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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

Summary 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 developmen... Full description

Journal Title: Lancet 2016, Vol.388 (10053), p.1603-1658
Main Author: Arora, Megha
Other Authors: Bhutta, Zulfiqar A , Casey, Daniel C , Charlson, Fiona J , Coggeshall, Megan , Gething, Peter W , Kutz, Michael J , Mensah, George A , Naghavi, Mohsen , Nsoesie, Elaine , Rankin, Zane , Reinig, Nikolas , Troeger, Chris , Truelsen, Thomas , Abu-Raddad, Laith J , Adsuar, José C , Agardh, Emilie Elisabet , Al-Aly, Ziyad , Alam, Khurshid , Alkerwi, Ala'a , Alvis-Guzman, Nelson , Anderson, Gregory M , Artaman, Al , Awasthi, Ashish , Banerjee, Amitava , Barker-Collo, Suzanne L , Bennett, Derrick A , Betsu, Balem Demtsu , Bikbov, Boris , Abdulhak, Aref A Bin , Boufous, Soufiane , Bourne, Rupert R A , Breitborde, Nicholas J K , Calabria, Bianca , Campos-Nonato, Ismael Ricardo , Cárdenas, Rosario , Christensen, Hanne , Colomar, Mercedes , das Neves, José , Dubey, Manisha , Esteghamati, Alireza , Fahimi, Saman , Farinha, Carla Sofia e Sa , Farvid, Maryam S , Frostad, Joseph , Gabbe, Belinda , Gibney, Katherine B , Goodridge, Amador , Hailu, Alemayehu Desalegne , Haro, Josep Maria , Hassen, Tahir Ahmed , Huang, Hsiang , Idrisov, Bulat T , Jauregui, Alejandra , Jayatilleke, Achala Upendra , Jin, Ye , Kalkonde, Yogeshwar , Keiyoro, Peter Njenga , Kim, Yun Jin , Koyanagi, Ai , Bicer, Burcu Kucuk , Leung, Ricky , Looker, Katharine J , Lotufo, Paulo A , Malta, Deborah Carvalho , Marcenes, Wagner , Martinez-Raga, Jose , Mayosi, Bongani M , Hernandez, Julio Cesar Montañez , Mori, Rintaro , Mumford, John Everett , Pete, Patrick Martial Nkamedjie , Oladimeji, Olanrewaju , Olusanya, Jacob Olusegun , Park, Eun-Kee , Piel, Frédéric B , Qorbani, Mostafa , Reitsma, Marissa B , Remuzzi, Giuseppe , Shaikh, Masood Ali , Sharma, Rajesh , Singh, Jasvinder A , Skirbekk, Vegard , Søreide, Kjetil , Stroumpoulis, Konstantinos , Sur, Patrick J , Tanne, David , Ao, Braden J Te , Terkawi, Abdullah Sulieman , Thomson, Alan J , Thorne-Lyman, Andrew L , Thurston, George D , Topor-Madry, Roman , Tuzcu, Emin Murat , Uthman, Olalekan A , Vlassov, Vasiliy Victorovich , Wijeratne, Tissa , Yan, Lijing L , Yano, Yuichiro , Lopez, Alan D
Format: Electronic Article Electronic Article
Language: English
Subjects:
Age
Non
VDP
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Ltd
ID: ISSN: 0140-6736
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title: 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
format: Article
creator:
  • Arora, Megha
  • Bhutta, Zulfiqar A
  • Casey, Daniel C
  • Charlson, Fiona J
  • Coggeshall, Megan
  • Gething, Peter W
  • Kutz, Michael J
  • Mensah, George A
  • Naghavi, Mohsen
  • Nsoesie, Elaine
  • Rankin, Zane
  • Reinig, Nikolas
  • Troeger, Chris
  • Truelsen, Thomas
  • Abu-Raddad, Laith J
  • Adsuar, José C
  • Agardh, Emilie Elisabet
  • Al-Aly, Ziyad
  • Alam, Khurshid
  • Alkerwi, Ala'a
  • Alvis-Guzman, Nelson
  • Anderson, Gregory M
  • Artaman, Al
  • Awasthi, Ashish
  • Banerjee, Amitava
  • Barker-Collo, Suzanne L
  • Bennett, Derrick A
  • Betsu, Balem Demtsu
  • Bikbov, Boris
  • Abdulhak, Aref A Bin
  • Boufous, Soufiane
  • Bourne, Rupert R A
  • Breitborde, Nicholas J K
  • Calabria, Bianca
  • Campos-Nonato, Ismael Ricardo
  • Cárdenas, Rosario
  • Christensen, Hanne
  • Colomar, Mercedes
  • das Neves, José
  • Dubey, Manisha
  • Esteghamati, Alireza
  • Fahimi, Saman
  • Farinha, Carla Sofia e Sa
  • Farvid, Maryam S
