Major risk factors for adult mortality from NCDs and injuries in Japan
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Major risk factors for adult mortality from NCDs and injuries in Japan

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GHME 2013 Conference

GHME 2013 Conference
Session: Risk factor burden
Date: June 18 2013
Presenter: Nayu Ikeda
Institute: AXA Department of Health and Human Security, University of Tokyo

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Major risk factors for adult mortality from NCDs and injuries in Japan Major risk factors for adult mortality from NCDs and injuries in Japan Presentation Transcript

  • Major risk factors for adult mortality from NCDs and injuries in Japan Nayu Ikeda AXA Department of Health and Human Security Graduate School of Medicine The University of Tokyo
  • Female life expectancy at birth (Source: Lancet 2011;378:1094-1105) Australia UK West Germany France Italy Sweden Canada USA Japan (1947-2008) Japan (1900-1936) Lifeexpectancy(years) 1900 1920 1940 1960 1980 2000 Year
  • Causes of death in Japan, 2008 (Data source: Vital records, adjusted for ill-defined codes)
  • CRA data (1/2) Cause-specific mortality – Vital records in 2007 – Redistribution of ill-defined codes (GBD 2010) Selection of 16 risk factors and diseases – US study (Danaei et al. 2009) – Infections Risk exposures – National Health and Nutrition Survey 2007 – Epidemiological studies
  • CRA data (2/2)  Selection of relative risks 1. Literature review of prospective studies in Japan a. Pooled/individual estimates from large-scale prospective studies b. Confirming causalities/associations already established in past studies 2. Asia-Pacific Cohort Studies Collaboration 3. GBD study  Theoretical-minimum-risk exposure distribution – US study
  • Deaths attributable to risk factors in Japan, 2007 (Source: PLoS Med 2012;1:e1001160) 129K 104K Diseases
  • Dietary risks High blood pressure Smoking Physical inactivity Ambient PM pollution High BMI High plasma glucose Alcohol use High total cholesterol Lead Occupational risks Low bone mineral density Intimate partner violence Drug use Ozone Childhood sexual abuse Iron deficiency Radon Sanitation Unimproved water Zinc deficiency Childhood underweight Vitamin A deficiency Household air pollution Suboptimal BF 0 40k 80k 120k 160k 200k 240k(Source: GBD Compare, IHME) GBD 2010 Japan, deaths
  • High sodium Low fruit Low nuts & seeds Low whole grains Low omega-3 Low fiber Low vegetables Low PUFA Low calcium High processed meat Low milk High sweetened beverages High trans fat High red meat 0 20k 40k 60k 80k 100k(Source: GBD Compare, IHME) GBD 2010 Japan, deaths
  • Smoking rate by age and sex (Data source: National Health and Nutrition Surveys)
  • Prevalence of high blood pressure 0 10 20 30 40 50 1960 1970 1980 1990 2000 2010 Year England Japan United States (Source: Ikeda et al. under review) 1970 1980 1990 2000 2010 England Japan United States 50 40 30 20 10 0 %ofpopulation 1960 1970 1980 1990 2000 2010 Year
  • Average dietary salt intake (Data source: National Health and Nutrition Surveys)
  • Policy implications Importance of improving the control of major risk factors • Investigate underlying causes for the inadequate risk factor control at the population level • Revise and strengthen policies and programs to appropriately address these issues Results cited in academic and official materials for health promotion
  • Next steps  Disability-adjusted life years • Preventing risk factors to decrease the burden of long-term care for the elderly  CRA at the subnational level • Disparity in life expectancy across prefectures