The environmental, behavioural, and metabolic risks that drive injury and disease are the mechanisms by which public health efforts can most efficiently and effectively prevent health loss. Effecting population health improvements, therefore, requires understanding of not only the injuries and diseases that drive health burdens, but also the risks that drive injury and disease. Through a constantly evolving collection of cohort studies, randomised trials, and case-control studies, decades of epidemiological research have worked to quantify the nature and magnitude of associations.

This study provides a comprehensive and comparable assessment of 84 environmental and occupational, behavioural, and metabolic risks across locations and time. By quantifying levels and trends in exposures to risk factors and the resulting disease burden, the assessment offers insights into past programme and policy successes and highlights the current priorities for public health action.

Key messages from the study include:
• Smoking was one of the five leading risks in 2017. High systolic blood pressure, high fasting plasma glucose, high body-mass index, and short gestation for birthweight were the others.

• Smoking and other factors like alcohol use, drug use, and high low-density lipoprotein cholesterol all show a pronounced increasing trend with development.

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