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The failure of governments to address a three-decade surge in preventable diseases such as obesity and type 2 diabetes has fueled the Covid-19 pandemic and is stagnating life expectancy worldwide, according to a comprehensive study.
The most recent data from the Global Burden of Disease study, published in the Lancet medical journal, is from 2019, before Covid, but it helps explain the world’s vulnerability to the virus.
In the UK, The Lancet editor Dr Richard Horton said that the areas where life expectancy was lowest – the North East, North West, Yorkshire and Humberside – were the areas most affected by Covid. “I don’t think it’s a coincidence,” he said, adding that Covid-19 was not a single pandemic, but “a synthesis of a coronavirus and an epidemic of non-communicable diseases in a context of poverty and inequality.
“It is the interaction of the virus with people living with other diseases, that is the challenge we face, especially when the problem of the social gradient is taken into account. So I think that governments, if they focus only on trying to reduce the prevalence of a virus, this is a strategy that will fail in the long term, “he said.
More people around the world experience high blood pressure and high blood sugar, are overweight or high cholesterol, all related to poor diet and lack of exercise, and all risk factors for disease. There is a rising tide of deaths from cardiovascular disease, particularly in the United States and the Caribbean.
The world could be approaching a tipping point in increasing life expectancy, the authors said. Since 1990, life expectancy has increased steadily, but it has slowed down. In the UK, life expectancy has increased, but not as fast as in the rest of Europe, by 5.3 years compared to the European average of 5.7. There is a wide gulf between the richest and poorest parts of the UK, from an average life expectancy in 2019 of 84.5 years in Richmond-upon-Thames to 76.4 years in Blackpool.
Most of those years are being lived in poor health. The UK’s healthy life expectancy is the lowest in Europe, tied with Monaco at 68.9 years. Chronic diseases are now responsible for 88% of the total burden of disease in the UK. The biggest contributors to the rise in poor health in the past 30 years are diabetes, falls, drug use disorders, lung disease, and dementia.
Smoking has contributed to 125,000 premature deaths in the UK, high blood pressure to 87,000, poor diet to 78,500, hyperglycemia to 75,500 and obesity to 56,200.
The emergence of Covid-19 among so many people with chronic diseases and underlying disease risks has created “a perfect storm,” said the study authors, based at the Institute for Health Metrics and Evaluation (IHME) in Seattle, in the NOS.
Horton said the study was “the most comprehensive analysis of the world’s readiness for Covid-19, immediately before the virus. It reveals that the world was extremely vulnerable to a virus that affects older citizens, those living with chronic non-communicable diseases and those living in societies with widespread inequalities.
“If we truly want to protect our communities from the ravages of this coronavirus, governments must design national strategies, not only to reduce the prevalence of the virus, but also to more assertively address the burden of chronic diseases and risk factors. chronic diseases. disease, ”he said.
Professor Christopher Murray, director of the IHME, said health systems had been slow to adapt to the implications of the rise in chronic non-communicable diseases in the long term. “We are seeing a shift around the world towards a greater burden of disease from disabling conditions, rather than death. It turns out that in the era of Covid many of those conditions are also things that increase the risk of death from Covid, so the shift towards disability is also a shift towards vulnerability, ”he said.
Looking ahead, he said: “We expect Covid to continue to have its direct effects in 2021 and to be quite considerable.” Child vaccination rates have dropped because families cannot go to clinics, women cannot deliver in safe facilities, and people who need treatment for diseases other than Covid are not receiving it. The economic effects would be a driver of poor health for the next three to four years, he said.
