Prince Michael Amegbor
Prince Michael Amegbor
Scroll
Assistant Professor of Global and Environmental Health
-
Professional overview
-
As a health geographer using big data and a multi-methods approach in his research on the environmental and social determinants of health, Dr. Prince Michael Amegbor is an assistant professor in the Department of Global and Environmental Health. He specializes in visualizing the geospatial distribution of risks and burdens on health that are associated with environmental exposures. He works to unravel how factors such as climate change, air pollution and other environmental exposures contribute to health inequalities, particularly in Sub-Saharan Africa and other geographic contexts (e.g., Denmark).
Prior to his appointment at GPH, Dr. Amegbor was a postdoctoral research fellow with the Big Data Centre for Environment and Health (BERTHA) and the Department of Environmental Science at Aarhus University (Denmark). He is also a guest researcher at Statistics Denmark and has worked as a co-task leader of two European Union Horizon 2020 Projects: REGREEN and ICARUS (Integrated Climate forcing and Air pollution Reduction in Urban Systems).
Dr. Amegbor has published dozens of articles in peer-reviewed scholarly journals including Scientific Report, Health & Place and Applied Geography. He earned his PhD in human geography from Queen’s University in Ontario, and holds an MPhil in development geography from the University of Oslo. He obtained his undergraduate degree in geography and resource development from the University of Ghana, Legon.
Below are links to the results from ICARUS – Favorite Location Study published in the Environment and Planning B: Urban Analytics and City Science journal:
-
Education
-
PhD, Department of Geography & Planning, Queen’s University, Kingston, OntarioMPhil Developmental Geography, University of Oslo, Oslo, NorwayBA Geography & Resource Development, University of Ghana, Accra
-
Honors and awards
-
Principal's International Doctoral Award, Queen’s University (201520162017)Quota Scheme Scholarship, Department of Sociology & Human Geography, University of Oslo (201220132014)
-
Areas of research and study
-
Aging and the Life CourseAlternative MedicineChild HealthComplementary MedicineEnvironmental Public Health ServicesImmigrant HealthPublic Health PolicySocial Determinants of HealthSocio-cultural Identities and Health Seeking BehaviorsTraditional MedicineUrban GeographyViolence and VictimisationWomen's Health
-
Publications
Publications
An Assessment of Care-Seeking Behavior in Asikuma-Odoben-Brakwa District : A Triple Pluralistic Health Sector Approach
AbstractAmegbor, P. M., & Amegbor, P. M. (n.d.).Publication year
2017Journal title
SAGE OpenVolume
7Issue
2AbstractDiscussions and studies on Ghana’s pluralistic health care system usually ignore or downplay self-care as a crucial sector in this system of care. In view of this, this study uses a triple sector approach of the pluralistic health care system as advocated by Kleinman to assess care-seeking behaviors of residents in the Asikuma-Odoben-Brakwa District (Ghana). The results of cross-tabulation analysis demonstrate that respondents’ general care–seeking behavior is different from the type of care sought for last illness before the study. Data for the study were obtained from 227 urban and rural respondents in the study district in 2013. The findings indicate that factors such as geographic location, health insurance, and perception of the cost of professional care had a bearing on residents’ general care–seeking behavior. However, age, sex, relationship status, economic status, and proximity to nearest biomedical care service influenced the type of treatment sought for last illness. The approach use of the study demonstrates that self-care remains a general avenue of care for residents, whereas in times of severe illness, respondents often rely on professional biomedical care. The use of professional indigenous care services is generally low due to the financial burden associated with its use.Assessing the association between overcrowding and human physiological stress response in different urban contexts : a case study in Salzburg, Austria
AbstractZhang, Z., Měchurová, K., Resch, B., Amegbor, P. M., & Sabel, C. E. (n.d.).Publication year
2023Journal title
International Journal of Health GeographicsVolume
22Issue
1AbstractOvercrowding in densely populated urban areas is increasingly becoming an issue for mental health disorders. Yet, only few studies have examined the association between overcrowding in cities and physiological stress responses. Thus, this study employed wearable sensors (a wearable camera, an Empatica E4 wristband and a smartphone-based GPS) to assess the association between overcrowding and human physiological stress response in four types of urban contexts (green space, transit space, commercial space, and blue space). A case study with 26 participants was conducted in Salzburg, Austria. We used Mask R-CNN to detect elements related to overcrowding such as human crowds, sitting facilities, vehicles and bikes from first-person video data collected by wearable cameras, and calculated a change score (CS) to assess human physiological stress response based on galvanic skin response (GSR) and skin temperature from the physiological data collected by the wristband, then this study used statistical and spatial analysis to assess the association between the change score and the above elements. The results demonstrate the feasibility of using sensor-based measurement and quantitative analysis to investigate the relationship between human stress and overcrowding in relation to different urban elements. The findings of this study indicate the importance of considering human crowds, sitting facilities, vehicles and bikes to assess the impact of overcrowding on human stress at street level.Assessing the association between urban features and human physiological stress response using wearable sensors in different urban contexts
