Global health is a giant knotted ball of yarn and thread and chain and red tape and dental floss and guts and nerves that seems impossible to untangle. Too hard to improve. Too complicated to fully understand. The key, as in untangling all things, is to find a loose end and tease it free. Pull and weave just a little at a time. Work not to create a new knot in the process. With patience and fortitude, eventually the knot will be a fraction less knotted.
Not all loose ends have the same potential for magnitude of change in global health. It’s difficult to know exactly what course of action will have the biggest positive effect, and the data on which we can base these decisions is filled with uncertainty.
The Institute for Health Metrics and Evaluation (IHME) gathers and curates the world’s health data to create and maintain the Global Burden of Disease study (GBD). GBD combines fatal and non-fatal health issues to measure health on a local and global scale. Beyond just measuring health, GBD also connects these measures of health to their associated risk factors.
Using indices of health from GBD can help prioritize change efforts and maximize efficiency. It is important, however, not to get stuck trying to optimize every effort. True optimization is often impossible to achieve. Suboptimal action is better than inaction. Find your easiest point of entry, the loose thread that calls to you to start untangling, and go!
To get you started, here are some loose ends ready to grab:
Safer and Cleaner Transportation
Traffic accidents and pollution contribute to 6 of the top 10 global causes of death. Improvements to the efficiency of transportation will reduce air pollution and improve health. The number of deaths caused by traffic accidents increased by 46% in the past 20 years. How can we design our roads and walkways to decrease vehicle, bicycle, and pedestrian accidents? There is a need for transportation engineers to design safer transportation systems. And then those safer systems need to be implemented.
The more years of education women receive on average in a country, the higher the life expectancy at birth of all people in that country. More educated women are able to make more educated health decisions for themselves and their family, increasing the overall health of the population. Those women who experience pregnancy in their lifetimes are more likely to be older for their first pregnancy and have fewer total pregnancies the longer they are in school. Both of which result in fewer pregnancy related health issues for those women.
The number one thing a person can do to lower their risk for globally significant health issues is to eat 300 grams of fruit every day. Eating fruit daily lowers a person’s risk for ischemic heart disease (heart problems caused by narrowing of arteries), the number one diet-influenced global health issue. Already eat enough fruit daily? Is upping your fruit intake unreasonable? Check out these other possible diet changes. Beyond just improving your personal health, educating the public about smart nutritional choices is a way of improving health. For an even larger impact, identify food deserts where it is nearly or actually impossible to access the foods needed for a low-risk diet and then work to increase access to fresh, healthy foods. For more on what you can do in your own life, check out the Afterward of Jeremy N. Smith’s Epic Measures: One Doctor. Seven Billion Patients.
Data Collection and Management
Our understanding of global health is the best it’s ever been, but that isn’t saying much. There is large uncertainty in the most basic of health statistics: How many people were born? How many people died? There were 747.76 to 786.24 deaths per 100,000 people in 2013. Assuming a global population of 7 billion people, that’s anywhere from 52.3 million to 55.0 million deaths in 2013. That’s a 2.7 million deaths confidence interval. This is morbid, but keeping a global data set is nothing like keeping track of whether or not your family members are alive. Counting every single person when that means counting over 7,000,000,000 people is an immense task. We need healthcare systems and professionals dedicated to keeping comprehensive and accurate records. We need governments that are willing to share their country’s data with the world. We need engineers to build computers and networks that can make accessing the data quick and easy. We need statisticians and mathematicians and computer scientists to manage the data. We need health experts to connect risk factors to the health conditions they affect. We need communications people who can take the data and its interpretations beyond the academic sphere to the wider public. Efforts to improve health record keeping and data accessibility will give us an even better understanding of what health problems exist where and in what magnitudes. Our ability to improve the world’s health can only be increased with more knowledge.
None of these action items calling to you? Play around with GBD’s data yourself! Start with IHME’s data visualizations to see what questions the medical measurement field’s experts are asking. Want to dig in to the data and ask your own questions? With GBD Compare, you can create your own infographics. Want to know the impact of anxiety on global health? In women? From ages 15-49? In Canada? In Brazil? You can see for yourself and even download the a file of the data set.
Find your loose thread and start pulling!