  • Frostad, Joseph
  • Gabbe, Belinda
  • Gibney, Katherine B
  • Goodridge, Amador
  • Hailu, Alemayehu Desalegne
  • Haro, Josep Maria
  • Hassen, Tahir Ahmed
  • Huang, Hsiang
  • Idrisov, Bulat T
  • Jauregui, Alejandra
  • Jayatilleke, Achala Upendra
  • Jin, Ye
  • Kalkonde, Yogeshwar
  • Keiyoro, Peter Njenga
  • Kim, Yun Jin
  • Koyanagi, Ai
  • Bicer, Burcu Kucuk
  • Leung, Ricky
  • Looker, Katharine J
  • Lotufo, Paulo A
  • Malta, Deborah Carvalho
  • Marcenes, Wagner
  • Martinez-Raga, Jose
  • Mayosi, Bongani M
  • Hernandez, Julio Cesar Montañez
  • Mori, Rintaro
  • Mumford, John Everett
  • Pete, Patrick Martial Nkamedjie
  • Oladimeji, Olanrewaju
  • Olusanya, Jacob Olusegun
  • Park, Eun-Kee
  • Piel, Frédéric B
  • Qorbani, Mostafa
  • Reitsma, Marissa B
  • Remuzzi, Giuseppe
  • Shaikh, Masood Ali
  • Sharma, Rajesh
  • Singh, Jasvinder A
  • Skirbekk, Vegard
  • Søreide, Kjetil
  • Stroumpoulis, Konstantinos
  • Sur, Patrick J
  • Tanne, David
  • Ao, Braden J Te
  • Terkawi, Abdullah Sulieman
  • Thomson, Alan J
  • Thorne-Lyman, Andrew L
  • Thurston, George D
  • Topor-Madry, Roman
  • Tuzcu, Emin Murat
  • Uthman, Olalekan A
  • Vlassov, Vasiliy Victorovich
  • Wijeratne, Tissa
  • Yan, Lijing L
  • Yano, Yuichiro
  • Lopez, Alan D
subjects:
  • 3112 Neurosciences
  • 3121 Internal medicine
  • 3122 Cancers
  • 3124 Neurology
  • 3142 Public health care science
  • Adjusted Life
  • Adjusted Life Years
  • Age
  • Analysis
  • Anos de vida perdidos ajustados por incapacidade
  • Articles
  • atira
  • Chair Nutrition and Disease
  • Clinical Medicine
  • Comment
  • Community medicine
  • Community medicine, Social medicine: 801
  • Cost of Illness
  • Disability
  • Disabled Persons
  • Disease
  • environmental
  • Epidemiology
  • Expectativa de vida saudável
  • Extramural
  • Folkhälsovetenskap
  • Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
  • General & Internal Medicine
  • Geriatrics
  • Geriatrik
  • Global Burden of Disease (GBD)
  • Global Health
  • global hälsa
  • Gov't
  • Health and Welfare
  • Health aspects
  • Health care
  • Health Sciences
  • Health sciences: 800
  • Healthy life expectancy
  • healthy life expectancy (HALE)
  • Helsefag
  • Helsefag: 800
  • HNE Nutrition and Disease
  • HNE Voeding en Ziekte
  • Humans
  • Hälsa och välfärd
  • Hälsovetenskap
  • Hälsovetenskaper
  • Injuries
  • Injury analysis
  • Internal Medicine
  • Journal Article
  • Klinisk medicin
  • Life Expectancy
  • Life Expectancy - trends
  • Life span
  • Medical And Health Sciences
  • Medical disciplines
  • Medical disciplines: 700
  • Medical research
  • Medicin och hälsovetenskap
  • Medicine(all)
  • Medicine, Experimental
  • Medisinske Fag
  • Medisinske Fag: 700
  • Morbidity
  • Neurologi
  • Neurology
  • Non
  • Nutrition and Disease
  • occupational health
  • Population
  • psychiatry
  • Public Health
  • Public Health, Global Health, Social Medicine and Epidemiology
  • pubmedpublicationtype
  • pure
  • Quality
  • Quality-Adjusted Life Years
  • Research Support
  • researchoutput
  • Samfunnsmedisin
  • Samfunnsmedisin, sosialmedisin: 801
  • SDG 3 - Good Health and Well-being
  • Social Medicine
  • socialmedicin och epidemiologi
  • sosialmedisin
  • Sustainable development
  • Trauma
  • trends
  • VDP
  • VLAG
  • Voeding en Ziekte
  • Years
  • years (DALYs)
ispartof: Lancet, 2016, Vol.388 (10053), p.1603-1658
description: Summary 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·
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
  • 1474-547X
url: Link


