Author
Christopher J L Murray
Other affiliations: Harvard University, University of Washington, University of Health and Allied Sciences ...read more
Bio: Christopher J L Murray is an academic researcher from Institute for Health Metrics and Evaluation. The author has contributed to research in topics: Population & Mortality rate. The author has an hindex of 209, co-authored 754 publications receiving 310329 citations. Previous affiliations of Christopher J L Murray include Harvard University & University of Washington.
Papers published on a yearly basis
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TL;DR: The increasing contribution of these diseases to the overall disease burden across India and the high rate of health loss from them, especially in the less developed low ETL states, highlights the need for focused policy interventions to address this significant cause of disease burden.
217 citations
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TL;DR: An integrated conceptual framework for monitoring and analyzing the delivery of high-quality interventions to those who need them is developed and the probability that individuals will receive health gain from an intervention if they need it is proposed.
217 citations
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TL;DR: Health spending remains disparate, with low-income and lower-middle-income countries increasing spending in absolute terms the least, and relying heavily on OOP spending and development assistance.
214 citations
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TL;DR: There was an overall decrease of 57% in the rate of death from malaria across sub-Saharan Africa over the past 15 years and several countries in which high rates of death were associated with low coverage of antimalarial treatment and prevention programs were identified.
Abstract: BackgroundMalaria control has not been routinely informed by the assessment of subnational variation in malaria deaths. We combined data from the Malaria Atlas Project and the Global Burden of Disease Study to estimate malaria mortality across sub-Saharan Africa on a grid of 5 km2 from 1990 through 2015. MethodsWe estimated malaria mortality using a spatiotemporal modeling framework of geolocated data (i.e., with known latitude and longitude) on the clinical incidence of malaria, coverage of antimalarial drug treatment, case fatality rate, and population distribution according to age. ResultsAcross sub-Saharan Africa during the past 15 years, we estimated that there was an overall decrease of 57% (95% uncertainty interval, 46 to 65) in the rate of malaria deaths, from 12.5 (95% uncertainty interval, 8.3 to 17.0) per 10,000 population in 2000 to 5.4 (95% uncertainty interval, 3.4 to 7.9) in 2015. This led to an overall decrease of 37% (95% uncertainty interval, 36 to 39) in the number of malaria deaths ann...
214 citations
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Institute for Health Metrics and Evaluation1, Auckland University of Technology2, University of Washington3, Mayo Clinic4, University of the Philippines Manila5, Johns Hopkins University6, Harvard University7, Heidelberg University8, Mario Negri Institute for Pharmacological Research9, New York University10, University at Buffalo11, University of California, San Diego12, Veterans Health Administration13, University of Peradeniya14, University of Rochester15, Tufts Medical Center16, Kaiser Permanente17, Rowan University18, Istituto Superiore di Sanità19, Tehran University of Medical Sciences20, University of Texas at Austin21, Sheffield Hallam University22, Florida State University College of Arts and Sciences23, Ball State University24, Northeastern University25, Duke University26, University of Michigan27, Ohio State University28, Nationwide Children's Hospital29, University of Bari30, National Institutes of Health31, University of Cape Town32, Pacific Institute33, Curtin University34, University of Mississippi35, Mizan–Tepi University36, Iran University of Medical Sciences37, Emory University38, Lund University39, University of Central Florida40, Charité41, University of Edinburgh42, Yonsei University43, University of Alabama at Birmingham44, United States Department of Veterans Affairs45, Imperial College London46, Norwegian University of Science and Technology47, University of Maryland, Baltimore48, George Washington University49, University of California, Berkeley50
TL;DR: A large and increasing number of people have various neurological disorders in the US, with significant variation in the burden of and trends in neurological disorders across the US states, and the reasons for these geographic variations need to be explored further.
Abstract: IMPORTANCE Accurate and up-to-date estimates on incidence, prevalence, mortality, and
disability-adjusted life-years (burden) of neurological disorders are the backbone of
evidence-based health care planning and resource allocation for these disorders. It appears
that no such estimates have been reported at the state level for the US.
OBJECTIVE To present burden estimates of major neurological disorders in the US states by
age and sex from 1990 to 2017.
DESIGN, SETTING, AND PARTICIPANTS This is a systematic analysis of the Global Burden of
Disease (GBD) 2017 study. Data on incidence, prevalence, mortality, and disability-adjusted
life-years (DALYs) of major neurological disorders were derived from the GBD 2017 study of
the 48 contiguous US states, Alaska, and Hawaii. Fourteen major neurological disorders were
analyzed: stroke, Alzheimer disease and other dementias, Parkinson disease, epilepsy,
multiple sclerosis, motor neuron disease, migraine, tension-type headache, traumatic brain
injury, spinal cord injuries, brain and other nervous system cancers, meningitis, encephalitis,
and tetanus.
