Wednesday, August 17, 2016
Measuring Burden of Unhealthy Behaviours
Unhealthy behaviours, including smoking, poor diet, physical inactivity, and unhealthy alcohol consumption, are leading risk factors for premature mortality worldwide [1–3]. Measuring the burden of health-behaviour–related deaths in populations is challenging because standard death certificates do not provide information about underlying risks factors for disease. Previous population burden studies have addressed this challenge using two methods. The most commonly used method—aggregated data approach, used in the Global Burden of Disease study and first described by Levin—starts with disease-specific mortality and indirectly attributes underlying risks to a fraction of deaths according to separately measured estimates of the association between the exposures and disease [2,4,5]. The second method, the population cohort approach, starts with population-based health surveys that individually ascertain exposures to different health behaviours [6,7]. Respondents are followed until death, with attribution of unhealthy behaviours estimated directly from a multivariable regression model.