Human infectious disease burdens decrease with urbanization but not with biodiversity

Infectious disease burdens vary from country to country and year to year due to ecological and economic drivers. Recently, Murray et al. (Murray CJ et al. 2012 Lancet 380, 2197–2223. (doi:10.1016/S0140-6736(12)61689-4)) estimated country-level morbidity and mortality associated with a variety of fac...

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Bibliographic Details
Published in:Philosophical transactions of the Royal Society of London. Series B. Biological sciences 2017-06, Vol.372 (1722), p.20160122-20160122
Main Authors: Wood, Chelsea L., McInturff, Alex, Young, Hillary S., Kim, DoHyung, Lafferty, Kevin D.
Format: Article
Language:English
Subjects:
Biodiversity
Communicable Diseases - epidemiology
Communicable Diseases - etiology
Demographics
Dilution
Dilution Effect
Disability-Adjusted Life Year
Disabled Persons - statistics & numerical data
Disease transmission
Environment
Global Change
Health care
Humans
Infectious Disease
Infectious diseases
Morbidity
Outbreaks
Pest outbreaks
Prevalence
Public Health
Quality-Adjusted Life Years
Sanitation
Socioeconomic Factors
Urbanization
Wildlife conservation
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Summary:Infectious disease burdens vary from country to country and year to year due to ecological and economic drivers. Recently, Murray et al. (Murray CJ et al. 2012 Lancet 380, 2197–2223. (doi:10.1016/S0140-6736(12)61689-4)) estimated country-level morbidity and mortality associated with a variety of factors, including infectious diseases, for the years 1990 and 2010. Unlike other databases that report disease prevalence or count outbreaks per country, Murray et al. report health impacts in per-person disability-adjusted life years (DALYs), allowing comparison across diseases with lethal and sublethal health effects. We investigated the spatial and temporal relationships between DALYs lost to infectious disease and potential demographic, economic, environmental and biotic drivers, for the 60 intermediate-sized countries where data were available and comparable. Most drivers had unique associations with each disease. For example, temperature was positively associated with some diseases and negatively associated with others, perhaps due to differences in disease agent thermal optima, transmission modes and host species identities. Biodiverse countries tended to have high disease burdens, consistent with the expectation that high diversity of potential hosts should support high disease transmission. Contrary to the dilution effect hypothesis, increases in biodiversity over time were not correlated with improvements in human health, and increases in forestation over time were actually associated with increased disease burden. Urbanization and wealth were associated with lower burdens for many diseases, a pattern that could arise from increased access to sanitation and healthcare in cities and increased investment in healthcare. The importance of urbanization and wealth helps to explain why most infectious diseases have become less burdensome over the past three decades, and points to possible levers for further progress in improving global public health. This article is part of the themed issue ‘Conservation, biodiversity and infectious disease: scientific evidence and policy implications’.
ISSN:0962-8436
1471-2970
DOI:10.1098/rstb.2016.0122