‘Go With the Science’ for Healthier Countries

The Global Burden of Disease metric is helping governments around the world measure and improve human health.

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“Governments everywhere ought to be monitoring the health of their population. Is it getting better? Is it getting worse? What is it that’s driving that? And we provide that platform through the burden of disease.”

Health economist Alan Lopez shares the 2018 John Dirks Canada Gairdner Global Health Award with physician and health economist Christopher Murray for their work on the Global Burden of Disease metric.

Their comprehensive approach measures every important aspect of health in every community in the world and how they change over time. This global standardization allows policy makers to judge the health of their populations and compare them across time or across different countries or communities so that we can keep improving.

Since the early 1990s, they have published their international findings annually in The Lancet. Their measurements now cover over 300 diseases and injuries in almost 200 countries, categorized by age and sex. They have around 3,200 collaborators around the world, forming the world’s largest publishing collaboration in science.

And the good news is, apart from a handful of countries under ongoing armed conflict, the large global trend is that nearly all countries are becoming healthier.

“Life spans are getting longer,” says Murray. “There’s a general trend from health being dominated by early death to ill health being dominated by disability. And the big causes of disability aren’t the same things that kill you. And so the big causes of disability are mental disorders, substance abuse, and musculoskeletal disorders, like back pain, neck pain, arthritis.”

For now, the platform looks at recorded health, but Lopez and Murray want to take it one step further.

“The idea that I’m most excited about right now is a comprehensive future health scenario platform, so that you can actually say, how would the future of Canada, or whatever country you’re thinking about, be different if I did a better job of reducing smoking, or if we tackled cholesterol, a wide array of the risks in drivers there?” says Murray.

“So that’s really exciting because I think it creates the connection from the diagnosis to the prescription.”

Lopez and Murray have collaborations around the world, shining light on problems that aren’t getting enough attention. When their collaborators in India recently published their analyses, they received broad support.

“It was the front page of every major Indian newspaper, you had the government saying that this is really important and we’re going to act on this,” says Murray. “So that model of uptake and co-ownership, I think, is the right model, and we’re going to keep investing and building that collaboration.”

Sometimes the data are going to go against popular opinion, and in these it will be especially important to follow the evidence.

“Yes, it’ll be tough, and there will be an environment around you that dissuades you from doing it, or there’s an easier road. Ignore that,” says Lopez.

“If you really believe that it’s important, go after it. You will upset people’s conventional ideas and wisdom. Too bad. Do what you think the science tells you to do and go with the science.”

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