High blood pressure, smoking and alcohol abuse are the most dangerous health risks in the world, a major study has shown.
In the space of 20 years, all three have overtaken child hunger to become the leading causes of premature death.
More than nine million people died as a result of high blood pressure in 2010, making it the deadliest single global risk factor.
Smoking accounted for 6.3 million deaths and alcohol consumption 4.9 million deaths.
The average trends masked a lot of regional variation, with different parts of the world experiencing different health problems.
International scientists participating in the Global Burden of Disease Study compared the effects of common health risk factors in 1990 and 2010.
Estimates were made both of the number of deaths attributed to each, and disability-adjusted life years (Dalys), a measurement that takes into account years of life both lost and lived with disability.
The findings form part of a series of papers published online today by The Lancet medical journal.
Together, they constitute the largest investigation of the global burden of disease, injury and health risks ever undertaken.
Professor Majid Ezzati, one of the study leaders from the School of Public Health at Imperial College London, said: “Overall we’re seeing a growing burden of risk factors that lead to chronic diseases in adults, such as cancer, heart disease and diabetes, and a decreasing burden for risks associated with infectious diseases in children.
“But this global picture disguises the starkly different trends across regions. The risks associated with poverty have come down in most places, like Asia and Latin America, but they remain the leading issues in sub-Saharan Africa.”
Obesity, expressed as high body mass index (BMI), showed the fastest rise in harmfulness. It moved up the rankings of health burden from 10th place in 1990 to sixth in 2010,
More than three million deaths in 2010 were attributable to excess body weight, according to the study. This was more than three times the death toll due to malnutrition.
High BMI was the leading risk factor in Australasia and southern Latin America.
Smoking, including passive smoking, had the greatest impact on health in the high-income countries of western Europe and North America.
Alcohol was the leading risk factor in eastern Europe, most of Latin America and southern sub-Saharan Africa.
Cooking and heating using dirty solid fuels such as coal and wood remained a leading health risk in southern Asia. However, its effect had generally diminished during the 1990s.
Prof Ezzati added: “The good news is there are lots of things we can do to reduce disease risk.
“To bring down the burden of high blood pressure, we need to regulate the salt content of food, provide easier access to fresh fruits and vegetables, and strengthen primary healthcare services.
“”Under-nutrition has come down in the ranking because we’ve made a lot of progress in many parts of the world. This should encourage us to continue those efforts and to replicate that success in Africa, where it’s still a major problem.”
Almost 500 authors took part in the massive study, which covered 187 countries, looked at 67 different risk factors and produced 650 million individual results.
Dr Richard Horton, editor of The Lancet, compared the work to mapping the human genetic code.
“The Global Burden of Disease 2010 is the most comprehensive assessment of human health in the history of medicine,” said Dr Horton.
“It provides insights into human health that are I think comparable in scope and depth to the sequencing of the human genome.”
– John von Radowitz
