Institute for Health Metrics and Evaluation

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Institute for Health Metrics and Evaluation
Institute for Health Metrics and Evaluation logo sm.jpg
Abbreviation IHME
Formation 2007
Type Global health research institute
Purpose Accelerating global health progress through sound measurement and accountable science
Headquarters 2301 5th Ave, Suite 600
Location
Website www.healthdata.org

The Institute for Health Metrics and Evaluation (IHME) is a research institute working in the area of global health statistics and impact evaluation at the University of Washington in Seattle. The Institute is headed by Dr. Christopher J.L. Murray, a physician and health economist, and professor at the University of Washington Department of Global Health, which is part of the School of Medicine. IHME's goal, as stated on the Institute’s website, is “to identify the best strategies to build a healthier world. By measuring health, tracking program performance, finding ways to maximize health system impact, and developing innovative measurement systems, IHME provides a foundation for informed decision-making that ultimately will lead to better health globally.” IHME (2011).[1] IHME conducts research and trains scientists, policymakers, and the public in health metrics concepts, methods, and tools. Its mission includes judging the effectiveness and efficacy of health initiatives and national health systems. IHME’s work seeks to be complementary to the United Nations' work in the World Health Organization in that it shares many tasks but is independent from member countries.[2][3]

IHME gathers health-related data from all available sources. It develops innovative analytical tools to track trends in mortality, diseases, and risk factors, and capsulizes many of its research findings in data visualizations.[4] It evaluates interventions such as vaccines, malaria control policies, cancer screenings, and birth care. To enable researchers to replicate IHME’s work and to foster new research, IHME created the Global Health Data Exchange (GHDx) where methods and results are cataloged and freely accessible. IHME is also committed to expanding the field of health metrics by training students at the post-baccalaureate and post-graduate levels.

History[edit]

IHME was launched in June 2007 based on a core grant of $105 million primarily funded by the Bill & Melinda Gates Foundation.[5] Among its earliest projects was to produce new estimates of mortality rates, which were published in The Lancet in September 2007.[6] The Institute updated these in 2010[7] and again in 2014.[8] Maternal,[9] child, and adult mortality[10] estimates have been published, as well.[11][12] Founding board members included Chair Julio Frenk, Dean of the Harvard School of Public Health; Harvey Fineberg, President of the Institute of Medicine; Gro Harlem Brundtland, former Prime Minister of Norway; Tedros Adhanom Ghebreyesus, the Minister of Health for Ethiopia; K. Srinath Reddy, President of the Public Health Foundation of India; Tomris Turmen, President of the International Children’s Center and Head of the Department of Pediatrics/Newborn Medicine at the University of Ankara Medical School in Ankara, Turkey; Lincoln Chen, President of the China Medical Board; Jane Halton, who has served as Secretary of the Department of Health and Ageing in Australia, as well as the Department of Finance; and David Roux, Co-Chief Executive of Silver Lake Partners.[13]

Current board members[14] are Frenk; Fineberg; Chen; Halton; and Roux, in addition to Stephen J. Cucchiaro, Chief Investment Officer of Windhaven Investment Management; Sally Davies, Chief Medical Officer (CMO) for England; and John W. Stanton, managing director of Trilogy Partnership.

In 2011, IHME co-sponsored the first Global Health Metrics & Evaluation conference in Seattle with The Lancet, London School of Hygiene & Tropical Medicine, Harvard School of Public Health, and University of Queensland School of Population Health.[15]

Research[edit]

IHME also has launched policy reports on a wide range of topics, including a June 2010 report on child and maternal mortality. The findings were updated in 2014. In 2009, IHME launched its series of Financing Global Health policy reports.[16][17] The initial report led to meetings with staff from the US House Foreign Affairs Committee and with a task force appointed by US President Barack Obama to guide the funding of his new Global Health Initiative. Annual updates have been published since then.

Recent publications have included estimations of causes of death worldwide,[18] the prevalence of HIV, TB, and malaria,[19] as well as obesity,[20][21] cigarette smoking,[22] heart disease,[23] and small area estimation of diabetes rates in the United States.[24] IHME has also worked with other organizations on projects. For example, IHME researchers helped create the 2010 WHO World Malaria Report,[25] generating all the estimates for insecticide-treated nets.[26] IHME has also collaborated on country-level research projects, including a partnership with the Kingdom of Saudi Arabia to help create a health surveillance system to track disease trends and inform policy. There is a list of publications at IHME’s website.