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titleGlobal, 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
sourceAlma/SFX Local Collection
creatorArora, Megha ; Bhutta, Zulfiqar A ; Casey, Daniel C ; Charlson, Fiona J ; Coggeshall, Megan ; Gething, Peter W ; Kutz, Michael J ; Mensah, George A ; Naghavi, Mohsen ; Nsoesie, Elaine ; Rankin, Zane ; Reinig, Nikolas ; Troeger, Chris ; Truelsen, Thomas ; Abu-Raddad, Laith J ; Adsuar, José C ; Agardh, Emilie Elisabet ; Al-Aly, Ziyad ; Alam, Khurshid ; Alkerwi, Ala'a ; Alvis-Guzman, Nelson ; Anderson, Gregory M ; Artaman, Al ; Awasthi, Ashish ; Banerjee, Amitava ; Barker-Collo, Suzanne L ; Bennett, Derrick A ; Betsu, Balem Demtsu ; Bikbov, Boris ; Abdulhak, Aref A Bin ; Boufous, Soufiane ; Bourne, Rupert R A ; Breitborde, Nicholas J K ; Calabria, Bianca ; Campos-Nonato, Ismael Ricardo ; Cárdenas, Rosario ; Christensen, Hanne ; Colomar, Mercedes ; das Neves, José ; Dubey, Manisha ; Esteghamati, Alireza ; Fahimi, Saman ; Farinha, Carla Sofia e Sa ; Farvid, Maryam S ; Frostad, Joseph ; Gabbe, Belinda ; Gibney, Katherine B ; Goodridge, Amador ; Hailu, Alemayehu Desalegne ; Haro, Josep Maria ; Hassen, Tahir Ahmed ; Huang, Hsiang ; Idrisov, Bulat T ; Jauregui, Alejandra ; Jayatilleke, Achala Upendra ; Jin, Ye ; Kalkonde, Yogeshwar ; Keiyoro, Peter Njenga ; Kim, Yun Jin ; Koyanagi, Ai ; Bicer, Burcu Kucuk ; Leung, Ricky ; Looker, Katharine J ; Lotufo, Paulo A ; Malta, Deborah Carvalho ; Marcenes, Wagner ; Martinez-Raga, Jose ; Mayosi, Bongani M ; Hernandez, Julio Cesar Montañez ; Mori, Rintaro ; Mumford, John Everett ; Pete, Patrick Martial Nkamedjie ; Oladimeji, Olanrewaju ; Olusanya, Jacob Olusegun ; Park, Eun-Kee ; Piel, Frédéric B ; Qorbani, Mostafa ; Reitsma, Marissa B ; Remuzzi, Giuseppe ; Shaikh, Masood Ali ; Sharma, Rajesh ; Singh, Jasvinder A ; Skirbekk, Vegard ; Søreide, Kjetil ; Stroumpoulis, Konstantinos ; Sur, Patrick J ; Tanne, David ; Ao, Braden J Te ; Terkawi, Abdullah Sulieman ; Thomson, Alan J ; Thorne-Lyman, Andrew L ; Thurston, George D ; Topor-Madry, Roman ; Tuzcu, Emin Murat ; Uthman, Olalekan A ; Vlassov, Vasiliy Victorovich ; Wijeratne, Tissa ; Yan, Lijing L ; Yano, Yuichiro ; Lopez, Alan D
creatorcontribArora, Megha ; Bhutta, Zulfiqar A ; Casey, Daniel C ; Charlson, Fiona J ; Coggeshall, Megan ; Gething, Peter W ; Kutz, Michael J ; Mensah, George A ; Naghavi, Mohsen ; Nsoesie, Elaine ; Rankin, Zane ; Reinig, Nikolas ; Troeger, Chris ; Truelsen, Thomas ; Abu-Raddad, Laith J ; Adsuar, José C ; Agardh, Emilie Elisabet ; Al-Aly, Ziyad ; Alam, Khurshid ; Alkerwi, Ala'a ; Alvis-Guzman, Nelson ; Anderson, Gregory M ; Artaman, Al ; Awasthi, Ashish ; Banerjee, Amitava ; Barker-Collo, Suzanne L ; Bennett, Derrick A ; Betsu, Balem Demtsu ; Bikbov, Boris ; Abdulhak, Aref A Bin ; Boufous, Soufiane ; Bourne, Rupert R A ; Breitborde, Nicholas J K ; Calabria, Bianca ; Campos-Nonato, Ismael Ricardo ; Cárdenas, Rosario ; Christensen, Hanne ; Colomar, Mercedes ; das Neves, José ; Dubey, Manisha ; Esteghamati, Alireza ; Fahimi, Saman ; Farinha, Carla Sofia e Sa ; Farvid, Maryam S ; Frostad, Joseph ; Gabbe, Belinda ; Gibney, Katherine B ; Goodridge, Amador ; Hailu, Alemayehu Desalegne ; Haro, Josep Maria ; Hassen, Tahir Ahmed ; Huang, Hsiang ; Idrisov, Bulat T ; Jauregui, Alejandra ; Jayatilleke, Achala Upendra ; Jin, Ye ; Kalkonde, Yogeshwar ; Keiyoro, Peter Njenga ; Kim, Yun Jin ; Koyanagi, Ai ; Bicer, Burcu Kucuk ; Leung, Ricky ; Looker, Katharine J ; Lotufo, Paulo A ; Malta, Deborah Carvalho ; Marcenes, Wagner ; Martinez-Raga, Jose ; Mayosi, Bongani M ; Hernandez, Julio Cesar