim, Mohamed EEshrati, BabakEsteghamati, AlirezaFaghmous, Imad A DFarzadfar, FarshadFeigl, Andrea BFereshtehnejad, Seyed-MohammadFilip, IrinaFischer, FlorianGankpé, Fortuné GGinawi, IbrahimGishu, Melkamu DedefoGupta, RahulHabash, Rami MHafezi-Nejad, NimaHamadeh, Randah RHamdouni, HayetHamidi, SamerHarb, Hilda LHassanvand, Mohammad SadeghHedayati, Mohammad THeydarpour, PouriaHsairi, MohamedHusseini, AbdullatifJahanmehr, NaderJha, VivekanandJonas, Jost BKaram, Nadim EKasaeian, AmirKassa, Nega AssefaKaul, AnilKhader, YousefKhalifa, Shams Eldin AKhan, Ejaz AKhan, GulfarazKhoja, TawfikKhosravi, ArdeshirKinfu, YohannesDefo, Barthelemy KuateBalaji, Arjun LakshmanaLunevicius, RaimundasObermeyer, Carla MakhloufMalekzadeh, RezaMansourian, MortezaMarcenes, WagnerFarid, Habibolah MasoudiMehari, AlemMehio-Sibai, AblaMemish, Ziad AMensah, George AMohammad, Karzan ANahas, ZiadNasher, Jamal TNawaz, HaseebNejjari, ChakibNisar, Muhammad ImranOmer, Saad BParsaeian, MahboubehPeprah, Emmanuel KPervaiz, AslamPourmalek, FarshadQato, Dima MQorbani, MostafaRadfar, AmirRafay, AnwarRahimi, KazemRahimi-Movaghar, VafaRahman, Sajjad UrRai, Rajesh KRana, Saleem MRao, Sowmya RRefaat, Amany HResnikoff, SergeRoshandel, GholamrezaSaade, GeorgesSaeedi, Mohammad YSahraian, Mohammad AliSaleh, ShadiSanchez-Riera, LidiaSatpathy, MaheswarSepanlou, Sadaf GSetegn, TesfayeShaheen, AmiraShahraz, SaeidSheikhbahaei, SaraShishani, KawkabSliwa, KarenTavakkoli, MohammadTerkawi, Abdullah SUthman, Olalekan AWesterman, RonnyYounis, Mustafa ZEl Sayed Zaki, MaysaaZannad, FaiezRoth, Gregory AWang, HaidongNaghavi, MohsenVos, TheoAl Rabeeah, Abdullah ALopez, Alan DMurray, Christopher J LMediterranean regionlife expectancyHealth conditionsCause of deathBackground: The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013. Methods: GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically. Findings: The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60–80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7% to 7·5% between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred. Interpretation: Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts. Funding: Bill & Melinda Gates Foundation.Bill & Melinda Gates Foundation. Qatar National Research Fund (NPRP 9-040-3-008). The Brien Holden Vision Institute. Oklahoma Council for Advancement of Science & Technology. UK National Institute for Health Research Oxford Biomedical Research Centre, National Institute for Health Research Career Development Fellowship, and Oxford Martin School.Elsevier, Ltd2016-10-17T05:19:43Z2016-10Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://dx.doi.org/10.1016/S2214-109X(16)30168-1Ali H Mokdad, Mohammad Hossein Forouzanfar, Farah Daoud, et al. "Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013", The Lancet Global Health, Volume 4, Issue 10, October 2016, Pages e704-e713,2214109Xhttp://www.sciencedirect.com/science/article/pii/S2214109X16301681http://hdl.handle.net/10576/4893104enhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:qspace.qu.edu.qa:10576/48932024-07-23T15:51:49Z |
| spellingShingle | Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 Mokdad, Ali H Mediterranean region life expectancy Health conditions Cause of death |
| status_str | publishedVersion |
| title | Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 |
| title_full | Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 |
| title_fullStr | Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 |
| title_full_unstemmed | Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 |
| title_short | Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 |
| title_sort | Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 |
| topic | Mediterranean region life expectancy Health conditions Cause of death |
| url | http://dx.doi.org/10.1016/S2214-109X(16)30168-1 http://www.sciencedirect.com/science/article/pii/S2214109X16301681 http://hdl.handle.net/10576/4893 |