Global Burden of Disease: Mortality Falls, Youth Deaths and Inequities Rise

Global Burden of Disease: Mortality Falls, Youth Deaths and Inequities Rise

M Hasan    9:00 PM   

Global Mortality Rates and the Challenges of Youth Health

According to the latest Global Burden of Disease (GBD) study published in The Lancet and presented at the World Health Summit in Berlin, global mortality rates are decreasing overall. However, this decline is not observed among youths and young adults. The research highlights a concerning trend that requires immediate attention from health care leaders and policymakers.

Noncommunicable diseases (NCDs) now account for nearly two-thirds of the world's total mortality and morbidity, with ischemic heart disease, stroke, and diabetes being the leading causes. Researchers suggest that nearly half of all death and disability could be prevented by addressing key risk factors such as high levels of blood sugar and high body mass index (BMI).

Dr. Christopher Murray, Director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine, emphasized the significance of these findings. "The rapid growth in the world's aging population and evolving risk factors have ushered in a new era of global health challenges," he said. "The evidence presented in the Global Burden of Disease study is a wake-up call, urging government and health care leaders to respond swiftly and strategically to the disturbing trends that are reshaping public health needs."

Comprehensive Data Collection and Analysis

Dr. Murray's team at IHME and its GBD Collaborator Network of 16,500 scientists and researchers collected and analyzed data to produce estimates for 375 diseases and injuries and 88 risk factors by age and sex globally, regionally, and nationally for 204 countries and territories and 660 subnational locations from 1990 to 2023. This makes the GBD the most comprehensive research quantifying health loss.

Over 310,000 total data sources were used for the latest iteration, with 30% of them being new to this year's study. The research includes 1,211 location-years of provisional all-age vital registration data, which had not previously been used, and which provide more timely information.

Demographic Analysis: Declines in Mortality and Rising Youth Deaths

Despite population growth and aging, the 2023 global age-standardized mortality rate has declined 67% since 1950, and all countries and territories marked declines. Global life expectancy returned to pre-pandemic levels at 76.3 years for females and 71.5 years for males, which is more than 20 years higher compared to 1950. Despite this progress, stark geographic differences remain, with life expectancy ranging from as high as 83 years in high-income regions to as low as 62 years in sub-Saharan Africa.

Among adolescents and young adults, the largest increase in deaths was registered among those aged 20 to 39 in high-income North America from 2011 to 2023, mainly due to suicide, drug overdose, and high quantities of alcohol. During the same period, deaths in the 5–19-year age group increased in Eastern Europe, high-income North America, and the Caribbean.

Over the entire study period, the number of infant deaths declined more than for any other age group. From 2011 to 2023, East Asia recorded the largest decrease of 68% in the mortality rate for the under-5 age group due to better nutrition, vaccines, and stronger health systems.

Causes of Death: Shift from Infectious to Noncommunicable Diseases

Causes of death are shifting from infectious to noncommunicable diseases (NCDs), creating new global health challenges, particularly for low-income countries. After standing as the leading cause of death in 2021, COVID-19 plunged to 20th place in 2023, putting ischemic heart disease and stroke back at the top, followed by chronic obstructive pulmonary disease, lower respiratory infections, and neonatal disorders.

Since 1990, mortality rates for ischemic heart disease and stroke have declined, and so have diarrheal diseases, tuberculosis, stomach cancer, and measles. Conversely, during the same period, the death rate increased for diabetes, chronic kidney disease, Alzheimer's disease, and HIV/AIDS.

While the global mean age at death increased from 46.4 in 1990 to 62.9 years in 2023, geographic inequities were profound. The highest mean age of death was recorded in the high-income super-region, with females reaching 80.5 years and males at 74.4 years. The lowest mean age of death was in sub-Saharan Africa, with females at 37.1 years and males at 34.8 years.

Burden of Diseases, Injuries, and Risk Factors

Noncommunicable diseases (NCDs) accounted for nearly two-thirds of the world's total death and disability. The top three causes were ischemic heart disease, stroke, and diabetes. Low-income regions also saw a sharp rise in NCDs, further constraining nations with limited resources.