Global Burden of Disease[edit]

In the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2010, a worldwide consortium of 500 researchers, coordinated by IHME measured the impact of more than 290 health conditions and 67 health risk factors worldwide.[27] The GBD enterprise produced estimates in 21 regions around the world for disability-adjusted life years by age and sex for the past two decades. Part of this research has involved conducting in-person surveys in several countries and gathering health information through a website survey. The team created a cause of death database that includes 60 years of data, or almost 800 million deaths. To illustrate the findings, IHME released a suite of interactive data visualizations, which are available to the public.

The aim is to allow policymakers and other decision-makers to “compare the effects of different diseases – such as cancer versus depression – that kill people prematurely and cause ill health,” to show disease trends over time, and to inform policy, IHME states on its website.

It has been labeled “the most comprehensive review of the state of humanity’s health ever undertaken.”[28]

The UK and China are among the countries working with IHME to generate subnational burden of disease estimates at the county and province levels.

In January 2014, IHME began releasing updates to the work, called the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2013. The work generated over 1 billion estimates of health outcomes.[29] GBD estimates are now being updated annually.

Some of the findings have been controversial. In 2012, IHME researchers estimated 1.2 million people died from malaria in 2010, double the WHO’s estimate.[30][31]

Disease Control Priorities Network[edit]

The Disease Control Priorities Network project generates cost-effectiveness estimates for a range of health interventions. A team of demographers, statisticians, economists, and other experts are studying how to improve the allocation of resources among interventions, technologies, hospitals, and other service delivery platforms. They are working in multiple countries, including the US, India, and South Africa. Their cost-effectiveness work has revealed some hidden connections. For example, a 2010 report showed improving girls’ education in poor countries is the most effective way to reduce child mortality,[32] which was a surprise for some people.[33]

An effort launched in 2011 called Access, Bottlenecks, Costs, and Equity (ABCE) involves collecting evidence and analyzing data to improve the cost-effectiveness and equity of health systems in Colombia, Ghana, India, Kenya, Lebanon, Uganda, and Zambia. The project examines four components that affect health care delivery: access (to health facilities), bottlenecks (limitations on the supply side), costs, and equity (across populations). The work includes in-depth facility surveys and inventories across a range of service delivery platforms; additional data is collected in countries with high HIV/AIDS burdens through exit interviews and chart extraction.

A 2013 report concluded that neonatal and maternal mortality in Ghana could be best improved not with sophisticated maternity care but with better transportation infrastructure.[34]

Population Health Metrics Research Consortium project[edit]

The Population Health Metrics Research Consortium created new methods for tracking health intervention coverage in low-resource settings. The methods have been used to measure mortality, causes of death, and incidence of major illnesses where data are incomplete.[35] Researchers collected data in India, Mexico, the Philippines, and Tanzania.

IHME's work on estimating mortality has been at times controversial. In 2009, IHME published a study on maternal mortality[36] which some advocacy groups tried to suppress – worried that results showing a decline in mortality would make it harder to fund-raise. The WHO also initially disagreed with the new results, but later revised their estimates in agreement with those of IHME.[37]

Malaria Control Policy Assessment project[edit]

The Malaria Control Policy Assessment project evaluates the effectiveness of malaria-control interventions in Uganda and Zambia by analyzing their effect on child mortality and producing estimates at the national and local levels.

United States public health research[edit]

IHME conducts US research, including estimates of mortality, life expectancy, risk factors, health disparities, and disease prevalence. IHME has compiled national and local health trends and integrated multiple data sources to monitor disparities in chronic diseases.

A 2013 report, the State of US Health,[38] looked at trends in premature deaths due to injury or disease, and demonstrated the major health threat stemming from behavioral risk factors such as poor diet and sedentary lifestyles. It concluded that dietary factors cause more deaths each year than cancer or smoking.[39] The results included life expectancy trends broken down by state and county.

First Lady Michelle Obama cited the research in her campaign to improve Americans’ diets and increase their level of physical activity.[40]

A paper published in the journal Population Health Metrics in June 2011 showed that life expectancy was rising in some poorer US counties – especially in the South[41] – a surprising result which was widely discussed.[42]

Other research projects include the Salud Mesoamérica 2015 Initiative, which focuses on inequalities in health outcomes and access in southern Mexico and Central America; Gavi Full Country Evaluations, which evaluates immunization programs in Bangladesh, India, Mozambique, Uganda and Zambia; and HealthRise, a partnership with Medtronic Philanthropy to evaluate programs targeting diabetes and heart disease, and sponsor small grants to make improvements.

