Health Equity: 06/27/11

Monday, June 27, 2011

[EQ] Global Trends in Diabetes

National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980:

systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participants

Goodarz Danaei MD a *, Mariel M Finucane PhD b *, Yuan Lu MSc c, Gitanjali M Singh PhD c, Melanie J Cowan MPH d, Christopher J Paciorek PhD b f, John K Lin AB c, Farshad Farzadfar MD c, Prof Young-Ho Khang MD g, Gretchen A Stevens DSc e, Mayuree Rao BA c, Mohammed K Ali MBChB h, Leanne M Riley MSc d, Carolyn A Robinson MSc i, Prof Majid Ezzati PhD j k , on behalf of the Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Glucose)†

The Lancet, Early Online Publication, 25 June 2011doi:10.1016/S0140-6736(11)60679-X

Website: http://bit.ly/liKGKK

"…….Data for trends in glycaemia and diabetes prevalence are needed to understand the effects of diet and lifestyle within populations, assess the performance of interventions, and plan health services. No consistent and comparable global analysis of trends has been done. We estimated trends and their uncertainties in mean fasting plasma glucose (FPG) and diabetes prevalence for adults aged 25 years and older in 199 countries and territories.

Methods

We obtained data from health examination surveys and epidemiological studies (370 country-years and 2·7 million participants). We converted systematically between different glycaemic metrics. For each sex, we used a Bayesian hierarchical model to estimate mean FPG and its uncertainty by age, country, and year, accounting for whether a study was nationally, subnationally, or community representative.

Findings

In 2008, global age-standardised mean FPG was 5·50 mmol/L (95% uncertainty interval 5·37—5·63) for men and 5·42 mmol/L (5·29—5·54) for women, having risen by 0·07 mmol/L and 0·09 mmol/L per decade, respectively. Age-standardised adult diabetes prevalence was 9·8% (8·6—11·2) in men and 9·2% (8·0—10·5) in women in 2008, up from 8·3% (6·5—10·4) and 7·5% (5·8—9·6) in 1980.
The number of people with diabetes increased from 153 (127—182) million in 1980, to 347 (314—382) million in 2008. We recorded almost no change in mean FPG in east and southeast Asia and central and eastern Europe. Oceania had the largest rise, and the highest mean FPG (6·09 mmol/L, 5·73—6·49 for men; 6·08 mmol/L, 5·72—6·46 for women) and diabetes prevalence (15·5%, 11·6—20·1 for men; and 15·9%, 12·1—20·5 for women) in 2008. Mean FPG and diabetes prevalence in 2008 were also high in south Asia, Latin America and the Caribbean, and central Asia, north Africa, and the Middle East. Mean FPG in 2008 was lowest in sub-Saharan Africa, east and southeast Asia, and high-income Asia-Pacific. In high-income subregions, western Europe had the smallest rise, 0·07 mmol/L per decade for men and 0·03 mmol/L per decade for women; North America had the largest rise, 0·18 mmol/L per decade for men and 0·14 mmol/L per decade for women.

Interpretation

Glycaemia and diabetes are rising globally, driven both by population growth and ageing and by increasing age-specific prevalences. Effective preventive interventions are needed, and health systems should prepare to detect and manage diabetes and its sequelae…."

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[EQ] The Intersection of Health and Security

GLOBAL HEALTH GOVERNANCE
The Scholarly Journal for the New Health Security Paradigm

VOLUME IV, ISSUE 2: SPRING 2011

SPRING 2011 SPECIAL ISSUE: The Intersection of Health and Security

Available online at: http://bit.ly/m9AMcO

Global Health Security: Closing the Gaps in Responding to Infectious Disease Emergencies
Jennifer B. Nuzzo and Gigi Kwik Gronvall

US Military Global Health Engagement since 9/11: Seeking Stability through Health
Jean-Paul Chretien

Securitizing Global Health: A View from Maternal Health
Laura Baringer and Steve Heitkamp

The International Flow of Risk: The Governance of Health in an Urbanizing World
Julie E. Fischer and Rebecca Katz

The Security Dividend: What the United States Can Obtain from Investing More in International Health Care Capacity
Kermit Jones

Why African Countries Need to Participate in Global Health Security Discourse
Lenias Hwenda, Percy Mahlathi, and Treasure Maphanga

H1N1 – The Social Costs of Cultural Confusion
Bill Durodié

Other Papers
Rise and Fall of Global Health as a Foreign Policy Issue
David P. Fidler

Global Health Governance at a Crossroads
Nora Y. Ng and Jennifer Prah Ruger

Epidemics as Politics with Case Studies from Malaysia, Thailand, and Vietnam
Tuong Vu

Stop Making Excuses: Understanding Hepatitis B and the Global Failure to Act
Laura L. Janik-Marusov

Regional HIV-Related Policy Processes in Peru
In the Context of the Peruvian National Decentralization Plan and Global Fund Support: Peru GHIN Study
Ruth Iguiñiz-Romero, Roberto López Chirinos, José Pajuelo and Carlos Cáceres, Clara Sandoval, Alejandro

Health Diplomacy in China
Xu Jing, Liu Peilong, and Guo Yan

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[EQ] Global Health Governance at a Crossroads

Global Health Governance at a Crossroads

Nora Y. Ng - Research Assistant - Yale University School of Public Health

Jennifer Prah Ruger -Associate Professor at Yale University Schools of Medicine, Public Health and Law (Adjunct) and Graduate School of Arts and Sciences.
Currently a member of the Institute of Medicine’s (IOM) Board on Global Health
GLOBAL HEALTH GOVERNANCE, VOLUME III, NO. 2 (SPRING 2011)

Available online PDF file [32p.] at: http://bit.ly/lccCiC

“…..This review takes stock of the global health governance (GHG) literature. We address the transition from international health governance (IHG) to global health governance, identify major actors, and explain some challenges and successes.

We analyze the framing of health as national security, human security, human rights, and global public good, and the implications of these various frames. We also establish and examine from the literature Global Health Governance GHG’s major themes and issues, which include:

1) persistent Global Health Governance GHG problems;
2) different approaches to tackling health challenges (vertical, horizontal, and diagonal);
3) health’s multisectoral connections;
4) neoliberalism and the global economy;
5) the framing of health (e.g. as a security issue, as a foreign policy issue, as a human rights issue, and as a global public good);
6) global health inequalities;
7) local and country ownership and capacity;
8) international law in Global Health Governance GHG; and
9) research gaps in Global Health Governance GHG.

We find that decades-old challenges in GHG persist and Global Health Governance GHG needs a new way forward. A framework called shared health governance offers promise….”

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