Explore our Research by Country

IHME's research spans the globe. From estimates for maternal and child mortality to childhood vaccination rates to insecticide-treated bed net coverage, IHME is measuring health, tracking performance of health programs, and identifying ways to maximize health improvement throughout the world. Most of our research looks at all countries, while some research is specific to a single country or involves a group of countries.

Discover IHME’s research and ongoing projects through the interactive map

 

Country-specific

Tracking development assistance for health for low- and middle-income countries gives policymakers information about spending patterns and potential improvements in resource allocation. We tracked the flows of development assistance and explored the relationship between national income, disease burden, and assistance.

Cigarette smoking is a leading risk factor for morbidity and premature mortality in the United States, yet information about smoking prevalence and trends is not routinely available below the state level, impeding local-level action.

Ischemic Heart Disease (IHD) is the leading cause of death worldwide. The Global Burden of Diseases, Risk Factors and Injuries (GBD) 2010 Study estimated global and regional IHD mortality from 1980 to 2010.

Ischemic heart disease (IHD) burden consists of years of life lost from IHD deaths and years of disability lived with three nonfatal IHD sequelae: nonfatal acute myocardial infarction (AMI), angina pectoris, and ischemic heart failure. Our aim was to estimate global and regional burden of IHD in 1990 and 2010.

Over the last 30 years, HIV/AIDS has emerged as a major global health challenge. Globally, the trend is that non-communicable diseases and injuries are accounting for a larger share of disease burden, but HIV/AIDS is a notable exception. Maintaining and expanding the response to the epidemic will require assessment of its magnitude and impact at the country level. It is also critical to examine the HIV/AIDS epidemic in the context of other health problems to clearly understand its impact and effectively allocate resources.

In 2012, data from GBD 2010 were published, providing results for 1990, 2005, and 2010. Hundreds of collaborators reported summary results for the world and 21 epidemiologic regions, covering 291 diseases and injuries, 1,160 sequelae of these causes, and mortality and burden attributable to 67 risk factors. GBD 2010 addressed a number of major limitations to previous analyses, including strengthening the statistical methods used for estimation and using disability weights derived from surveys of the general population. Metrics produced include leading causes of death, years of life lost, years lived with disability, and disability-adjusted life years (DALYs), which are the years of healthy life lost by a person due to death or disability.

Under-5 mortality, the probability of death before age 5, is an important indicator of child health in a population. Because estimates of under-5 mortality are often derived from birth history data from censuses or surveys, it is important to know how accurate these estimates are, particularly estimates derived from small samples of women. Researchers aimed to assess the magnitude and direction of error for estimates derived from birth histories using several analysis methods.

HIV prevalence over time is a critical metric for understanding the effectiveness of programs aiming to prevent HIV. Prevalence is often measured using surveillance of clinic patients, which can lead to selection bias: clinics located in areas of high HIV prevalence are often the first to be monitored by the surveillance systems, distorting the estimated HIV prevalence based on clinic data. To help understand the impact of selection bias on the estimation of HIV prevalence trends, researchers compared the efficacy of two approaches for handling selection bias.

The United States spends more than any other country on health care, but US life expectancy at birth ranked 40th for males and 39th for females globally in 2010. To help understand this poor national performance, as well as the large disparities seen in life expectancy across communities, researchers estimated age-specific mortality rates for males and females by US county from 1985 to 2010.

Obesity and lack of physical activity are associated with several chronic conditions, such as heart disease and diabetes, increased health care costs, and premature death. Since different local governments have pursued different approaches to address both risks, levels of obesity and physical activity are likely to vary substantially across counties. To understand local trends in physical activity and obesity that would help identify successful and less successful strategies, researchers examined county-level changes in physical activity and obesity between 2001 and 2011.

To better inform national health policy, it is critical to understand the major health problems in the United States and how they are changing over time. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), researchers compared health outcomes in the US with those of the 34 countries in the Organization for Economic Co-operation and Development (OECD).

China has seen striking declines in child mortality and an increase in life expectancy due to rapid demographic and epidemiological changes in the past few decades, yet dietary risks, tobacco use, and the rise of non-communicable diseases such as cancer pose risks to continued improvements in health.

