Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
, 388 (10053), 1659-1724

Global, Regional, and National Comparative Risk Assessment of 79 Behavioural, Environmental and Occupational, and Metabolic Risks or Clusters of Risks, 1990-2015: A Systematic Analysis for the Global Burden of Disease Study 2015

Collaborators
Comparative Study

Global, Regional, and National Comparative Risk Assessment of 79 Behavioural, Environmental and Occupational, and Metabolic Risks or Clusters of Risks, 1990-2015: A Systematic Analysis for the Global Burden of Disease Study 2015

GBD 2015 Risk Factors Collaborators. Lancet.

Erratum in

  • Department of Error.
    Lancet. 2017 Jan 7;389(10064):e1. doi: 10.1016/S0140-6736(16)32632-0. Epub 2017 Jan 6. Lancet. 2017. PMID: 28091378 Free PMC article. No abstract available.

Abstract

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context.

Methods: We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors-the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI).

Findings: Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6-58·8) of global deaths and 41·2% (39·8-42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa.

Interpretation: Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden.

Funding: Bill & Melinda Gates Foundation.

Figures

Figure 1
Figure 1
Global proportion of all-cause DALYs attributable to behavioural, environmental and occupational, and metabolic risk factors and their overlaps by region for both sexes combined in 2015 Locations are reported in order of total all-cause DALYs population attributable fraction. DALYs=disability-adjusted life-years. ∩=interaction.
Figure 2
Figure 2
Global DALYs attributable to Level 2 risk factors for (A) men and (B) women in 2015 DALYs=disability-adjusted life-years.
Figure 3
Figure 3
Leading 30 Level 3 global risk factors for DALYs for both sexes combined, 1990, 2005, and 2015, with percentage change in number of DALYs, and all-age, and age-standardised rates Risks are connected by lines between time periods. For the time period of 1990 to 2005 and for 2005 to 2015, three measures of change are shown: percent change in the number of DALYs, percent change in the all-age DALY rate, and percent change in the age-standardised DALY rate. Changes that are statistically significant are shown in bold. DALYs=disability-adjusted life-years.
Figure 4
Figure 4
Global attributable DALYs in 2015 for each Level 3 risk factor versus percentage change in SEV from 1990 to 2015 for both sexes combined Risks with 100 000 DALYs or more are presented. DALYs are represented on a logarithmic scale. We have excluded occupational exposure to benzene, diesel engine exhaust, and occupational exposure to silica, which all had SEV increases of greater than 50%. Ambient PM=ambient particulate matter pollution. Arsenic=occupational exposure to arsenic. Asbestos=occupational exposure to asbestos. Asthmagens=occupational asthmagens. Beryllium=occupational exposure to beryllium. BMD=low bone mineral density. BMI=high body-mass index. Cadmium=occupational exposure to cadmium. Calcium=diet low in calcium. Cholesterol=high total cholesterol. Chromium=occupational exposure to chromium. DALYs=disability-adjusted life-years. Ergonomic=occupational ergonomic factors. Fibre=diet low in fibre. Formaldehyde=occupational exposure to formaldehyde. FPG=high fasting plasma glucose. Fruits=diet low in fruits. GFR=low glomerular filtration rate. Handwashing=no handwashing with soap. Household air=household air pollution. IPV=intimate partner violence. Lead=lead exposure. Milk=diet low in milk. Nickel=occupational exposure to nickel. Noise=occupational noise. Nuts and seeds=diet low in nuts and seeds. Occupational SHS=occupational exposure to second-hand smoke. Omega-3=diet low in seafood omega-3 fatty acids. Ozone=ambient ozone pollution. PAH=occupational exposure to polycyclic aromatic hydrocarbons. Physical activity=low physical activity. PM, gases, and fumes=occupational particulate matter, gases, and fumes. Processed meat=diet high in processed meat. PUFA=diet low in polyunsaturated fatty acids. Radon=residential radon. Red meat=diet high in red meat. Sanitation=unsafe sanitation. SBP=high systolic blood pressure. SEV=summary exposure value. SHS=second-hand smoke. Sodium=diet high in sodium. Sugar-sweetened beverages=diet high in sugar-sweetened beverages. Sulphuric acid=occupational exposure to sulphuric acid. Stunting=childhood stunting. Trans fatty acids=diet high in trans fatty acids. Trichloroethylene=occupational exposure to trichloroethylene. Underweight=childhood underweight. Vegetables=diet low in vegetables. Wasting=childhood wasting. Water=unsafe water. Whole grains=diet low in whole grains.
Figure 5
Figure 5
Global decomposition of changes in all-cause DALYs attributable to Level 3 risk factors from 1990 to 2015 Risks are reported in order of percentage change in the number of attributable DALYs from 1990 to 2015. We excluded DALYs attributable to unsafe sex because this risk factor is not estimated on the basis of exposure and relative risk. Changes due to population growth, population ageing, risk exposure, and the risk-deleted DALY rate are shown. DALYs=disability-adjusted life-years.
