Faculty of Health and Environmental Sciences

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The research carried out at AUT's Faculty of Health and Environmental Sciences can be broadly defined in three themes:
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Browsing Faculty of Health and Environmental Sciences by Author "Abbafati, C"

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    Measuring Universal Health Coverage Based on an Index of Effective Coverage of Health Services in 204 Countries and Territories, 1990–2019: A Systematic Analysis for the Global Burden of Disease Study 2019
    (Elsevier, 2020) Lozano, R; Fullman, N; Mumford, JE; Knight, M; Barthelemy, CM; Abbafati, C; Abbastabar, H; Abd-Allah, F; Abdollahi, M; Abedi, A; Abolhassani, H; Abosetugn, AE; Abreu, LG; Abrigo, MRM; Abu Haimed, AK; Abushouk, AI; Adabi, M; Adebayo, OM; Adekanmbi, V; Adelson, J; Adetokunboh, OO; Adham, D; Advani, SM; Afshin, A; Agarwal, G; Agasthi, P; Aghamir, SMK; Agrawal, A; Ahmad, T; Akinyemi, RO; Alahdab, F; Al-Aly, Z; Alam, K; Albertson, SB; Alemu, YM; Alhassan, RK; Ali, M; Ali, S; Alipour, V; Aljunid, SM; Alla, F; Almadi, MAH; Almasi, A; Almasi-Hashiani, A; Almasri, NA; Al-Mekhlafi, HM; Almulhim, AM; Alonso, J; Al-Raddadi, RM; Altirkawi, KA; Alvis-Guzman, N; Alvis-Zakzuk, NJ; Amini, S; Amini-Rarani, M; Amiri, F; Amit, AML; Amugsi, DA; Ancuceanu, R; Anderlini, D; Andrei, CL; Androudi, S; Ansari, F; Ansari-Moghaddam, A; Antonio, CAT; Antony, CM; Antriyandarti, E; Anvari, D; Anwer, R; Arabloo, J; Arab-Zozani, M; Aravkin, AY; Aremu, O; Ärnlöv, J; Asaad, M; Asadi-Aliabadi, M; Asadi-Pooya, AA; Ashbaugh, C; Athari, SS; Atout, MMDW; Ausloos, M; Avila-Burgos, L; Ayala Quintanilla, BP; Ayano, G; Ayanore, MA; Aynalem, YA; Aynalem, GL; Ayza, MA; Azari, S; Azzopardi, PS; B, DB; Babaee, E; Badiye, AD; Bahrami, MA; Baig, AA; Bakhshaei, MH; Bakhtiari, A; Bakkannavar, SM; Balachandran, A; Balassyano, S; Banach, M
    Background: Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings: Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation: The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC. Funding: Bill & Melinda Gates Foundation.
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    Spatial, Temporal, and Demographic Patterns in Prevalence of Smoking Tobacco Use and Attributable Disease Burden in 204 Countries and Territories, 1990–2019: A Systematic Analysis From the Global Burden of Disease Study 2019
    (Elsevier BV, 2021) Reitsma, MB; Kendrick, PJ; Ababneh, E; Abbafati, C; Abbasi-Kangevari, M; Abdoli, A; Abedi, A; Abhilash, ES; Abila, DB; Aboyans, V; Abu-Rmeileh, NME; Adebayo, OM; Advani, SM; Aghaali, M; Ahinkorah, BO; Ahmad, S; Ahmadi, K; Ahmed, H; Aji, B; Akunna, CJ; Al-Aly, Z; Alanzi, TM; Alhabib, KF; Ali, L; Alif, SM; Alipour, V; Aljunid, SM; Alla, F; Allebeck, P; Alvis-Guzman, N; Amin, TT; Amini, S; Amu, H; Amul, GGH; Ancuceanu, R; Anderson, JA; Ansari-Moghaddam, A; Antonio, CAT; Antony, B; Anvari, D; Arabloo, J; Arian, ND; Arora, M; Asaad, M; Ausloos, M; Awan, AT; Ayano, G; Aynalem, GL; Azari, S; B, DB; Badiye, AD; Baig, AA; Bakhshaei, MH; Banach, M; Banik, PC; Barker-Collo, SL; Bärnighausen, TW; Barqawi, HJ; Basu, S; Bayati, M; Bazargan-Hejazi, S; Behzadifar, M; Bekuma, TT; Bennett, DA; Bensenor, IM; Berfield, KSS; Bhagavathula, AS; Bhardwaj, N; Bhardwaj, P; Bhattacharyya, K; Bibi, S; Bijani, A; Bintoro, BS; Biondi, A; Birara, S; Braithwaite, D; Brenner, H; Brunoni, AR; Burkart, K; Butt, ZA; Caetano