The United Kingdom has provided universal health care and public health programming for more than six decades. To guide future policymaking in the UK, it is important to analyze trends in population health over time. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), researchers examined three critical questions: what are the patterns of health loss in the UK, what are the leading preventable risks that explain some of those patterns, and how do UK outcomes compare to a set of comparable countries in the European Union (EU) and elsewhere in 1990 and 2010.

While many Americans reported losing weight between 2008 and 2009, the actual prevalence of obesity in the United States increased over this time period, according to researchers at IHME. Results from the study “In denial: misperceptions of weight change among adults in the United States” show that public health officials should interpret self-reported weight losses with caution.

New data published in the study “Developing a comprehensive time series of GDP per capita for 210 countries from 1950 to 2015” track gross domestic product (GDP) over six decades. Researchers from IHME used models to fill in gaps in time and across 210 countries for existing GDP datasets and created two new GDP time series.

In 2009, the influenza vaccination coverage level in the United States was 69% in adults 65 years and older but only 32% in adults between the ages of 18 and 64. This study was conducted to inform future vaccination strategies by identifying the characteristics of people who are less likely to receive influenza vaccination.

This study proposes five general principles for cause of death model development, validation, and reporting and details an analytical tool – the Cause of Death Ensemble model (CODEm) – that explores a large number of possible models to estimate trends in causes of death. CODEm produces better estimates of cause of death trends than previous methods.

Noncommunicable diseases and related risk factors are the leading causes of disease burden in Iran and other middle-income countries. High blood pressure caused 80,000 deaths in Iran in 2005, and hyperglycemia caused 34,000 deaths in that year. 

Compared to four other risk factors, high systolic blood pressure had the largest impact on mortality in Iran, causing an estimated 80,000 annual deaths in 2005, according to researchers at the Tehran University of Medical Sciences, Harvard School of Public Health, the Iranian Ministry of Health and Medical Education, IHME, and Imperial College London.

Avahan, a program aimed at preventing HIV in India, averted an estimated 100,178 HIV infections between 2003 and 2008, according to researchers at IHME, the Public Health Foundation of India, the Ministry of Health and Family Welfare of India, and the University of Hong Kong.

More than half of the countries around the world are lowering maternal and child mortality at an accelerated rate, according to a study conducted by researchers at IHME and the University of Queensland.

Choosing the best method for verbal autopsy (VA) requires the appropriate metrics to assess a given method’s performance, and researchers from IHME and the University of Queensland undertook a study to determine these metrics.

The vital registration system in Mexico relies on information collected from death certificates to generate official mortality figures. A study by researchers at IHME and the National Institute of Public Health in Mexico set out to test the validity of this system.

An innovative method of computer-coded verbal autopsy, the Random Forest (RF) Method from machine learning, was found to outperform physician-certified verbal autopsy (PCVA) in almost all settings, according to a study by researchers from IHME and the Bill & Melinda Gates Foundation as part of the Population Health Metrics Research Consortium (PHMRC).

Between 2000 and 2007, life expectancies in more than 80% of United States counties fell in standing against the average of the 10 nations with the best life expectancies in the world, according to new research by IHME, in collaboration with researchers from Imperial College London.

In South Africa, deaths from HIV/AIDS are often misclassified as being caused by another condition, according to a study by IHME researchers. The study found that more than 90% of HIV/AIDS deaths from 1996 to 2006 were incorrectly attributed to other causes.

Researchers at IHME have created a new approach for generating estimates of health trends in counties and other small population areas. They used this new small area estimation methodology to estimate the prevalence of diagnosed diabetes in all counties in the United States for 2008, in this study.

A program in India that pays women to give birth in a health facility appears to be saving newborns’ lives and lowering the number of stillbirths, as demonstrated by research conducted by IHME.

Research shows that more than 44,000 Iranian children under the age of 15 died due to injuries between 2001 and 2006, making injuries the leading cause of death among children in Iran.

Life expectancy in the US is shortened by more than four years because of preventable risk factors such as smoking and being overweight, IHME researchers found.

