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The Global Burden of Disease (GBD) is a measure of the years of life lost as a result of premature mortality or complete disability. The contribution of a disease or risk factor to the GBD is commonly used by public health epidemiologists as a measure of the relative importance of that disease or risk factor. The metric used for these contributions is “disability adjusted life years” (DALYs).
First a look at the latest data from developed countries (technically countries with a high Socio-demographic Index (SDI). SDI is a summary measure of a country’s socio-demographic development. It is based on average income per person, educational attainment, and total fertility rate.)
Consumption of tobacco products is the single largest contribution to GBD in developed countries — contributing roughly 10% of the total DALYs. Consumption of alcohol and other drugs contributes another roughly 8% of the total DALYs. The combined contribution of tobacco, alcohol and drugs is about 18% of the total Burden of Disease in highly developed countries — clearly the largest single public health problem we face.
The global data looks a little different:
The single largest contributor to the GBD including data from all countries is Child and Maternal Malnutrition which contributes roughly 21% of the total DALYS. Tobacco consumption is the fourth largest contributor at 13%. Alcohol and drug consumption is the eighth largest contributor at roughly 11% of the total. If you combine the contributions of tobacco, alcohol and drugs, they represent roughly 24% of the total GBD — again suggesting that consumption of addictive substances is one of the largest, if not the largest, public health problems on the planet.
It should be emphasized that this data includes all DALY’s attributable to, for example, alcohol consumption – it does not distinguish between mild, moderate, and severe substance use disorders.
For more details than you probably want: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Lancet 2017; 390: 1345–422
I am happy to announce that Dr. Matt Russell has recently been appointed as a half-time Assistant Professor of Recovery Ministry and as Associate Director of the Fuller Institute for Recovery Ministry! After graduating with an M.Div. from Fuller, Matt was instrumental in founding “Mercy Street”, a vibrant recovery-oriented congregation in Houston, TX. In 2010 he earned a Ph.D. in Human Development and Family Studies at Texas Tech University and subsequently spent two years as a Visiting Scholar at Cambridge University in their Psychology and Religion Research Group. Currently he is a Senior Associate Pastor at Saint Paul’s United Methodist Church in Houston. Matt has taught a variety of courses for Fuller both as an Adjunct and an Affiliate Professor, and we are delighted that this transition to Assistant Professor status has been made possible. Matt will be teaching both on-line and on Fuller’s campus in Houston. For an introduction to Matt’s story and teaching see: Matt Russell Videos