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

Abstract

SummaryBackgroundHealthy 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.MethodsWe 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.FindingsTotal 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 violen...

Burden of Ischaemic heart disease and attributable risk factors in China from 1990 to 2015: findings from the global burden of disease 2015 study

“…Data for this study were obtained from the GBD 2015 study, which estimated the burden of 315 diseases and injuries, 2619 unique sequelae, and 79 risk factors in 195 countries worldwide from 1990 to 2015 [4][5][6][7]. Original data from three main data sources including the Disease Surveillance Points (DSPs), the Maternal and Child Surveillance System, and the Chinese Center for Disease Control and Prevention (CDC) Cause of Death Reporting System were adapted by the GBD 2015 collaborators to estimate outcomes of IHD in China.…”

“…The general methodological approaches of GBD 2015 and the specific methodology used to study IHD in China have been described elsewhere [4][5][6][7]. We used mortality and DALYs to measure the burden caused by IHD.…”

“…Cause of Death Ensemble modelling (CODEm) was the principal method adapted to estimate fatal IHD mortality and YLLs [4]. Prevalence for non-fatal IHD sequelae was estimated using Bayesian meta-regression analysis using the DisMod-MR 2.1 software, and its disability weight was evaluated by population-based health surveys and an open web-based survey [5,21]. We computed DALYs via the summation of YLLs and YLDs [5].…”

“…Of all CVDs, ischaemic heart disease (IHD) is one of the leading causes of mortality and disease burden worldwide [3], resulting in approximately 8.9 million deaths and 164.0 million disability-adjusted life years (DALYs) globally in 2015 [4][5][6]. A number of risk factors have been found to be associated with IHD such as hypertension, high total cholesterol, diet high in sodium, and smoking [7][8][9].…”

Prediction of long-term absence due to sickness in employees: development and validation of a multifactorial risk score in two cohort studies

“…Participants reported physician-diagnosed diseases from a list of common ailments. We matched the diseases with the top 30 causes of global disability-adjusted life years (25). Diseases matched included bronchial asthma, myocardial infarction, angina pectoris, cerebrovascular diseases, migraine, depression, and diabetes.…”