ISLAMABAD: People in Pakistan are living longer, but not happily.

It is not a political statement but the finding of a worldwide study that the longer living Pakistanis are spending more time in ill health.

International researchers working for the Global Burden of Disease project reported that in 2013 migraines, chronic obstructive pulmonary disease and diabetes were among the 10 leading causes of ‘years lived with disability’ (YLDs) in Pakistan.

Other leading causes included hearing loss, anxiety disorders and neck pain.

Titled “1990-2013: A systematic analysis for the Global Burden of Disease Study 2013” the study was led by the Institute for Health Metrics and Evaluation at the University of Washington, and is based on data of 301 acute and chronic diseases and injuries in 188 countries.

Death rates are falling faster than those of nonfatal diseases and injuries

People are living longer in Pakistan despite spending more time in ill health because rates of non-fatal diseases and injuries decline more slowly than death rates, the study explained.

For both sexes combined, the leading causes of YLDs remained largely the same during the period 1990-2013. But they take an increased toll on health due to population growth and aging, it said.

It also shows that musculoskeletal disorders – which include shoulder injuries and fractures from osteoporosis – have replaced diarrheal diseases as a leading cause of YLDs for Pakistani women. In the 23 years the study covers, iron-deficiency anemia at 11 per cent was the smallest percentage increase among the top causes of YLDs while musculoskeletal disorders as the cause increased by 163 per cent, and diabetes by 170 per cent.

Diabetes YLDs for men in Pakistan increased by 100 per cent and depression by 94 per cent during those years, while that from iron-deficiency anemia declined by 9 per cent.

“The health of Pakistanis is increasingly threatened by non-communicable diseases such as depression, chronic back pain, and migraines,” said Dr. Zulfiqar Bhutta, co-author of the study and founding director of the Centre of Excellence in Women and Child Health at the Aga Khan University in Karachi.

“At the same time, diseases like iron-deficiency anemia, chronic obstructive pulmonary disease, and diabetes are also costing people in Pakistan many years of healthy life. It is critical that we understand which diseases and injuries are causing disability so that we can effectively allocate resources for national planning,” Professor Bhutta added.

Globally, the YLDs increased from 537.6 million in 1990 to 764.8 million in 2013 for both sexes.

Men and women around the world share the same leading causes of YLDs, with the exception of schizophrenia as a leading cause for men and other musculoskeletal disorders for women. Musculoskeletal disorders, mental and substance use disorders, neurological disorders, and chronic respiratory conditions were the main drivers of YLDs in 2013. The disease burdens of both low back pain and depression have increased more than 50 per cent since 1990.

Researchers found that as people aged they experienced a greater number of ailments resulting from non-fatal diseases and injuries. Many people also suffered from multiple conditions at the same time.

Although the impact of YLDs increases with age, 81 per cent of the 2.3 billion people who suffered from more than five ailments were younger than 65 years old.

War and conflict was a leading cause of YLDs in several countries in 2013, including El Salvador, Guatemala, Lebanon, Peru, and Syria. In Cambodia, Nicaragua, and Rwanda – war was the top cause of YLD.

“What ails you isn’t necessarily what kills you,” said Dr. Christopher Murray, Director of the Institute for Health Metrics and Evaluation in Washington. “As non-fatal illnesses and related ailments affect more people of all ages, countries must look closely at health policy and spending to target these conditions.”

Vice Chancellor of Pakistan Institute of Medical Sciences (Pims) Dr Javed Akram while talking to Dawn said that people have to change their lifestyle to avoid the disabilities.

“We have the worst lifestyle in the world. Children play games on computer instead of grounds. People eat fast food instead of normal diet. Government does not have a health policy. And imagine Pakistan is to become the third most populous country of the world in 2042,” he said.

He said that 15 percent population is affected with diabetes and it is increasing because people are not ready to change their lifestyle. They would wait long for the lifts rather climb the stairs to second and third floors,” he said.

Health expert Dr Waseem Khawaja said that focus groups should be made to do counseling of people affected with different diseases.

“Moreover, government should spend money on rehabilitation of people. NGOs should also come forward to resolve the issue,” he said.

Published in Dawn, June 9th, 2015

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