Journal article
Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010
The Lancet (British edition), Vol.380(9859), pp.2197-2223
12/15/2012
DOI: 10.1016/S0140-6736(12)61689-4
PMID: 23245608
Abstract
Background Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorporating a systematic reassessment of disease and injury-specific epidemiology has been done since the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and 2010 with methods to enable meaningful comparisons over time.
Methods We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYs were calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional and global estimates of disease burden for three points in time with strictly comparable definitions and methods. YLLs were calculated from age-sex-country-time-specific estimates of mortality by cause, with death by standardised lost life expectancy at each age. YLDs were calculated as prevalence of 1160 disabling sequelae, by age, sex, and cause, and weighted by new disability weights for each health state. Neither YLLs nor YLDs were age-weighted or discounted. Uncertainty around cause-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific mortality, prevalence, and disability weights.
Findings Global DALYs remained stable from 1990 (2.503 billion) to 2010 (2.490 billion). Crude DALYs per 1000 decreased by 23% (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution of deaths and disability among children (younger than 5 years of age) declining from 41% of global DALYs in 1990 to 25% in 2010. YLLs typically account for about half of disease burden in more developed regions (high-income Asia Pacific, western Europe, high-income North America, and Australasia), rising to over 80% of DALYs in sub-Saharan Africa. In 1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from non-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010 (up from fourth rank in 1990, increasing by 29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs), stroke (fifth in 1990; 19% increase), diarrhoeal diseases (second in 1990; 51% decrease), and HIV/AIDS (33rd in 1990; 351% increase). Major depressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34% increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions.
Interpretation Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results.
Details
- Title: Subtitle
- Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010
- Creators
- Christopher J. L. Murray - Institute for Health Metrics and EvaluationTheo Vos - The University of QueenslandRafael Lozano - Institute for Health Metrics and EvaluationMohsen Naghavi - Institute for Health Metrics and EvaluationAbraham D. Flaxman - Institute for Health Metrics and EvaluationCatherine Michaud - China Medical BoardMajid Ezzati - University of LondonKenji Shibuya - The University of TokyoJoshua A. Salomon - Massachusetts Department of Public HealthSafa AbdallaVictor Aboyans - Dupuytren Univ Hosp, Dept Cardiol, Limoges, FranceJerry Abraham - The University of Texas at San AntonioIlana Ackerman - The University of MelbourneRakesh Aggarwal - Sanjay Gandhi Post Graduate Institute of Medical SciencesStephanie Y. Ahn - Institute for Health Metrics and EvaluationMohammed K. Ali - Emory UniversityMiriam Alvarado - Institute for Health Metrics and EvaluationH. Ross Anderson - St George's, University of LondonLaurie M. Anderson - Public Health – Seattle & King CountyKathryn G. Andrews - Institute for Health Metrics and EvaluationCharles Atkinson - Institute for Health Metrics and EvaluationLarry M. Baddour - Mayo Clinic in ArizonaAdil N. BahalimSuzanne Barker-Collo - University of AucklandLope H. Barrero - Pontificia Universidad JaverianaDavid H. Bartels - Harvard UniversityMaria-Gloria Basanez - Imperial College LondonAmanda Baxter - Queensland Centre for Mental Health ResearchMichelle L. Bell - Yale UniversityEmelia J. BenjaminDerrick Bennett - MRC Clinical Trials Unit at UCLEduardo Bernabe - Eastman Dental HospitalKavi Bhalla - Harvard UniversityBishal Bhandari - Queen Mary University of LondonBoris Bikbov - Moscow State University of Medicine and DentistryAref Bin Abdulhak - King Fahd Medical CityGretchen Birbeck - Michigan State UniversityJames A. Black - MRC Epidemiology