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- from personalmd.com
NEW YORK, May 02 (Reuters) -- The United Nations' World Health Organization (WHO) has released sobering global statistics on who dies, where, and why.

"While the diseases of poverty stalk people living in the developing world, the so-called 'diseases of affluence' are now becoming the leading killers in the developing world, as they have been in the developed world," according to the British medical journal The Lancet, which this week carries a study entitled "The Global Burden of Disease."

The study, which categorizes by cause and demographics the over 50 million deaths which occurred worldwide in the year 1990, was funded by a grant from the World Health Organization.

The study authors determined the top 10 global killers to be: heart attack (6.3 million deaths); stroke (4.4 million); pneumonia (4.3 million); diarrhea (2.9 million); birth-related illnesses (2.4 million); bronchitis/emphysema (2.2 million); tuberculosis (2 million); measles (1.1 million); road accidents (1 million); and cancers of the lung, bronchus, and trachea (900,000).

- Sadly, many of the dead are children. "One in four of the estimated 50 million deaths that occurred in 1990 was the death of a child under the age of 5 years," according to the Lancet report. The study authors point out that most of these childhood diseases occur in poorer nations and can be prevented: "5 of the 10 leading killers are communicable, perinatal (birth-related), and nutritional disorders."

- But, increasingly, the 'diseases of poverty' (such as diarrhea, pneumonia, and unchecked measles), are giving way in the mortality figures of the developing world to noninfectious diseases long associated with more affluent countries. "Noncommunicable diseases (accounted) for 28.1 million deaths," the study authors say -- and now make up a majority of the overall global death count.

- Scientists believe development itself may provide the answer as to why noninfectious diseases (like heart disease or cancers) are beginning to overshadow the threat of communicable disease within the developing world. The researchers speculate that poverty-based, debilitating infectious disease (and malnutrition) in childhood may weaken individuals as they become adults. As incomes rise with development, the health burdens brought on by unhealthy 'affluent' lifestyles (high-fat diets and smoking, for example), may then be less easily resisted in those individuals. The result? An increased number of deaths due to heart disease and cancer in the developing world.

- As the study points out, "by 1990,... there were already 50% more cancer deaths in less developed countries than in developed countries."

- There were other surprises in the WHO study: "56% of all females suicides in the world occurred in China," researchers discovered. In fact, they estimate suicide to be the cause of death of one in four Chinese women between the ages of 14 and 44.

- When it comes to being murdered, the researchers found "40% of male homicides were in sub-Saharan Africa, and a further 20% were in Latin America and the Caribbean."

- And they say it remains unclear why women in India had double or triple the risk of dying from burns than women elsewhere.

- The researchers believe more study is needed to understand why men, ages 15 to 60, face a higher risk of death in the formerly socialist economies of Eastern Europe than anywhere else except sub-Saharan Africa.

- The study (whose results will continue to be published in three installments within future issues of The Lancet) -- is described as a starting point for further investigation into the reasons behind death rates among various populations -- and strategies to help curb them. SOURCE: The Lancet (1997;349:1269-1277)