Montañez ; Mori, Rintaro ; Mumford, John Everett ; Pete, Patrick Martial Nkamedjie ; Oladimeji, Olanrewaju ; Olusanya, Jacob Olusegun ; Park, Eun-Kee ; Piel, Frédéric B ; Qorbani, Mostafa ; Reitsma, Marissa B ; Remuzzi, Giuseppe ; Shaikh, Masood Ali ; Sharma, Rajesh ; Singh, Jasvinder A ; Skirbekk, Vegard ; Søreide, Kjetil ; Stroumpoulis, Konstantinos ; Sur, Patrick J ; Tanne, David ; Ao, Braden J Te ; Terkawi, Abdullah Sulieman ; Thomson, Alan J ; Thorne-Lyman, Andrew L ; Thurston, George D ; Topor-Madry, Roman ; Tuzcu, Emin Murat ; Uthman, Olalekan A ; Vlassov, Vasiliy Victorovich ; Wijeratne, Tissa ; Yan, Lijing L ; Yano, Yuichiro ; Lopez, Alan D ; GBD 2015 DALYs and HALE Collaborators ; Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa ; Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri ; Göteborgs universitet ; Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för arbets-och miljömedicin ; Gothenburg University ; Institute of Medicine, School of Public Health and Community Medicine ; Sahlgrenska Academy ; Sahlgrenska akademin ; Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics ; Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
descriptionSummary 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.
identifier
0ISSN: 0140-6736
1ISSN: 1474-547X
2EISSN: 1474-547X
3DOI: 10.1016/S0140-6736(16)31460-X
4PMID: 27733283
languageeng
publisherEngland: Elsevier Ltd
subject3112 Neurosciences ; 3121 Internal medicine ; 3122 Cancers ; 3124 Neurology ; 3142 Public health care science ; Adjusted Life ; Adjusted Life Years ; Age ; Analysis ; Anos de vida perdidos ajustados por incapacidade ; Articles ; atira ; Chair Nutrition and Disease ; Clinical Medicine ; Comment ; Community medicine ; Community medicine, Social medicine: 801 ; Cost of Illness ; Disability ; Disabled Persons ; Disease ; environmental ; Epidemiology ; Expectativa de vida saudável ; Extramural ; Folkhälsovetenskap ; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ; General & Internal Medicine ; Geriatrics ; Geriatrik ; Global Burden of Disease (GBD) ; Global Health ; global hälsa ; Gov't ; Health and Welfare ; Health aspects ; Health care ; Health Sciences ; Health sciences: 800 ; Healthy life expectancy ; healthy life expectancy (HALE) ; Helsefag ; Helsefag: 800 ; HNE Nutrition and Disease ; HNE Voeding en Ziekte ; Humans ; Hälsa och välfärd ; Hälsovetenskap ; Hälsovetenskaper ; Injuries ; Injury analysis ; Internal Medicine ; Journal Article ; Klinisk medicin ; Life Expectancy ; Life Expectancy - trends ; Life span ; Medical And Health Sciences ; Medical disciplines ; Medical disciplines: 700 ; Medical research ; Medicin och hälsovetenskap ; Medicine(all) ; Medicine, Experimental ; Medisinske Fag ; Medisinske Fag: 700 ; Morbidity ; Neurologi ; Neurology ; Non ; Nutrition and Disease ; occupational health ; Population ; psychiatry ; Public Health ; Public Health, Global Health, Social Medicine and Epidemiology ; pubmedpublicationtype ; pure ; Quality ; Quality-Adjusted Life Years ; Research Support ; researchoutput ; Samfunnsmedisin ; Samfunnsmedisin, sosialmedisin: 801 ; SDG 3 - Good Health and Well-being ; Social Medicine ; socialmedicin och epidemiologi ; sosialmedisin ; Sustainable development ; Trauma ; trends ; VDP ; VLAG ; Voeding en Ziekte ; Years ; years (DALYs)
ispartofLancet, 2016, Vol.388 (10053), p.1603-1658
rights
0The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
12016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license
2info:eu-repo/semantics/restrictedAccess
3Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.