The rate of diabetes in the US varies widely state to state, as does the rate of diagnosis, depending in part on which state a person lives in, race, and whether the person has insurance. This is the first study to examine the prevalence of diabetes and the proportion of undiagnosed diabetes state by state. 

Researchers found that self-rated national health studies are too inconsistent to be used to measure trends in overall population health.

Research shows that Americans are hearing better today than they were 30 years ago, but progress on reducing hearing loss has slowed.

Iran has the highest death rate resulting from road traffic accidents of any country in the world, according to a study conducted by IHME researchers.

Smoking, high blood pressure, and being overweight or obese are responsible for the largest number of preventable deaths in the United States, research shows.

Research shows that Mexico’s recent health reforms appear to have considerably reduced catastrophic and out-of-pocket health spending on both inpatient and outpatient medical procedures, especially among the poor.

According to new research, declining mean systolic blood pressure (SBP) in Japan between 1986 and 2002 could be attributed to the increased use of antihypertensive medications, particularly among older adults, and lowered mean body mass index (BMI) in young women.

Research into a novel application of Bayesian inference shows that this method demonstrates considerable success in estimating the number of hospital admissions due to external causes based on injury diagnosis.

Despite gains in overall life expectancy in the United States between 1961 and 1999, the life expectancy of a significant segment of the population is actually declining or, at best, stagnating, according to new research.

Research shows that women suffer more from uncontrolled hypertension than men in every state, with the greatest prevalence of uncontrolled hypertension in the Southern United States.

Researchers at IHME propose a method of estimating cause-specific mortality fractions (CSMFs), or the fraction of all deaths due to a specific cause.

Research published in PLoS Medicine  in November 2007 validated a novel method for analyzing verbal autopsy data (the symptom pattern method, developed at IHME) and found that this method outperformed another common verbal autopsy analytical method (physician-coded verbal autopsy, or PCVA).

Global

The goal of this study is to calculate what proportion of deaths or disability‐adjusted life years (DALYs) can be attributed to specific risk factors, holding other independent factors unchanged. Quantification of the disease burden caused by different risks informs prevention by identifying which risks make the greatest contribution to poor health. No complete revision of global burden of disease caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time.

The number of deaths in each age and sex group for countries, regions, and the world is a critical starting point for assessing the Global Burden of Disease (GBD). A careful estimation of deaths and mortality rates by age and sex is essential to assess progress, improve health, and extend the lives of people around the world. Information about mortality rates and causes of death at different ages, especially premature mortality, is also an important impetus for public policy action.

Measurement of the global burden of disease using disability‐adjusted life years (DALYs) requires disability weights that measure health losses for all non‐fatal consequences of disease and injury. There has been vigorous debate over the definition and measurement of these weights. The primary objective was a comprehensive re‐estimation of disability weights through a large‐scale, population‐based, empirical investigation in which judgments about health loss associated with many causes were elicited from the general public in diverse communities. This is a marked improvement over previous efforts, which relied solely upon judgments from a small group of health professionals.

In this paper, results on years lost due to premature mortality (YLLs) and years lived with disability (YLDs) are combined to examine the overall burden of disease across 291 diseases and injuries by country for the period 1990 to 2010.

The goal of this research was to estimate deaths and years of lives lost (YLLs) by age, sex, and region for 235 causes at two points in time – 1990 and 2010. This information can be used to better inform global efforts to assess whether society is or is not making progress in reducing the burden of premature – and especially avoidable – mortality.

Healthy life expectancy, or HALE, is a measure of average population health summarizing both mortality and non‐fatal outcomes. HALE is used for comparisons of health across countries or for measuring change over time. These comparisons can shed light on key questions about how morbidity worsens or improves as mortality declines.

Individuals, households, and health systems devote enormous resources to curing, preventing, and eliminating non‐fatal, disabling health conditions. Therefore, it is essential that some form of measuring and tracking non‐fatal burdens be available for policy and planning purposes.

Malaria caused over 1.2 million deaths worldwide in 2010, twice the number found in the most recent comprehensive study of the disease. While malaria is traditionally considered a childhood disease, this study shows that there is a significant disease burden in adults.