From 1990 to 2023, the age-standardized rate of disability-adjusted life years (DALYs) fell 36%. This measures the total years of healthy life lost by examining the years lost from premature death and years lived with disability. From 2010 to 2023, DALY rates for communicable, maternal, neonatal, and nutritional (CMNN) diseases fell by almost 26%. This was led by rates for diarrheal diseases being cut in half, a 43% decrease in rates for HIV/AIDS, and a 42% drop for tuberculosis.

Neonatal disorders and lower respiratory infections remain the top causes of CMNN diseases but have declined 17% and 25%, respectively.

Almost half of the global mortality and morbidity in 2023 was attributable to 88 modifiable risk factors. The 10 risk factors with the highest proportion of health loss were high systolic blood pressure, particulate matter pollution, smoking, high fasting plasma glucose, low birthweight and short gestation, high BMI, high LDL cholesterol, kidney dysfunction, child growth failure, and lead exposure.

Urgent Need for Policy Changes

The GBD 2023 study highlights the urgent need for policymakers to expand health priorities beyond reducing child mortality to include adolescents and young adults, particularly in areas with higher rates of mortality than previously known.

"Decades of work to close the gap in low-income regions with persistent health inequities are in danger of unraveling due to the recent cuts to international aid," said Emmanuela Gakidou, senior author and professor at IHME. "These countries rely on global health funding for life-saving primary care, medicine, and vaccines. Without it, the gap is sure to widen."

The GBD estimates are also available in various interactive data visualization tools, including GBD Compare and GBD Results.

Reducing Humboldt County Public Health Funds Harms Children and Seniors

Reducing Humboldt County Public Health Funds Harms Children and Seniors

M Hasan    4:13 AM   

Funding Cuts Impact Health and Education Programs in Humboldt County

Humboldt County is facing significant challenges as it prepares to lose $250,000 in federal funds effective October 1. This funding, part of the CalFresh Healthy Living program, was used to support various initiatives aimed at improving public health and wellness across the county. The loss comes following the passage of HR 1, the One Big Beautiful Bill Act, which eliminated SNAP-Ed funding that had been crucial for nutrition and physical activity education in schools and communities.

The impact of these cuts is expected to be most felt by children and seniors, who rely heavily on the programs funded by this money. The Humboldt County Department of Health and Human Services (DHHS) highlighted that the loss includes critical programs such as Safe Routes to Schools and “Rethink Your Drink,” which educate young people about healthy alternatives to sugary drinks. These programs play a vital role in combating obesity and promoting healthier lifestyles among youth.

Additionally, the funding cut will result in the elimination of falls prevention classes for senior citizens. These classes are essential in helping older adults maintain their independence and reduce the risk of injury from falls. DHHS spokesperson Christine Messinger confirmed that while the county is shifting personnel working on CalFresh Healthy Living to other programs, there will be no staffing cuts. However, the loss of these specific programs is still a major concern for the community.

Open Door Community Health Centers Affected

Open Door Community Health Centers, one of the recipients of CalFresh Healthy Living funds, has expressed concerns over the potential negative health impacts of the funding cuts. CEO Tory Starr emphasized that the funds are used to help supply patients with access to food through the program. Any decrease in funding could have serious consequences for those relying on these services.

“Access to healthy food is a key element in everyone’s health,” Starr said. “The implications for negatively impacting the overall health of our community will be present because of the cuts.”

Second District Humboldt County Supervisor Michelle Bushnell also voiced her disappointment over the loss of funding. She noted that prevention programs are more effective than addressing problems after they occur. By focusing on upstream solutions, these programs help residents make healthy choices and avoid crises, ultimately making the community more resilient.

Senior Programs Face Challenges

Despite the funding cuts, Renee Arche with the Humboldt Senior Resource Center (HSRC) stated that the center's day-to-day operations would not be significantly affected. Tasha Romo, HSRC’s director of nutrition and activities, mentioned that the Heritage Cafés and Meals on Wheels Redwood Coast would continue as usual. However, fall prevention classes offered at HSRC, in partnership with Area 1 Agency on Aging (A1AA) and DHHS, will be eliminated.

Maggie Kraft, A1AA director, emphasized the importance of these classes in reducing the risk of injury for older adults. With one in four older adults falling each year, these programs are essential for maintaining independence and quality of life. The loss of funding means these vital classes will no longer be available, creating a gap in support that seniors rely on.