Figure 6
Figure 6
Coevolution of SEV and SDI for the top ten global risks in terms of attributable disability-adjusted life-years in 2015 Coloured points show SEVs for Global Burden of Disease regions. Each point represents 1 year in 5 year intervals from 1990 to 2015. The solid black line represents the expected SEV on the basis of SDI alone. SDI=Socio-demographic Index. SEV=summary exposure values.
Figure 7
Figure 7
Leading ten Level 3 risk factors in terms of disability-adjusted life-years for both sexes combined in 2015, by location The 15 leading risk factors are coloured. Bone mineral density=low bone mineral density. Handwashing=no handwashing with soap. Int partner violence=intimate partner violence. Nuts and seeds=diet low in nuts and seeds. Occ=occupational. Particulate matter=ambient particulate matter pollution. Physical activity=low physical activity. Processed meat=diet high in processed meat. SDI=Socio-demographic Index. Subopt=suboptimal. Sweetened beverages=diet high in sugar-sweetened beverages. Vegetables=diet low in vegetables.
Figure 7
Figure 7
Leading ten Level 3 risk factors in terms of disability-adjusted life-years for both sexes combined in 2015, by location The 15 leading risk factors are coloured. Bone mineral density=low bone mineral density. Handwashing=no handwashing with soap. Int partner violence=intimate partner violence. Nuts and seeds=diet low in nuts and seeds. Occ=occupational. Particulate matter=ambient particulate matter pollution. Physical activity=low physical activity. Processed meat=diet high in processed meat. SDI=Socio-demographic Index. Subopt=suboptimal. Sweetened beverages=diet high in sugar-sweetened beverages. Vegetables=diet low in vegetables.
Figure 7
Figure 7
Leading ten Level 3 risk factors in terms of disability-adjusted life-years for both sexes combined in 2015, by location The 15 leading risk factors are coloured. Bone mineral density=low bone mineral density. Handwashing=no handwashing with soap. Int partner violence=intimate partner violence. Nuts and seeds=diet low in nuts and seeds. Occ=occupational. Particulate matter=ambient particulate matter pollution. Physical activity=low physical activity. Processed meat=diet high in processed meat. SDI=Socio-demographic Index. Subopt=suboptimal. Sweetened beverages=diet high in sugar-sweetened beverages. Vegetables=diet low in vegetables.
Figure 7
Figure 7
Leading ten Level 3 risk factors in terms of disability-adjusted life-years for both sexes combined in 2015, by location The 15 leading risk factors are coloured. Bone mineral density=low bone mineral density. Handwashing=no handwashing with soap. Int partner violence=intimate partner violence. Nuts and seeds=diet low in nuts and seeds. Occ=occupational. Particulate matter=ambient particulate matter pollution. Physical activity=low physical activity. Processed meat=diet high in processed meat. SDI=Socio-demographic Index. Subopt=suboptimal. Sweetened beverages=diet high in sugar-sweetened beverages. Vegetables=diet low in vegetables.
Figure 7
Figure 7
Leading ten Level 3 risk factors in terms of disability-adjusted life-years for both sexes combined in 2015, by location The 15 leading risk factors are coloured. Bone mineral density=low bone mineral density. Handwashing=no handwashing with soap. Int partner violence=intimate partner violence. Nuts and seeds=diet low in nuts and seeds. Occ=occupational. Particulate matter=ambient particulate matter pollution. Physical activity=low physical activity. Processed meat=diet high in processed meat. SDI=Socio-demographic Index. Subopt=suboptimal. Sweetened beverages=diet high in sugar-sweetened beverages. Vegetables=diet low in vegetables.
Figure 7
Figure 7
Leading ten Level 3 risk factors in terms of disability-adjusted life-years for both sexes combined in 2015, by location The 15 leading risk factors are coloured. Bone mineral density=low bone mineral density. Handwashing=no handwashing with soap. Int partner violence=intimate partner violence. Nuts and seeds=diet low in nuts and seeds. Occ=occupational. Particulate matter=ambient particulate matter pollution. Physical activity=low physical activity. Processed meat=diet high in processed meat. SDI=Socio-demographic Index. Subopt=suboptimal. Sweetened beverages=diet high in sugar-sweetened beverages. Vegetables=diet low in vegetables.
Figure 7
Figure 7
Leading ten Level 3 risk factors in terms of disability-adjusted life-years for both sexes combined in 2015, by location The 15 leading risk factors are coloured. Bone mineral density=low bone mineral density. Handwashing=no handwashing with soap. Int partner violence=intimate partner violence. Nuts and seeds=diet low in nuts and seeds. Occ=occupational. Particulate matter=ambient particulate matter pollution. Physical activity=low physical activity. Processed meat=diet high in processed meat. SDI=Socio-demographic Index. Subopt=suboptimal. Sweetened beverages=diet high in sugar-sweetened beverages. Vegetables=diet low in vegetables.