For policymaking, planning, and advocacy, decision-makers need to know how funding to developing countries for health improvement changed in the wake of the global financial crisis. According to IHME researchers, development assistance for health (DAH) continued to grow in 2011, but the rate of growth was low. 

The number of cases and deaths from breast and cervical cancer are rising in most countries, especially in the developing world where more women are dying at younger ages, according to a new study. 

Children who live in households that own at least one insecticide-treated mosquito net (ITN), also known as bed nets, are less likely to be infected with malaria and less likely to die from the disease, according to new study.

The King and Lu (KL) method for directly estimating the fraction of all deaths in a population due to a given cause has been used to interpret verbal autopsies (VAs) in areas with incomplete vital registration systems.

InterVA, an automated and widely available tool for assigning cause of death using verbal autopsies (VAs), does not perform as well as other methods, such as physician-certified verbal autopsy (PCVA) and the Simplified Symptom Pattern (SSP) method, according to a study published by researchers at IHME and the University of Queensland, as part of the Population Health Metrics Research Consortium (PHMRC).

Physician certification is the most widely used method for interpreting verbal autopsy (VA), yet physicians correctly determine cause of death less than half of the time, according to new research by IHME and the University of Queensland as part of the Population Health Metrics Research Consortium (PHMRC).

The Tariff method, an easy-to-use tool developed by researchers at IHME for turning verbal autopsy (VA) results into meaningful cause of death data for health workers and policymakers, is capable of outperforming the more costly physician-certified verbal autopsy (PCVA) approach in most cases, according to new research by IHME as part of the Population Health Metrics Research Consortium (PHMRC).

The creation of the first strictly defined gold standard database of diagnoses for causes of death will help strengthen verbal autopsy (VA) methods in low-resource settings, according to a study published by a global group of researchers, the Population Health Metrics Research Consortium (PHMRC), which includes researchers from IHME. 

New research from IHME, the Department of Health Services at the University of Washington, and the University of Queensland as part of the Population Health Metrics Research Consortium (PHMRC) shows that the Simplified Symptom Pattern (SSP) method can be used to accurately interpret verbal autopsies (VAs).

The global economic crisis that unfolded in 2008 raised serious concerns about developing countries ability to meet global health targets and commitments to fund health programs. The commentary points out how the uncertainty underscores the importance of tracking spending on global health to ensure resources are directed efficiently to the world's most pressing health issues.

New research by IHME demonstrates how the quality of mortality data can be improved by redistributing deaths attributed to heart failure to their underlying causes of death according to statistically derived redistribution proportions.

A substantial proportion of individuals with diabetes remain undiagnosed and untreated, in both developed and developing countries, according to a study by IHME researchers and collaborators. 

 

 

 

New research shows that global systolic blood pressure (SBP) has decreased slightly since 1980, but trends varied significantly across regions and countries.

Researchers have found wide variability among countries’ efforts to control high cholesterol with medication. Many people in these countries are not aware of their high cholesterol, which significantly increases the risk of heart attack and stroke. 

Between 1970 and 2009, women of reproductive age worldwide have doubled the average number of years of education they have been able to attain, and this increase is estimated to be responsible for lowering the mortality rate in children by more than half, according to a study by IHME researchers.

Bed net distribution and use has expanded rapidly across Africa, especially in countries that have received significant health aid for malaria prevention efforts, research shows. The study makes use of an innovative statistical tool that could have broader application in other public health settings.

 

Mortality in children younger than 5 years is falling in every region of the world, dropping from 11.9 million deaths in 1990 to 7.7 million deaths in 2010, according to research by IHME. These figures represent a 35% reduction in under-5 mortality within 10 years, a rate of decline that was faster than expected. 

Valid, reliable, and comparable assessments of trends in causes of death are limited by a number of factors.

The most comprehensive assessment to date of global adult mortality shows how health disparities among countries and between men and women are widening around the world. 