In 2014, IHME announced the establishment of the University of Washington Center for Demography and Economics of Aging, funded by the National Institute on Aging (NIA). It is one of 14 NIA Demography Centers at leading universities and policy organizations around the United States.

Global Health Data Exchange (GHDx)[edit]

In March 2011, IHME launched the Global Health Data Exchange (or GHDx), which indexes and hosts information about microdata, aggregated data, and research results with a focus on health-related and demographic datasets. At launch, the site listed about 1,000 datasets; as of 2015, there are more than 30,000. As part of a partnership with the Centers for Disease Control and Prevention (CDC), GHDx includes 35 years of CDC data on child and maternal health. GHDx uses the Drupal 7 open source content management system and Apache SOLR for search. The site includes visualization and GIS tools, and has been noted by the health and global health communities.[43]

Degree Programs[edit]

IHME offers two types of global health fellowships, plus Master’s degrees and PhD programs.[44]

Funders[edit]

IHME receives core grant funding from the Bill & Melinda Gates Foundation[45] and the state of Washington. The US Centers for Disease Control and Prevention (CDC); Inter-American Development Bank; Gavi, the Vaccine Alliance; the National Heart, Lung and Blood Institute; Kingdom of Saudi Arabia Ministry of Health; Medtronic Philanthropy; and the National Institute on Aging have also contributed funding through project grants and contracts.

References[edit]

