Lower-Income Countries That Face The Most Rapid Shift In Noncommunicable Disease Burden Are Also The Least Prepared
Lower-Income Countries That Face The Most Rapid Shift In Noncommunicable Disease Burden Are Also The Least Prepared
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DOI：
10.1377/hlthaff.2017.0708
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发表时间：
2017-11-01
期刊：
影响因子：
9.7
通讯作者：
Dieleman, Joseph L.
中科院分区：
文献类型：
--
作者：
Bollyky, Thomas J.;Templin, Tara;Dieleman, Joseph L.
在低收入国家，人口和流行病的变化正在将疾病负担从传染性疾病转移到非传染性疾病。在一代人的时间内，一些贫穷国家非传染性疾病造成的疾病负担将超过80%，与富裕国家相当，但这一负担可能会影响较贫穷国家的年轻人。低收入国家的卫生系统对这一变化毫无准备。我们使用非传染性疾病的卫生系统能力指数对172个国家进行了排名，研究了向非传染性疾病的转变，并估计了对这种转变的准备情况。我们预计，在今后25年中，非传染性疾病所占疾病负担比例增加最多的国家也将是对这一变化准备最少的国家，因为它们在我们的能力指数中排名靠后，预计国家卫生支出的增加最少。各国政府和捐助者必须加大投资力度，使低收入国家的卫生系统做好应对非传染性疾病急剧转变的准备，并减少可改变的非传染性疾病风险。
Demographic and epidemiological changes are shifting the disease burden from communicable to noncommunicable diseases in lower-income countries. Within a generation, the share of disease burden attributed to noncommunicable diseases in some poor countries will exceed 80 percent, rivaling that of rich countries, but this burden is likely to affect much younger people in poorer countries. The health systems of lower-income countries are unprepared for this change. We examined the shift to noncommunicable diseases and estimated preparedness for the shift by ranking 172 nations using a health system capacity index for noncommunicable disease. We project that the countries with the greatest increases in the share of disease burden attributable to noncommunicable disease over the next twenty-five years will also be the least prepared for the change, as they ranked low on our capacity index and are expected to have the smallest increases in national health spending. National governments and donors must invest more in preparing the health systems of lower-income countries for the dramatic shift to noncommunicable diseases and in reducing modifiable noncommunicable disease risks.