dos Santos, FL; Cámera, LA; Car, J; Cárdenas, R; Carreras, G; Carrero, JJ; Castaldelli-Maia, JM; Cattaruzza, MSS; Chang, J-C; Chen, S; Chu, D-T; Chung, S-C; Cirillo, M; Costa, VM; Couto, RAS; Dadras, O; Dai, X; Damasceno, AAM; Damiani, G; Dandona, L; Dandona, R; Daneshpajouhnejad, P; Darega Gela, J; Davletov, K; Derbew Molla, M; Dessie, GA; Desta, AA; Dharmaratne, SD; Dianatinasab, M; Diaz, D; Do, HT; Douiri, A; Duncan, BB; Duraes, AR; Eagan, AW; Ebrahimi Kalan, M; Edvardsson, K; Elbarazi, I; El Tantawi, M; Esmaeilnejad, S; Fadhil, I; Faraon, EJA; Farinha, CSES; Farwati, M; Farzadfar, F; Fazlzadeh, M; Feigin, VL; Feldman, R; Fernandez Prendes, C; Ferrara, P; Filip, I; Filippidis, F; Fischer, F; Flor, LS; Foigt, NA; Folayan, MO; Foroutan, M; Gad, MM; Gaidhane, AM; Gallus, S; Geberemariyam, BS; Ghafourifard, M; Ghajar, A; Ghashghaee, A; Giampaoli, S; Gill, PS; Glozah, FN; Gnedovskaya, EV; Golechha, M; Gopalani, SV; Gorini, G; Goudarzi, H; Goulart, AC; Greaves, F; Guha, A; Guo, Y; Gupta, B; Gupta, RD; Gupta, R; Gupta, T; Gupta, V; Hafezi-Nejad, N; Haider, MR; Hamadeh, RR; Hankey, GJ; Hargono, A; Hartono, RK; Hassankhani, H; Hay, SI; Heidari, G; Herteliu, C; Hezam, K; Hird, TR; Hole, MK; Holla, R; Hosseinzadeh, M; Hostiuc, S; Househ, M; Hsiao, T; Huang, J; Iannucci, VC; Ibitoye, SE; Idrisov, B; Ilesanmi, OS; Ilic, IM; Ilic, MD; Inbaraj, LR; Irvani, SSN; Islam, JY; Islam, RM; Islam, SMS; Islami, F; Iso, H; Itumalla, R; Iwagami, M; Jaafari, J; Jain, V; Jakovljevic, M; Jang, S-I; Janjani, H; Jayaram, S; Jeemon, P; Jha, RP; Jonas, JB; Joo, T; Jürisson, M; Kabir, A; Kabir, Z; Kalankesh, LR; Kanchan, T; Kandel, H; Kapoor, N; Karimi, SE; Katikireddi, SV; Kebede, HK; Kelkay, B; Kennedy, RD; Khoja, AT; Khubchandani, J; Kim, GR; Kim, Y-E; Kimokoti, RW; Kivimäki, M; Kosen, S; Koulmane Laxminarayana, SL; Koyanagi, A; Krishan, K; Kugbey, N; Kumar, GA; Kumar, N; Kurmi, OP; Kusuma, D; Lacey, B; Lam, JO; Landires, I; Lasrado, S; Lauriola, P; Lee, DW; Lee, YH; Leung, J; Li, S; Lin, H; Linn, S; Liu, W; Lopez, AD; Lopukhov, PD; Lorkowski, S; Lugo, A; Majeed, A; Maleki, A; Malekzadeh, R; Malta, DC; Mamun, AA; Manjunatha, N; Mansouri, B; Mansournia, MA; Martinez-Raga, J; Martini, S; Mathur, MR; Medina-Solís, CE; Mehata, S; Mendoza, W; Menezes, RG; Meretoja, A; Meretoja, TJ; Miazgowski, B; Michalek, IM; Miller, TR; Mirrakhimov, EM; Mirzaei, H; Mirzaei-Alavijeh, M; Misra, S; Moghadaszadeh, M; Mohammad, Y; Mohammadian-Hafshejani, A; Mohammed, S; Mokdad, AH; Monasta, L; Moni, MA; Moradi, G; Moradi-Lakeh, M; Moradzadeh, R; Morrison, SD; Mossie, TB; Mubarik, S; Mullany, EC; Murray, CJL; Naghavi, M; Naghshtabrizi, B; Nair, S; Nalini, M; Nangia, V; Naqvi, AA; Narasimha Swamy, S; Naveed, M; Nayak, S; Nayak, VC; Nazari, J; Nduaguba, SO; Neupane