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Population Health Metrics

, 1:1

First Online: 14 April 2003Received: 20 February 2003Accepted: 14 April 2003DOI: 10.1186-1478-7954-1-1

Cite this article as: Murray, C.J., Ezzati, M., Lopez, A.D. et al. Popul Health Metrics 2003 1: 1. doi:10.1186-1478-7954-1-1


Reliable and comparable analysis of risks to health is key for preventing disease and injury. Causal attribution of morbidity and mortality to risk factors has traditionally been conducted in the context of methodological traditions of individual risk factors, often in a limited number of settings, restricting comparability.

In this paper, we discuss the conceptual and methodological issues for quantifying the population health effects of individual or groups of risk factors in various levels of causality using knowledge from different scientific disciplines. The issues include: comparing the burden of disease due to the observed exposure distribution in a population with the burden from a hypothetical distribution or series of distributions, rather than a single reference level such as non-exposed; considering the multiple stages in the causal network of interactions among risk factors and disease outcome to allow making inferences about some combinations of risk factors for which epidemiological studies have not been conducted, including the joint effects of multiple risk factors; calculating the health loss due to risk factors as a time-indexed -stream- of disease burden due to a time-indexed -stream- of exposure, including consideration of discounting; and the sources of uncertainty.

Electronic supplementary materialThe online version of this article doi:10.1186-1478-7954-1-1 contains supplementary material, which is available to authorized users.

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Autor: Christopher JL Murray - Majid Ezzati - Alan D Lopez - Anthony Rodgers - Stephen Vander Hoorn


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