Health trends, inequalities and opportunities in South Africa's provinces, 1990-2019: findings from the Global Burden of Disease 2019 Study.
Health trends, inequalities and opportunities in South Africa's provinces, 1990-2019: findings from the Global Burden of Disease 2019 Study.
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DOI：
10.1136/jech-2021-217480
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发表时间：
2022-01-19
影响因子：
6.3
通讯作者：
Naghavi M
中科院分区：
文献类型：
--
作者：
Achoki T;Sartorius B;Watkins D;Glenn SD;Kengne AP;Oni T;Wiysonge CS;Walker A;Adetokunboh OO;Babalola TK;Bolarinwa OA;Claassens MM;Cowden RG;Day CT;Ezekannagha O;Ginindza TG;Iwu CCD;Iwu CJ;Karangwa I;Katoto PD;Kugbey N;Kuupiel D;Mahasha PW;Mashamba-Thompson TP;Mensah GA;Ndwandwe DE;Nnaji CA;Ntsekhe M;Nyirenda TE;Odhiambo JN;Oppong Asante K;Parry CDH;Pillay JD;Schutte AE;Seedat S;Sliwa K;Stein DJ;Tanser FC;Useh U;Zar HJ;Zühlke LJ;Mayosi BM;Hay SI;Murray CJL;Naghavi M
在过去30年里，南非经历了艾滋病毒和结核病、慢性病和精神健康、伤害和暴力以及孕产妇、新生儿和儿童死亡率这四种“相互冲突的流行病”，对健康和福祉产生了重大影响。利用2019年全球疾病、伤害和风险因素负担研究（GBD 2019）的数据，我们评估了1990年至2019年国家和省级卫生趋势以及实现可持续发展目标重要目标的进展。我们分析了GBD 2019对死亡率、非致命性健康损失、汇总健康措施和风险因素负担的估计，并比较了1990-2007年和2007-2019年的趋势。此外，我们根据死亡原因分解了预期寿命的变化，并评估了医疗保健系统的表现。在9个省份，死亡率和预期寿命的不平等在1990年至2007年期间有所增加，这主要是由于艾滋病毒/艾滋病的差异，然后在2007年至2019年期间有所下降。1990年至2019年期间，人口变化和非传染性疾病的增加使残疾生活年数几乎翻了一番。从1990年到2019年，风险因素负担普遍从传染病和营养疾病风险转向非传染性疾病和伤害风险；不安全性行为仍然是头号风险因素。尽管医疗保健系统的表现得到了广泛的改善，但最大的收益通常是在经济优势省份。自2007年以来，艾滋病毒/艾滋病和相关疾病的减少改善了健康状况，尽管大多数省份在关键领域仍然落后。为实现卫生目标，省级政府应加强卫生投资，并与落后人群交流知识、资源和最佳做法，特别是在COVID-19大流行之后。
Over the last 30 years, South Africa has experienced four ‘colliding epidemics’ of HIV and tuberculosis, chronic illness and mental health, injury and violence, and maternal, neonatal, and child mortality, which have had substantial effects on health and well-being. Using data from the 2019 Global Burden of Diseases, Injuries and Risk Factors Study (GBD 2019), we evaluated national and provincial health trends and progress towards important Sustainable Development Goal targets from 1990 to 2019. We analysed GBD 2019 estimates of mortality, non-fatal health loss, summary health measures and risk factor burden, comparing trends over 1990–2007 and 2007–2019. Additionally, we decomposed changes in life expectancy by cause of death and assessed healthcare system performance. Across the nine provinces, inequalities in mortality and life expectancy increased over 1990–2007, largely due to differences in HIV/AIDS, then decreased over 2007–2019. Demographic change and increases in non-communicable diseases nearly doubled the number of years lived with disability between 1990 and 2019. From 1990 to 2019, risk factor burdens generally shifted from communicable and nutritional disease risks to non-communicable disease and injury risks; unsafe sex remained the top risk factor. Despite widespread improvements in healthcare system performance, the greatest gains were generally in economically advantaged provinces. Reductions in HIV/AIDS and related conditions have led to improved health since 2007, though most provinces still lag in key areas. To achieve health targets, provincial governments should enhance health investments and exchange of knowledge, resources and best practices alongside populations that have been left behind, especially following the COVID-19 pandemic.
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DOI：
10.1016/s0140-6736(20)30925-9
发表时间：
2020-10-17
期刊：
Lancet (London, England)
影响因子：
--
作者：
GBD 2019 Diseases and Injuries Collaborators
通讯作者：
GBD 2019 Diseases and Injuries Collaborators
影响因子：
4.5
作者：
Akseer N;Mehta S;Wigle J;Chera R;Brickman ZJ;Al-Gashm S;Sorichetti B;Vandermorris A;Hipgrave DB;Schwalbe N;Bhutta ZA
通讯作者：
Bhutta ZA
影响因子：
34.3
作者：
Pillay-van Wyk, Victoria;Msemburi, William;Bradshaw, Debbie
通讯作者：
Bradshaw, Debbie
DOI：
10.1016/s0140-6736(17)32336-x
发表时间：
2017-09-16
期刊：
Lancet (London, England)
影响因子：
--
作者：
GBD 2016 SDG Collaborators
通讯作者：
GBD 2016 SDG Collaborators
影响因子：
4.5
作者：
Loennroth, Knut;Williams, Brian G.;Stadlin, Stephanie;Jaramillo, Ernesto;Dye, Christopher
通讯作者：
Dye, Christopher