For the global health field, 2015 is a year with a lot riding on it. The deadline for reaching the Millennium Development Goals (MDGs) looms, and deliberations continue about the post-MDG world should approach sustainable development (and what that should even mean). We’re celebrating improved survival in much of the world, yet we’re still struggling to contain Ebola in West Africa and less traditional “public health” problems, such as violence, are on rise in many places.
Two days into 2015, Vox published a piece that showcased the #1 cause of early death in each country. From Australia (heart disease) to Zimbabwe (HIV/AIDS), the article emphasized what causes are killing the most people too soon.
This Vox piece generated a lot of discussion about premature mortality and why certain causes led a given country’s death toll – all important issues and topics to cover. But to best tackle our world’s health challenges, we need a balanced understanding of what’s not working and what’s getting worse – and what’s getting better and why such progress is happening. Luckily, that’s the primary focus for the folks at Solutions Journalism (along with their data-loving, number-crunching partners at the Institute for Health Metrics and Evaluation [IHME]).
Using data produced through the Global Burden of Disease 2013 study, the graphic below illustrates the #1 reason why fewer people are dying, country-by-country.
Each of these causes was identified by looking at the top causes of death in 1990, and then calculating which ones fell dramatically between 1990 and 2013.
This graphic paints the very diverse picture of progress we’ve achieved in health since 1990. Some of the stories are decently well-known – for instance, the world’s gains against measles has been heralded as one of the biggest successes in global health, even in places where success stories are hard to find (e.g., Elissa Thomas’s SJN piece on the Democratic Republic of the Congo).
On the other hand, other success stories seem to have less documentation, or at least beyond their immediate fields and disease specialists. For instance:
- Deaths caused by tetanus fell more 90% in several countries, from Eritrea to India. A very effective vaccine against tetanus exists, but given the vaccination challenges facing places like Pakistan and South Sudan, there’s something clearly unique happening for tetanus in these places.
- Among higher income countries, road injuries are killing far fewer people now than two decades ago – but why exactly?
- Mortality from typhoid and African trypanosomiasis, two traditionally neglected tropical diseases (NTDs), has dropped significantly in affected countries. For example, in Uganda, African trypanosomiasis was the 9th leading cause of death in 1990; by 2013, mortality fell by 95%, dropping to the 79th leading cause of death. What did these countries do?
With this new year, SJN and IHME will delve deeper into these instances of “positive deviance” in health, as well as how countries are actually improving their health systems and how they deliver care. We will happily dive into the data and report back on what we find – but we don’t want to do alone.
We encourage you, from the health journalist to policy advocate, to think about the stories of progress you want to know – and tell us. Explore IHME’s data visualizations, read their policy reports, consider what your local news sources are telling you about health. Ask the questions about how we, collectively, can achieve better health throughout the world, whether it’s decreasing smoking rates in Palm Beach County, Florida or improving survival from HIV in Rwanda. It may not sound like much, but it’s asking those kinds of questions – and learning from what’s working to improve the world’s health – that can really make a difference.