AbstractZhang, Z., Amegbor, P. M., Sigsgaard, T., & Sabel, C. E. (n.d.).Publication year
2022Journal title
Health and PlaceVolume
78AbstractPublic open space (POS) plays a significant role in fostering human health and wellbeing in cities. A major limitation of current research on POS and health is that there is little attention on the role of various urban features on people's mental health, in different urban context. This study employed wearable sensors (a wearable camera, Empatica 4 wristband and a GPS device) to measure human physiological responses to urban indicators, objectively. To do this, we selected six kinds of public open space (water area, transit area, green area, commercial area, motor traffic area and mixed office and residential area) and recruited 86 participants for an experimental study. Next, we detected urban features by using Microsoft Cognitive Services (MCS) and calculated a change score to assess human physiological stress responses based on galvanic skin response (GSR) and skin temperature from the wristband. Lastly, we applied random effect model and geographically weighted regression analysis to examine the relationship between urban indicators and human physiological stress responses. The findings show that urban flow (vehicles, bikes and people), waterbodies, greenery and places to sit are associated with the changes of human physiological stress response. The findings indicate that the type of urban context may confound the effect of green and blue urban features; i.e., the effect on physiological stress response can be positive or negative depending on the context. The paper highlights the relevance of considering urban context in research on associations between urban features and stress response.Assessing the current integration of multiple personalised wearable sensors for environment and health monitoring
AbstractZhang, Z., Amegbor, P. M., & Sabel, C. E. (n.d.).Publication year
2021Journal title
SensorsVolume
21Issue
22AbstractThe ever-growing development of sensor technology brings new opportunities to investigate impacts of the outdoor environment on human health at the individual level. However, there is limited literature on the use of multiple personalized sensors in urban environments. This review paper focuses on examining how multiple personalized sensors have been integrated to enhance the monitoring of co-exposures and health effects in the city. Following PRISMA guidelines, two reviewers screened 4898 studies from Scopus, Web of Science, ProQuest, Embase, and PubMed databases published from January 2010 to April 2021. In this case, 39 articles met the eligibility criteria. The review begins by examining the characteristics of the reviewed papers to assess the current situation of integrating multiple sensors for health and environment monitoring. Two main challenges were identified from the quality assessment: choosing sensors and integrating data. Lastly, we propose a checklist with feasible measures to improve the integration of multiple sensors for future studies.Assessing the Effect of Pre- and Post-natal Environmental Exposures, Geographic Factors and Socio-Economic Conditions on Acute Respiratory Infections among Children Under Five in Sub-Saharan Africa – A Machine Learning Approach
AbstractWang, R., Siguenza, C., Dadwal-Gupta, E., North, H., Wu, R., Yang, X., Zhang, Z., & Amegbor, P. M. (n.d.).Publication year
2025Journal title
PLOS OneAbstract~Associations between early-life exposure to ambient air pollution and childhood health outcomes: Exploring potential spatial heterogeneity
AbstractAmegbor, P. M. (n.d.).Publication year
2023AbstractAt the 2023 APHA annual meeting, I delivered a roundtable presentation centered on the impact of early-life exposure to ambient air pollutants on childhood health outcomes among children under 5 in Sub-Saharan Africa (SSA). The presentation delved into the Developmental Origins of Health and Disease (DOHaD) theory, which posits that exposure to adverse environmental factors during early life can significantly influence short- and long-term health outcomes. Specifically, the talk highlighted the application of spatial variation coefficient models as a tool to investigate disparities in the impact or effect of early-life ambient air pollution exposure on health.Determinants of Overnight Stay in Health Centres and Length of Admission : A Study of Canadian Seniors
AbstractAmegbor, P. M., Plumb, K. B., & Rosenberg, M. W. (n.d.).Publication year
