Eleven Health Issues To Watch Out For In 2023
The Institute for Health Metrics and Evaluation (IHME) published a list of disorders that may turn out to be the most serious health issues in numerous countries and should thus be closely monitored.
Long COVID-19 Long COVID-19 is certainly a health problem to maintain a close eye on in 2023. Long COVID-19 has a negative impact on a person's ability to participate in school, employment, or relationships for months at a time.Advertisement
People with long COVID-19 need diagnostic and proper rehabilitation support from primary care physicians. There is a need for more research to find effective treatments as well as preventive measures to reduce the risk of developing long COVID-19 (1✔ ✔Trusted SourceEstimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021Go to source
).Mental Health Mental disorders are the leading cause of disability worldwide, with no sign of a decline since 1990. The impact of the COVID-19 pandemic, war, and violence on mental health remains of utmost importance, especially understanding how these have impacted the prevalence and burden of mental disorders in 2022 onward and how countries should be adapting their mental health response accordingly.Current studies investigate childhood sexual abuse, intimate partner violence, and bullying victimization as risk factors for mental disorders. Going forward, better understanding of the other risk factors for mental disorders is needed along with how these vary across different populations. Offering the best opportunities for prevention at the population level is top priority (2✔ ✔Trusted SourceGlobal Burden of Disease (GBD)
Go to source).
Impact of Climate Change Climate change is already impacting the health of millions of people around the world, and it will worsen over the course of this century. People are experiencing both the direct effects of extreme heat that is measured and a myriad of indirect effects. Flooding can force people from their homes and affect their mental health, droughts and storms can impact food security and water availability, and wildfire smoke episodes can increase air pollution. As the pandemic has taught the world, preparedness is key, and we are not prepared for the health impacts of a warmer climate.Most of the emphasis to date on climate change has been on what we call mitigation: reducing the emissions that lead to global warming. Yet to date these efforts have been far too modest. We are now at a point where climate change is clearly with us, and much more attention needs to be put on minimizing the impacts on global health through adaptation or enhancing resilience.
One aspect of this is improving overall health and enhancing socioeconomic development because we know that those who are more vulnerable will suffer the most. In addition, there are technological solutions that can support adaptation, such as the use of drought-resistant crops, increasing vegetation in cities to reduce the urban heat island effect, or repurposing land use to adapt to rising sea levels.
Air pollution is one of the leading global risk factors that we evaluate and is currently responsible for about 8% of all global mortality, yet it is a problem with known solutions. Increasing the speed at which we address air pollution will save lives. Those solutions will move the world closer to the net-zero carbon emissions goals that we need to ultimately address the root causes of climate change (3✔ ✔Trusted SourceAdapting Our Cities to the Future
Go to source).
Cardiovascular Disease Ischemic heart disease and stroke are the main causes of death worldwide, accounting for 28% of total fatalities in 2021. Additionally, cardiovascular diseases substantially contribute to health loss and the economic burden on health care systems. Most cardiovascular diseases can be prevented by addressing modifiable cardiovascular risk factors such as high blood pressure, high cholesterol, obesity, dietary risks, smoking, and air pollution (4✔ ✔Trusted SourceEffects of elevated systolic blood pressure on ischemic heart disease: a Burden of Proof studyGo to source
).Lower Respiratory Infections Lower respiratory infections (LRI), particularly respiratory syncytial virus (RSV) and influenza, will be major health concerns in 2023.There was a general decline in influenza and RSV infections in 2020 due to COVID-19 mitigation measures such as mask use and social distancing. With the relaxation of these measures, many young children who haven't been exposed to RSV in the past couple of years are being infected, resulting in RSV outbreaks. Countries have also seen an increase in influenza cases of all ages.
Annual influenza vaccination provides an opportunity to reduce the LRI burden attributable to flu. There is no vaccine yet to prevent RSV, but promising vaccine trials are underway (5✔ ✔Trusted SourceThe race to make vaccines for a dangerous respiratory virus
Go to source).