4COPYRIGHT 2016 Elsevier B.V.
5Copyright Elsevier Limited Oct 8, 2016
6info:eu-repo/semantics/openAccess
72016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license 2016
8Wageningen University & Research
lds50peer_reviewed
oafree_for_read
citedbyFETCH-LOGICAL-13027t-9ade8b33e1ff9284a008a05d9299c2fb62fb151cce454c95ec501359394c3f773
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search
creatorcontrib
0Arora, Megha
1Bhutta, Zulfiqar A
2Casey, Daniel C
3Charlson, Fiona J
4Coggeshall, Megan
5Gething, Peter W
6Kutz, Michael J
7Mensah, George A
8Naghavi, Mohsen
9Nsoesie, Elaine
10Rankin, Zane
11Reinig, Nikolas
12Troeger, Chris
13Truelsen, Thomas
14Abu-Raddad, Laith J
15Adsuar, José C
16Agardh, Emilie Elisabet
17Al-Aly, Ziyad
18Alam, Khurshid
19Alkerwi, Ala'a
20Alvis-Guzman, Nelson
21Anderson, Gregory M
22Artaman, Al
23Awasthi, Ashish
24Banerjee, Amitava
25Barker-Collo, Suzanne L
26Bennett, Derrick A
27Betsu, Balem Demtsu
28Bikbov, Boris
29Abdulhak, Aref A Bin
30Boufous, Soufiane
31Bourne, Rupert R A
32Breitborde, Nicholas J K
33Calabria, Bianca
34Campos-Nonato, Ismael Ricardo
35Cárdenas, Rosario
36Christensen, Hanne
37Colomar, Mercedes
38das Neves, José
39Dubey, Manisha
40Esteghamati, Alireza
41Fahimi, Saman
42Farinha, Carla Sofia e Sa
43Farvid, Maryam S
44Frostad, Joseph
45Gabbe, Belinda
46Gibney, Katherine B
47Goodridge, Amador
48Hailu, Alemayehu Desalegne
49Haro, Josep Maria
50Hassen, Tahir Ahmed
51Huang, Hsiang
52Idrisov, Bulat T
53Jauregui, Alejandra
54Jayatilleke, Achala Upendra
55Jin, Ye
56Kalkonde, Yogeshwar
57Keiyoro, Peter Njenga
58Kim, Yun Jin
59Koyanagi, Ai
60Bicer, Burcu Kucuk
61Leung, Ricky
62Looker, Katharine J
63Lotufo, Paulo A
64Malta, Deborah Carvalho
65Marcenes, Wagner
66Martinez-Raga, Jose
67Mayosi, Bongani M
68Hernandez, Julio Cesar Montañez
69Mori, Rintaro
70Mumford, John Everett
71Pete, Patrick Martial Nkamedjie
72Oladimeji, Olanrewaju
73Olusanya, Jacob Olusegun
74Park, Eun-Kee
75Piel, Frédéric B
76Qorbani, Mostafa
77Reitsma, Marissa B
78Remuzzi, Giuseppe
79Shaikh, Masood Ali
80Sharma, Rajesh
81Singh, Jasvinder A
82Skirbekk, Vegard
83Søreide, Kjetil
84Stroumpoulis, Konstantinos
85Sur, Patrick J
86Tanne, David
87Ao, Braden J Te
88Terkawi, Abdullah Sulieman
89Thomson, Alan J
90Thorne-Lyman, Andrew L
91Thurston, George D
92Topor-Madry, Roman
93Tuzcu, Emin Murat
94Uthman, Olalekan A
95Vlassov, Vasiliy Victorovich
96Wijeratne, Tissa
97Yan, Lijing L
98Yano, Yuichiro
99Lopez, Alan D
100GBD 2015 DALYs and HALE Collaborators
101Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
102Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri
103Göteborgs universitet
104Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för arbets-och miljömedicin
105Gothenburg University
106Institute of Medicine, School of Public Health and Community Medicine
107Sahlgrenska Academy
108Sahlgrenska akademin
109Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
110Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
title
0Global, 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
1Lancet
addtitleLancet
descriptionSummary 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.