  1. ^ "Institute for Heath Metrics and Evaluation". Retrieved 27 June 2011. 
  2. ^ McNiel, Donal (16 February 2008). "Gates Foundation’s Influence Criticized". New York Times. Retrieved 9 May 2010. 
  3. ^ Doughton, Sandi (9 April 2008). "Seattle institute aims to help cure world-health data disorder". Seattle Times. Retrieved 9 May 2010. 
  4. ^ "Data Visualizations". Institute for Health Metrics and Evaluation. Retrieved 27 February 2015. 
  5. ^ Paulson, Tom (4 June 2007). "$105 million Gates gift helps start global health center". Seattle PI. Retrieved 9 May 2010. 
  6. ^ Murray, CJL; Laakso, T; Shibuya, K; Lopez, AD (22 September 2007). "Can we achieve Millennium Development Goal 4? New analysis of country trends and forecasts of under-5 mortality to 2015". The Lancet 370: 1040–1054. Retrieved 27 February 2015. 
  7. ^ Rajaratnam, JK; Marcus, JR; Flaxman, AD; Wang, H; Levin-Rector, A; Dwyer, L; Costa, M; Lopez, AD; Murray, CJL (24 May 2010). "Neonatal, postneonatal, childhood, and under-5 mortality for 187 countries, 1970–2010: a systematic analysis of progress towards Millennium Development Goal 4". The Lancet 375: 1988–2008. 
  8. ^ "Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013" (PDF). The Lancet. Retrieved 28 February 2015. 
  9. ^ Hogan, MC; Foreman, KJ; Naghavi, M; Ahn, SY; Wang, M; Makela, SM; Lopez, AD; Lozano, R; Murray, CJL (8 May 2010). "Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5". The Lancet 375: 1609–1623. 
  10. ^ Rajaratnam, JK; Marcus, JR; Levin-Rector, A; Chalupka, AN; Wang, H; Dwyer, L; Costa, M; Lopez, AD; Murray, CJL (30 April 2010). "Worldwide mortality in men and women aged 15–59 years from 1970 to 2010: a systematic analysis". The Lancet 375: 1704–1720. 
  11. ^ "Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013". Retrieved 28 February 2015. 
  12. ^ "Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013" (PDF). 
  13. ^ "IHME’s Founding Board Members". IHME. Retrieved 28 February 2015. 
  14. ^ "Governance". 
  15. ^ "Global Health Metrics & Evaluation conference (Media Advisory)". 
  16. ^ Ravishankar, N; Gubbins, P; Cooley, RJ; Leach-Kemon, K; Michaud, CM; Jamison, DT; Murray, CJL (20 June 2009). "Financing of global health: tracking development assistance for health from 1990 to 2007". The Lancet 373: 2113–2124. 
  17. ^ Lu, C; Schneider, MT; Gubbins, P; Leach-Kemon, K; Jamison, D; Murray, CJL (17 April 2010). "Public financing of health in developing countries: a cross-national systematic analysis". The Lancet 375: 1375–1387. 
  18. ^ "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013". 
  19. ^ [(http://www.healthdata.org/research-article/global-regional-and-national-incidence-and-mortality-hiv-tuberculosis-and-malaria "http://www.healthdata.org/research-article/global-regional-and-national-incidence-and-mortality-hiv-tuberculosis-and-malaria"]. 
  20. ^ "Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013". 
  21. ^ "Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013". The Lancet. 
  22. ^ "Cigarette smoking prevalence in US counties: 1996- 2012". 
  23. ^ "Temporal trends in ischemic heart disease mortality in 21 world regions, 1980-2010: the Global Burden of Disease 2010 Study". 
  24. ^ Srebotnjak, T; Mokdad, AH; Murray, CJL (29 September 2010). "A novel framework for validating and applying standardized small area measurement strategies". Population Health Metrics. 
  25. ^ "WHO: World Malaria Report 2010". World Health Organization. Retrieved 27 February 2015. 
  26. ^ Gakidou, E; Cowling, K; Lozano, R; Murray, CJL. "Increased educational attainment and its effect on child mortality in 175 countries between 1970 and 2009: a systematic analysis". The Lancet 376: 959–974. 
  27. ^ "The story of GBD 2010: a "super-human" effort". 
  28. ^ Doughton, Sandi (14 March 2013). "Gates, UW teaming up on massive health study". The Seattle Times. Retrieved 27 February 2015. 
  29. ^ "GBD History". 
  30. ^ "New estimates of malaria deaths: concern and opportunity". 
  31. ^ Kelland, Kate (14 May 2012). "Analysis: Health by numbers: A statistician's challenge". Reuters. Retrieved 27 February 2015. 
  32. ^ Gakidou, E; Cowling, K; Lozano, R; Murray, CJL (18 September 2010). "Increased educational attainment and its effect on child mortality in 175 countries between 1970 and 2009: a systematic analysis.". The Lancet 376: 959–974. 
  33. ^ Paulson, Paul. "Number crunchers say the evidence is: Transparency strengthens global health". NPR Humanosphere. Retrieved 30 June 2011. 
  34. ^ "Travel time to maternity care and its effect on utilization in rural Ghana: a multilevel analysis". 
  35. ^ "Population Health Metrics Research Consortium gold standard verbal autopsy validation study: design, implementation, and development of analysis datasets". 
  36. ^ Hogan, MC; Foreman, KJ; Naghavi, M; Ahn, SY; Wang, M; Makela, SM; Lozano, R; Lopez, AD; Murray, CJL (8 May 2010). "Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5". The Lancet 375: 1609–1623. 
  37. ^ Paulson, Tom. "Number crunchers say the evidence is: Transparency strengthens global health". NPR Humanosphere. Retrieved 27 February 2015. 
  38. ^ "The State of US Health: Innovations, Insights, and Recommendations from the Global Burden of Disease Study". IHME. 
  39. ^ "The State of US Health, 1990-2010 Burden of Diseases, Injuries, and Risk Factors". JAMA 310. 10 July 2013. 
  40. ^ "Healthy Diet Important For Increasing Years of Healthy Life, New Study Says". 
  41. ^ Kulkarni, SC; Levin-Rector, A; Ezzati Murray CJL., M; Murray, CJL (15 June 2011). "Falling behind: life expectancy in US counties from 2000 to 2007 in an international context". Population Health Metrics. 
  42. ^ Pallarito, Karen (16 June 2011). "Life expectancy in U.S. trails top nations". CNN. Retrieved 28 February 2015. 
  43. ^ Van Dam, Andrew. "Institute launches global health data clearinghouse". Association of Health Care Journalists. Retrieved 28 February 2015. 
  44. ^ "Degree Programs in Health Metrics and Evaluation". Institute for Health Metrics and Evaluation. University of Washington. Retrieved 27 March 2015. 
  45. ^ Paulson, Tom (4 June 2007). "$105 million Gates’ gift helps start global health center". Seattle PI. Retrieved 27 February 2015. 

External links[edit]

Coordinates: 47°36′58″N 122°20′36″W / 47.615982°N 122.343217°W / 47.615982; -122.343217