After experiencing significant disruptions to health care systems worldwide due to the COVID-19 pandemic, the increase in respiratory infections and other communicable diseases have added to the existing burden of chronic non-communicable diseases. This creates a dual burden of disease exacerbated by social inequalities observed globally.
Role of Poverty in Health Poverty appears to be the root cause of health disparities. Climate change and rising violence have exacerbated the unequal distribution of resources. Low- and middle-income countries experience worse health outcomes than high-income countries. The life expectancy is 34 years lower, the under-5 mortality around 100 times higher, deaths due to interpersonal violence and suicide are 30 times higher, and deaths attributable to antimicrobial resistance (AMR) are 12 times higher. There is an urgent need to address the impact of poverty on health, life, and death.Strengthening Health Systems Global health system strengthening is a crucial component of what is required for resilient health systems. This will be particularly relevant as countries refocus their resources and attention after the acute phase of the COVID-19 pandemic.A longer-term commitment from donors and governments is needed. Financial and human resources, governance structures, management and information systems are required to ensure that interventions are set up for long-term sustainability and can deliver the outcomes that are aspired to across health systems.
Given the immense strain of COVID-19 on primary care and hospital systems in the past, attention should be paid to building back up the health care system and enabling frontline workers to do their jobs effectively. Public health leaders and policymakers need to reflect on lessons learned from the pandemic to prevent health care system collapse in the next crisis and to ensure that people who need care can access quality health care.
Diabetes Diabetes affects around 422 million people globally, with the majority residing in low- and middle-income countries, and diabetes is directly responsible for 1.5 million fatalities per year.Population-based interventions such as taxes and incentives, more informative food labeling, improving the built environment to facilitate exercise, and greater advocacy to inform people of the risk diabetes poses, combined with expanded health education to combat diabetes risk factors, are the best options. Policies aimed to help avoid weight gain and improve dietary quality are also important.
Another important aspect is improving the response of health systems in terms of access and quality care. These should include universal access to low-cost insulin and oral anti-diabetic medication to decrease avoidable deaths from acute complications. Health systems should also strive to furnish feedback from their administrative data systems to providers to help orient diabetes care (6✔ ✔Trusted SourceBurden of diabetes and hyperglycaemia in adults in the Americas, 1990â€"2019: a systematic analysis for the Global Burden of Disease Study 2019
Go to source).
Road Accidents Road traffic accidents are still a serious and preventable problem. Road traffic accidents are the main cause of death among those aged 15 to 49.Helmets, seatbelts, airbags, speed limits, and laws against drunk driving are effective interventions. However, execution is not the only factor that defines their performance; human conduct must comply with those policies in order for them to be effective.
Dementia Anticipated trends in population growth and population aging are expected to lead to large increases in the number of people affected by dementia globally, underscoring the public health importance of dementia. To adequately care for those with dementia, appropriate planning for the necessary supports and services required is needed.Interventions targeting modifiable risk factors, such as low education, smoking, and high blood sugar, have the potential to reduce the overall societal burden and should be prioritized (7✔ ✔Trusted SourceEstimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019
Go to source).
Aging of the Population Adapting health-care systems to meet the requirements of older people should be a top priority in 2023. Globally, the proportion of the population that is above 65 is expected to increase in the coming years. While most attention has historically been placed on diseases affecting children, it will be important to begin thinking about and planning for some of the forthcoming changes in demography, particularly in low- and middle-income nations.References :
Source: Medindia
Does Childhood Adversity Cause Mental Health Problems?
It’s well known that experiencing adverse events in childhood (such as maltreatment, domestic violence, or parental substance abuse) is associated with mental health problems. But, despite decades of research, we still don’t know the extent to which these adverse childhood experiences (ACEs) cause mental health problems.
This confusion arises from the fact that children exposed to ACEs are likely to experience other risk factors for mental health problems, including social factors like poverty, as well as genetic factors. So it’s not clear whether higher rates of mental health problems in individuals who experienced ACEs are due to the adversity per se or to other risks.
