162 The World Health Report 2002 This report represents one of the largest research projects ever coordinated by the World Health Organization. It has quantified many of the important global risks and assessed the cost-effectiveness of measures to reduce them. The ultimate goal is to support gover ments in all countries to lower the impact of these risk The conclusions have already been described as a wake-up call to health leaders around the world. They are also the basis for building a healthier future for entire populations THE WORLD FACES SOME COMMON LARGE AND CERTAIN RISKS TO HEALTH Leading 10 selected risk factors as percentage causes of There are countless risks to health, but even among the selected disease burden measured in dalys major risks in this report, relatively few are responsible for large amounts of the global disease burden. Almost all of them are more Developing countries common among the world's poor than the better-off. Until now, their High mortality countries true impact has been underestimated, particularly in developing coun underweight tnes Unsafe sex 102% Unsafe water, sanitation and hygiene 5 59 The picture that has emerged from this research gives an intrigu Indoor smoke from solid fuels 3.6n.ing a alarming-insight into current and important causes of Zinc deficiency 3.296 diseases and death and the factors underlying them. Human behav- 3.19 jour and societies are changing around the world and global changes Vitamin A deficiency 3.0% are having a large impact on peoples health Blood pressure 2.5% The table, left, shows the top 10 selected risk factors as causes of Tobacco 2.0% disease burden in high and low mortality developing countries and holesterol 1.9% in developed countries. While this table shows the burden attribut- Low mortality cour able to the selected factors at a global level, it does not show the high 6.29 risks faced by certain sections of the population( for example, the Blood pressure 5.09 many people whose occupations place them at high risk of life-threat 4.0% ening injury or chronic disease), or the burden resulting from major Underweight 3.1% diseases(such as malaria, tuberculosis and HiViaidS which in total Overweight 2.7% cause more than 10% of global disease burden). Also, the combined holesterol 2.1% effects of the risk factors in this table will be less than the sum of their Low fruit and vegetable intake Indoor smoke from solid fuels 1.9% Separate effects At least 30%%of all disease burden occurring in high mortal- 1.8%0 ity developing countries, such as those in sub-Saharan Africa Unsafe water, sanitation and hygiene 1.8% and South-East Asia, is due to just five risk factors: underweight Developed countries unsafe sex, micronutrient deficiencies, unsafe water, and in Tobacco door smoke Risks associated with food insecurity, hunger and 122% Blood pressure 109% malnutrition still dominate the health of the world,'s poorest nations. Most of the childhood deaths in developing countries Cholesterol 756% each year are associated with malnutrition. In addition, the 74% onsequences of unsafe sex are fuelling the HIVIAIDS epide ics in africa and asia Physical inactivity 33%. In low mortality developing countries, such as the Peoples llicit drugs Republic of China and most countries in Central and South Unsafe sex 0.8% America, the top five risk factors cause at least one sixth of on deficiency their total disease burden. These populations face a double burden of risks. Indeed, the analysis on which this report162 The World Health Report 2002 This report represents one of the largest research projects ever coordinated by the World Health Organization. It has quantified many of the important global risks and assessed the cost-effectiveness of measures to reduce them. The ultimate goal is to support govern￾ments in all countries to lower the impact of these risks. The conclusions have already been described as a wake-up call to health leaders around the world. They are also the basis for building a healthier future for entire populations across the world. THE WORLD FACES SOME COMMON, LARGE AND CERTAIN RISKS TO HEALTH There are countless risks to health, but even among the selected major risks in this report, relatively few are responsible for large amounts of the global disease burden. Almost all of them are more common among the world’s poor than the better-off. Until now, their true impact has been underestimated, particularly in developing coun￾tries. The picture that has emerged from this research gives an intrigu￾ing – and alarming – insight into current and important causes of diseases and death and the factors underlying them. Human behav￾iour and societies are changing around the world and global changes are having a large impact on people’s health. The table, left, shows the top 10 selected risk factors as causes of disease burden in high and low mortality developing countries and in developed countries. While this table shows the burden attribut￾able to the selected factors at a global level, it does not show the high risks faced by certain sections of the population (for example, the many people whose occupations place them at high risk of life-threat￾ening injury or chronic disease), or the burden resulting from major diseases (such as malaria, tuberculosis and HIV/AIDS which in total cause more than 10% of global disease burden). Also, the combined effects of the risk factors in this table will be less than the sum of their separate effects. • At least 30%% of all disease burden occurring in high mortal￾ity developing countries, such as those in sub-Saharan Africa and South-East Asia, is due to just five risk factors: underweight, unsafe sex, micronutrient deficiencies, unsafe water, and in￾door smoke. Risks associated with food insecurity, hunger and malnutrition still dominate the health of the world’s poorest nations. Most of the childhood deaths in developing countries each year are associated with malnutrition. In addition, the consequences of unsafe sex are fuelling the HIV/AIDS epidem￾ics in Africa and Asia. • In low mortality developing countries, such as the People’s Republic of China and most countries in Central and South America, the top five risk factors cause at least one sixth of their total disease burden. These populations face a double burden of risks. Indeed, the analysis on which this report is Leading 10 selected risk factors as percentage causes of disease burden measured in DALYs Developing countries High mortality countries Underweight 14.9% Unsafe sex 10.2% Unsafe water, sanitation and hygiene 5.5% Indoor smoke from solid fuels 3.6% Zinc deficiency 3.2% Iron deficiency 3.1% Vitamin A deficiency 3.0% Blood pressure 2.5% Tobacco 2.0% Cholesterol 1.9% Low mortality countries Alcohol 6.2% Blood pressure 5.0% Tobacco 4.0% Underweight 3.1% Overweight 2.7% Cholesterol 2.1% Low fruit and vegetable intake 1.9% Indoor smoke from solid fuels 1.9% Iron deficiency 1.8% Unsafe water, sanitation and hygiene 1.8% Developed countries Tobacco 12.2% Blood pressure 10.9% Alcohol 9.2% Cholesterol 7.6% Overweight 7.4% Low fruit and vegetable intake 3.9% Physical inactivity 3.3% Illicit drugs 1.8% Unsafe sex 0.8% Iron deficiency 0.7%