Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015
نویسندگان
چکیده
BACKGROUND Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. METHODS We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate. FINDINGS Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2·9 years (95% uncertainty interval 2·9-3·0) for men and 3·5 years (3·4-3·7) for women, while HALE at age 65 years improved by 0·85 years (0·78-0·92) and 1·2 years (1·1-1·3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs. INTERPRETATION Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum. FUNDING Bill & Melinda Gates Foundation.
منابع مشابه
Burden of Disease Attributable to Suboptimal Breastfeeding in Iran during 1990-2010; Findings from the Global Burden of Disease Study 2010
Background: This study uses data of the global burden of diseases (GBD) study 2010 to report death, disability-adjusted life year (DALYs), years of life lived with disability (YLDs) and years of life lost due to premature mortality (YLLs), attributed to suboptimal breastfeeding by age and gender during 1990 to 2010 in Iran. Materials and Methods:The GBD assessments were used, together with esti...
متن کاملGlobal, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
BACKGROUND Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measu...
متن کاملLost Output by Road Traffic Injuries in Iran, an Estimate Based on Disability-Adjusted Life Years Index
The main objective of this study is to estimate a part of road traffic injury costs including costs due to fatality and disability, which are related to lost social products. Lost output consists of costs, which are related to losses of national product or lost-income in death, hospitalization or physical disabilities. In recent years, the Disability-Adjusted Life Years (DALYs) has been used as...
متن کاملمحاسبه بار ناشی از سوانح و حوادث ترافیکی در استان خراسان جنوبی 1384
Background & Objectives: Burden of disease studies have been implemented in many countries using the disability adjusted life year (DALY) to assess major health problems. This study was designed to assess the burden of transport accident in South Khorasan (SK) province of Iran for 2005.Methods: Years of life lost (YLLs), Years lived with Disability (YLDs) and DALYs were calculated by using meth...
متن کاملBurden of esophageal cancer in Iran during 1995-2015: Review of findings from the Global Burden of Disease studies
Background: Iran is located in Asian esophageal cancer belt, with age-standardized incidence rate (ASR) of approximately 7 per 100,000 for both men and women. To provide potential solution recommendations for achieving accurate estimations regarding the burden of the disease in Iran, we designed a study to assess the burden of esophageal cancer in Iran during 1995-2015 by collecting data from t...
متن کاملBurden of Gastrointestinal and Liver Diseases in Iran: Estimates Based on the Global Burden of Disease, Injuries, and Risk Factors Study, 2010
BACKGROUND Gastrointestinal and liver diseases (GILD) constitute a noteworthy portion of causes of death and disability in Iran. However, data on their prevalence and burden is sparse in Iran. The Global Burden of Disease (GBD) study in 2010 has provided invaluable comprehensive data on the burden of GILD in Iran. METHODS Estimations of death, years of life lost due to premature death (YLL), ye...
متن کامل