2020Journal title
Canadian Journal on AgingVolume
39Issue
4Page(s)
533-544AbstractThis study examines the influence of chronic health conditions and socio-economic status on overnight admission and length of stay among Canadian seniors. Incremental multivariate logistic and zero-inflated negative binomial regression models assessed the relationship between selected predictors, overnight admission, and duration of stay. The findings show that all chronic health conditions and socio-economic factors examined were significantly associated with overnight hospital admission. However, seniors with cardiovascular health conditions, the very old, and seniors living in lower-income households had a greater risk of longer stays. Canadian seniors diagnosed with hypertension, cancer, diabetes, and stroke had greater risk of longer overnight hospital stays. Seniors aged 75 to 79 years, 80 years or older, and those living in lower-income households (≤ $39,999) were more likely to have a longer overnight hospital stay. Findings suggest that improving seniors' health and socio-economic status may reduce the risk of overnight admission and longer stays of hospitalisation.Determinants of the type of health care sought for symptoms of Acute respiratory infection in children : analysis of Ghana demographic and health surveys
AbstractDanquah, L., Amegbor, P. M., & Ayele, D. G. (n.d.).Publication year
2021Journal title
BMC PediatricsVolume
21Issue
1AbstractBackground: Globally, acute respiratory infection (ARI) is a leading cause of infant and childhood morbidity and mortality. Currently, it is estimated that 50 million cases of childhood ARI are untreated. In this study, we identified determinants of the type of treatment sought for symptoms of childhood acute respiratory infection (ARI), including non-treatment, amongst a nationally representative sample of children under five years in Ghana. Methods: In total, 1 544 children were studied by a secondary analysis of pooled survey data from the 1993, 1998, 2003, 2008, and 2014 Ghana Demographic and Health Surveys (GDHS). Cross-tabulations, chi-square, multinomial logistic regression, and Bayesian hierarchical spatial logistic regression analyses were used to identify relationships between the type of treatment sought and maternal socio-economic and household characteristics. Results: Seeking medical care was significantly associated with child age (RRR= 1.928, 95 % CI 1.276 – 2.915), maternal employment status (RRR = 1.815, 95 % CI 1.202 – 2.740), maternal health insurance status, (RRR = 2.618, 95 % CI 1.801 – 3.989), children belonging to middle (RRR = 2.186, 95 % CI 1.473 – 3.243), richer (RRR = 1.908, 95 % CI 1.145 – 3.180) and richest households (RRR = 2.456, 95 % CI 1.363 – 4.424) and the 1998 survey period (RRR = 0.426, 95 % CI 0.240 – 7.58). Seeking self-care or visiting a traditional healer was significantly associated with maternal educational status (RRR = 0.000, 95 % CI 0.000 – 0.000), and the 1998 (RRR= 0.330, 95 % CI 0.142 – 0.765), 2003 (RRR= 0.195, 95 % CI 0.071 – 0.535), 2008 (RRR= 0.216, 95 % CI 0.068 – 0.685) and 2014 (RRR= 0.230, 95 % CI 0.081 – 0.657) GDHS periods. The probability that the odds ratio of using medical care exceeded 1 was higher for mothers/caregivers in the Western, Ashanti, Upper West, and Volta regions. Conclusions: Government policies that are aimed at encouraging medical care-seeking for children with ARI may yield positive results by focusing on improving maternal incomes, maternal NHIS enrolment, and maternal household characteristics. Improving maternal education could be a positive step towards addressing challenges with self-care or traditional healing amongst children with ARI.Does place matter? A multilevel analysis of victimization and satisfaction with personal safety of seniors in Canada
AbstractAmegbor, P. M., Rosenberg, M. W., & Kuuire, V. Z. (n.d.).Publication year
2018Journal title
Health and PlaceVolume
53Page(s)
17-25AbstractStudies on the victimization and abuse of seniors in Canada have largely ignored the influence of place-based variations in social bonds and socioeconomic characteristics. Using the 2014 General Social Survey (GSS) data on Canadians’ safety, we examine neighborhood, social capital, and socioeconomic characteristics as predictors of the incidence of victimization among seniors and their satisfaction with personal safety from crime. Generally, seniors with poor neighborhood ties and social capital were more likely to have experienced victimization and have a lower satisfaction with personal safety. Seniors who viewed people in their neighborhood as unhelpful were more likely to have experienced some form of victimization and more likely to have a lower satisfaction with personal safety. Highly educated and high-income seniors were also more likely to have experienced some form of victimization. Paradoxically, such seniors were less likely to have lower satisfaction with personal safety. The results also show that place, defined as population centers (urban and rural) may have a significant influence on variations in victimization and satisfaction with personal safety. A significant proportion of the variance in victimization (38%) and satisfaction with personal safety (23%) are largely the result of differences in place of residence (urban and rural). Our findings suggest that there is the need to improve neighborhood social capital, reduce neighborhood disorder and improve the socioeconomic status of community-dwelling seniors in order to minimize their susceptibility to victimization as well as to improve their sense of safety from crime.Early-life air pollution and green space exposures as determinants of stunting among children under age five in Sub-Saharan Africa
