Dataset Information

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:

SUBMITTER: GBD 2015 DALYs and HALE Collaborators

PROVIDER: S-EPMC5388857 | biostudies-literature | 2016 Oct

REPOSITORIES: biostudies-literature

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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.

Lancet (London, England) 20161001 10053

<h4>Background</h4>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.< ...[more]

PMID: 27733283

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Project description:BackgroundHealth impact assessment (HIA) studies are increasingly predicting the health effects of mode shifts in traffic. The challenge for such studies is to combine the health effects, caused by injuries, with the disease driven health effects, and to express the change in the health with a common health indicator. Disability-adjusted life year (DALY) combines years lived disabled or injured (YLD) and years of life lost (YLL) providing practical indicator to combine injuries with diseases. In this study, we estimate the average YLDs for one person injured in a transport crash to allow easy to use methods to predict health effects of transport injuries.MethodsWe calculated YLDs and YLLs for transport fatalities and injuries based on the data from the Swedish Traffic Accident Data Acquisition (STRADA). In STRADA, all the fatalities and most of the injuries in Sweden for 2007-2011 were recorded. The type of injury was recorded with the Abbreviated Injury Scale (AIS) codes. In this study these AIS codes were aggregated to injury types, and YLDs were calculated for each victim by multiplying the type of injury with the disability weight and the average duration of that injury. YLLs were calculated by multiplying the age of the victim with life expectancy of that age and gender. YLDs and YLLs were estimated separately for different gender, mode of transport and location of the crash.ResultsThe average YLDs for injured person was 14.7 for lifelong injuries and 0.012 for temporal injuries. The average YLDs per injured person for lifelong injuries for pedestrians, cyclists and car occupants were 9.4, 12.8 and 18.4, YLDs, respectively. Lifelong injuries sustained in rural areas were on average 31% more serious than injuries in urban areas.ConclusionsThe results show that shifting modes of transport will not only change the likelihood of injuries but also the severity of injuries sustained, if injured. The results of this study can be used to predict DALY changes in HIA studies that take into account mode shifts between different transport modes, and in other studies predicting the health effects of traffic injuries.

Project description:OBJECTIVE:To quantify and compare the contribution of 306 diseases and injuries to the changes in health adjusted life expectancy at birth (HALE0) between 1990 and 2013. DESIGN:Retrospective demographic analysis based on aggregated data and using life table technique, Sullivan method, and decomposition method for differences in health expectancy. SETTING:The globe, 21 regions, and 187 countries, covered in the Global Burden of Disease Study (GBD) 2013. MAIN OUTCOME MEASURES:Cause specific contribution to changes in HALE0 between 1990 and 2013 in terms of mortality effect, disability effect, and total effect. RESULTS:Between 1990 and 2013, global HALE0 increased by 5.31 years for males and 5.73 years for females. The cross national Gini coefficient of HALE0 for both sexes combined decreased by 15.22% from 0.0736 to 0.0624. HALE0 declined in 11 countries during the period, predominantly owing to HIV/AIDS except in Belize, Belarus, and Paraguay. Controlling communicable, maternal, neonatal, and nutritional diseases accounted for 56.47% (3.10 years) of changes in HALE0 for both sexes combined, followed by non-communicable diseases (30.05%; 1.65 years) and injuries (13.67%; 0.75 years). Globally, HIV/AIDS caused the biggest reduction in HALE0 (-0.28 years) and mainly afflicted residents in southern (-7.86 years), western (-1.53 years), and eastern (-1.38 years) sub-Saharan Africa. Diabetes had the second biggest negative total effect on changes in HALE0 (-0.12 years), which was quite widespread across regions. Despite their positive total effect in high income regions, such non-communicable diseases as ischaemic heart disease, cerebrovascular disease, and hypertensive heart disease had a negative total effect in many low and middle income regions. Mortality reduction was the predominant driver (93.62%; 5.14 years) for improvement in HALE0, accompanied by an increase of 0.80 years in life expectancy lived with disability at birth. Only 44 (27%) of 163 causes at level 3 in the GBD cause hierarchy influenced changes in HALE0, mainly or only through disability. CONCLUSIONS:Between 1990 and 2013, the globe made achievements in not only promoting population health as a whole but reducing health inequality between countries. This study pinpoints the priority diseases and injuries for altering the declining health trend in 11 countries, for curbing the epidemic of non-communicable diseases in low and middle income countries, and for promoting compression of morbidity worldwide. The detailed country specific decomposition results of effects of diseases and injuries on change in population health will further facilitate the development of national health policies.

Project description:ObjectiveThis study aims to investigate sex, age, and cause-specific contributions to changes and trend disparities in life expectancy (LE) and health-adjusted life expectancy (HALE) attributed to disability and mortality from 1990 to 2019 in China, which provides insight into policy-making, health systems planning, and resource allocation.MethodsContributions of disability and mortality to changes and trend disparities in LE and HALE were estimated with standard abridged life table, Sullivan's method, and decomposition method, using retrospective demographic analysis based on mortality and years lived with disability (YLD) rates extracted from Global Burden of Disease Study 2019 (GBD 2019).ResultsFrom 1990 to 2019, LE and HALE increased by 10.49 and 8.71 years for both sexes, mainly due to noncommunicable diseases (NCDs) (5.83 years, 55.58% for LE and 6.28 years, 72.10% for HALE). However, HIV/AIDS and sexually transmitted infections had negative effects on changes in LE (-0.03 years, -0.29%) and HALE (-0.05 years, -0.57%). Lung cancer and ischemic heart disease caused the biggest reduction in LE (-0.14 years, -1.33%) and HALE (-0.42 years, -4.82%). Also, cardiovascular diseases (-0.08 years, -0.92%), neurological disorders (-0.08 years, -0.92%), diabetes and kidney diseases (-0.06 years, -0.69%), and transport injuries (-0.06 years, -0.69%) had main negative disability effects in HALE. Moreover, life expectancy lived with disability (LED) increased by 1.78 years, mainly attributed to respiratory infections and tuberculosis (1.04 years, 58.43%) and maternal and neonatal disorders (0.78 years, 43.82%).ConclusionThe LE and HALE in China have grown rapidly over the past few decades, mainly attributed to NCDs. It is necessary to further reduce the negative mortality effect of HIV/AIDS, lung cancer, colon and rectum cancer, pancreatic cancer, and ischemic heart disease and the negative disability effect of stroke, diabetes mellitus, and road injuries. In addition, the signs of disparities in mortality and disability of different sexes and ages call for targeted and precise interventions for key groups such as males and the elderly. According to the decomposition results, we may better determine the key objects of health policies that take into account substantial cause-specific variations to facilitate the realization of "healthy China 2030" plan.

Dataset Information

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.

Publications

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.

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