Most of the Eastern Mediterranean has seen progress in maternal and child mortality, but conflict-countries fall behind

New Global Burden of Disease study reveals that income, education, and birth rates - while critical - are not the only keys to healthy living in 195 countries 

Dubai, UAE, October 10, 2016:  Since 1990, life expectancy has risen and both child and maternal mortality have declined in the Eastern Mediterranean Region, according to a new scientific analysis of more than 300 diseases and injuries in 195 countries. 

However, such progress is threatened by increasing numbers of people suffering from serious health challenges related to metabolic risk factors, such as high blood pressure, high body mass index, and high blood sugar.  

These and other significant health findings are being published in a dedicated issue of The Lancet as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). The study draws on the work of more than 1,800 collaborators in nearly 130 countries and territories.

“We are seeing a rise in non-communicable disease in the region, mainly due to behavioral changes such as diet and physical activity,” said Dr. Ali Mokdad, Director of Middle Eastern Initiatives at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. “At the same time, unrest and instability in the region will only further health loss from these diseases as services become limited and infrastructure is destroyed.”

Ischemic heart disease was the leading killer in 19 of the region’s 22 countries in 2015, resulting in 56,391 deaths in Afghanistan, 30,156 deaths in Morocco, and 15,650 deaths in Saudi Arabia. The leading causes of death in the region’s remaining three countries were pneumonia (668 deaths in Djibouti), diarrheal disease (19,738 deaths in Somalia), and war (54,060 deaths in Syria).

But the conditions that kill are not typically those that make people sick. The top three nonfatal causes of health loss in the Eastern Mediterranean Region overall were iron-deficiency anemia, low back pain, and depression.

Globally, life expectancy increased from about 62 years to nearly 72 from 1980 to 2015, with several nations in sub-Saharan Africa rebounding from high death rates due to HIV/AIDS. Child deaths are falling fast, as are illnesses related to infectious diseases. But each country has its own specific challenges and improvements, from fewer suicides in France, to lower death rates on Nigerian roadways, to a reduction in asthma-related deaths in Indonesia.

Findings for the Eastern Mediterranean Region include:

• Over the past 25 years, life expectancy has increased throughout the Eastern Mediterranean Region. In 2015, the life expectancy at birth was 79 years in Bahrain, 72 in Egypt, 66 in Pakistan, and 68 in Sudan. 
• While the world has made great progress in reducing deaths of young children, globally 5.8 million children under the age of 5 died in 2015. Of that global figure, 750 of those deaths were in Oman, 2,780 in Tunisia, and were in 19,910 in Iran.
• Many countries in the Eastern Mediterranean Region have reduced deaths of expecting or new mothers. For example, the number of maternal deaths in 2015 in Lebanon was 13, down from 24 in 1990. And in Jordan, the ratio of maternal deaths fell from 116 deaths per 100,000 livebirths to 48.

The report was released at an event co-sponsored by IHME, The Lancet, and the World Bank in Washington, DC. The study was established in 1990 with support from the World Bank. This year, researchers analyzed each country using a Socio-demographic Index, examining rates of education, fertility, and income. This new categorization goes beyond the historical “developed” versus “developing” or economic divisions based on income alone.

The six papers provide in-depth analyses of causes of death, maternal mortality, deaths of children under age 5, overall disease burden and life expectancy, years lived with disability, and the risk factors that lead to health loss.

In much of the world, giving birth is safer for mothers and newborns than it has been over the past 25 years. The number of maternal deaths globally dropped by roughly 29% since 1990, and the ratio of maternal deaths fell 30%, from 282 per 100,000 live births in 1990 to 196 in 2015. 

“Development drives, but does not determine health,” said Dr. Christopher Murray, Director of IHME, the coordinating center for the GBD enterprise. “We see countries that have improved far faster than can be explained by income, education, or fertility. And we also continue to see countries - including the United States - that are far less healthy than they should be given their resources.”