AbstractAmegbor, P. M., Sabel, C. E., Mortensen, L. H., Mehta, A. J., & Rosenberg, M. W. (n.d.).Publication year
2023Journal title
Journal of Exposure Science and Environmental EpidemiologyAbstractBackground: Childhood malnutrition is a major public health issue in Sub-Saharan Africa (SSA) and 61.4 million children under the age of five years in the region are stunted. Although insight from existing studies suggests plausible pathways between ambient air pollution exposure and stunting, there are limited studies on the effect of different ambient air pollutants on stunting among children. Objective: Explore the effect of early-life environmental exposures on stunting among children under the age of five years. Methods: In this study, we used pooled health and population data from 33 countries in SSA between 2006 and 2019 and environmental data from the Atmospheric Composition Analysis Group and NASA’s GIOVANNI platform. We estimated the association between early-life environmental exposures and stunting in three exposure periods – in-utero (during pregnancy), post-utero (after pregnancy to current age) and cumulative (from pregnancy to current age), using Bayesian hierarchical modelling. We also visualise the likelihood of stunting among children based on their region of residence using Bayesian hierarchical modelling. Results: The findings show that 33.6% of sampled children were stunted. In-utero PM2.5 was associated with a higher likelihood of stunting (OR = 1.038, CrI = 1.002–1.075). Early-life exposures to nitrogen dioxide and sulphate were robustly associated with stunting among children. The findings also show spatial variation in a high and low likelihood of stunting based on a region of residence. Impact Statement: This study explores the effect of early-life environmental exposures on child growth or stunting among sub-Saharan African children. The study focuses on three exposure windows – pregnancy, after birth and cumulative exposure during pregnancy and after birth. The study also employs spatial analysis to assess the spatial burden of stunted growth in relation to environmental exposures and socioeconomic factors. The findings suggest major air pollutants are associated with stunted growth among children in sub-Saharan Africa.Early-life environmental exposures and anaemia among children under age five in Sub-Saharan Africa : An insight from the Demographic & Health Surveys
AbstractAmegbor, P. M. (n.d.).Publication year
2022Journal title
Science of the Total EnvironmentVolume
832AbstractBackground: Reports show that the majority (60%) of children under age five years in Sub-Saharan Africa are anaemic. Studies in the region have mainly focused on the effect of individual, maternal and household socioeconomic status on the prevalence of anaemia. Currently, there is limited understanding of the association between early-life environmental exposures and anaemia among children in Sub-Saharan Africa. Objective: The study examines the association between early-life environmental exposures and anaemia among children under five in Sub-Saharan Africa. Methods: The study used health and demographic data from the Demographic and Health Survey (DHS) program and environmental data from NASA's Geospatial Interactive Online Visualization ANd aNalysis Infrastructure (GIOVANNI) and Atmospheric Composition Analysis Group. Three exposure periods were defined for the study, namely: in-utero, post-utero and cumulative life exposures. Multilevel mixed-effect models were used to assess the associations between environmental exposures and anaemia in each exposure period. Results: The findings show that 63% of children in the study were anaemic. It also reveals that mean PM 2.5 exposure for in-utero (34.93 μgm−3), post-utero (35.23 μgm−3) and cumulative exposure (35.08 μgm−3) were seven times higher than the new air quality guideline WHO recommended. A 10 μgm−3 increase in in-utero, post-utero and cumulative PM 2.5 exposures was associated with 4% to 5% increase in the prevalence of anaemia among children. A 10ppbv increase in in-utero, post-utero and cumulative carbon monoxide exposures was associated with 1% increase in the prevalence of anaemia among children. The spatial risk distribution maps show that socioeconomic factors modify the spatial risk distribution pattern. Conclusion: The findings of the study suggest that early-life exposure to ambient air pollution is significantly associated with anaemia among children in Sub-Saharan Africa. Thus, policies aimed at addressing air quality should be incorporated into targeted interventions for anaemia among children in the region.Effect of cognitive and structural social capital on depression among older adults in Ghana : A multilevel cross-sectional analysis