Public financing of health by domestic governments nearly doubled between 1995 and 2006, according to IHME research.  The study also analyzes the effect of development assistance for health, gross domestic product, government size, debt relief, and HIV prevalence on government health spending from domestic sources.

A novel analytical technique shows that more adults are dying between the ages of 15 and 60 in developing countries than previously thought, according to new research. Additionally, the new techniques provide a tool for directly measuring the impact of HIV instead of relying solely on theoretical models.

Research shows that new analytical methods can measure child mortality more accurately and less expensively, enabling policymakers to respond more quickly to pressing public health concerns. The study shows how these new methods can be used to evaluate mortality trends in specific regions, revealing health disparities. 

Novel techniques can make better use of incomplete vital registration systems for population health studies, according to new research. The study describes an approach to check the completeness and accuracy of databases that compile information from death certificates. 

Despite previous estimates of maternal mortality that showed little progress, this study, reveals that maternal deaths fell from more than 500,000 annually to fewer than 350,000 over the past 30 years. 

Funding for health in developing countries quadrupled from $5.6 billion in 1990 to $21.8 billion in 2007, with private citizens, private foundations, and non-governmental organizations contributing an increasingly larger percentage of global health funding, research shows.

A patient’s satisfaction with the health care system depends more on factors external to the system than the patient’s actual health care experience, research shows.

The financial burden of out-of-pocket health spending is hampered by inconsistent survey methods, research shows.

Research conducted at IHME examines the number of children receiving diphtheria, tetanus, and pertussis (DTP3) immunizations in 193 countries from 1986 to 2006.

War causes more deaths than previously estimated, according by researchers at IHME and Harvard Medical School.

Cervical cancer is a leading cause of mortality worldwide, and research shows that effective coverage of cervical cancer screening is lacking, particularly in developing countries.

The impact of the adoption of the World Health Organization’s (WHO) DOTS (directly observed therapy, short-course) tuberculosis control strategy in 187 WHO member states has been investigated using a novel approach.

Treatment of individuals in low-income and middle-income countries at high risk for cardiovascular disease with a preventive multidrug regimen could prevent almost a fifth of all deaths from cardiovascular disease, research shows.

Research shows that for the world as a whole, there has been little improvement in the reduction of child mortality within the last three decades. 

Projects

The goal of this project is to provide a burden of disease study at the national and subnational levels and create an integrated surveillance system in the Kingdom of Saudi Arabia in order to regularly update estimates of the burden of conditions and risk factors.

IHME is evaluating the effectiveness of malaria interventions in two countries by analyzing their effect on child mortality and producing estimates at the national and local levels.

This project will explore disparities in chronic disease among US communities by designing a cost-effective and easily scalable data collection system to track such diseases and their accompanying risk factors using multiple data sources.

The goal of the PHMRC Mexico Study was to offer better instruments and methods to countries for measuring population health where cause of death coding and information on disease prevalence is incomplete or inadequate. As part of the study, IHME pioneered new ways to collect cause of death information through verbal autopsies.

In support of USAID’s strategic plan in reducing child mortality with a view to achieving zero preventable child deaths, IHME is conducting quantitative analyses.  

IHME is measuring effective coverage in all Washington state counties and conducting one of the largest health surveys ever launched in a local population, work that will provide a model for other states.

GBD 2010 is the most comprehensive effort to date to measure epidemiological levels and trends worldwide. It is the product of a global research collaborative and quantifies the impact of hundreds of diseases, injuries, and risk factors in 187 countries around the world over two decades.

To provide critical information for planning government facilities, policies, and interventions, IHME is working with collaborators in four countries to improve the understanding of leading causes of death in areas with poor or nonexistent vital registration systems.

IHME, working in close collaboration with research organizations in four countries, has developed methods to measure mortality, causes of death, and incidence of major illnesses where data are incomplete.

IHME, in collaboration with the Inter-American Development Bank, is measuring effective intervention coverage and health systems performance in southern Mexico and Central America.

Institute for Health Metrics and Evaluation
2301 Fifth Ave., Suite 600, Seattle, WA 98121, USA
Tel: +1.206.897.2800 Fax: +1.206.897.2899
© 2014 University of Washington