Education and Community Initiatives Hit Hard

Much of the funding being cut from Public Health’s budget is aimed at the health of children and students. Alice Birney Elementary School Principal Kristin Sobilo highlighted the significance of the support provided by these programs in encouraging kids to walk safely to school, learn about nutritious food and drink choices, and stay active daily.

Amy Terrones, coordinator for the Southern Humboldt Family Resource Center, noted that the center had already faced a 5% reduction in CalFresh funding for its Backpacks for Kids program. However, she mentioned that the Humboldt Area Foundation helped offset some of these losses. Terrones expressed hope that the community would continue to support organizations like hers, despite the challenges posed by the funding cuts.

Collaborative Efforts to Mitigate Impact

Several partnering organizations, including Eureka City Schools, Redwood Community Action Agency, and others, will be affected by the funding cuts. While some agencies have found ways to mitigate the impact, the overall effect on the community remains a concern.

The Times-Standard reached out to Comunidad Unida del Norte de Arcata (CUNA), but a spokesperson for the organization stated that they were not recipients of any Public Health funding.

As the community grapples with these changes, many are looking for ways to collaborate and support local initiatives. Despite the challenges, there is a sense of determination to find solutions and continue providing essential services to those in need.

Who Are the MAHA Moms? They Finally Feel Heard by RFK Jr.

Who Are the MAHA Moms? They Finally Feel Heard by RFK Jr.

M Hasan    9:21 AM   

After years of feeling dismissed for their views, which often diverge from mainstream science, the mothers in the Make America Healthy Again movement — known as MAHA moms — are experiencing a sense of validation. Their perspectives are now being acknowledged at the highest levels of government.

At an event on September 22, where President Donald Trump and Health and Human Services Secretary Robert F. Kennedy Jr. discussed the potential link between Tylenol use during pregnancy and the development of autism or attention-deficit/hyperactivity disorder (ADHD), the men handed the microphone to two MAHA moms, encouraging the audience to listen to their voices.

Claire Dooley, a second-generation advocate from Washington, D.C., who is skeptical of vaccines, expressed that this moment marked a shift for many MAHA moms. "There’s a whole group of people who have been feeling alienated for a very long time, and now we don’t feel like that anymore," she said. "I think that’s kind of the way we can step into the future."

Vaccines are a central issue for MAHA moms

The MAHA movement unites advocates for independent healthcare and parental rights. It includes mothers seeking a more organic lifestyle, individuals distrustful of pharmaceutical companies, grassroots organizations, donor-backed groups, Facebook communities, and nonprofits like Children's Health Defense, which was previously associated with Kennedy.

Dooley noted that many MAHA members come from the left, having felt excluded from mainstream conversations. "So we have people on the right who are listening to us, so we’re like 'OK, the right is listening to us, let’s do that.'"

One of the key themes within the MAHA movement is the belief that vaccines cause autism. This idea has been repeatedly debunked by scientific research. The 1998 study that popularized this myth was retracted 15 years ago, and the British Medical Journal labeled it "an elaborate fraud." Despite this, many parents continue to support the view and seek answers.

Dooley, a filmmaker and member of the MAHA Action committee, works with others who claim their children were severely harmed by vaccines. She emphasizes the importance of striving to make vaccines as safe as possible.

Her mother, Melisha Dooley, a self-described "crunchy" mom of six from Mississippi, lobbied for the state to allow parents to opt out of vaccines based on religious grounds. A federal judge implemented this exemption in 2023 following a lawsuit from parents.

"It all comes down to parental rights," Melisha Dooley said. "It’s not my right to tell you what to do with your child, just like it’s not your right to tell me what to do with mine."

Melisha Dooley also wants to see Kennedy address "corporate capture" in American healthcare. Specifically, she hopes he will help repeal the 1986 law that shields doctors and pharmaceutical companies from liability for vaccine injuries and establish an arbitration system for those claiming vaccine-related harm.

Kennedy highlighted his comments about the connection between vaccines and autism on Facebook after the September 22 event. He stated that a significant portion of mothers of children with autism believe their child was injured by a vaccine. He also criticized the scientific community for not doing enough in the past.