AbstractAmegbor, P. M., Braimah, J. A., Adjaye-Gbewonyo, D., Rosenberg, M. W., & Sabel, C. E. (n.d.).Publication year
2020Journal title
Archives of Gerontology and GeriatricsVolume
89AbstractEvidence from existing studies suggests social capital has mixed effects on depression and other common mental disorders. There is little knowledge of the possible association between social capital and depression among the growing older population in sub-Saharan Africa. This study investigates the effect of cognitive social capital (trust and sense of safety) and structural social capital (social participation or engagement in social activities) on depression among older adults in Ghana. Utilizing multilevel mixed-effect analysis, we investigate the effect of individual-level and neighborhood-level social capital (cognitive and structural) on depression using data from the World Health Organization Study on Global Ageing and Adult Health (WHO-SAGE) survey (Wave 1). The findings show that at an individual level, older adults who felt safe at home were less likely to have depression. We observed mixed results for elements of structural social capital at the individual level. Older adults who frequently engaged in club or group meetings, worked with neighbors and engaged in social outings were more likely to have depression; while attending public meetings and socializing with co-workers were associated with reduced likelihood of having depression. At the neighborhood level, increased trust in neighbors was associated with an increased likelihood of having depression (OR = 1.01, p < 0.05) while higher levels of neighborhood safety and structural social capital were associated with a reduced likelihood of having depression. The findings suggest that the differential associations between elements of social capital and depression may be the result of contextual factors.Effect of individual, household and regional socioeconomic factors and PM2.5 on anaemia : A cross-sectional study of sub-Saharan African countries
AbstractAmegbor, P. M., Borges, S. S., Pysklywec, A., & Sabel, C. E. (n.d.).Publication year
2022Journal title
Spatial and Spatio-temporal EpidemiologyVolume
40AbstractThere is limited knowledge on the effect of contextual and environmental factors on the risk of anaemia, as well as the spatial distribution of anaemia in the Sub-Saharan Africa region. In this study, we used multi-country data from the Demographic & Health survey (DHS) with 270,011 observations and PM2.5 data from NASA, applied to the spatial risk pattern of anaemia in the SSA region. The prevalence of anaemia amongst women (41%) was almost twice that of men (22%). A Bayesian hierarchical model showed that individual household, neighbourhood and regional socioeconomic factors were significantly associated with the likelihood of being anaemic. 1 μg/m3 increase in cumulative lifetime PM2.5 exposure accounted for 1% (β = 0.011, CI = 0.008 – 0.015) increase in the likelihood of being anaemic. The results suggest the need for a multidimensional approach to tackle anaemia in the Sub-Saharan African region and identify high-risk areas for target intervention policies or programs.Examining Spatial Variability in the Association Between Male Partner Alcohol Misuse and Intimate Partner Violence Against Women in Ghana : A GWR Analysis
AbstractAmegbor, P. M., Yankey, O., Rosenberg, M. W., & Sabel, C. E. (n.d.).Publication year
2021Journal title
Journal of Interpersonal ViolenceVolume
36Issue
23-24Page(s)
NP12855-NP12874AbstractGlobally, it is estimated that about 30% of ever-partnered women have experienced some form of intimate partner violence (IPV)—physical assault, sexual assault, or emotional abuse. The prevalence of IPV in sub-Saharan Africa is considerably higher than the global estimate. In Ghana, it is estimated that 24% of women have experienced physical and/or sexual IPV in their lifetime. Studies point to the association between alcohol misuse by intimate male partners and violence against women. However, there has been no consideration for potential spatial variation or heterogeneity in this association. Using estimates from the 2008 Ghana Demographic and Health Survey Data, we employed geographically weighted regression (GWR) analysis to examine spatial variations in the relationship between male partner’s alcohol misuse and IPV among women in Ghana. We fitted three models to assess the relationship using a step-wise approach. The first model has alcohol misuse as the only predictor, whereas the second model included other male partner characteristics, such as post-secondary education and employment status. The final introduced female characteristics as additional covariates. The result of the GWR analysis shows that the effect of alcohol misuse on IPV is elevated in the south-western part of Ghana. The findings suggest the potential influence of place-based or contextual factors on the association between alcohol misuse and women’s exposure to IPV.Examining the Effect of Geographic Region of Residence on Childhood Malnutrition in Uganda
AbstractAmegbor, P. M., Yankey, O., & Sabel, C. E. (n.d.).Publication year
2020Journal title
Journal of Tropical PediatricsVolume
66Issue
6Page(s)