Comment in

Similar articles

  • Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.
    GBD 2017 Risk Factor Collaborators. GBD 2017 Risk Factor Collaborators. Lancet. 2018 Nov 10;392(10159):1923-1994. doi: 10.1016/S0140-6736(18)32225-6. Epub 2018 Nov 8. Lancet. 2018. PMID: 30496105 Free PMC article.
  • Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.
    GBD 2016 Risk Factors Collaborators. GBD 2016 Risk Factors Collaborators. Version 2. Lancet. 2017 Sep 16;390(10100):1345-1422. doi: 10.1016/S0140-6736(17)32366-8. Lancet. 2017. PMID: 28919119 Free PMC article.
  • Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
    GBD 2013 Risk Factors Collaborators, Forouzanfar MH, Alexander L, Anderson HR, Bachman VF, Biryukov S, Brauer M, Burnett R, Casey D, Coates MM, Cohen A, Delwiche K, Estep K, Frostad JJ, Astha KC, Kyu HH, Moradi-Lakeh M, Ng M, Slepak EL, Thomas BA, Wagner J, Aasvang GM, Abbafati C, Abbasoglu Ozgoren A, Abd-Allah F, Abera SF, Aboyans V, Abraham B, Abraham JP, Abubakar I, Abu-Rmeileh NM, Aburto TC, Achoki T, Adelekan A, Adofo K, Adou AK, Adsuar JC, Afshin A, Agardh EE, Al Khabouri MJ, Al Lami FH, Alam SS, Alasfoor D, Albittar MI, Alegretti MA, Aleman AV, Alemu ZA, Alfonso-Cristancho R, Alhabib S, Ali R, Ali MK, Alla F, Allebeck P, Allen PJ, Alsharif U, Alvarez E, Alvis-Guzman N, Amankwaa AA, Amare AT, Ameh EA, Ameli O, Amini H, Ammar W, Anderson BO, Antonio CA, Anwari P, Argeseanu Cunningham S, Arnlöv J, Arsenijevic VS, Artaman A, Asghar RJ, Assadi R, Atkins LS, Atkinson C, Avila MA, Awuah B, Badawi A, Bahit MC, Bakfalouni T, Balakrishnan K, Balalla S, Balu RK, Banerjee A, Barber RM, Barker-Collo SL, Barquera S, Barregard L, Barrero LH, Barrientos-Gutierrez T, Basto-Abreu AC, Basu A, Basu S, Basulaiman MO, Batis Ruvalcaba C, Beardsley J, Bedi N, Bekele T, Bell ML, Benjet C, Bennett DA, Benzian H, Bernabé E, Beyene TJ, Bhala N, Bhalla A, Bhutta ZA, Bikbov B, Bin Abdulhak AA, Blore JD, Blyth FM, Bohensky MA, Bora Başara B, Borges G, Bornstein NM, Bose D, Boufous S, Bourne RR, Brainin M, Brazinova A, Breitborde NJ, Brenner H, Briggs AD, Broday DM, Brooks PM, Bruce NG, Brugha TS, Brunekreef B, Buchbinder R, Bui LN, Bukhman G, Bulloch AG, Burch M, Burney PG, Campos-Nonato IR, Campuzano JC, Cantoral AJ, Caravanos J, Cárdenas R, Cardis E, Carpenter DO, Caso V, Castañeda-Orjuela CA, Castro RE, Catalá-López F, Cavalleri F, Çavlin A, Chadha VK, Chang JC, Charlson FJ, Chen H, Chen W, Chen Z, Chiang PP, Chimed-Ochir O, Chowdhury R, Christophi CA, Chuang TW, Chugh SS, Cirillo M, Claßen TK, Colistro V, Colomar M, Colquhoun SM, Contreras AG, Cooper C, Cooperrider K, Cooper LT, Coresh J, Courville KJ, Criqui MH, Cuevas-Nasu L, Damsere-Derry J, Danawi H, Dandona L, Dandona R, Dargan PI, Davis