[사이언스미디어센터] 전문가 의견 '세계 질병 부담(GBD)' 논문 해설(랜싯)

*2025.10.13.

AUTHOR COMMENT

Professor Aziz Rahman is Associate Dean of Research from the Institute of Health and Wellbeing at Federation University and a Professor of Public Health

"While life expectancy in Australia has significantly improved for both males and females, ischaemic heart disease continues to be the leading cause of death, a trend that has remained unchanged over the past 30 years. To address this issue, it is essential to prioritise primary prevention by tackling modifiable risk factors such as tobacco use, unhealthy diets, and lifestyle choices. Elevating health literacy is crucial, with a focus on recognising symptoms and understanding individual risk factors. Additionally, we must enhance access to cardiovascular risk assessment tools, particularly for disadvantaged groups, including First Nations people, culturally and linguistically diverse (CALD) populations, and those residing in rural areas. Strengthening cardiac rehabilitation through increased home-based support programs will also contribute to effective secondary prevention.

Interestingly, in 2023, Alzheimer’s Disease emerged as the second leading cause of death in Australia, while it ranks as the sixth leading cause of death globally, highlighting a significant area for attention. It is vital to raise awareness through dementia risk reduction campaigns that address lifestyle factors. Simultaneously, integrating dementia risk assessments into primary care settings and promoting early diagnosis can help alleviate the burden of this condition.

In 2023, high BMI was identified as the leading risk factor, while smoking maintained its status as the second leading risk factor over the last three decades in Australia. Beyond ongoing population-level initiatives aimed at promoting healthy behaviours to combat overweight and obesity, it is crucial to address policy issues such as implementing taxes on sugar-sweetened beverages and mitigating industry interference in marketing unhealthy foods to children. Furthermore, the prevailing misconception that 'tobacco control is done' among the public and policymakers in Australia is hindering progress. Therefore, smokers, particularly those with higher dependence and those in remote areas, need to have access to adequate smoking cessation support."

Aziz is a Senior Collaborator for the Global Burden of Disease study.

INDEPENDENT COMMENTS

Yutang Wang is a Senior Lecturer in Biomedical Science from the Health Innovation and Transformation Centre at Federation University Australia

"According to the latest Global Burden of Disease (GBD) studies, global age-standardised mortality rates are declining for many of the leading causes of death, including ischemic heart disease and stroke, over the past three decades. In contrast, mortality rates associated with diabetes, kidney disease, hypertensive heart disease, and Alzheimer’s disease are on the rise.

To assess overall health loss, the Disability-Adjusted Life Year (DALY)—an age-standardised metric combining years of life lost due to premature death and years lived with disability—is routinely used. Between 2010 and 2023, DALY rates decreased globally for 22 of the 25 leading risk factors, indicating an overall improvement in population health worldwide. However, three risk factors showed an increase in DALY rates: high body mass index (up 10.5%), drug use (up 8.4%), and high blood sugar (up 6.2%).

Australians are generally healthier than the global average, with lower all-cause mortality rates (418 vs 822 per 100,000 population) and longer life expectancy (83.9 years vs 73.8 years globally). In 2023, the top three risk factors contributing to DALYs in Australia were high body mass index (7.0%), smoking (5.8%), and high blood sugar (5.5%).

These findings highlight the need for continued public health efforts in Australia, particularly in promoting healthier lifestyles. Strategies should include increasing physical activity, reducing overeating, and supporting smoking cessation to further enhance the nation’s health outcomes."

Yutang Wang has declared he has no conflicts of interest.
He is contactable on +61 3 5327 9394 and Yutang.wang@federation.edu.au

Professor Richard Edwards is Head of Public Health in the College of Medicine and Public Health at Flinders University

"The Global Burden of Disease (GBD) study demonstrates increasing dominance of non-communicable diseases (NCDs) like heart disease, stroke and diabetes and their risk factors as causes of premature death and disease. Rapidly growing prevalence of anxiety, depression and Alzheimer’s disease is also apparent. 

The GBD study also shows some remarkable progress since 1990, including substantial reductions in the burden of disease from communicable diseases and poor nutrition and greatly improved maternal and child health. Unfortunately, recent cuts to resources for development assistance for health threaten to undermine this progress. 

Findings from Australia mirror the picture of rapidly increasing health burdens from NCDs; the commonest causes of death are heart disease, stroke and lung cancer, and the biggest population health risk factors are obesity, smoking and high blood sugar.

The Ottawa Charter is 40 years old in 2026. The Charter’s advocacy for making healthy choices easy choices through healthy public policies and creating supportive environments is as relevant today as in 1986. 

The growing importance of NCDs underlines the enormous potential health gains from introducing preventive evidence-based policy measures such as sugary drinks taxes and denicotinising tobacco products. 

With growing misinformation about health and health interventions and increasing abandonment of goals prioritising societal well-being and social justice, what better time for Australia to show leadership and provide inspiration by introducing the pioneering public health policy measures to prevent NCDs, which the findings from the GBD study surely demand?"

Richard declares the following:

• Current research funding support from: Government of South Australia, Health Research Council of New Zealand, New Zealand Cancer Society, University of Otago, University of Queensland/NHMRC Australia, National Cancer Institute/NIH (US)

• Occasional honoraria for contributions to scientific meetings/conferences, published papers/editorials (Tobacco Control, The Lancet), scientific funding panels and PhD assessments.

• Travel costs refunded for attendance at

  • National SUDI conference in Rotorua, New Zealand; May 2022

  • SRNT-O/NHMRC tobacco endgame Centre of Research Excellence meeting; Brisbane 2024

• Honorary/advisory affiliations (all unpaid)

• Honorary Professor of Public Health and member of ASPIRE Aotearoa Research Centre at Otago University in Wellington, New Zealand

• Member/Fellow of Society of Research on Nicotine and Tobacco and President SRNT-Oceania

He is contactable on +61 489 187 070 and Richard.edwards@flinders.edu.au and is available after 11:30am ACDT on Friday

Professor Jenny Gunton is Chair of Medicine at the University of Sydney, Westmead Hospital

"The paper shows that diabetes is now one of the top three causes of disability worldwide. There has been a huge and steady increase in disability due to diabetes since 1990, when diabetes was only 20th on the list of causes. Diabetes is also an important cause of cardiovascular disease, with up to 2/3 of people with diabetes dying from cardiovascular causes like heart attack and stroke.

Peak disability years for people with diabetes are between 50 and 69 years, affecting millions of people of working age worldwide, but there is also a worryingly high burden of disability in adolescents and young adults with diabetes."

Jenny has not declared any conflicts of interest.
She is contactable on jenny.gunton@sydney.edu.au and +61 2 8890 8089.

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