598-611AbstractObjectives: In our study, we examine how geographic region of residence may predict childhood malnutrition, expressed as stunting, wasting and underweight, among children under the age of 5 years in Uganda. Methods: Using data from the 2016 Uganda Demographic and Health Survey, we performed an incremental multivariate multilevel mixed-effect modelling to examine the effect of a child, parental and household factors on the association between region of residence and each indicator of childhood malnutrition. Results: Approximately 28%, 3% and 9% of children under age 5 suffered from stunting, wasting and underweight, respectively. The bivariate result shows that the proportion of children suffering from stunting and underweight was relatively lower in the Kampala region compared with the other regions. With the exception of the Northern region (6.44%), wasting was higher (4.12%) among children in the Kampala region. Children in the other regions were more likely to experience stunting and underweight. When controlling for child, parent and household factors, children in the other regions were less likely to suffer from underweight and stunting, compared with those in Kampala region. Children in the other regions, except the Northern region, were less likely to be wasted compared with those in Kampala region. Conclusion: Our finding suggests that child, parental and household characteristics have effects on the association between region of residence and childhood malnutrition. Addressing individual and household socioeconomic disparities may be vital in tackling regional differences in childhood malnutrition.Exploring the effect of early-life climate anomalies on child growth in Sub-Saharan African context : Insight from the demographic & health survey
AbstractAmegbor, P. M., Lapurga, K., Carr, E., Guerrero, M., Babayode, O., Crisci, S. E., Fang, X. Y., Siddeky, A., & Quansah, R. (n.d.).Publication year
2025Journal title
Science of the Total EnvironmentVolume
983AbstractBackground: Childhood malnutrition remains a critical public health issue in Sub-Saharan Africa (SSA), with about 30 % of children affected by stunting, a marker of chronic malnutrition and micronutrient deficiencies during early development. While previous research suggests a link between climatic conditions and child growth, a deeper understanding is needed, particularly across diverse climatic zones. This study explores the impact of prenatal and postnatal climate anomalies (temperature and precipitation) on stunted growth among children in SSA. Methods: We analyzed health and demographic data from 30 SSA countries (2004–2021) within a Big Data framework, incorporating climatic and environmental data. Using three Bayesian hierarchical models, we examined the linear associations between pre- and post-natal climate anomalies and stunted growth, focusing on deviations from reference period means. Findings: Approximately 34.5 % of children in the study were stunted. The analysis identified significant associations between maximum temperature anomalies and increased stunting, while mean temperature and precipitation anomalies had varying effects. Reduced maximum temperatures were linked to lower stunting rates, whereas increased temperatures consistently correlated with higher stunting probabilities. Additionally, children residing in the Tropical Monsoon (Am) zone had a lower likelihood of stunting, whereas certain temperate zones were associated with increased stunting. Interpretation: The study highlights a complex relationship between climate anomalies and child growth in SSA. It underscores the need for targeted, context-specific policies that integrate climate adaptation with child health initiatives to address the growing impacts of climate change on child health in the region.Exploring the Impact of Early-Life Climate Anomalies on Child Growth: A Developmental Origins of Health and Disease (DoHD) Perspective
AbstractAmegbor, P. M., Lapurga, K., Carr, E., Guerrero, M., Babayode, O., Sarah, C. E., Fang, X. Y., Siddeky, A., & Quansah, R. (n.d.).Publication year
2025Journal title
Science of the Total EnvironmentAbstract~Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021 : a systematic analysis for the Global Burden of Disease Study 2021
AbstractGBD 2021 Causes of Death Collaborators, A., Naghavi, M., Ong, K. L., Aali, A., Ababneh, H. S., Abate, Y. H., Abbafati, C., Abbasgholizadeh, R., Abbasian, M., Abbasi-Kangevari, M., Abbastabar, H., Abd ElHafeez, S., Abdelmasseh, M., Abd-Elsalam, S., Abdelwahab, A., Abdollahi, M., Abdollahifar, M. A., Abdoun, M., Abdulah, D. M., … Peprah, E. K. (n.d.).Publication year
2024Journal title
The LancetVolume
403Issue
10440Page(s)
2100-2132AbstractBackground: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings: The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation: Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. Funding: Bill & Melinda Gates Foundation.Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
AbstractNaghavi, M., & Amegbor, P. M. (n.d.).Publication year
2024Journal title
The LancetAbstract~Global Burden of Cardiovascular Diseases and Risks, 1990-2022
AbstractAmegbor, P. M., Mensah, G. A., Fuster, V., Murray, C. J., & Roth, G. A. (n.d.).Publication year
2023Volume
82Abstract~Global Burden of Cardiovascular Diseases and Risks, 1990-2022