Kennedy previously restructured a key vaccine panel, adding members who are skeptical of vaccines. The panel voted against recommending vaccines containing thimerosal, a preservative that anti-vaccine advocates have long targeted, and encouraged more discussions between patients and their doctors about vaccine risks.

Claire Dooley expressed trust in Kennedy’s intentions. "I just know he’s going to do everything he can in his position," she said. "But he also can’t come out and say, 'Vaccines are causing autism, and let’s take them all away.'"

Tylenol use during pregnancy

Alana Newman, a 39-year-old mother of three from Dallas, found comfort in the September 22 news conference with Kennedy, Trump, and other health officials. The discussion focused on a potential link between Tylenol use during pregnancy and later diagnoses of autism or ADHD, though Trump made unfounded claims.

"It was comforting that Trump actually cared about the mother’s perspective and brought two mothers to the podium," Newman said. "I’m so sick and tired of people saying to me, 'Alana you’re not a doctor,' and basically calling me stupid."

Public health experts, scientists, doctors, and the maker of Tylenol have refuted the claims made during the news conference. While some studies suggest a link between acetaminophen and neurodevelopmental disorders, others have called this into question, leaving no settled conclusion in the scientific community.

Dr. Mehmet Oz, head of the Centers for Medicare and Medicaid Services, emphasized that while there seems to be a higher risk of autism in children whose mothers used acetaminophen, causation has not been proven. He noted that the administration has taken a different approach compared to previous governments.

Dr. Andrea Baccarelli, a Harvard University professor, said that the risk of neurodevelopmental disorders after prenatal use of Tylenol is most pronounced when the expecting mother uses it for four weeks or longer. Animal studies support a causal relationship, but Baccarelli stressed the importance of using acetaminophen cautiously.

Stephanie Carmody, a podcaster from Glastonbury, Connecticut, praised Kennedy for addressing Big Pharma and spoke about her own reluctance to take over-the-counter drugs. "Something as simple as acetaminophen, I don't think most people realize the damage it can do," she said.

Some MAHA moms focus on the food system

Dr. Ana-Maria Temple, a holistic pediatrician from Charlotte, North Carolina, supports Kennedy's efforts to change the status quo. She bases her treatments for conditions like eczema and autism on nutrition rather than medication.

Temple criticized the traditional medical model, which often provides only 10 minutes per patient, making it difficult to implement nutritional interventions. "I like that (since) RFK has come into play, he's like, 'Wait, what are we doing? Why are so many kids sick?'" she said.

Vani Hari, a 46-year-old mom of two from Charlotte, has been advocating for the removal of chemicals in processed foods for over a decade. She is pleased with Kennedy's efforts to eliminate certain additives from food.

Hari launched a Change.org petition in 2013 to remove artificial food dyes from Kraft products, which led to changes in specific items. She also convinced Chick-fil-A to switch to antibiotic-free chicken in 2014, although the company has faced supply chain challenges since 2024.

"It’s been mere months since he took office, and he's already convinced over half of the food industry to start removing artificial food dyes," Hari said. "He's called for the review of the nutritional guidelines of infant formula to be updated."

Mississippi Urges Action as Infant Death Toll Surges

Mississippi Urges Action as Infant Death Toll Surges

M Hasan    9:23 AM   

Mississippi Declares Public Health Emergency Over Rising Infant Mortality Rates

Mississippi health officials have declared a public health emergency after data revealed that the state’s infant mortality rate has reached its highest level in over a decade. In 2024, the state recorded 9.7 infant deaths for every 1,000 live births, nearly double the national average of 5.6 deaths per 1,000. Since 2014, more than 3,500 infants in Mississippi have died before their first birthday. This alarming trend has prompted officials to take urgent action, highlighting the broader national issue of infant mortality and the systemic challenges that contribute to it.

Infant Mortality Rate: A Nationwide Concern

The problem is not unique to Mississippi. Even in cities with robust healthcare systems like Boston, Black infants continue to face higher mortality rates compared to White infants. Recent reports from Boston show that Black infants die at more than twice the rate of the overall population and triple the rate of White infants. Despite the city's overall infant mortality rate falling below the national average, these disparities underscore the limitations of focusing solely on individual behavior or clinical care. Structural inequities remain a critical factor in the high number of infant deaths across the country.

