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The Arab World’s Health: Death by Lifestyle, Not Disease

Behavior is beating out bacteria as a danger to the health of those who live in the Arab world.

A new study of the health of the region has found that its residents have become less apt to die young from infectious disease or malnutrition. The region has experienced a strong increase in life expectancy and a significant reduction in child mortality.

But those who live are more apt to suffer from non-communicable conditions, including backaches, road injuries, kidney disease and depression. The shifting Arab health trends suggest that lifestyle changes, not the genetic make-up of the population, have caused a rapid increase in non-communicable disease.

“The nature of the diseases plaguing us today has changed,” said Ali Mokdad, a professor of global health at the University of Washington and a chief author of the study. “We used to address infections by treating patients with antibiotics, but our problems today relate to our everyday habits, so we primarily need to prevent disease by altering behaviour.”

The decline in activity and the rise of unhealthy diets are two of the leading causes of diseases plaguing the Arab region, including blood pressure, diabetes and obesity.

Put together, the burden of both communicable and non-communicable diseases is stretching the already thin public-health resources of Arab countries, where treatment is often given greater priority than prevention. “A road map for health in the Arab world is urgently needed,” the researchers said in an article in The Lancet published last month.

The article is part of a series in The Lancet on Arab health that is a collaborative project among the Faculty of Health Sciences at the American University of Beirut, the Institute of Community and Public Health of Birzeit University and the journal itself. The series was launched last month in events in London and Beirut and focuses on priority health issues in the Arab world, based on evidence interpreted mainly by scholars from the region, using a multidisciplinary approach.

To arrive at the findings on the “state of Arab health,” researchers at the University of Washington pulled out health data on the 22 countries of the Arab League from global data for three years: 1990, 2005 and 2010. The researchers divided the countries into low-income, middle-income and high-income clusters. They looked at such factors as life expectancy, the burden of disease and years spent living with disabilities to try to get a big picture view of health—and the lack of it—in Arab countries.

The highlights of their conclusions:

• Heart disease has replaced lung disease as the leading cause of death. Heart disease caused about 14 percent of deaths in the region in 2010.

• Diseases that can largely be attributed to lifestyles, such as cirrhosis and diabetes, are taking away many healthy years of life from the citizens of the Arab world. Drug and alcohol use appears to be taking a toll.

• Road injuries and occupational injuries still rank high as causes of death and disability.

• Depression, anxiety and other mental health issues are rising as conditions that are disabling Arab citizens, perhaps due to the fallout from war, other conflicts, and economic difficulties.

• Depression was the leading cause of “years lost to disability” in all three years that were studied. Women were disproportionately affected by depression, with the condition peaking in women aged 20 to 29.

• Rates of HIV/AIDS are increasing.

The University of Washington scientists recognized the high variability among the Arab countries, with no one disease pattern prevailing. In Sudan, “suboptimal breastfeeding” was a high cause of death, where as in the United Arab Emirates, traffic accidents were a more serious danger.

In some burdens on health, Arab countries mirrored global trends, where as in others, they contradicted those trends. The danger of depression and cirrhosis was greater in the Arab world than elsewhere, but aggressive prevention has made the burden of malaria and diarrhea less in the Arab world than in the rest of the world.

Huda Zurayk, a professor of epidemiology and population health at the American University of Beirut, said in a press release that many Arab countries “have slid backwards in terms of health and economic parameters, but the region still represents great promise for the future and requires all our hard work, perseverance, and patience.

Nay El Rahi contributed reporting to this article.

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