subject
03112 Neurosciences
13121 Internal medicine
23122 Cancers
33124 Neurology
43142 Public health care science
5Adjusted Life
6Adjusted Life Years
7Age
8Analysis
9Anos de vida perdidos ajustados por incapacidade
10Articles
11atira
12Chair Nutrition and Disease
13Clinical Medicine
14Comment
15Community medicine
16Community medicine, Social medicine: 801
17Cost of Illness
18Disability
19Disabled Persons
20Disease
21environmental
22Epidemiology
23Expectativa de vida saudável
24Extramural
25Folkhälsovetenskap
26Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
27General & Internal Medicine
28Geriatrics
29Geriatrik
30Global Burden of Disease (GBD)
31Global Health
32global hälsa
33Gov't
34Health and Welfare
35Health aspects
36Health care
37Health Sciences
38Health sciences: 800
39Healthy life expectancy
40healthy life expectancy (HALE)
41Helsefag
42Helsefag: 800
43HNE Nutrition and Disease
44HNE Voeding en Ziekte
45Humans
46Hälsa och välfärd
47Hälsovetenskap
48Hälsovetenskaper
49Injuries
50Injury analysis
51Internal Medicine
52Journal Article
53Klinisk medicin
54Life Expectancy
55Life Expectancy - trends
56Life span
57Medical And Health Sciences
58Medical disciplines
59Medical disciplines: 700
60Medical research
61Medicin och hälsovetenskap
62Medicine(all)
63Medicine, Experimental
64Medisinske Fag
65Medisinske Fag: 700
66Morbidity
67Neurologi
68Neurology
69Non
70Nutrition and Disease
71occupational health
72Population
73psychiatry
74Public Health
75Public Health, Global Health, Social Medicine and Epidemiology
76pubmedpublicationtype
77pure
78Quality
79Quality-Adjusted Life Years
80Research Support
81researchoutput
82Samfunnsmedisin
83Samfunnsmedisin, sosialmedisin: 801
84SDG 3 - Good Health and Well-being
85Social Medicine
86socialmedicin och epidemiologi
87sosialmedisin
88Sustainable development
89Trauma
90trends
91VDP
92VLAG
93Voeding en Ziekte
94Years
95years (DALYs)
issn
00140-6736
11474-547X
21474-547X
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0Arora, Megha
1Bhutta, Zulfiqar A
2Casey, Daniel C
3Charlson, Fiona J
4Coggeshall, Megan
5Gething, Peter W
6Kutz, Michael J
7Mensah, George A
8Naghavi, Mohsen
9Nsoesie, Elaine
10Rankin, Zane
11Reinig, Nikolas
12Troeger, Chris
13Truelsen, Thomas
14Abu-Raddad, Laith J
15Adsuar, José C
16Agardh, Emilie Elisabet
17Al-Aly, Ziyad
18Alam, Khurshid
19Alkerwi, Ala'a
20Alvis-Guzman, Nelson
21Anderson, Gregory M
22Artaman, Al
23Awasthi, Ashish
24Banerjee, Amitava
25Barker-Collo, Suzanne L
26Bennett, Derrick A
27Betsu, Balem Demtsu
28Bikbov, Boris
29Abdulhak, Aref A Bin
30Boufous, Soufiane
31Bourne, Rupert R A
32Breitborde, Nicholas J K
33Calabria, Bianca
34Campos-Nonato, Ismael Ricardo
35Cárdenas, Rosario
36Christensen, Hanne
37Colomar, Mercedes
38das Neves, José
39Dubey, Manisha
40Esteghamati, Alireza
41Fahimi, Saman
42Farinha, Carla Sofia e Sa
43Farvid, Maryam S
44Frostad, Joseph
45Gabbe, Belinda
46Gibney, Katherine B
47Goodridge, Amador
48Hailu, Alemayehu Desalegne
49Haro, Josep Maria
50Hassen, Tahir Ahmed
51Huang, Hsiang
52Idrisov, Bulat T
53Jauregui, Alejandra
54Jayatilleke, Achala Upendra
55Jin, Ye
56Kalkonde, Yogeshwar
57Keiyoro, Peter Njenga
58Kim, Yun Jin
59Koyanagi, Ai
60Bicer, Burcu Kucuk
61Leung, Ricky
62Looker, Katharine J
63Lotufo, Paulo A
64Malta, Deborah Carvalho
65Marcenes, Wagner
66Martinez-Raga, Jose
67Mayosi, Bongani M
68Hernandez, Julio Cesar Montañez
69Mori, Rintaro
70Mumford, John Everett
71Pete, Patrick Martial Nkamedjie
72Oladimeji, Olanrewaju
73Olusanya, Jacob Olusegun
74Park, Eun-Kee