A, Davitoiu DV, Dayama A, de Castro EF, De la Cruz-Góngora V, De Leo D, de Lima G, Degenhardt L, del Pozo-Cruz B, Dellavalle RP, Deribe K, Derrett S, Des Jarlais DC, Dessalegn M, deVeber GA, Devries KM, Dharmaratne SD, Dherani MK, Dicker D, Ding EL, Dokova K, Dorsey ER, Driscoll TR, Duan L, Durrani AM, Ebel BE, Ellenbogen RG, Elshrek YM, Endres M, Ermakov SP, Erskine HE, Eshrati B, Esteghamati A, Fahimi S, Faraon EJ, Farzadfar F, Fay DF, Feigin VL, Feigl AB, Fereshtehnejad SM, Ferrari AJ, Ferri CP, Flaxman AD, Fleming TD, Foigt N, Foreman KJ, Paleo UF, Franklin RC, Gabbe B, Gaffikin L, Gakidou E, Gamkrelidze A, Gankpé FG, Gansevoort RT, García-Guerra FA, Gasana E, Geleijnse JM, Gessner BD, Gething P, Gibney KB, Gillum RF, Ginawi IA, Giroud M, Giussani G, Goenka S, Goginashvili K, Gomez Dantes H, Gona P, Gonzalez de Cosio T, González-Castell D, Gotay CC, Goto A, Gouda HN, Guerrant RL, Gugnani HC, Guillemin F, Gunnell D, Gupta R, Gupta R, Gutiérrez RA, Hafezi-Nejad N, Hagan H, Hagstromer M, Halasa YA, Hamadeh RR, Hammami M, Hankey GJ, Hao Y, Harb HL, Haregu TN, Haro JM, Havmoeller R, Hay SI, Hedayati MT, Heredia-Pi IB, Hernandez L, Heuton KR, Heydarpour P, Hijar M, Hoek HW, Hoffman HJ, Hornberger JC, Hosgood HD, Hoy DG, Hsairi M, Hu G, Hu H, Huang C, Huang JJ, Hubbell BJ, Huiart L, Husseini A, Iannarone ML, Iburg KM, Idrisov BT, Ikeda N, Innos K, Inoue M, Islami F, Ismayilova S, Jacobsen KH, Jansen HA, Jarvis DL, Jassal SK, Jauregui A, Jayaraman S, Jeemon P, Jensen PN, Jha V, Jiang F, Jiang G, Jiang Y, Jonas JB, Juel K, Kan H, Kany Roseline SS, Karam NE, Karch A, Karema CK, Karthikeyan G, Kaul A, Kawakami N, Kazi DS, Kemp AH, Kengne AP, Keren A, Khader YS, Khalifa SE, Khan EA, Khang YH, Khatibzadeh S, Khonelidze I, Kieling C, Kim D, Kim S, Kim Y, Kimokoti RW, Kinfu Y, Kinge JM, Kissela BM, Kivipelto M, Knibbs LD, Knudsen AK, Kokubo Y, Kose MR, Kosen S, Kraemer A, Kravchenko M, Krishnaswami S, Kromhout H, Ku T, Kuate Defo B, Kucuk Bicer B, Kuipers EJ, Kulkarni C, Kulkarni VS, Kumar GA, Kwan GF, Lai T, Lakshmana Balaji A, Lalloo R, Lallukka T, Lam H, Lan Q, Lansingh VC, Larson HJ, Larsson A, Laryea DO, Lavados PM, Lawrynowicz AE, Leasher JL, Lee JT, Leigh J, Leung R, Levi M, Li Y, Li Y, Liang J, Liang X, Lim SS, Lindsay MP, Lipshultz SE, Liu S, Liu Y, Lloyd BK, Logroscino G, London SJ, Lopez N, Lortet-Tieulent J, Lotufo PA, Lozano R, Lunevicius R, Ma J, Ma S, Machado VM, MacIntyre MF, Magis-Rodriguez C, Mahdi AA, Majdan M, Malekzadeh R, Mangalam S, Mapoma CC, Marape M, Marcenes W, Margolis DJ, Margono C, Marks GB, Martin RV, Marzan MB, Mashal MT, Masiye F, Mason-Jones AJ, Matsushita K, Matzopoulos R, Mayosi BM, Mazorodze TT, McKay AC, McKee M, McLain A, Meaney PA, Medina C, Mehndiratta MM, Mejia-Rodriguez