AbstractGlobal Burden of Cardiovascular Diseases and Risks Collaborators, A., Mensah, G. A., Habtegiorgis Abate, Y., Abbasian, M., Abd-Allah, F., Abdollahi, A., Abdollahi, M., Morad Abdulah, D., Abdullahi, A., Abebe, A. M., Abedi, A., Abedi, A., Olusola Abiodun, O., Ali, H. A., Abu-Gharbieh, E., Abu-Rmeileh, N. M., Aburuz, S., Abushouk, A. I., Abu-Zaid, A., … Peprah, E. K. (n.d.).Publication year
2023Journal title
Journal of the American College of CardiologyVolume
82Issue
25Page(s)
2350-2473Abstract~Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021 : a systematic analysis for the Global Burden of Disease Study 2021
AbstractGBD 2021 Diseases and Injuries Collaborators, A., Ferrari, A. J., Santomauro, D. F., Aali, A., Abate, Y. H., Abbafati, C., Abbastabar, H., Abd ElHafeez, S., Abdelmasseh, M., Abd-Elsalam, S., Abdollahi, A., Abdullahi, A., Abegaz, K. H., Abeldaño Zuñiga, R. A., Aboagye, R. G., Abolhassani, H., Abreu, L. G., Abualruz, H., Abu-Gharbieh, E., … Peprah, E. K. (n.d.).Publication year
2024Journal title
The LancetVolume
403Issue
10440Page(s)
2133-2161AbstractBackground: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. Methods: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. Findings: Global DALYs increased from 2·63 billion (95% UI 2·44–2·85) in 2010 to 2·88 billion (2·64–3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7–17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8–6·3) in 2020 and 7·2% (4·7–10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0–234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7–198·3]), neonatal disorders (186·3 million [162·3–214·9]), and stroke (160·4 million [148·0–171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3–51·7) and for diarrhoeal diseases decreased by 47·0% (39·9–52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54–1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5–9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0–19·8]), depressive disorders (16·4% [11·9–21·3]), and diabetes (14·0% [10·0–17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7–27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6–63·6) in 2010 to 62·2 years (59·4–64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6–2·9) between 2019 and 2021. Interpretation: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. Funding: Bill & Melinda Gates Foundation.Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: A systematic analysis for the Global Burden
AbstractAmegbor, P. M. (n.d.).Publication year
2024Journal title
The LancetAbstract~Global, regional, and national burden of stroke and its risk factors, 1990–2021 : a systematic analysis for the Global Burden of Disease Study 2021
AbstractGBD 2021 Stroke Risk Factor Collaborators, A., Feigin, V. L., Abate, M. D., Abate, Y. H., Abd ElHafeez, S., Abd-Allah, F., Abdelalim, A., Abdelkader, A., Abdelmasseh, M., Abd-Elsalam, S., Abdi, P., Abdollahi, A., Abdoun, M., Abd-Rabu, R., Abdulah, D. M., Abdullahi, A., Abebe, M., Abeldaño Zuñiga, R. A., Abhilash, E. S., … Amegbor, P. M. (n.d.).Publication year
2024Journal title
The Lancet NeurologyVolume
23Issue
10Page(s)
973-1003AbstractBackground: Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990–2021. Methods: We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and age-standardised rates per 100 000 people per year for overall stroke, ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage, for 204 countries and territories from 1990 to 2021. We also calculated burden of stroke attributable to 23 risk factors and six risk clusters (air pollution, tobacco smoking, behavioural, dietary, environmental, and metabolic risks) at the global and regional levels (21 GBD regions and Socio-demographic Index [SDI] quintiles), using the standard GBD methodology. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In 2021, stroke was the third most common GBD level 3 cause of death (7·3 million [95% UI 6·6–7·8] deaths; 10·7% [9·8–11·3] of all deaths) after ischaemic heart disease and COVID-19, and the fourth most common cause of DALYs (160·5 million [147·8–171·6] DALYs; 5·6% [5·0–6·1] of all DALYs). In 2021, there were 93·8 million (89·0–99·3) prevalent and 11·9 million (10·7–13·2) incident strokes. We found disparities in stroke burden and risk factors by GBD region, country or territory, and SDI, as well as a stagnation in the reduction of incidence from 2015 onwards, and even some increases in the stroke incidence, death, prevalence, and DALY rates in southeast Asia, east Asia, and Oceania, countries with lower SDI, and people younger than 70 years. Globally, ischaemic stroke constituted 65·3% (62·4–67·7), intracerebral haemorrhage constituted 28·8% (28·3–28·8), and subarachnoid haemorrhage constituted 5·8% (5·7–6·0) of incident strokes. There were substantial increases in DALYs attributable to high BMI (88·2% [53·4–117·7]), high ambient temperature (72·4% [51·1 to 179·5]), high fasting plasma glucose (32·1% [26·7–38·1]), diet high in sugar-sweetened beverages (23·4% [12·7–35·7]), low physical activity (11·3% [1·8–34·9]), high systolic blood pressure (6·7% [2·5–11·6]), lead exposure (6·5% [4·5–11·2]), and diet low in omega-6 polyunsaturated fatty acids (5·3% [0·5–10·5]). Interpretation: Stroke burden has increased from 1990 to 2021, and the contribution of several risk factors has also increased. Effective, accessible, and affordable measures to improve stroke surveillance, prevention (with the emphasis on blood pressure, lifestyle, and environmental factors), acute care, and rehabilitation need to be urgently implemented across all countries to reduce stroke burden. Funding: Bill & Melinda Gates Foundation.Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990–2021 : a systematic analysis from the Global Burden of Disease Study 2021
