Here’s a breakdown of the key findings from the provided text,organized for clarity:
Overall Trend (2010-2019):
* Generally Declining Mortality: The probability of dying from a Non-Communicable Disease (NCD) before age 80 decreased in the majority of countries - 82% for females and 79% for males.
* Slowdown in Progress: However, the rate of decline slowed down compared to the 2000s. About half the countries showed smaller declines or even reversals in progress during 2010-2019 compared to the previous decade.
Regional Variations:
* Largest Reductions: Central Asia, the Middle East, and North Africa (females); Central and Eastern Europe (males).
* Smallest Declines: Pacific Island nations.
* Reversals/Slower Declines: High-income Western nations, Latin America & Caribbean, East & Southeast Asia, and South Asia (females).
Country Specifics:
* Best Performers: Denmark (leading for both sexes).
* Worst Performers (among large countries): USA (smallest drop), India and Papua New Guinea (increases in mortality).
* Improvements: China, Egypt, Nigeria, Russia, and Brazil.
Key Disease Contributors:
* Dominant Improvement: Circulatory diseases, particularly ischemic heart disease (lowering NCD death probability by up to 7.9 percentage points) and stroke.
* Favorable Trends: Colorectal, cervical, stomach, breast, and prostate cancers. Lung cancer mortality declined for males in most countries. COPD showed some favorable contributions.
* Unfavorable Trends: Pancreatic and liver cancers, neuropsychiatric conditions (Alzheimer’s, dementia, alcohol use disorders), and diabetes (mixed effects – improving in some areas, worsening in others).
Age & Other Factors:
* Older Age Impact: Changes in mortality rates for those 65 and older had the biggest impact on overall national probabilities. Failure to reduce older-age mortality led to stagnation or increases.
* Multiple Causes: Changes weren’t driven by a single disease; a combination of causes and age groups shaped the trends.
Reasons for slowdown (as suggested by the authors):
* Plateau in coverage of proven interventions.
* Fiscal constraints after the 2008 global recession.
* Widening health inequalities.
Recommendations:
* ”Learning health-system” approach (continuous monitoring, benchmarking, evaluation).
* Sustained focus on tobacco and metabolic risk control.
* Strengthening primary and specialty care.
* Improving death registration and cause certification.
crucial Note: The authors caution that mortality data quality is a concern, especially in low- and middle-income countries, which introduces uncertainty into the findings.