F, Mekonnen W, Melaku YA, Meltzer M, Memish ZA, Mendoza W, Mensah GA, Meretoja A, Mhimbira FA, Micha R, Miller TR, Mills EJ, Misganaw A, Mishra S, Mohamed Ibrahim N, Mohammad KA, Mokdad AH, Mola GL, Monasta L, Montañez Hernandez JC, Montico M, Moore AR, Morawska L, Mori R, Moschandreas J, Moturi WN, Mozaffarian D, Mueller UO, Mukaigawara M, Mullany EC, Murthy KS, Naghavi M, Nahas Z, Naheed A, Naidoo KS, Naldi L, Nand D, Nangia V, Narayan KM, Nash D, Neal B, Nejjari C, Neupane SP, Newton CR, Ngalesoni FN, Ngirabega Jde D, Nguyen G, Nguyen NT, Nieuwenhuijsen MJ, Nisar MI, Nogueira JR, Nolla JM, Nolte S, Norheim OF, Norman RE, Norrving B, Nyakarahuka L, Oh IH, Ohkubo T, Olusanya BO, Omer SB, Opio JN, Orozco R, Pagcatipunan RS Jr, Pain AW, Pandian JD, Panelo CI, Papachristou C, Park EK, Parry CD, Paternina Caicedo AJ, Patten SB, Paul VK, Pavlin BI, Pearce N, Pedraza LS, Pedroza A, Pejin Stokic L, Pekericli A, Pereira DM, Perez-Padilla R, Perez-Ruiz F, Perico N, Perry SA, Pervaiz A, Pesudovs K, Peterson CB, Petzold M, Phillips MR, Phua HP, Plass D, Poenaru D, Polanczyk GV, Polinder S, Pond CD, Pope CA, Pope D, Popova S, Pourmalek F, Powles J, Prabhakaran D, Prasad NM, Qato DM, Quezada AD, Quistberg DA, Racapé L, Rafay A, Rahimi K, Rahimi-Movaghar V, Rahman SU, Raju M, Rakovac I, Rana SM, Rao M, Razavi H, Reddy KS, Refaat AH, Rehm J, Remuzzi G, Ribeiro AL, Riccio PM, Richardson L, Riederer A, Robinson M, Roca A, Rodriguez A, Rojas-Rueda D, Romieu I, Ronfani L, Room R, Roy N, Ruhago GM, Rushton L, Sabin N, Sacco RL, Saha S, Sahathevan R, Sahraian MA, Salomon JA, Salvo D, Sampson UK, Sanabria JR, Sanchez LM, Sánchez-Pimienta TG, Sanchez-Riera L, Sandar L, Santos IS, Sapkota A, Satpathy M, Saunders JE, Sawhney M, Saylan MI, Scarborough P, Schmidt JC, Schneider IJ, Schöttker B, Schwebel DC, Scott JG, Seedat S, Sepanlou SG, Serdar B, Servan-Mori EE, Shaddick G, Shahraz S, Levy TS, Shangguan S, She J, Sheikhbahaei S, Shibuya K, Shin HH, Shinohara Y, Shiri R, Shishani K, Shiue I, Sigfusdottir ID, Silberberg DH, Simard EP, Sindi S, Singh A, Singh GM, Singh JA, Skirbekk V, Sliwa K, Soljak M, Soneji S, Søreide K, Soshnikov S, Sposato LA, Sreeramareddy CT, Stapelberg NJ, Stathopoulou V, Steckling N, Stein DJ, Stein MB, Stephens N, Stöckl H, Straif K, Stroumpoulis K, Sturua L, Sunguya BF, Swaminathan S, Swaroop M, Sykes BL, Tabb KM, Takahashi K, Talongwa RT, Tandon N, Tanne D, Tanner M, Tavakkoli M, Te Ao BJ, Teixeira CM, Téllez Rojo MM, Terkawi AS, Texcalac-Sangrador JL, Thackway SV, Thomson B, Thorne-Lyman AL, Thrift AG, Thurston GD, Tillmann T, Tobollik M, Tonelli M, Topouzis F, Towbin JA, Toyoshima H, Traebert J, Tran BX, Trasande L, Trillini M, Trujillo U, Dimbuene ZT, Tsilimbaris M, Tuzcu EM, Uchendu US, Ukwaja