Healthy life expectancy increases in Vietnam, despite health loss from stroke, road injury, and low back and neck pain
Healthy life expectancy in Vietnam has increased more than life expectancy since 1990
SEATTLE — People in Vietnam are living longer, but a complex mix of fatal and nonfatal ailments cause a tremendous amount of health loss, according to a new analysis of 306 diseases and injuries in 188 countries.
Thanks to marked declines in death and illness caused by HIV/AIDS and malaria in the past decade and significant advances made in addressing communicable, maternal, neonatal, and nutritional disorders, health has improved significantly around the world. Global life expectancy at birth for both sexes rose by 6.2 years (from 65.3 in 1990 to 71.5 in 2013), while healthy life expectancy at birth rose by 5.4 years (from 56.9 in 1990 to 62.3 in 2013).
Healthy life expectancy takes into account not just mortality but also the impact of nonfatal conditions and summarizes years lived with disability and years lost due to premature mortality. The increase in healthy life expectancy for most countries has not been as dramatic as the growth of life expectancy, and as a result, people are living more years with illness and disability.
This is not true in Vietnam. Life expectancy gains for men since 1990, 6.4 years, was less than for women, 7.9 years, and while men gained 8.2 years of healthy life expectancy women gained 10.6 years. But life expectancy for women in Vietnam still outpaces that of men, 80.1 years compared to 72.4 years.
“Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition,” is the first study to examine fatal and nonfatal health loss across countries. Published in The Lancet on August 27, the study was conducted by an international consortium of researchers working on the Global Burden of Disease study and led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
For most countries, changes in healthy life expectancy for males and females between 1990 and 2013 were significant and positive, but in dozens of countries, including Botswana, Belize, and Syria, healthy life expectancy in 2013 was not significantly higher than in 1990.
“It’s encouraging to see the healthy life expectancy increase for people in Vietnam,” said Dr. Bach Tran,
Lecturer in Health Economics at Hanoi Medical University and a co-author of the study. “But the gap between life expectancy and healthy life expectancy is still significant. We need to identify and address the major causes of health loss to ensure Vietnamese people are living longer and healthier lives.”
The study’s researchers use DALYs, or disability-adjusted life years, to compare the health of different populations and health conditions across time. One DALY equals one lost year of healthy life and is measured by the sum of years of life lost and years lived with disability.
In 2013 in Vietnam, the leading causes of health loss, as measured by DALYs, were stroke, road injuries, low back and neck pain, sense organ diseases like vision and hearing loss, lower respiratory infections, neonatal preterm birth, liver cancer, depression, violence, and chronic obstructive pulmonary disease (COPD). Of these leading causes sense organ diseases, liver cancer, depression, and violence were not among the leading causes of health loss globally.
The study also examines the role that socio-demographic status – a combination of per capita income, population age, fertility rates, and average years of schooling – plays in determining health loss. Researchers’ findings underscore that this accounts for more than half of the differences seen across countries and over time for certain leading causes of DALYs, including maternal and neonatal disorders. But the study notes that socio-demographic status is much less responsible for the variation seen for ailments including cardiovascular disease and diabetes.
“Factors including income and education have an important impact on health but don’t tell the full story,” said IHME Director Dr. Christopher Murray. “Looking at healthy life expectancy and health loss at the country level can help guide policies to ensure that people everywhere can have long and healthy lives no matter where they live.”
Leading causes of health loss or DALYs in Vietnam for both sexes, 2013
|3||Low back and neck pain|
|4||Sense organ diseases|
|5||Lower respiratory diseases|
|6||Neonatal preterm birth|
Download the study at http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)61340-X/abstract