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How to Win Friends and Influence Global Health Policy

Darker and redder means unhealthier, global DALY rankings

One of the biggest challenges in global health is getting accurate information.

I once interviewed a health official in Abidjan, Ivory Coast, who proudly handed me data showing the government had pushed its immunization coverage rates up to 120 percent. Wow! How’d they do that?

You can help those trying to improve this situation by participating in a 15-minute survey for the new Global Burden of Disease study, a massive analysis aimed at determining what kills, sickens and injures worldwide.

When Chris Murray, now director of the UW’s Institute for Health Metrics and Evaluation, and his colleague Alan Lopez did the first “Global Burden” study back in 1990, it’s fair to say they transformed the way we look at disease and health. One of the primary products of the Murray-Lopez collaboration was the DALY, or “disability adjusted life year,” measurement that they believe more accurately portrays the impact of health and disease.

World map of DALY measures


Darker and redder means unhealthier, global DALY rankings

Not everyone was happy with the change wrought by these two number-crunchers, of course, since it was a lot easier to seek funding and support for your project if you could adjust the numbers to fit your pitch. Now, these troublemakers are up to it again — and you can join them!

The new Global Burden study is led by Murray and Lopez in collaboration with Harvard, Johns Hopkins, University of Queensland and the World Health Organization.

But this “regular folks” survey, I have to say, might strike participants as a bit odd. Basically, they are asking you to choose between various kinds of disability and illness and decide which one is worse. They say there are no right or wrong answers.

Huh? So what’s the point?

“In order to truly assess the impact of diseases and injuries worldwide, we need to know the values that people place on different conditions,” said Ali Mokdad, an expert on behavior and health risk who works with Murray at the UW.

For example, Mokdad said, Indonesians say they would choose to live an additional five years disability free rather than 15 years longer with disability. In other countries, he said, they are finding most people choose just the opposite.

By asking 50,000 people to take this survey and make similar hypothetical choices, Mokdad said they hope to provide a more accurate “weighting” or valuation of certain disabilities and health conditions.

And you can even become a fan of the Global Burden of Disease (that sounds a bit funny) on Facebook or follow it on Twitter.


About Author

Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at] or follow him on Twitter @tompaulson.