Noting that mental disorders and neurological illnesses affect some 400 million people worldwide, the Director-General of the World Health Organization (WHO), Dr. Gro Harlem Brundtland, has launched WHO’s new Global Strategies for Mental Health. [The first Surgeon General’s report on the issue of mental health has been released in the US. See pages 89-10L]
Psychiatric disorders and neurological diseases are amongst the most important contributors to the global burden of disease,” Dr. Brundtland said at a press conference in Beijing. “In 1998, these disorders were estimated to account for almost 12% of the deaths and lost productivity due to all diseases and injuries globally.”
WHO’s Director-General emphasized that the traditional way of prioritizing health problems, based on prevalence and mortality, has important limitations. Prevalence rates, she said, do^iiot take into account the severity and duration of disease-related disability, while the number of deaths does not take into consideration the non-fatal outcomes of illness. For many years, the burden of psychiatric and neurological conditions has been underestimated because of these limitations. This, Dr. Brundtland said, has had obvious consequences for budget allocation and policy planning.
Underpinning WHO’s approach is a belief that mental health goes beyond the mere absence of mental or neurological disorders, and that psychological well-being is an integral part of mental health. Dr. Brundtland described poverty as a major obstacle to well-being. “More than three billion people—that is, half of the world’s population—still remain poor and live on less than two US dollars per day. Of these, 1.3 billion live on less than one dollar a day,” she pointed out.
WHO’s strategies also address the social stigma, misconceptions, anddiscrimination associated with neuropsychiatric conditions, as well as the human rights of mentally ill people. “Very often and in many countries, individuals who are affected by neuropsychiatric disorders endure doublesuffering,…from the conditions themselves and from the social,
stigma and discrimination attached to them. In this respect, every country is a developing country,” said Dr. Brundtland.
Death Rates of
I I he Institute of Medicine
(IOM) has released the report of a study of the causes and rates of death among the nearly 70,000
I soldiers, sailors, airmen, and marines who participated in one or more of five selected series of atmospheric nuclear tests during the 1950s. These servicepeople were present at tests conducted in the Nevada desert or in the South Pacific. Approximately 30% have since died, and the question remains whether some percentage of these deaths are attributable to radiation exposure.
IOM researchers looked at whether participants’ death rates were
higher than those of a comparison group of nearly 65,000 military personnel serving at the same time but not involved in the nuclear tests.
The researchers found no difference between the study and comparison groups in overall death rates or in total deaths from cancer. Participants in the nuclear tests had a 14% higher death rate from leukemia than those in the comparison group, although the difference was not statistically significant.
The death rate from leukemia among participants in the Nevada desert tests was 50% higher than that of military personnel from similar units who did not take part in atomic tests.
Participants in the South Pacific tests did not differ from their comparison group in leukemia death rates.
Deaths from prostate cancer were 20% higher among test participants than among the comparison group, and the difference was even greater for nasal cancer.