Seattle (United States) – A new study revealed that the cases of suicide, murder and sexual assault have increased rapidly in the Middle East, compared to other parts of the world.
These violent acts have resulted in 1.4 million deaths in 2015, without taking into consideration the 144,000 lives claimed by wars.
“Intractable and endemic violence is creating a lost generation of children and young adults,” said lead author Ali Mokdad, director for Middle Eastern Initiatives at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
“The future of the Middle East is grim unless we can find a way to bring stability to the region.”
Psychological problems and suicide
In addition to violence in the region, there has been a sharp increase in non-communicable diseases and mental health conditions such as depression, anxiety, bipolar disorder and schizophrenia. Depression and anxiety disorders were the most common mental conditions, according to the study, published Tuesday in the International Journal of Public Health. Both affect women more than men.
“With globalization and urbanization of most societies, women may be exposed to numerous stressors, which have repercussions on the entire household, and children in particular,” said Dr. Raghid Charara, of American University of Beirut and one of the study’s more than 500 collaborators.
Meanwhile, experts such as counselors, psychiatrists and psychologists are in severe shortage.
Throughout the region, the ratio of practitioners to 100,000 people was about seven on average and was as low as 0.5 psychiatrists per 100,000 people in countries such as Libya, Sudan, and Yemen. By comparison, among European nations the ratio ranges from nine per 100,000 to more than 40.
“There must be a comprehensive plan to build on existing expertise and projects addressing health challenges that exist at the nexus of human health, environmental resilience, and social and economic equity,” Dr. Mokdad said.
In 2015, nearly 30,000 people in the region committed suicide and another 35,000 died from interpersonal violence, representing increases of 100 percent and 152 percent, respectively, over the past 25 years. In other parts of the world during the same period, the number of deaths from suicide increased 19 percent and interpersonal violence by 12 percent.
The study found that hanging and poisoning are the most common methods of suicide in the Eastern Mediterranean Region. The authors note that statistics on suicide likely are underestimated due to cultural and religious barriers, social stigma, and legal punishments that discourage victims, families and governments from disclosing such information.
The 15 papers and three editorials that constitute the study are based on the most recent estimates from the annual Global Burden of Diseases, Injuries, and Risk Factors study (GBD), a systematic, scientific effort to quantify the magnitude of health loss from all major diseases, injuries, and risk factors by age, sex and population. With more than 2,300 collaborators in 132 countries and 3 non-sovereign locations, GBD examines 300-plus diseases and injuries.
This is the first GBD study to examine trends of HIV/AIDS-related mortality comprehensively in the region between 1990 and 2015. There was a 10-fold increase in HIV/AIDS mortality rates, with most of the cases occurring in three nations – Djibouti, Somalia, and Sudan.
“In this region, individuals infected with HIV are dying faster than the rest of the world,” said Dr. Charbel El Bcheraoui, an Assistant Professor at IHME. “This is a sign that that that that HIV patients are not receiving proper treatment in an era where HIV can be well controlled with the appropriate treatment regimens.”
In addition, this study was the first ever to report on transportation-related deaths and injuries in the region between 1990 and 2015.
In 2015, these incidents comprised the eighth leading cause of death in the region overall, but were ranked second in Qatar, Oman, and the United Arab Emirates (UAE). The percentage of total deaths in Qatar was the highest at 20 percent followed by Oman (16 percent) and UAE (14 percent) whereas the lowest rates were in Pakistan (1.9 percent) Lebanon (1.8 percent) and Somalia (1.5 percent). Death rates from this cause in the region have not fallen as quickly as they have globally, and, in fact, three countries – Libya, Pakistan and Egypt – had increases in death rates.
“Transportation-related injuries and deaths are just as much a public health issue as HIV or diabetes,” said Dr. Mokdad. “And like HIV and diabetes, prevention measures, combined with education and treatment, are vital to mitigating this problem.”
Ischemic heart disease was the leading cause of death in the region followed by cerebrovascular disease. Changes in total deaths ranged from a reduction of 65 percent for diarrheal diseases to an increase of nearly 140 percent for diabetes and tracheal, bronchus, and lung cancer.
Progress on child survival remains uneven, and total deaths for children under the age of 5 decreased at a slower rate than globally, with about 80 percent of under-5 deaths occurring in six countries: Afghanistan, Pakistan, Somalia, South Sudan, Sudan and Yemen. Three countries – Sudan, Afghanistan and Pakistan – are among the 10 countries with the highest child mortality in the world.
The top five causes of under-5 mortality were: neonatal preterm birth complications, neonatal encephalopathy, lower respiratory tract infections (LRI), congenital defects, and diarrheal diseases.
Communicable diseases and the health consequences of natural disasters reduced substantially between 1990 and 2015. However, these gains have been offset by the health effects of war, mental health disorders and self-harm.
Among adolescents, tobacco use and high body mass index were common health risks. Many countries had high rates of adolescent pregnancy and unmet need for contraception.
Poor diet is the leading cause of disability-adjusted life years (DALYs) in the region. People in many countries are suffering from malnutrition and at the same time from poor diet that is leading to disease. In addition, tobacco smoking and high blood pressure are among the top causes of DALYs.
The region also has wide variation in per capita gross national product (GNP), ranging from a high of $134,420 in Qatar to a low of $2,000 in Afghanistan.
The proportion of the population living below the national poverty line, according to World Bank data, is more than 20 percent in seven EMR countries: Afghanistan (36 percent), Egypt (22 percent), Iraq (23 percent), Pakistan (22 percent), Palestine (22 percent), Sudan (47 percent) and Yemen (35 percent). In five of these countries, approximately one-third of the population is also food-insecure: Afghanistan (34 percent), Iraq (30 percent), Pakistan (30 percent), Sudan (33 percent) and Yemen (36 percent).
“In recent years, many of the health gains for some countries have slowed and several health conditions that were under control are re-emerging, said Dr. Mokdad. “This study clearly indicates that the future health of the region is in danger.”
The Eastern Mediterranean Region is home to more than 600 million people, representing a diverse group of 22 countries: Afghanistan, Egypt, Bahrain, Djibouti, Iraq, Iran, Jordan, Saudi Arabia, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Yemen, Somalia, Sudan, Syria, Tunisia and the UAE.