| 1. |
- Hay, S. I., et al.
(författare)
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Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016 : A systematic analysis for the Global Burden of Disease Study 2016
- 2017
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Ingår i: The Lancet. - : Lancet Publishing Group. - 0140-6736 .- 1474-547X. ; 390:10100, s. 1260-1344
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Tidskriftsartikel (refereegranskat)abstract
- Background: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). Methods: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE difered from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. Findings: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs ofset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the fve lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. Interpretation: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs ofset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention eforts, and development assistance for health, including fnancial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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| 2. |
- Vos, T., et al.
(författare)
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Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016
- 2017
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Ingår i: Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 390:10100, s. 1211-1259
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Tidskriftsartikel (refereegranskat)abstract
- Background As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016. Methods We estimated prevalence and incidence for 328 diseases and injuries and 2982 sequelae, their non-fatal consequences. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between incidence, prevalence, remission, and cause of death rates for each condition. For some causes, we used alternative modelling strategies if incidence or prevalence needed to be derived from other data. YLDs were estimated as the product of prevalence and a disability weight for all mutually exclusive sequelae, corrected for comorbidity and aggregated to cause level. We updated the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. GBD 2016 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, low back pain, migraine, age-related and other hearing loss, iron-deficiency anaemia, and major depressive disorder were the five leading causes of YLDs in 2016, contributing 57.6 million (95% uncertainty interval [UI] 40.8-75.9 million [7.2%, 6.0-8.3]), 45.1 million (29.0-62.8 million [5.6%, 4.0-7.2]), 36.3 million (25.3-50.9 million [4.5%, 3.8-5.3]), 34.7 million (23.0-49.6 million [4.3%, 3.5-5.2]), and 34.1 million (23.5-46.0 million [4.2%, 3.2-5.3]) of total YLDs, respectively. Age-standardised rates of YLDs for all causes combined decreased between 1990 and 2016 by 2.7% (95% UI 2.3-3.1). Despite mostly stagnant age-standardised rates, the absolute number of YLDs from non-communicable diseases has been growing rapidly across all SDI quintiles, partly because of population growth, but also the ageing of populations. The largest absolute increases in total numbers of YLDs globally were between the ages of 40 and 69 years. Age-standardised YLD rates for all conditions combined were 10.4% (95% UI 9.0-11.8) higher in women than in men. Iron-deficiency anaemia, migraine, Alzheimer's disease and other dementias, major depressive disorder, anxiety, and all musculoskeletal disorders apart from gout were the main conditions contributing to higher YLD rates in women. Men had higher age-standardised rates of substance use disorders, diabetes, cardiovascular diseases, cancers, and all injuries apart from sexual violence. Globally, we noted much less geographical variation in disability than has been documented for premature mortality. In 2016, there was a less than two times difference in age-standardised YLD rates for all causes between the location with the lowest rate (China, 9201 YLDs per 100 000, 95% UI 6862-11943) and highest rate (Yemen, 14 774 YLDs per 100 000, 11 018-19 228). Interpretation The decrease in death rates since 1990 for most causes has not been matched by a similar decline in age-standardised YLD rates. For many large causes, YLD rates have either been stagnant or have increased for some causes, such as diabetes. As populations are ageing, and the prevalence of disabling disease generally increases steeply with age, health systems will face increasing demand for services that are generally costlier than the interventions that have led to declines in mortality in childhood or for the major causes of mortality in adults. Up-todate information about the trends of disease and how this varies between countries is essential to plan for an adequate health-system response. Copyright (C) The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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| 3. |
- Becker, J. C., et al.
(författare)
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What do national flags stand for? : An exploration of associations across 11 countries
- 2017
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Ingår i: Journal of Cross-Cultural Psychology. - : Sage Publications. - 0022-0221 .- 1552-5422. ; 48:3, s. 335-352
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Tidskriftsartikel (refereegranskat)abstract
- We examined the concepts and emotions people associate with their national flag, and how these associations are related to nationalism and patriotism across 11 countries. Factor analyses indicated that the structures of associations differed across countries in ways that reflect their idiosyncratic historical developments. Positive emotions and egalitarian concepts were associated with national flags across countries. However, notable differences between countries were found due to historical politics. In societies known for being peaceful and open-minded (e.g., Canada, Scotland), egalitarianism was separable from honor-related concepts and associated with the flag; in countries that were currently involved in struggles for independence (e.g., Scotland) and countries with an imperialist past (the United Kingdom), the flag was strongly associated with power-related concepts; in countries with a negative past (e.g., Germany), the primary association was sports; in countries with disruption due to separatist or extremist movements (e.g., Northern Ireland, Turkey), associations referring to aggression were not fully rejected; in collectivist societies (India, Singapore), obedience was linked to positive associations and strongly associated with the flag. In addition, the more strongly individuals endorsed nationalism and patriotism, the more they associated positive emotions and egalitarian concepts with their flag. Implications of these findings are discussed.