UnitHannah Blencowe - London School of Hygiene & Tropical MedicineJed D. Blore - The University of QueenslandFiona Blyth - The University of SydneyIan Bolliger - Institute for Health Metrics and EvaluationAudrey Bonaventure - InsermSoufi Ane BoufousRupert Bourne - Anglia Ruskin UniversityMichel Boussinesq - Institut de Recherche pour le DéveloppementTasanee Braithwaite - University College LondonCarol Brayne - University of CambridgeLisa Bridgett - The University of SydneySimon Brooker - London School of Hygiene & Tropical MedicinePeter Brooks - The University of MelbourneTraolach S. Brugha - University of LeicesterClaire Bryan-Hancock - Flinders UniversityChiara Bucello - UNSW SydneyRachelle Buchbinder - Cabrini HospitalGeoffrey Buckle - Johns Hopkins UniversityChristine M. Budke - Texas A&M UniversityMichael Burch - University College LondonPeter Burney - Imperial College LondonRoy Burstein - Institute for Health Metrics and EvaluationBianca Calabria - Univ New S Wales, Natl Drug & Alcohol Res Ctr, Sydney, NSW, AustraliaBenjamin Campbell - Institute for Health Metrics and EvaluationCharles E. Canter - Washington University in St. LouisHelene Carabin - University of Oklahoma Health Sciences CenterJonathan Carapetis - The Kids Research Institute AustraliaLoreto Carmona - Camilo José Cela UniversityClaudia Cella - Mario Negri Institute for Pharmacological ResearchFiona Charlson - The University of QueenslandHonglei Chen - National Institute of Environmental Health SciencesAndrew Tai-Ann Cheng - Institute of Biomedical Sciences, Academia SinicaDavid Chou - Institute for Health Metrics and EvaluationSumeet S. Chugh - Cedars-Sinai Medical CenterLuc E. Coffeng - Erasmus MCSteven D. Colan - Boston Children's HospitalSamantha Colquhoun - Menzies School of Health ResearchK. Ellicott Colson - Institute for Health Metrics and EvaluationJohn Condon - Menzies School of Health ResearchMyles D. Connor - National Health Service ScotlandLeslie T. Cooper - Loyola University ChicagoMatthew Corriere - Wake Forest UniversityMonica Cortinovis - Mario Negri Institute for Pharmacological ResearchKaren Courville De Vaccaro - Hosp Dr Gustavo N Collado, Puerto Chitre, PanamaWilliam Couser - University of WashingtonBenjamin C. Cowie - Victorian Infectious Diseases Reference LaboratoryMichael H. Criqui - University of California San DiegoMarita Cross - The University of SydneyKaustubh C. Dabhadkar - Emory UniversityManu Dahiya - Queen Mary University of LondonNabila Dahodwala - University of PennsylvaniaJames Damsere-Derry - Bldg & Rd Res Inst, Kumasi, GhanaGoodarz Danaei - Massachusetts Department of Public HealthAdrian Davis - Massachusetts Rehabilitation CommissionDiego De Leo - Griffith UniversityLouisa Degenhardt - The University of MelbourneRobert Dellavalle - Denver VA Medical CenterAllyne Delossantos - Institute for Health Metrics and EvaluationJulie Denenberg - University of California San DiegoSarah Derrett - University of OtagoDon C. Des Jarlais - Beth Israel Deaconess Med Ctr, New York, NY 10003 USASamath D. Dharmaratne - University of PeradeniyaDavid C Schwebel (Contributor) - Research AdministrationGlobal Burden of Disease Study 2010 Collaborators
- Resource Type
- Journal article
- Publication Details
- The Lancet (British edition), Vol.380(9859), pp.2197-2223
- DOI
- 10.1016/S0140-6736(12)61689-4
- PMID
- 23245608
- NLM abbreviation
- Lancet
- ISSN
- 0140-6736
- eISSN
- 1474-547X
- Publisher
- Elsevier
- Number of pages
- 27
- Grant note
- K23 AG034236 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA University of Tasmania World Health Organization Commonwealth Government of Australia; Australian Government Department of Health London for the National Health Service Information Centre; National Institutes of Health Research (NIHR) AUT University Harold Amos Medical Faculty Development Award of the Robert Wood Johnson Foundation European Center for Injury Prevention, Universidad de Navarra Lundbeck; Lundbeck Corporation Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia
- Language
- English
- Date published
- 12/15/2012
- Academic Unit
- Research Administration
- Record Identifier
- 9984949181502771
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