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including Murray and Evans (2003) and Lopez and others (2006), refute this criticism. Given these disparate views, DALYs-based estimations must be viewed as a rough and indicative methodology and not an absolute measure of the BOD. The DALY data used in this chapter are updated from the WHO GBD estimations for 2004, which builds on the previous GBD for 2002. This information updated, among other things, mortality estimations for communicable diseases and AIDS, wars, civil conflicts, and natural disasters in 192 countries; the latest death registration in 112 countries; and revised estimations of disability for 52 causes in all countries. More on the updated information in the 2004 estimations can be found in WHO (2008). 6. This paper uses the World Bank classification of regions by development level: High-Income Countries (HIC), East Asia and Pacific (EAP), Latin America and the Caribbean (LAC), Europe and Central Asia (ECA), Middle East and North Africa (MENA), South Asia (SAR), and Sub-Saharan Africa (SSA). 7. Jean Downes, in a remarkable article written in 1941, pointed out that “The seriousness of the problem of the chronic diseases characteristic of middle and old age has been judged by their rank as leading causes of death. The amount of and need for institutional and other community facilities for the treatment and care of cases of chronic illness, such as cancer, heart disease, mental disease, and tuberculosis has been another measure of their importance. Both of these criteria imply an unusual risk of complete incapacity and death for the chronic-disease sufferer” (Downes 1941). 8. The SABE was a survey of over 10,500 older adults (age = 60 in 1999) conducted in the following seven cities in LAC during 1999–2000: Buenos Aires (Argentina), Bridgetown (Barbados), São Paulo (Brazil), Santiago (Chile), Havana (Cuba), Mexico City (Mexico), and Montevideo (Uruguay). The study, which received technical support from PAHO, comprised a research team that included members from PAHO, the University of Wisconsin–Madison, and local investigators from each collaborating city. The survey collected comprehensive information on health, functional ability, and social support networks. Data from this survey have been available to the public for free download since January 2005 from the National Archive of Computerized Data on Aging, and details about the methodology of the SABE study have already been published. The SABE questionnaire response rates were 63 percent in Buenos Aires, 65 percent in Montevideo, 80 percent in Bridgetown, 84 percent in Santiago, 85 percent in São Paulo and Mexico City, and 95 percent in Havana. 9. Sheps and others (2004) describe the INTERHEART study as follows: “INTERHEART was a standardized case-control study of acute myocardial infarction conducted in 52 countries. . . The study was designed to examine the