KN, Uzun SB, van de Vijver S, Van Dingenen R, van Gool CH, van Os J, Varakin YY, Vasankari TJ, Vasconcelos AM, Vavilala MS, Veerman LJ, Velasquez-Melendez G, Venketasubramanian N, Vijayakumar L, Villalpando S, Violante FS, Vlassov VV, Vollset SE, Wagner GR, Waller SG, Wallin MT, Wan X, Wang H, Wang J, Wang L, Wang W, Wang Y, Warouw TS, Watts CH, Weichenthal S, Weiderpass E, Weintraub RG, Werdecker A, Wessells KR, Westerman R, Whiteford HA, Wilkinson JD, Williams HC, Williams TN, Woldeyohannes SM, Wolfe CD, Wong JQ, Woolf AD, Wright JL, Wurtz B, Xu G, Yan LL, Yang G, Yano Y, Ye P, Yenesew M, Yentür GK, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Younoussi Z, Yu C, Zaki ME, Zhao Y, Zheng Y, Zhou M, Zhu J, Zhu S, Zou X, Zunt JR, Lopez AD, Vos T, Murray CJ. GBD 2013 Risk Factors Collaborators, et al. Lancet. 2015 Dec 5;386(10010):2287-323. doi: 10.1016/S0140-6736(15)00128-2. Epub 2015 Sep 11. Lancet. 2015. PMID: 26364544 Free PMC article.
  • Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010.
    Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, Charlson FJ, Norman RE, Flaxman AD, Johns N, Burstein R, Murray CJ, Vos T. Whiteford HA, et al. Lancet. 2013 Nov 9;382(9904):1575-86. doi: 10.1016/S0140-6736(13)61611-6. Epub 2013 Aug 29. Lancet. 2013. PMID: 23993280 Review.
  • Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010.
    Degenhardt L, Whiteford HA, Ferrari AJ, Baxter AJ, Charlson FJ, Hall WD, Freedman G, Burstein R, Johns N, Engell RE, Flaxman A, Murray CJ, Vos T. Degenhardt L, et al. Lancet. 2013 Nov 9;382(9904):1564-74. doi: 10.1016/S0140-6736(13)61530-5. Epub 2013 Aug 29. Lancet. 2013. PMID: 23993281 Review.
See all similar articles

Cited by 595 articles

See all "Cited by" articles

References

    1. Public Health England . From evidence into action: opportunities to protect and improve the nation's health. Public Health England; London: 2014.
    1. Institute for Health Metrics and Evaluation President Ian Khama: emboldened by evidence to reduce harms of alcohol use in Botswana. http://www.healthdata.org/acting-data/president-ian-khama-emboldened-evidence-reduce-harms-alcohol-use-botswana (accessed July 24, 2016).
    1. Lim SS, Vos T, Flaxman AD. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2224–2260. - PMC - PubMed
    1. GBD 2013 Risk Factors Collaborators. Forouzanfar MH, Alexander L. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386:2287–2323. - PMC - PubMed
    1. Kellerborg K, Danielsson AK, Allebeck P, Coates MM, Agardh E. Disease burden attributed to alcohol: how methodological advances in the Global Burden of Disease 2013 Study have changed the estimates in Sweden. Scand J Public Health. 2016;44:604–610. - PubMed

Publication types

MeSH terms

Feedback