# Presentation: 350406

## Update on “Disease Burden Attributable to Risk Factors in the US” Project

**Armineh Zohrabian, CDC**
**IAWG on Summary and Outcome Measures of Health **
**July 12, 2006**

**Notes:**
Project started October 2004 for three years.

## Presentation Outline

**Overview of the specific activities of CDC/Harvard University current  Burden of Disease (BOD) project **
**Brief mention of CDC’s Health Related **
**	****Quality of Life Surveillance Program**

## BOD Project

**CDC/Harvard University cooperative agreement**
**$325,000 over 3 years (2004-2007)**

## BOD Objectives

**Update 1996 disease burden estimates to the year for which most recent data are available (2001)**
**Estimate *****distributions***** and *****trends***** of total and *****risk-factor attributable disease burden***** by *****age, sex, race *****and***** geography***

## Specific Activities

**	****Inputs for estimating disease burden attributable to risk factors are:**
**Risk factor exposure **
**Uses risk assessment module from the Comparative Risk Assessment (CRA) Project, WHO **
**Risk factor hazard **
**Estimates will be based on systematic review of epi literature **
**Burden of disease **
**Will use Disability Adjusted Life Years (DALYs)**

## Collation of data sources and development of methods to
re-distribute ill-defined causes of death in the US (completed)
estimate unbiased overweight and obesity trends from self-reported data (completed)
estimate unbiased trends for other risk factors from self-reported data (initiated)
estimate sub-national risk factor exposure and trends in risk factor exposure (ongoing)

Development of new algorithms to update 1996 US burden of disease estimates to the year 2000 or 2001(ongoing)

**re-distribute ill-defined causes of death in the US (completed)**
**estimate unbiased overweight and obesity trends from self-reported data (completed)**
**estimate unbiased trends for other risk factors from self-reported data (initiated)**
**estimate *****sub-national *****risk factor exposure and trends in risk factor exposure (ongoing)**
**Development of new algorithms to update 1996 US burden of disease estimates to the year 2000 or 2001(ongoing)**

- Specific Activities

**(continued)**

**Notes:**
The key barriers to estimating sub-national RF attributable disease burden arise from the paucity of valid or comparable sub-national RF exposure and on mortality and disease burden.

## Contribution to scientific literature

- Contribution to scientific literature

- Ezzati M, Martin H, Skjold S,Vander Hoorn S, Murray CJ.** Trends in National and State-Level Obesity in the USA after correction for self-reported bias. ***JR Soc Med*. 2006 May; 99(5):250-7. Erratum in: *J R Soc Med.* 2006 Jun;99(6):280.
- Christopher J.L. Murray, Sandeep C. Kulkarni and Majid Ezzati. **Understanding the Coronary Heart Disease Versus Total Cardiovascular Mortality Paradox: A Method to Enhance the Comparability of Cardiovascular Death Statistics in the United States.** *Circulation* 2006;113;2071-2081

## CDC's Health-Related Quality of Life Surveillance Program 

**Housed in the Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion  **
**Its purpose is to learn about unmet health needs; recognize trends, disparities, and determinants of health in the population**
**It uses the Healthy Days surveillance measures in summary measures of population health **

## Resources on Healthy Days Measures

** **
**Moriarty DG, Zack MM, Kobau R, Zahran HS. Tracking Health-Related Quality of Life in the United States 1993-2004. Presented at the Institute of Medicine Committee to Evaluate Measures of Health Benefits for Environmental, Health, and Safety Regulation. Washington, DC, December 1, 2004.  See PowerPoint slides @ **_**[http://](http://www.iom.edu/subpage.asp?id=23875)**__**[www.iom.edu/subpage.asp?id](http://www.iom.edu/subpage.asp?id=23875)**__**[=23875](http://www.iom.edu/subpage.asp?id=23875)**_** **
**Klementiev A. Chapter 5 -- An Alternative Measure of Years of Healthy Life, from:Estes RJ (Ed). Social Indicators Research Series, 2006; 29 ISBN: 1-4020-5099-2 [In press, available November 15, 2006].    **
**For additional information, including copies of the measures,  annual state-based HRQOL prevalence data from 1993 and later, and references to research based on the measures, please see the CDC HRQOL Website at **_**[http://](http://www.cdc.gov/hrqol)**__**[www.cdc.gov/hrqol](http://www.cdc.gov/hrqol)**_** .**