The latest global estimates for the state of the world's health from the Global Burden of Disease study highlight that global progress in health is not inevitable.

Latest global estimates for the state of the world's health from the Global Burden of Disease study (GBD) estimate that:

  1. Improvements in overall mortality rates were less pronounced overall, and rates stagnated or got worse in some countries in 2017.
  2. Globally, fertility rates have declined since 1950. In 91 nations, fertility rates are not high enough to maintain the current population, and in 104 nations high fertility rates are driving population increases.
  3. Half of countries estimated to face shortfall in healthcare workforce – with 47% of having fewer than 10 doctors to serve 10,000 people and 46% having fewer than 30 nurses or midwives to serve 10,000 people.
  4. Emerging adverse trends (such as conflict and terrorism, and the opioid crisis) could lead to negative shifts over time if action is not taken.
  5. Half of all global deaths were caused by just four risk factors in 2017 – high blood pressure, smoking, high blood glucose, and high body mass index (BMI).
  6. Low back pain, headache disorders, and depressive disorders were the three leading causes of disability globally in 2017, and have prevailed as leading causes for nearly three decades.

The latest global estimates for the state of the world's health from the Global Burden of Disease Study (GBD), published in a special issue of  The Lancet, highlight that global progress in health is not inevitable.

This year's GBD study estimates that improvements in mortality rates for adults were less pronounced overall and stagnated or got worse in some countries in 2017. In addition, no countries are on target to meet the United Nation's Sustainable Development Goals to improve health by 2030.

Emerging adverse trends

Emerging adverse trends could lead to negative shifts over time if action is not taken – for example, conflict and terrorism is an increasing threat to global health (with numbers of related deaths increasing by 118% between 2007-2017), and an era- defining epidemic of opioid dependence continues – with more than 4 million new cases and around 110,000 deaths in 2017.

In addition, half of all global deaths (51.5%, 28.8 million of 55.9 million deaths) were caused by just four preventable risk factors in 2017 (high blood pressure [10.4 million deaths], smoking [7.1 million deaths], high blood glucose [6.5 million deaths], and high body mass index [4.7 million deaths], presenting a public health challenge and an opportunity for action.

The GBD is the only annual, comprehensive, peer-reviewed assessment of global trends in health, providing global and national estimates for around 280 causes of death, 359 diseases and injuries, and 84 risk factors in 195 countries and territories worldwide.

Health Worker Density 

For the first time, the estimates include a global analysis of health worker density using surveys and census data on people's occupations. The authors note that the figures can not estimate the quality of care, only the number of health workers available.

"The balance of physicians, nurses, midwives and pharmacists in a country's workforce underpins the types of care that are available to the population, while increasing the number of health workers will be important for many countries, workforce composition, "says lead author Professor Rafael Lozano, the Institute for Health Metrics and Evaluation at the University of Washington, USA.

The authors note that the study does not include physicians and nurses by specialty, which may be important for understanding the workforce shortfalls for each country's varying burden of disease. In future, the GBD study will refine health worker estimates by using more recent occupational data.