Dr. Dan Edney, State Health Officer, emphasized the gravity of the situation when he announced the declaration. "Every single infant loss represents a family devastated, a community impacted, and a future cut short," he said. "We cannot and will not accept these numbers as our reality."

Causes Behind the Rising Mortality Rate

The leading causes of infant death in Mississippi include congenital malformations, premature birth, low birthweight, and Sudden Infant Death Syndrome (SIDS). Racial disparities are stark—Black infants in Mississippi are more than twice as likely as White infants to die before their first birthday, and recent data shows these gaps have widened.

Experts argue that declaring a public health emergency is a necessary step to address this crisis. Dr. Michael Warren, Chief Medical and Health Officer at March of Dimes, stated, "This is a novel and necessary step. It elevates infant mortality to the level of urgent crisis response, which it truly is."

Why the Declaration Matters

The declaration allows Mississippi to act swiftly to address gaps in care. The state’s plan includes expanding prenatal services in counties without obstetric providers, creating an obstetric system of care to regionalize services, and improving emergency transfers. Additionally, the state aims to strengthen home visiting and community health worker programs.

"Improving maternal health is the best way to reduce infant mortality," Dr. Edney said. Dr. Morgan McDonald of the Milbank Memorial Fund added that the declaration should draw attention to a preventable tragedy. "We applaud Dr. Edney and his team for raising the alarm in a way that honors the families who have suffered this loss and focuses on solutions."

However, experts caution that individual and clinical interventions alone are not enough. Dr. Rebekah Gee, CEO of Nest Health, stressed, "Healthy babies come from healthy moms. If women can't get continuous healthcare before, during, and after pregnancy, it's no surprise their babies are dying at higher rates."

Federal Funding Cuts and Their Impact

Federal funding cuts are complicating the state’s response. The Pregnancy Risk Assessment Monitoring System (PRAMS), a CDC program that collects data on maternal and infant health, has been targeted for elimination. CDC staff who conducted the survey for nearly 40 years were recently fired, and many Safe Motherhood initiatives are now at risk of losing funding.

"This is willful ignorance to cut vital programs when we have public health crises," said a former CDC staffer. "For many people, it's downright dangerous to be pregnant in the U.S. in the 21st century."

Polling suggests most Americans support maintaining these programs. According to the Emory-Rollins National Child Policy Poll, 65% of Americans believe PRAMS is important for improving outcomes, while only 10% think it's unnecessary.

Medicaid and Its Role in Maternal and Infant Health

Medicaid plays a significant role in Mississippi, financing almost 60% of births in the state. In 2023, the state extended postpartum Medicaid coverage from two months to a full year. However, Mississippi has not expanded Medicaid under the Affordable Care Act, leaving many low-income women uninsured before or between pregnancies.

Congressional proposals could further impact Medicaid coverage, including a reconciliation bill that would require many enrollees to prove they are working, volunteering, or in school to receive coverage. KFF analysts estimate that such policies could raise Mississippi’s uninsured rate by 1 to 2%, potentially leaving 20,000 to 40,000 more residents without coverage.

Public health experts warn that these policies could destabilize rural hospitals reliant on Medicaid reimbursement, limiting access to prenatal and delivery services in regions already described as "OB deserts."

Lessons from Other States

Other states that expanded Medicaid under the Affordable Care Act have seen measurable improvements in infant health. Arkansas reported a 29% reduction in Black infant mortality after expansion, while Louisiana saw increases in early prenatal care and decreases in premature births. Colorado also experienced declines in infant mortality, particularly in rural areas.

Nationally, one analysis found a 50% greater reduction in infant mortality in expansion states compared to non-expansion states, with the steepest gains among Black infants. Today, 40 states and the District of Columbia have expanded Medicaid, while Mississippi remains one of 10 holdouts.

A Call for Action

The U.S. has long treated infant mortality as a measure of societal health. Sociologist W.E.B. Du Bois argued over a century ago that high rates of infant deaths among Black families reflected inequities in living conditions rather than innate differences. Mississippi’s emergency declaration and Boston’s persistent disparities suggest these inequities remain deeply entrenched.

State officials say the declaration is intended to galvanize coordinated action across hospitals, state agencies, and community groups. "It will take all of us working together to give every child the chance to live, thrive, and celebrate their first birthday," Dr. Edney said.