Health advances in Gulf countries threatened by diabetes, drug use

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SEATTLE, Aug 31: People in several Gulf nations countries are living longer than in 1990, but challenges like traffic accidents, back and neck pain, and diabetes could erode that progress, according to a new scientific study. Across the Eastern Mediterranean Region, improved health conditions and life expectancy over the past 20 years are being subverted by wars and civil unrest.

“The Eastern Mediterranean Region needs attention in this critical health phase,” said Dr Ali Mokdad, Director for Middle Eastern Initiatives at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle. “In the past decade the region has experienced improved health and life expectancy, but recent distress in the region will result in deteriorating health conditions in these countries for many years to come.” “Several Gulf states made impressive improvements in life expectancy in the past two decades. While these countries have made significant progress against ailments like premature births, ischemic heart disease, and lower respiratory, there now are challenges related to obesity, mental health, and drug use. If left unchecked, these problems could have dire consequences,” explained Dr Mokdad.

The study examines 22 nations in Central Asia, the Middle East, and North Africa between 1990 and 2013. It is based on findings from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) coordinated by IHME. With more than 1,800 collaborators in 124 countries, the GBD is the largest and most comprehensive effort measuring epidemiological levels and trends worldwide.

Disease
The paper, published in The Lancet Global Health, also finds that chronic diseases, such as heart disease and diabetes, cause a greater burden to health in the region overall than communicable diseases like diarrheal diseases and tuberculosis. In high-income countries of the region the top five causes of health burden in 2013 were: road injuries, low back and neck pain, diabetes, heart disease, and depression. The rise of diabetes is particularly alarming. Between 1990 and 2013, the health burden of diabetes increased in Oman by 24.4%, in Kuwait by 51.7%, and in Saudi Arabia – where it is the number one cause of disability and death – by 90.9%. Years of good health lost to communicable, maternal, neonatal, and nutritional disorders in the region dropped from 109 million to 73 million from 1990 to 2013.

This is consistent with a similar global shift. Childhood wasting was cited as the leading health risk in low-income countries, such as Somalia, Afghanistan, and Yemen. In the region’s high- and middle-income countries, non-communicable diseases were the leading factors. Overall life expectancy increased from 65 years in 1990 to 71 years in 2013, a sign of general progress in the region. For example, in Bahrain, life expectancy for men increased from 71 years in 1990 to 78 year in 2013, and for women from 72 to 80 years. Qatar revealed the highest life expectancy in the region, at 81 years for men and 83 years for women, but not all countries showed such promising results, especially in areas riven by confl ict.

Uprisings in Syria, Yemen, Egypt, Libya, and Tunisia caused a drop in life expectancy from 2010 onward. Specifically, in Syria life expectancy would have been six years higher without the war. Moreover, Syria saw an increase in infant and maternal mortality, the only country in the region to see this trend. Across the region, mental health and drug use disorders have increased significantly since 1990 and have taken a greater toll. In several countries, depression and opioid use were in the top six causes of health loss in 2013, with the health toll of both ailments significantly increasing over two decades. In Qatar, opioid use was the number one cause of health disability and death, with its toll rising 18.9% since 1990.

Unfortunately, this rise has not been met with investment in prevention by most countries; it is largely overlooked by domestic health ministries, international agencies, and insurance systems, Dr Mokdad said. “The rise of non-communicable diseases and challenges like mental health and drug use disorders requires new approaches, skills, and prevention efforts,” he said.

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