It's understandable that children exposed to ACEs are likely to experience other social risk factors, like poverty. But why might children exposed to adversities have a greater genetic predisposition to mental health problems?
First, we know that ACEs are more common in families in which parents have mental health problems, and experiencing severe parental mental health problems is also considered to be an ACE. This means that children living in these families may be more likely to inherit a genetic predisposition to mental health problems from their parents and also experience adverse environments.
Second, it’s also possible that children who inherit mental health problems might be responded to in a negative way by their parents. For example, parents may lose their tempers more often with hyperactive children, increasing the likelihood that these children experience shouting or physical discipline.
These are examples of gene-environment correlation, whereby exposure to environmental experiences depends on a person’s genotype. Such gene-environment correlations can mean that the association between ACEs and mental health may be at least partly explained by genetic factors.
In a recent study, we aimed to account for genetics to better understand the environmental impact of ACEs on mental health. To do so, we studied over 11,000 genotyped children taking part in the UK-based Avon Longitudinal Study of Parents and Children or the US-based Adolescent Brain and Cognitive Development Study. To assess ACEs (maltreatment, domestic violence, parental mental health problems, parental substance abuse, parental criminality, and parental separation), we used information from parent and child interviews. We assessed children’s internalising problems (e.G., anxiety and depression), and externalising problems (e.G., ADHD and disruptive behaviours) through parent reports when children were aged 9 or 10 years.
To assess a child’s genetic predisposition to mental health problems, we calculated polygenic risk scores. Polygenic risk scores index a person’s genetic liability for a disorder (e.G., depression) based on the number of genetic risk variants they have for that disorder. We calculated children’s polygenic risk scores for a range of mental health problems, including depression, anxiety, schizophrenia, bipolar disorder, ADHD, autism, antisocial behaviour, and alcohol abuse.
We first examined whether children with a greater genetic predisposition to mental health problems were more likely to experience ACEs. We found that this was the case: children with higher polygenic risk scores for mental health problems (such as depression, ADHD, and schizophrenia) were, on average, slightly more likely to experience ACEs.
Importantly, this doesn’t mean that exposure to ACEs is determined by genes, is the fault of the child, or is not preventable. Rather, the findings suggest that children with a greater genetic predisposition to mental health problems are, on average, slightly more likely to experience ACEs.
This finding is likely to at least partly reflect passive gene-environment correlation, whereby parents with mental health problems pass on this genetic predisposition to their children and provide adverse environments. For example, a parent with depression might transmit genetic risk variants linked to depression to their child and also find it harder to interact with the child.
But despite these genetic influences, it’s important to emphasise that ACEs are also influenced by modifiable social and environmental risk factors and can be effectively prevented through environmental interventions, like parenting support programmes.
We next examined the extent to which any associations between ACEs and mental health might be explained by children’s genetic predisposition to mental health problems. After controlling for polygenic risk scores for mental health problems, we found that ACEs remained associated with mental health problems.
However, polygenic risk scores aren’t the best way to account for genetic factors because they only partially capture a person’s genetic liability to mental health problems. To address this limitation, we used a new statistical method which estimates associations between environmental factors and outcomes under a scenario in which polygenic risk scores could explain greater genetic liability to mental health problems.
Using this method, we found that genetic factors accounted for at least part of the associations between ACEs and mental health. Notably, though, child maltreatment and parental mental health problems were still associated with child mental health problems, independent of genetic factors. This suggests that the environmental experience of maltreatment and living with a parent with mental health problems could influence children’s mental health.
Our study is not without limitations. First, we examined a narrow set of ACEs, but many other adversities affect children, such as bullying or death of a family member. Second, our study was based on participants with European ancestry, so it’s important to investigate whether the findings generalise to populations with different ancestral backgrounds. Finally, although we examined the role of individual risk factors (e.G., genetic predisposition and ACEs), wider structural inequalities (e.G., poverty) can play an important role in influencing both ACEs and mental health.