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| 4. |
- Hopkins, N., et al.
(författare)
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Explaining effervescence : Investigating the relationship between shared social identity and positive experience in crowds
- 2016
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Ingår i: Cognition & Emotion. - : Routledge. - 0269-9931 .- 1464-0600. ; 30:1, s. 20-32
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Tidskriftsartikel (refereegranskat)abstract
- We investigated the intensely positive emotional experiences arising from participation in a large-scale collective event. We predicted such experiences arise when those attending a collective event are (1) able to enact their valued collective identity and (2) experience close relations with other participants. In turn, we predicted both of these to be more likely when participants perceived crowd members to share a common collective identity. We investigated these predictions in a survey of pilgrims (N = 416) attending a month-long Hindu pilgrimage festival in north India. We found participants' perceptions of a shared identity amongst crowd members had an indirect effect on their positive experience at the event through (1) increasing participants' sense that they were able to enact their collective identity and (2) increasing the sense of intimacy with other crowd members. We discuss the implications of these data for how crowd emotion should be conceptualised.
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| 5. |
- Khan, Sammyh, 1979-, et al.
(författare)
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Efficacy and well-being in rural north India : The role of social identification with a large-scale community identity
- 2014
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Ingår i: European Journal of Social Psychology. - : John Wiley & Sons. - 0046-2772 .- 1099-0992. ; 44:7, s. 787-798
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Tidskriftsartikel (refereegranskat)abstract
- Identifying with a group can contribute to a sense of well-being. The mechanisms involved are diverse: social identification with a group can impact individuals' beliefs about issues such as their connections with others, the availability of social support, the meaningfulness of existence, and the continuity of their identity. Yet, there seems to be a common theme to these mechanisms: identification with a group encourages the belief that one can cope with the stressors one faces (which is associated with better well-being). Our research investigated the relationship between identification, beliefs about coping, and well-being in a survey (N=792) administered in rural North India. Using structural equation modelling, we found that social identification as a Hindu had positive and indirect associations with three measures of well-being through the belief that one can cope with everyday stressors. We also found residual associations between participants' social identification as a Hindu and two measures of well-being in which higher identification was associated with poorer well-being. We discuss these findings and their implication for understanding the relationship between social identification (especially with large-scale group memberships) and well-being. We also discuss the application of social psychological theory developed in the urban West to rural north India.
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| 6. |
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| 7. |
- Khan, Sammyh, 1979-, et al.
(författare)
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Shared identity predicts enhanced health at a mass gathering
- 2015
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Ingår i: Group Processes & Intergroup Relations. - : Sage Publications. - 1368-4302 .- 1461-7188. ; 18:4, s. 504-522
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Tidskriftsartikel (refereegranskat)abstract
- Identifying with a group can impact (positively) upon group members' health. This can be explained (in part) through the social relations that a shared identity allows. We investigated the relationship between a shared identity and health in a longitudinal study of a month-long pilgrimage in north India. Questionnaire data (N = 416) showed that self-reported health (measured before, during, and after the event) was better at the event than before, and although it reduced on returning home, it remained higher than before the event. This trajectory was predicted by data concerning pilgrims' perceptions of a shared identity with other pilgrims at the event. We also found evidence that a shared identity amongst pilgrims had an indirect effect on changes in self-assessed health via the belief one had closer relations with one's fellow pilgrims. We discuss the implications of these data for our understandings of the role of shared identity in social relations and health.
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| 8. |
- Tewari, S., et al.
(författare)
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Participation in Mass Gatherings Can Benefit Well-Being : Longitudinal and Control Data from a North Indian Hindu Pilgrimage Event
- 2012
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 7:10
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Tidskriftsartikel (refereegranskat)abstract
- How does participation in a long-duration mass gathering (such as a pilgrimage event) impact well-being? There are good reasons to believe such collective events pose risks to health. There are risks associated with communicable diseases. Moreover, the physical conditions at such events (noise, crowding, harsh conditions) are often detrimental to well-being. Yet, at the same time, social psychological research suggests participation in group-related activities can impact well-being positively, and we therefore investigated if participating in a long-duration mass gathering can actually bring such benefits. In our research we studied one of the world's largest collective events - a demanding month-long Hindu religious festival in North India. Participants (comprising 416 pilgrims who attended the gathering for the whole month of its duration, and 127 controls who did not) completed measures of self-assessed well-being and symptoms of ill-health at two time points. The first was a month before the gathering commenced, the second was a month after it finished. We found that those participating in this collective event reported a longitudinal increase in well-being relative to those who did not participate. Our data therefore imply we should reconceptualise how mass gatherings impact individuals. Although such gatherings can entail significant health risks, the benefits for well-being also need recognition. Indeed, an exclusive focus on risk is misleading and limits our understanding of why such events may be so attractive. More importantly, as our research is longitudinal and includes a control group, our work adds robust evidence to the social psychological literature concerning the relationship between participation in social group activities and well-being.
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