Kandel, S; Nguyen, CT; Nguyen, HLT; Nguyen, SH; Nguyen, TH; Nixon, MR; Nnaji, CA; Norrving, B; Noubiap, JJ; Nowak, C; Ogbo, FA; Oguntade, AS; Oh, I-H; Olagunju, AT; Oren, E; Otstavnov, N; Otstavnov, SS; Owolabi, MO; P A, M; Pakhale, S; Pakshir, K; Palladino, R; Pana, A; Panda-Jonas, S; Pandey, A; Parekh, U; Park, E-C; Park, E-K; Pashazadeh Kan, F; Patton, GC; Pawar, S; Pestell, RG; Pinheiro, M; Piradov, MA; Pirouzpanah, S; Pokhrel, KN; Polibin, RV; Prashant, A; Pribadi, DRA; Radfar, A; Rahimi-Movaghar, V; Rahman, A; Rahman, MHU; Rahman, MA; Rahmani, AM; Rajai, N; Ram, P; Ranabhat, CL; Rathi, P; Rawal, L; Renzaho, AMN; Reynales-Shigematsu, LM; Rezapour, A; Riahi, SM; Riaz, MA; Roever, L; Ronfani, L; Roshandel, G; Roy, A; Roy, B; Sacco, S; Saddik, B; Sahebkar, A; Salehi, S; Salimzadeh, H; Samaei, M; Samy, AM; Santos, IS; Santric-Milicevic, MM; Sarrafzadegan, N; Sathian, B; Sawhney, M; Saylan, M; Schaub, MP; Schmidt, MI; Schneider, IJC; Schutte, AE; Schwendicke, F; Seidu, A-A; Senthil Kumar, N; Sepanlou, SG; Seylani, A; Shafaat, O; Shah, SM; Shaikh, MA; Shalash, AS; Shannawaz, M; Sharafi, K; Sheikh, A; Sheikhbahaei, S; Shigematsu, M; Shiri, R; Shishani, K; Shivakumar, KM; Shivalli, S; Shrestha, R; Siabani, S; Sidemo, NB; Sigfusdottir, ID; Sigurvinsdottir, R; Silva, DAS; Silva, JP; Singh, A; Singh, JA; Singh, V; Sinha, DN; Sitas, F; Skryabin, VY; Skryabina, AA; Soboka, M; Soriano, JB; Soroush, A; Soshnikov, S; Soyiri, IN; Spurlock, EE; Sreeramareddy, CT; Stein, DJ; Steiropoulos, P; Stortecky, S; Straif, K; Suliankatchi Abdulkader, R; Sulo, G; Sundström, J; Tabuchi, T; Tadakamadla, SK; Taddele, BW; Tadesse, EG; Tamiru, AT; Tareke, M; Tareque, MI; Tarigan, IU; Temsah, M-H; Thankappan, KR; Thapar, R; Tichopad, A; Tolani, MA; Topouzis, F; Tovani-Palone, MR; Tran, BX; Tripathy, JP; Tsegaye, GW; Tsilimparis, N; Tymeson, HD; Ullah, A; Ullah, S; Unim, B; Updike, RL; Vacante, M; Valdez, PR; Vardavas, C; Varona Pérez, P; Vasankari, TJ; Venketasubramanian, N; Verma, M; Vetrova, MV; Vo, B; Vu, GT; Waheed, Y; Wang, Y; Welding, K; Werdecker, A; Whisnant, JL; Wickramasinghe, ND; Yamagishi, K; Yandrapalli, S; Yatsuya, H; Yazdi-Feyzabadi, V; Yeshaw, Y; Yimmer, MZ; Yonemoto, N; Yu, C; Yunusa, I; Yusefzadeh, H; Zahirian Moghadam, T; Zaman, MS; Zamanian, M; Zandian, H; Zar, HJ; Zastrozhin, MS; Zastrozhina, A; Zavala-Arciniega, L; Zhang, J; Zhang, Z-J; Zhong, C; Zuniga, YMH; Gakidou, E
    Summary Background Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. Methods We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Findings Globally in 2019, 1·14 billion (95% uncertainty interval 1·13–1·16) individuals were current smokers, who consumed 7·41 trillion (7·11–7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5% [26·5–28·5] reduction) and females (37·7% [35·4–39·9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98–1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16–8·20) deaths and 200 million (185–214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% [19·3–21·1] of male deaths). 6·68 million [86·9%] of 7·69 million deaths attributable to smoking tobacco use were among current smokers. Interpretation In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens.
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