Overall, though, our findings can help to inform interventions to help prevent children from developing mental health problems. Because maltreatment and parental mental health problems were associated with children’s mental health problems through environmental pathways, preventing those experiences might help to prevent mental health problems in the population. Therefore, investing in parenting support programmes and effective parental mental health care could not only improve family functioning but also prevent later costly mental health problems.
To prevent children exposed to ACEs from developing mental health problems, accessible mental health support is essential. Because children exposed to ACEs were more likely to have genetic predispositions to mental health problems, therapeutic techniques that address heritable psychiatric vulnerabilities (e.G., through skills-building) could reduce their risk of developing mental health problems.
This post was written by Jessie Baldwin, PhD, Megan Briggs, and Jean-Baptiste Pingault, PhD.
Childhood Maltreatment Linked With Multiple Mental Health Problems
Experiencing abuse or neglect as a child can cause multiple mental health problems, finds a new study led by UCL researchers.
The research, published in the American Journal of Psychiatry, seeks to examine the causal effects of childhood maltreatment on mental health by accounting for other genetic and environmental risk factors, such as a family history of mental illness and socioeconomic disadvantage.
The first-of-its-kind research analysed 34 quasi-experimental studies, involving over 54,000 people.
Quasi-experimental studies can better establish cause and effect in observational data, by using specialised samples (eg. Identical twins) or innovative statistical techniques to rule out other risk factors. For example, in samples of identical twins, if a maltreated twin has mental health problems but their non-maltreated twin does not, the association cannot be due to genetics or the family environment shared between twins.
Across the 34 studies, researchers found small effects of child maltreatment on a range of mental health problems, including internalising disorders (eg. Depression, anxiety, self-harm, and suicide attempt), externalising disorders (eg. Alcohol and drug abuse, ADHD, and conduct problems), and psychosis.
These effects were consistent regardless of the method used or way in which maltreatment and mental health were measured.
The findings suggest that preventing eight cases of child maltreatment would prevent one person from developing mental health problems.
Corresponding author, Dr Jessie Baldwin (UCL Psychology & Language Sciences), said:
"It is well known that child maltreatment is associated with mental health problems, but it was unclear whether this relationship is causal, or is better explained by other risk factors.
"This study provides rigorous evidence to suggest that childhood maltreatment has small causal effects on mental health problems. Although small, these effects of maltreatment could have far-reaching consequences, given that mental health problems predict a range of poor outcomes, such as unemployment, physical health problems and early mortality.
"Interventions that prevent maltreatment are therefore not only essential for child welfare, but could also prevent long-term suffering and financial costs due to mental illness."
Nevertheless, the researchers also found that part of the overall risk of mental health problems in individuals exposed to maltreatment was due to pre-existing vulnerabilities -- which might include other adverse environments (eg. Socioeconomic disadvantage) and genetic liability.
Dr Baldwin said: "Our findings also suggest that to minimise risk of mental health problems in individuals exposed to maltreatment, clinicians should address not only the maltreatment experience, but also pre-existing psychiatric risk factors."
Researchers defined childhood maltreatment as any physical, sexual or emotional abuse or neglect before the age of 18.
The study was funded by Wellcome and is in collaboration with King's College London, University of Lausanne, Yale University School of Medicine, University of Bristol and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust.
Study limitations
Each of the quasi-experimental studies analysed may have been subject to potential biases. However, the findings were consistent across studies using different quasi-experimental methods, suggesting that the results are robust.
Additionally, it was not possible to draw firm conclusions about the specific effects of different types of maltreatment, as it is common for different types of abuse/neglect to happen at the same time, and studies rarely account for this.
The lack of available data mean that it was not possible to examine the effects of the timing of maltreatment, the interval between maltreatment and mental health issues, or differences between racial or ethnic groups. Future quasi-experimental research is needed to address these questions.
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