EXPOSURES Any of the 14 listed neurological diseases.
MAIN OUTCOME AND MEASURE Absolute numbers in detail by age and sex and
age-standardized rates (with 95% uncertainty intervals) were calculated.
RESULTS The 3 most burdensome neurological disorders in the US in terms of absolute
number of DALYs were stroke (3.58 [95% uncertainty interval [UI], 3.25-3.92] million DALYs),
Alzheimer disease and other dementias (2.55 [95% UI, 2.43-2.68] million DALYs), and
migraine (2.40 [95% UI, 1.53-3.44] million DALYs). The burden of almost all neurological
disorders (in terms of absolute number of incident, prevalent, and fatal cases, as well as
DALYs) increased from 1990 to 2017, largely because of the aging of the population.
Exceptions for this trend included traumatic brain injury incidence (−29.1% [95% UI, −32.4%
to −25.8%]); spinal cord injury prevalence (−38.5% [95% UI, −43.1% to −34.0%]); meningitis
prevalence (−44.8% [95% UI, −47.3% to −42.3%]), deaths (−64.4% [95% UI, −67.7% to
−50.3%]), and DALYs (−66.9% [95% UI, −70.1% to −55.9%]); and encephalitis DALYs
(−25.8% [95% UI, −30.7% to −5.8%]). The different metrics of age-standardized rates varied
between the US states from a 1.2-fold difference for tension-type headache to 7.5-fold for
tetanus; southeastern states and Arkansas had a relatively higher burden for stroke, while
northern states had a relatively higher burden of multiple sclerosis and eastern states had
higher rates of Parkinson disease, idiopathic epilepsy, migraine and tension-type headache,
and meningitis, encephalitis, and tetanus.
CONCLUSIONS AND RELEVANCE There is a large and increasing burden of noncommunicable
neurological disorders in the US, with up to a 5-fold variation in the burden of and trends in
particular neurological disorders across the US states. The information reported in this article
can be used by health care professionals and policy makers at the national and state levels to
advance their health care planning and resource allocation to prevent and reduce the burden
of neurological disorders.
212 citations
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TL;DR: A substantial proportion of the worldwide burden of cancer could be prevented through the application of existing cancer control knowledge and by implementing programs for tobacco control, vaccination, and early detection and treatment, as well as public health campaigns promoting physical activity and a healthier dietary intake.
Abstract: The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking, in economically developing countries. Based on the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths are estimated to have occurred in 2008; of these, 56% of the cases and 64% of the deaths occurred in the economically developing world. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of the total cancer cases and 14% of the cancer deaths. Lung cancer is the leading cancer site in males, comprising 17% of the total new cancer cases and 23% of the total cancer deaths. Breast cancer is now also the leading cause of cancer death among females in economically developing countries, a shift from the previous decade during which the most common cause of cancer death was cervical cancer. Further, the mortality burden for lung cancer among females in developing countries is as high as the burden for cervical cancer, with each accounting for 11% of the total female cancer deaths. Although overall cancer incidence rates in the developing world are half those seen in the developed world in both sexes, the overall cancer mortality rates are generally similar. Cancer survival tends to be poorer in developing countries, most likely because of a combination of a late stage at diagnosis and limited access to timely and standard treatment. A substantial proportion of the worldwide burden of cancer could be prevented through the application of existing cancer control knowledge and by implementing programs for tobacco control, vaccination (for liver and cervical cancers), and early detection and treatment, as well as public health campaigns promoting physical activity and a healthier dietary intake. Clinicians, public health professionals, and policy makers can play an active role in accelerating the application of such interventions globally.
52,293 citations
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TL;DR: A substantial portion of cancer cases and deaths could be prevented by broadly applying effective prevention measures, such as tobacco control, vaccination, and the use of early detection tests.
Abstract: Cancer constitutes an enormous burden on society in more and less economically developed countries alike. The occurrence of cancer is increasing because of the growth and aging of the population, as well as an increasing prevalence of established risk factors such as smoking, overweight, physical inactivity, and changing reproductive patterns associated with urbanization and economic development. Based on GLOBOCAN estimates, about 14.1 million new cancer cases and 8.2 million deaths occurred in 2012 worldwide. Over the years, the burden has shifted to less developed countries, which currently account for about 57% of cases and 65% of cancer deaths worldwide. Lung cancer is the leading cause of cancer death among males in both more and less developed countries, and has surpassed breast cancer as the leading cause of cancer death among females in more developed countries; breast cancer remains the leading cause of cancer death among females in less developed countries. Other leading causes of cancer death in more developed countries include colorectal cancer among males and females and prostate cancer among males. In less developed countries, liver and stomach cancer among males and cervical cancer among females are also leading causes of cancer death. Although incidence rates for all cancers combined are nearly twice as high in more developed than in less developed countries in both males and females, mortality rates are only 8% to 15% higher in more developed countries. This disparity reflects regional differences in the mix of cancers, which is affected by risk factors and detection practices, and/or the availability of treatment. Risk factors associated with the leading causes of cancer death include tobacco use (lung, colorectal, stomach, and liver cancer), overweight/obesity and physical inactivity (breast and colorectal cancer), and infection (liver, stomach, and cervical cancer). A substantial portion of cancer cases and deaths could be prevented by broadly applying effective prevention measures, such as tobacco control, vaccination, and the use of early detection tests.