AbstractGBD 2021 Lower Respiratory Infections and Antimicrobial Resistance Collaborators, A., Bender, R. G., Sirota, S. B., Swetschinski, L. R., Dominguez, R. M., Novotney, A., Wool, E. E., Ikuta, K. S., Vongpradith, A., Rogowski, E. L., Doxey, M., Troeger, C. E., Albertson, S. B., Ma, J., He, J., Maass, K. L., A.F.Simões, E., Abdoun, M., Abdul Aziz, J. M., … Amuasi, J. H. (n.d.).Publication year
2024Journal title
The Lancet Infectious DiseasesAbstractBackground: Lower respiratory infections (LRIs) are a major global contributor to morbidity and mortality. In 2020–21, non-pharmaceutical interventions associated with the COVID-19 pandemic reduced not only the transmission of SARS-CoV-2, but also the transmission of other LRI pathogens. Tracking LRI incidence and mortality, as well as the pathogens responsible, can guide health-system responses and funding priorities to reduce future burden. We present estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 of the burden of non-COVID-19 LRIs and corresponding aetiologies from 1990 to 2021, inclusive of pandemic effects on the incidence and mortality of select respiratory viruses, globally, regionally, and for 204 countries and territories. Methods: We estimated mortality, incidence, and aetiology attribution for LRI, defined by the GBD as pneumonia or bronchiolitis, not inclusive of COVID-19. We analysed 26 259 site-years of mortality data using the Cause of Death Ensemble model to estimate LRI mortality rates. We analysed all available age-specific and sex-specific data sources, including published literature identified by a systematic review, as well as household surveys, hospital admissions, health insurance claims, and LRI mortality estimates, to generate internally consistent estimates of incidence and prevalence using DisMod-MR 2.1. For aetiology estimation, we analysed multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature data using a network analysis model to produce the proportion of LRI deaths and episodes attributable to the following pathogens: Acinetobacter baumannii, Chlamydia spp, Enterobacter spp, Escherichia coli, fungi, group B streptococcus, Haemophilus influenzae, influenza viruses, Klebsiella pneumoniae, Legionella spp, Mycoplasma spp, polymicrobial infections, Pseudomonas aeruginosa, respiratory syncytial virus (RSV), Staphylococcus aureus, Streptococcus pneumoniae, and other viruses (ie, the aggregate of all viruses studied except influenza and RSV), as well as a residual category of other bacterial pathogens. Findings: Globally, in 2021, we estimated 344 million (95% uncertainty interval [UI] 325–364) incident episodes of LRI, or 4350 episodes (4120–4610) per 100 000 population, and 2·18 million deaths (1·98–2·36), or 27·7 deaths (25·1–29·9) per 100 000. 502 000 deaths (406 000–611 000) were in children younger than 5 years, among which 254 000 deaths (197 000–320 000) occurred in countries with a low Socio-demographic Index. Of the 18 modelled pathogen categories in 2021, S pneumoniae was responsible for the highest proportions of LRI episodes and deaths, with an estimated 97·9 million (92·1–104·0) episodes and 505 000 deaths (454 000–555 000) globally. The pathogens responsible for the second and third highest episode counts globally were other viral aetiologies (46·4 million [43·6–49·3] episodes) and Mycoplasma spp (25·3 million [23·5–27·2]), while those responsible for the second and third highest death counts were S aureus (424 000 [380 000–459 000]) and K pneumoniae (176 000 [158 000–194 000]). From 1990 to 2019, the global all-age non-COVID-19 LRI mortality rate declined by 41·7% (35·9–46·9), from 56·5 deaths (51·3–61·9) to 32·9 deaths (29·9–35·4) per 100 000. From 2019 to 2021, during the COVID-19 pandemic and implementation of associated non-pharmaceutical interventions, we estimated a 16·0% (13·1–18·6) decline in the global all-age non-COVID-19 LRI mortality rate, largely accounted for by a 71·8% (63·8–78·9) decline in the number of influenza deaths and a 66·7% (56·6–75·3) decline in the number of RSV deaths. Interpretation: Substantial progress has been made in reducing LRI mortality, but the burden remains high, especially in low-income and middle-income countries. During the COVID-19 pandemic, with its associated non-pharmaceutical interventions, global incident LRI cases and mortality attributable to influenza and RSV declined substantially. Expanding access to health-care services and vaccines, including S pneumoniae, H influenzae type B, and novel RSV vaccines, along with new low-cost interventions against S aureus, could mitigate the LRI burden and prevent transmission of LRI-causing pathogens. Funding: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care (UK).