75Piel, Frédéric B
76Qorbani, Mostafa
77Reitsma, Marissa B
78Remuzzi, Giuseppe
79Shaikh, Masood Ali
80Sharma, Rajesh
81Singh, Jasvinder A
82Skirbekk, Vegard
83Søreide, Kjetil
84Stroumpoulis, Konstantinos
85Sur, Patrick J
86Tanne, David
87Ao, Braden J Te
88Terkawi, Abdullah Sulieman
89Thomson, Alan J
90Thorne-Lyman, Andrew L
91Thurston, George D
92Topor-Madry, Roman
93Tuzcu, Emin Murat
94Uthman, Olalekan A
95Vlassov, Vasiliy Victorovich
96Wijeratne, Tissa
97Yan, Lijing L
98Yano, Yuichiro
99Lopez, Alan D
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titleGlobal, 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
authorArora, Megha ; Bhutta, Zulfiqar A ; Casey, Daniel C ; Charlson, Fiona J ; Coggeshall, Megan ; Gething, Peter W ; Kutz, Michael J ; Mensah, George A ; Naghavi, Mohsen ; Nsoesie, Elaine ; Rankin, Zane ; Reinig, Nikolas ; Troeger, Chris ; Truelsen, Thomas ; Abu-Raddad, Laith J ; Adsuar, José C ; Agardh, Emilie Elisabet ; Al-Aly, Ziyad ; Alam, Khurshid ; Alkerwi, Ala'a ; Alvis-Guzman, Nelson ; Anderson, Gregory M ; Artaman, Al ; Awasthi, Ashish ; Banerjee, Amitava ; Barker-Collo, Suzanne L ; Bennett, Derrick A ; Betsu, Balem Demtsu ; Bikbov, Boris ; Abdulhak, Aref A Bin ; Boufous, Soufiane ; Bourne, Rupert R A ; Breitborde, Nicholas J K ; Calabria, Bianca ; Campos-Nonato, Ismael Ricardo ; Cárdenas, Rosario ; Christensen, Hanne ; Colomar, Mercedes ; das Neves, José ; Dubey, Manisha ; Esteghamati, Alireza ; Fahimi, Saman ; Farinha, Carla Sofia e Sa ; Farvid, Maryam S ; Frostad, Joseph ; Gabbe, Belinda ; Gibney, Katherine B ; Goodridge, Amador ; Hailu, Alemayehu Desalegne ; Haro, Josep Maria ; Hassen, Tahir Ahmed ; Huang, Hsiang ; Idrisov, Bulat T ; Jauregui, Alejandra ; Jayatilleke, Achala Upendra ; Jin, Ye ; Kalkonde, Yogeshwar ; Keiyoro, Peter Njenga ; Kim, Yun Jin ; Koyanagi, Ai ; Bicer, Burcu Kucuk ; Leung, Ricky ; Looker, Katharine J ; Lotufo, Paulo A ; Malta, Deborah Carvalho ; Marcenes, Wagner ; Martinez-Raga, Jose ; Mayosi, Bongani M ; Hernandez, Julio Cesar Montañez ; Mori, Rintaro ; Mumford, John Everett ; Pete, Patrick Martial Nkamedjie ; Oladimeji, Olanrewaju ; Olusanya, Jacob Olusegun ; Park, Eun-Kee ; Piel, Frédéric B ; Qorbani, Mostafa ; Reitsma, Marissa B ; Remuzzi, Giuseppe ; Shaikh, Masood Ali ; Sharma, Rajesh ; Singh, Jasvinder A ; Skirbekk, Vegard ; Søreide, Kjetil ; Stroumpoulis, Konstantinos ; Sur, Patrick J ; Tanne, David ; Ao, Braden J Te ; Terkawi, Abdullah Sulieman ; Thomson, Alan J ; Thorne-Lyman, Andrew L ; Thurston, George D ; Topor-Madry, Roman ; Tuzcu, Emin Murat ; Uthman, Olalekan A ; Vlassov, Vasiliy Victorovich ; Wijeratne, Tissa ; Yan, Lijing L ; Yano, Yuichiro ; Lopez, Alan D
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languageeng
creationdate2016
topic
03112 Neurosciences
13121 Internal medicine
23122 Cancers
33124 Neurology
43142 Public health care science
5Adjusted Life
6Adjusted Life Years
7Age
8Analysis
9Anos de vida perdidos ajustados por incapacidade
10Articles
11atira
12Chair Nutrition and Disease
13Clinical Medicine
14Comment
15Community medicine
16Community medicine, Social medicine: 801
17Cost of Illness
18Disability
19Disabled Persons
20Disease
21environmental
22Epidemiology
23Expectativa de vida saudável
24Extramural
25Folkhälsovetenskap
26Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
27General & Internal Medicine
28Geriatrics
29Geriatrik
30Global Burden of Disease (GBD)
31Global Health
32global hälsa
33Gov't
34Health and Welfare
35Health aspects
