Ranking of diseases and deaths caused by them in Spain

Non-communicable diseases, particularly heart disease and cancer, are the leading cause of death and disease in Spain. Back pain and depression also contribute significantly to the burden of disease, especially for women. Smoking, poor diet and being overweight are among the main risk factors and require adequate health policies.

These are some of the conclusions of a study led by the collaborative group of the Study of the Global Burden of Diseases in Spain, made up of researchers from the Center for Networked Biomedical Research (CIBER), the Barcelona Institute for Global Health (ISGlobal) and other Spanish and North American centers, which has used data from the 2019 Global Burden of Disease (GBD) report to offer a detailed portrait of health in Spain before the pandemic and make forecasts on compliance with the health goals of the Goals of Sustainable Development (SDG) in 2030.

“The objective of this study was to better identify unmet health needs in Spain, guide appropriate interventions, and provide information on future health trends,” explains Jeffrey V. Lazarus, head of ISGlobal’s Health Systems research group. center promoted by the “la Caixa” Foundation.

A portrait of health in Spain before the pandemic

The GBD 2019 study includes 369 diseases, injuries and disabilities, and 87 risk factors and combinations thereof. In 2019, almost 90% of deaths and illnesses in Spain were due to non-communicable diseases, in particular ischemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), Alzheimer’s disease and lung cancer. Back pain and depression also contribute considerably to the disease burden in Spain, especially in the case of women.

The main risk factors for death and disease were smoking, high body mass index, and hyperglycemia/diabetes. “The results clearly show the influence of a sedentary lifestyle and the aging of the population,” says Joan B. Soriano, co-author of the study and researcher in the Respiratory Diseases area of ​​the CIBER (CIBERES) in the Pneumology Service of the Hospital Universitario de La Princesa in Madrid.

Soriano also has an impact: “But it is behavioral risk factors, such as smoking and poor diet, and environmental ones such as air pollution, or the more recently added suboptimal environmental temperature, which added a significant burden to poor health. of the Spanish population.

Projections for 2030

The research team used 41 indicators (such as the prevalence of smoking, air pollution, intimate partner violence and vaccination coverage) to measure Spain’s progress towards Sustainable Development Goal (SDG) number 3, which promotes a healthy living and well-being for all people at all ages.

In 2019, Spain was ranked 20 out of 195 countries and territories. By 2030, the country could surpass Japan, the United States and the European Union in most indicators, although those related to alcohol consumption, childhood overweight, the prevalence of smoking and child sexual abuse will continue to be low.

Likewise, life expectancy in Spain is expected to reach 84.8 years (87.2 for women and 82.3 for men), although COVID-19, with its health and social repercussions, has slowed down the decline in the mortality rate.

Mortality rate per 100,000 people/age-standardized) since 1990 and projected changes to 2030, in both sexes. In green, men. In red, women. In purple, both. (Image: Lazarus et al. 2022)

recommendations

“Like much of Europe, Spain has experienced a rapid aging of the population due to the increase in life expectancy and the decrease in mortality and fertility,” says Lazarus. To address this, it will be necessary to focus on promoting health and care for the elderly by strengthening long-term care facilities, social support services and telemedicine.

Social protection measures, such as pensions and sick leave, are key interventions to offset the cost of population ageing, but the authors caution that these policies may not cover those outside the formal employment system.

Smoking, poor diet and environmental factors must also be monitored. Professor Esteve Fernández, a researcher at the Catalan Institute of Oncology and the Bellvitge Biomedical Research Institute, as well as head of the CIBERES group, warns that “in men, smoking was the main risk factor in each of the years studied; and in women, it ranked third, behind only obesity and hyperglycemia/diabetes.

It is urgent to resume population measures such as reviewing the 2010 Tobacco Control Law, already obsolete in some sections, or proposing the so-called Tobacco Endgame as a national priority”.

Finally, the study authors point out that a major challenge in Spain is coordinating the 17 autonomous communities and the national government, and providing regional data broken down by specific groups, including migrants and the homeless. “These data will help us to assess how the 2008 financial crisis and the current COVID pandemic have influenced, and will continue to influence, Spain’s health trajectory,” the researchers conclude.

Researchers from the Autonomous University of Madrid (UAM) in Spain, and the University of Washington in the United States, among other institutions, have also participated in the study.

The study is entitled “A GBD 2019 study of health and Sustainable Development Goal gains and forecasts to 2030 in Spain” and has been published in the academic journal Scientific Reports. (Source: CIBER / UAM)