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. 2019 Jul;7(7):e883-e892.
doi: 10.1016/S2214-109X(19)30172-X. Epub 2019 May 22.

The escalating global burden of serious health-related suffering: projections to 2060 by world regions, age groups, and health conditions

Katherine E Sleeman  1 , Maja de Brito  2 , Simon Etkind  3 , Kennedy Nkhoma  3 , Ping Guo  3 , Irene J Higginson  3 , Barbara Gomes  2 , Richard Harding  3
Affiliations

The escalating global burden of serious health-related suffering: projections to 2060 by world regions, age groups, and health conditions

Katherine E Sleeman et al. Lancet Glob Health. 2019 Jul.

Abstract

Background: Serious life-threatening and life-limiting illnesses place an enormous burden on society and health systems. Understanding how this burden will evolve in the future is essential to inform policies that alleviate suffering and prevent health system weakening. We aimed to project the global burden of serious health-related suffering requiring palliative care until 2060 by world regions, age groups, and health conditions.

Methods: We projected the future burden of serious health-related suffering as defined by the Lancet Commission on Palliative Care and Pain Relief, by combining WHO mortality projections (2016-60) with estimates of physical and psychological symptom prevalence in 20 conditions most often associated with symptoms requiring palliative care. Projections were described in terms of absolute numbers and proportional change compared with the 2016 baseline data. Results were stratified by World Bank income regions and WHO geographical regions.

Findings: By 2060, an estimated 48 million people (47% of all deaths globally) will die with serious health-related suffering, which represents an 87% increase from 26 million people in 2016. 83% of these deaths will occur in low-income and middle-income countries. Serious health-related suffering will increase in all regions, with the largest proportional rise in low-income countries (155% increase between 2016 and 2060). Globally, serious health-related suffering will increase most rapidly among people aged 70 years or older (183% increase between 2016 and 2060). In absolute terms, it will be driven by rises in cancer deaths (16 million people, 109% increase between 2016 and 2060). The condition with the highest proportional increase in serious-related suffering will be dementia (6 million people, 264% increase between 2016 and 2060).

Interpretation: The burden of serious health-related suffering will almost double by 2060, with the fastest increases occurring in low-income countries, among older people, and people with dementia. Immediate global action to integrate palliative care into health systems is an ethical and economic imperative.

Funding: Research Challenge Fund, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London.

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Figures

Figure 1
Figure 1
Projected evolution of burden of serious health-related suffering in World Bank income regions until 2060
Figure 2
Figure 2
Increase in serious health-related suffering from 2016 to 2060, by World Bank income region
Figure 3
Figure 3
Changes in the number of people dying with serious health-related suffering for global population stratified by age group and sex
Figure 4
Figure 4
Changes in the number of people dying with serious health-related suffering, stratified by age group and sex, for World Bank income regions
Figure 5
Figure 5
Health conditions driving the global burden of serious health-related suffering (2016–60) *Excluding leukaemia. †Including birth trauma, low birthweight, and prematurity.
Figure 6
Figure 6
Health conditions driving the global burden of serious health-related suffering in World Bank income regions (2016–60) *Excluding leukaemia. †Including birth trauma, low birthweight, and prematurity.
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