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102Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri
103Göteborgs universitet
104Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för arbets-och miljömedicin
105Gothenburg University
106Institute of Medicine, School of Public Health and Community Medicine
107Sahlgrenska Academy
108Sahlgrenska akademin
109Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
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jtitleLancet
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au
0Arora, Megha
1Bhutta, Zulfiqar A
2Casey, Daniel C
3Charlson, Fiona J
4Coggeshall, Megan
5Gething, Peter W
6Kutz, Michael J
7Mensah, George A
8Naghavi, Mohsen
9Nsoesie, Elaine
10Rankin, Zane
11Reinig, Nikolas
12Troeger, Chris
13Truelsen, Thomas
14Abu-Raddad, Laith J
15Adsuar, José C
16Agardh, Emilie Elisabet
17Al-Aly, Ziyad
18Alam, Khurshid
19Alkerwi, Ala'a
20Alvis-Guzman, Nelson
21Anderson, Gregory M
22Artaman, Al
23Awasthi, Ashish
24Banerjee, Amitava
25Barker-Collo, Suzanne L
26Bennett, Derrick A
27Betsu, Balem Demtsu
28Bikbov, Boris
29Abdulhak, Aref A Bin
30Boufous, Soufiane
31Bourne, Rupert R A
32Breitborde, Nicholas J K
33Calabria, Bianca
34Campos-Nonato, Ismael Ricardo
35Cárdenas, Rosario
36Christensen, Hanne
37Colomar, Mercedes
38das Neves, José
39Dubey, Manisha
40Esteghamati, Alireza
41Fahimi, Saman
42Farinha, Carla Sofia e Sa
43Farvid, Maryam S
44Frostad, Joseph
45Gabbe, Belinda
46Gibney, Katherine B
47Goodridge, Amador
48Hailu, Alemayehu Desalegne
49Haro, Josep Maria
50Hassen, Tahir Ahmed
51Huang, Hsiang
52Idrisov, Bulat T
53Jauregui, Alejandra
54Jayatilleke, Achala Upendra
55Jin, Ye
56Kalkonde, Yogeshwar
57Keiyoro, Peter Njenga
58Kim, Yun Jin
59Koyanagi, Ai
60Bicer, Burcu Kucuk
61Leung, Ricky
62Looker, Katharine J
63Lotufo, Paulo A
64Malta, Deborah Carvalho
65Marcenes, Wagner
66Martinez-Raga, Jose
67Mayosi, Bongani M
68Hernandez, Julio Cesar Montañez
69Mori, Rintaro
70Mumford, John Everett
71Pete, Patrick Martial Nkamedjie
72Oladimeji, Olanrewaju
73Olusanya, Jacob Olusegun
74Park, Eun-Kee
75Piel, Frédéric B
76Qorbani, Mostafa
77Reitsma, Marissa B
78Remuzzi, Giuseppe
79Shaikh, Masood Ali
80Sharma, Rajesh
81Singh, Jasvinder A
82Skirbekk, Vegard
83Søreide, Kjetil
84Stroumpoulis, Konstantinos
85Sur, Patrick J
86Tanne, David
87Ao, Braden J Te
88Terkawi, Abdullah Sulieman
89Thomson, Alan J
90Thorne-Lyman, Andrew L
91Thurston, George D
92Topor-Madry, Roman
93Tuzcu, Emin Murat
94Uthman, Olalekan A
95Vlassov, Vasiliy Victorovich
96Wijeratne, Tissa
97Yan, Lijing L
98Yano, Yuichiro
99Lopez, Alan D
aucorp
0GBD 2015 DALYs and HALE Collaborators
1Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
2Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri
3Göteborgs universitet
4Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för arbets-och miljömedicin
5Gothenburg University
6Institute of Medicine, School of Public Health and Community Medicine
7Sahlgrenska Academy
8Sahlgrenska akademin
9Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
10Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
formatjournal
genrearticle
ristypeJOUR
atitleGlobal, 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
jtitleLancet
addtitleLancet
date2016
risdate2016
volume388
issue10053
spage1603
epage1658
pages1603-1658
issn
00140-6736
11474-547X
eissn1474-547X
notes
0The Lancet
1Collaborators listed at the end of the Article
abstractSummary 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.
copEngland
pubElsevier Ltd
pmid27733283
doi10.1016/S0140-6736(16)31460-X
oafree_for_read