23,203 citations
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TL;DR: The results for 20 world regions are presented, summarizing the global patterns for the eight most common cancers, and striking differences in the patterns of cancer from region to region are observed.
Abstract: Estimates of the worldwide incidence and mortality from 27 cancers in 2008 have been prepared for 182 countries as part of the GLOBOCAN series published by the International Agency for Research on Cancer. In this article, we present the results for 20 world regions, summarizing the global patterns for the eight most common cancers. Overall, an estimated 12.7 million new cancer cases and 7.6 million cancer deaths occur in 2008, with 56% of new cancer cases and 63% of the cancer deaths occurring in the less developed regions of the world. The most commonly diagnosed cancers worldwide are lung (1.61 million, 12.7% of the total), breast (1.38 million, 10.9%) and colorectal cancers (1.23 million, 9.7%). The most common causes of cancer death are lung cancer (1.38 million, 18.2% of the total), stomach cancer (738,000 deaths, 9.7%) and liver cancer (696,000 deaths, 9.2%). Cancer is neither rare anywhere in the world, nor mainly confined to high-resource countries. Striking differences in the patterns of cancer from region to region are observed.
21,040 citations
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University of Manchester1, University of Barcelona2, St George's Hospital3, University of Marburg4, University of Texas Health Science Center at San Antonio5, Imperial College London6, University of Modena and Reggio Emilia7, University of Michigan8, Hokkaido University9, University of British Columbia10
TL;DR: It is recommended that spirometry is required for the clinical diagnosis of COPD to avoid misdiagnosis and to ensure proper evaluation of severity of airflow limitation.
Abstract: Chronic obstructive pulmonary disease (COPD) remains a major public health problem. It is the fourth leading cause of chronic morbidity and mortality in the United States, and is projected to rank fifth in 2020 in burden of disease worldwide, according to a study published by the World Bank/World Health Organization. Yet, COPD remains relatively unknown or ignored by the public as well as public health and government officials. In 1998, in an effort to bring more attention to COPD, its management, and its prevention, a committed group of scientists encouraged the U.S. National Heart, Lung, and Blood Institute and the World Health Organization to form the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Among the important objectives of GOLD are to increase awareness of COPD and to help the millions of people who suffer from this disease and die prematurely of it or its complications. The first step in the GOLD program was to prepare a consensus report, Global Strategy for the Diagnosis, Management, and Prevention of COPD, published in 2001. The present, newly revised document follows the same format as the original consensus report, but has been updated to reflect the many publications on COPD that have appeared. GOLD national leaders, a network of international experts, have initiated investigations of the causes and prevalence of COPD in their countries, and developed innovative approaches for the dissemination and implementation of COPD management guidelines. We appreciate the enormous amount of work the GOLD national leaders have done on behalf of their patients with COPD. Despite the achievements in the 5 years since the GOLD report was originally published, considerable additional work is ahead of us if we are to control this major public health problem. The GOLD initiative will continue to bring COPD to the attention of governments, public health officials, health care workers, and the general public, but a concerted effort by all involved in health care will be necessary.
17,023 citations
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TL;DR: Findings indicate that the "diabetes epidemic" will continue even if levels of obesity remain constant, and given the increasing prevalence of obesity, it is likely that these figures provide an underestimate of future diabetes prevalence.
Abstract: OBJECTIVE —The goal of this study was to estimate the prevalence of diabetes and the number of people of all ages with diabetes for years 2000 and 2030. RESEARCH DESIGN AND METHODS —Data on diabetes prevalence by age and sex from a limited number of countries were extrapolated to all 191 World Health Organization member states and applied to United Nations’ population estimates for 2000 and 2030. Urban and rural populations were considered separately for developing countries. RESULTS —The prevalence of diabetes for all age-groups worldwide was estimated to be 2.8% in 2000 and 4.4% in 2030. The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. The prevalence of diabetes is higher in men than women, but there are more women with diabetes than men. The urban population in developing countries is projected to double between 2000 and 2030. The most important demographic change to diabetes prevalence across the world appears to be the increase in the proportion of people >65 years of age. CONCLUSIONS —These findings indicate that the “diabetes epidemic” will continue even if levels of obesity remain constant. Given the increasing prevalence of obesity, it is likely that these figures provide an underestimate of future diabetes prevalence.
16,648 citations