Global shift from premature death to chronic disability

[MeSci]

Interesting review article in New England Journal of Medicine 1st August 2013.

It is long, and covers a range of global health issues, but of particular interest to us perhaps is the fact that:

Overall, there is a progressive shift toward a larger share of the burden of disease from disability.

This would appear to be somewhat at odds with attempts by governments to reduce welfare budgets by trying to force sick people back to work, and indicates perhaps that welfare levels should increase rather than decrease to adapt to the increasing number of chronically-disabled people.

On the other hand, these policies are perhaps achieving a money-saving aim by causing numbers of disabled people to die, shifting the balance a little towards how it was in 'the good old days.'

 

[currer]

As far as I know the department of health does not keep statistics on the relative frequency of different diseases in the British population, which is odd because it would be easy to do.

I always thought is strange that our government can simply decree that there are too many disabled people claiming benefit, because the numbers of disabling conditions could genuinely be increasing, and if they are we need to know about it, so that we can try to find out why and do something to protect society.

 

[Sean]

What do they think happened to the disabled and sick before medicine recognised their problems, and before there was any kind of state support?

Did these problems simply not exist?

What they really want is for us to just shut up, go away, and not remind them anymore of this stuff, so they can go on wallowing in their nasty little ideological morality-play fantasy, free from the ravages of reality.

 

[Snow Leopard]

What do they think happened to the disabled and sick before medicine recognised their problems, and before there was any kind of state support?

They were either supported by their families/friends, or had a much reduced life expectancy (to put it politely).

 

[Little Bluestem]

While disability has always existed, according to the report it is increasing.

The third transition is a profound shift toward a greater fraction of the burden of disease from disability than from premature death. Of the top 25 causes of years lived with disability, only COPD, diabetes, road-traffic injury, ischemic heart disease, tuberculosis, and diarrhea are also among the top 25 causes of years of life lost. Simply put, what ails most persons is not necessarily what kills them. Major groups of disorders that cause disability include musculoskeletal disorders, mental disorders and substance abuse, neurologic conditions, anemias, vision loss, hearing loss, diabetes, and skin diseases. Age-specific and sex-specific prevalence rates of nearly all these conditions are stable or decreasing only slightly, and the rates of some conditions, such as diabetes, are increasing. Stable or increasing rates combined with population growth and aging lead to substantial increases in the number of years lived with these disabling conditions. Overall, there is a progressive shift toward a larger share of the burden of disease from disability.