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The concept of health underwent significant changes
during the twentieth century. A twentieth century hallmark was the
WHO's founding definition, in 1948, of health as "a state of
physical, mental and psychological well being, and not merely the
absence of disease". But mere enlightenment is usually not
enough to change the way we do things. The epidemiological
transition from high to low mortality conditions made it necessary
to look at new ways of measuring population health by combining the
mortality and morbidity experience. These transitions produce
characteristic changes in disease profile and age composition,
namely: (a) reduced incidence or prevalence of infectious diseases,
(b) increased prevalence of non - communicable and degenerative
diseases, and (c) increase in proportion of elderly and geriatric
population. Each of these changes has its impact on the measurement
of health status. Rising costs of health care, provided added
impetus towards development of summary measures of health status to
facilitate cost-effectiveness studies. Although, the WHO adopted an
inclusive definition of health in 1948, conventional measures of
health status like the life expectancy, infant mortality rate, and
disease specific measures of morbidity continued to provide the
basic framework of indicators of health status. By end of the
twentieth century, after 52 years of its founding, WHO adopted a set
of summary measures of population health status. These new measures
are being commonly referred to as burden of disease measures, since
they combine the impact of diseases on mortality as well as
morbidity. The World Health Report, 2000 (WHR, 2000) contained a set
of health status measurements for different countries using the
Burden of disease framework. Publication of the WHR 2000 has
stimulated interest in National Burden of Disease studies. This book
describes the experience and insights from the first National Burden
of Disease study started after publication of the Global Burden of
Disease (GBD) estimates in the World Bank's World Development
Report, 1993. The Andhra Pradesh Burden of Disease study was started
in 1993. However, it took about seven years for the study to
partially complete, leading to publication of these results. This
book is result of this long exercise. The book describes in detail
various aspects of the NBD estimation process, focusing on the
Andhra Pradesh state in India. A major concern addressed by the book
is how to anchor NBD estimates to local data and there by provide a
strong foundation of evidence and information for policy. Although
the book revolves around the AP state in India, its contents has
wider application and will be a useful guide for National Burden of
Disease Studies
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