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The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3·5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.
Hearing loss affects health and quality of life. The prevalence of hearing loss may be growing because of an aging population and increasing noise exposure. However, accurate national estimates of hearing loss prevalence based on recent objective criteria are lacking. We determined hearing loss prevalence among US adults and evaluated differences by demographic characteristics and known risk factors for hearing loss (smoking, noise exposure, and cardiovascular risks). A national cross-sectional survey with audiometric testing was performed. Participants were 5742 US adults aged 20 to 69 years who participated in the audiometric component of the National Health and Nutrition Examination Survey 1999-2004. The main outcome measure was 25-dB or higher hearing loss at speech frequencies (0.5, 1, 2, and 4 kHz) and at high frequencies (3, 4, and 6 kHz). In 2003-2004, 16.1% of US adults (29 million Americans) had speech-frequency hearing loss. In the youngest age group (20-29 years), 8.5% exhibited hearing loss, and the prevalence seems to be growing among this age group. Odds of hearing loss were 5.5-fold higher in men vs women and 70% lower in black subjects vs white subjects. Increases in hearing loss prevalence occurred earlier among participants with smoking, noise exposure, and cardiovascular risks. Hearing loss is more prevalent among US adults than previously reported. The prevalence of US hearing loss differs across racial/ethnic groups, and our data demonstrate associations with risk factors identified in prior smaller-cohort studies. Our findings also suggest that hearing loss prevention (through modifiable risk factor reduction) and screening should begin in young adulthood.
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