It has also been shown that the UK is one of the top 5 nations in achieving global health goals, but it still has problems with childhood obesity, alcohol consumption and smoking.

"The balance of doctors, nurses, midwives and pharmacists among the workers of one country underpins the available types of care."

Rafael Lozano

The latest estimates of the health status of the world have been published in a special edition of The lancetshow that the United Kingdom ranked fifth in 2017 in terms of achieving the United Nations Sustainable Development Goals.

However, the results of the Global Burden of Disease (GBD) study show that advances in health are not inevitable, as a lack of health workers is partly to blame.

The GBD study, featured in seven new articles in The Lancet, is coordinated by the Institute for Health Metrics and Evaluation of the University of Washington, USA, and has more than 3,500 employees from more than 140 countries.

For the first time, the estimates include an analysis of "health density", looking at the numbers of nurses and midwives, physicians and pharmacists.

The authors have found that more than 30 doctors, 100 nurses and midwives and five pharmacists per 10,000 people are the best at ensuring access to health services and quality services.

Countries were rated 0 to 100 based on the resources of their health systems, with 15 – including Sweden, Germany and New Zealand – reaching the maximum and the United Kingdom 99 points.

The other nations that reached the maximum of 100 were Cuba, Andorra, Norway, Switzerland, Finland, Iceland, Denmark, Belgium, Slovakia, Austria, Bermuda and the Czech Republic.

A breakdown of the results for different countries shows that in 2017 the United Kingdom was estimated at around 150 nurses and midwives per 10,000 inhabitants. The number is expected to increase by nearly 9% by 2030, up to 168 nurses and midwives per 10,000.

According to the study, there were approximately 27 doctors per 10,000 inhabitants in 2017, and the number is expected to increase by more than 25% to 34 by 2030.

There are now about six pharmacists per 10,000 inhabitants, and the number is expected to increase by 18% to eight by 2030.

However, the analysis suggests that there is a shortage of staff in many other countries, with nearly half of the countries having fewer than 30 nurses or midwives and less than 10 physicians serving 10,000 people.

While the authors of the study said that the numbers could not predict the quality of care offered, they said that the composition of health workers was the key.

"The balance of doctors, nurses, midwives and pharmacists among the workers of one country underpins the type of care available to the population," said senior author, Professor Rafael Lozano.

University of Washington

Lozano Rafael

Lozano Rafael

"Increasing the total number of health workers will be important for many countries, but it is important that this growth ensures a different composition of the workforce," he said.

The authors noted that they did not look at doctors and nurses by subjects, which could be important for analyzing labor shortages in health trends in each country.

The GBD study is the only annual peer-reviewed assessment of global health trends. It provides global and national estimates for approximately 280 causes of death, 359 diseases and injuries, and 84 risk factors in 195 countries and territories worldwide.

Respondents to the survey indicated that the 2017 data is a "disturbing" picture with a worrying slowdown in key areas.

For example, the study shows that improvements in overall adult mortality rates were less pronounced and stagnated and worsened in some countries in 2017.

"Although many high-income countries, including the US and the UK, have seen significant increases in life expectancy for many decades, the pace of progress has stalled in recent years, especially in the last decade," the article said mortality rates.

The study shows that no country is on track to achieve the United Nations Sustainable Development Goals to improve health by 2030.

While the UK scores well in many areas in relation to these goals, the study shows that it remains in the danger zone for childhood obesity, alcohol consumption and smoking – as in other affluent countries.

The number of respondents is mediocre in terms of the incidence of HIV and the extent of child abuse, with Britain also performing less well on suicide rates.

Forecasts for the year 2030 indicate that all these areas will continue to be a problem. Children's childhood obesity is getting worse and the UK is falling back to sixth in the global ranking.

The study shows that half of all deaths worldwide were caused by only four risk factors – high blood pressure, smoking, high blood sugar and high body mass index.

In addition, back pain, headache disorders and depressive disorders were the top three causes of disability for almost three decades.

Prevalence of obesity continues to increase in almost every country in the world, with more than one million deaths attributable to type 2 diabetes in 2017, the study found.

The birth rates have declined overall since 1950. In 91 countries – including the UK – where women have on average less than two children each, although in more than 100 countries a "baby boom" occurs.

The study identified some adverse trends in which conflict and terrorism pose an increasing threat to global health, resulting in a 118% increase in deaths between 2007 and 2017.

An editorial to the study, also published in The lancethoped the results would bring national governments to action.

"GBD 2017 is worrying. The amalgamated global figures not only show a worrying slowdown, but the more detailed data also shows just how patchy the progress was, "he said.

"GBD 2017 recalls that without vigilance and constant effort, progress can easily be reversed," he added.

The study is an indication of the need to find innovative ways to tackle existing and new health challenges.

"The GBD 2017 should be an electric shock that not only causes national governments and international authorities to step up their efforts to avoid the imminent loss of hard earned profits, but also to find a new approach to growing threats," said the editorial.

Sustainable Development Goals Index: UK results

  • Disaster mortality – 100
  • Children stunting – 98
  • Child wasted – 99
  • Overweight in children – 41
  • Maternal mortality rate – 87
  • Qualified Obstetrics – 100
  • Child mortality under 5 years – 87
  • Neonatal mortality – 80
  • HIV incidence – 54
  • Tuberculosis incidence – 80
  • Malaria Incidence – 100
  • Hepatitis B incidence – 93
  • Neural tube defect prevalence – 100
  • Non-communicable mortality from diseases – 85
  • Suicide mortality – 61
  • Alcohol consumption – 30
  • Road accident mortality – 100
  • Family planning needs met with modern contraceptive methods – 99
  • Birth rate of adolescents – 66
  • Index for the coverage of the general health protection – 95
  • Air mortality – 84
  • WaSH mortality (water, hygiene and hygiene) – 92
  • Poisoning mortality – 86
  • Smoking prevalence – 46
  • Vaccination – 94
  • Health density – 99
  • Violence between partners – 91
  • Sexual violence unfamiliar partner – 68
  • Water – 100
  • Hygiene – 100
  • Hygiene – 100
  • Air Pollution in Households – 100
  • Hazards at the workplace – 60
  • Mean of special matter 2.5 – 80
  • Murder – 100
  • Conflict mortality – 100
  • Physical violence – 79
  • Sexual violence – 86
  • Child abuse – 52
  • Well Certified Death Records – 98


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