Citation

Murray CJ, Lopez AD. Lancet 1997; 349(9061): 1269-1276.

Affiliation

Harvard School of Public Health, Boston, Massachusetts, USA.

Comment In:

Lancet 1997;350(9071):142.

Copyright

(Copyright © 1997, Elsevier Publishing)

DOI

10.1016/S0140-6736(96)07493-4

PMID

9142060

Abstract

The Global Burden of Disease Study used vital registration, sample registration, and small-scale population study data to develop cause of death estimates for 107 disorders by age, sex, and world region. Of the estimated 50,467,000 global deaths in 1990, 17.2 million involved infectious and parasitic diseases, respiratory infections, and maternal and perinatal disorders (group 1); 28.1 million were attributable to cancer, cardiovascular disease, and other non-communicable disorders (group 2); and 5.1 million were caused by injuries (group 3). 39,554,000 of these deaths occurred in developing countries; the numbers of group 1, 2, and 3 deaths were 16.6 million, 18.7 million, and 5.1 million, respectively. Of the 10,912,000 deaths in developed countries (established market economies and formerly socialist economies of Europe), these numbers were 0.7 million, 9.4 million, and 4.3 million, respectively. Worldwide, the 10 leading causes of death in 1990--accounting for 52% of total deaths--were ischemic heart disease (6.3 million), cerebrovascular disease (4.4 million), lower respiratory infections (4.3 million), diarrheal diseases (2.9 million), perinatal disorders (2.4 million), chronic obstructive pulmonary disease (2.2 million), tuberculosis (2.0 million), measles (1.1 million), road-traffic accidents (1.0 million), and lung cancer (0.9 million). Five of these causes are preventable communicable or perinatal disorders. These statistics provide clear evidence that noncommunicable disease rates drop with development. In fact, the ratio of group 2 to group 1 deaths has been proposed as a crude indicator the epidemiologic transition. These ratios ranged from more than 13 in established market economies and formerly socialist economies of Europe to 0.4 in sub-Saharan Africa.

Language: en