Global, Regional, and National Disability-Adjusted Life Years (DALYs) for 306 Diseases and Injuries and Healthy Life Expectancy (Hale) for 188 Countries, 1990-2013: Quantifying the Epidemiological Transition

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Murray, Christopher J. L.; Barber, Ryan M.; Foreman, Kyle J.; Abbasoglu Ozgoren, Ayse; Abd-Allah, Foad; Abera, Semaw Ferede; Aboyans, Victor; Abraham, Jerry P.; Abubakar, Ibrahim; & Abu-Raddad, Laith J., et al. (2015). Global, Regional, and National Disability-Adjusted Life Years (DALYs) for 306 Diseases and Injuries and Healthy Life Expectancy (Hale) for 188 Countries, 1990-2013: Quantifying the Epidemiological Transition. Lancet, 386(10009), 2145-2191. PMCID: PMC4673910

Abstract

BACKGROUND: The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age-sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development.
METHODS: We used the published GBD 2013 data for age-specific mortality, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) to calculate DALYs and HALE for 1990, 1995, 2000, 2005, 2010, and 2013 for 188 countries. We calculated HALE using the Sullivan method; 95% uncertainty intervals (UIs) represent uncertainty in age-specific death rates and YLDs per person for each country, age, sex, and year. We estimated DALYs for 306 causes for each country as the sum of YLLs and YLDs; 95% UIs represent uncertainty in YLL and YLD rates. We quantified patterns of the epidemiological transition with a composite indicator of sociodemographic status, which we constructed from income per person, average years of schooling after age 15 years, and the total fertility rate and mean age of the population. We applied hierarchical regression to DALY rates by cause across countries to decompose variance related to the sociodemographic status variable, country, and time.
FINDINGS: Worldwide, from 1990 to 2013, life expectancy at birth rose by 6·2 years (95% UI 5·6-6·6), from 65·3 years (65·0-65·6) in 1990 to 71·5 years (71·0-71·9) in 2013, HALE at birth rose by 5·4 years (4·9-5·8), from 56·9 years (54·5-59·1) to 62·3 years (59·7-64·8), total DALYs fell by 3·6% (0·3-7·4), and age-standardised DALY rates per 100 000 people fell by 26·7% (24·6-29·1). For communicable, maternal, neonatal, and nutritional disorders, global DALY numbers, crude rates, and age-standardised rates have all declined between 1990 and 2013, whereas for non-communicable diseases, global DALYs have been increasing, DALY rates have remained nearly constant, and age-standardised DALY rates declined during the same period. From 2005 to 2013, the number of DALYs increased for most specific non-communicable diseases, including cardiovascular diseases and neoplasms, in addition to dengue, food-borne trematodes, and leishmaniasis; DALYs decreased for nearly all other causes. By 2013, the five leading causes of DALYs were ischaemic heart disease, lower respiratory infections, cerebrovascular disease, low back and neck pain, and road injuries. Sociodemographic status explained more than 50% of the variance between countries and over time for diarrhoea, lower respiratory infections, and other common infectious diseases; maternal disorders; neonatal disorders; nutritional deficiencies; other communicable, maternal, neonatal, and nutritional diseases; musculoskeletal disorders; and other non-communicable diseases. However, sociodemographic status explained less than 10% of the variance in DALY rates for cardiovascular diseases; chronic respiratory diseases; cirrhosis; diabetes, urogenital, blood, and endocrine diseases; unintentional injuries; and self-harm and interpersonal violence. Predictably, increased sociodemographic status was associated with a shift in burden from YLLs to YLDs, driven by declines in YLLs and increases in YLDs from musculoskeletal disorders, neurological disorders, and mental and substance use disorders. In most country-specific estimates, the increase in life expectancy was greater than that in HALE. Leading causes of DALYs are highly variable across countries.
INTERPRETATION: Global health is improving. Population growth and ageing have driven up numbers of DALYs, but crude rates have remained relatively constant, showing that progress in health does not mean fewer demands on health systems. The notion of an epidemiological transition--in which increasing sociodemographic status brings structured change in disease burden--is useful, but there is tremendous variation in burden of disease that is not associated with sociodemographic status. This further underscores the need for country-specific assessments of DALYs and HALE to appropriately inform health policy decisions and attendant actions.

URL

http://dx.doi.org/10.1016/s0140-6736(15)61340-x

Reference Type

Journal Article

Year Published

2015

Journal Title

Lancet

Author(s)

Murray, Christopher J. L.
Barber, Ryan M.
Foreman, Kyle J.
Abbasoglu Ozgoren, Ayse
Abd-Allah, Foad
Abera, Semaw Ferede
Aboyans, Victor
Abraham, Jerry P.
Abubakar, Ibrahim
Abu-Raddad, Laith J.
Abu-Rmeileh, Niveen M. E.
Achoki, Tom
Ackerman, Ilana N.
Ademi, Zanfina
Adou, Arsène K.
Adsuar, José C.
Afshin, Ashkan
Agardh, Emilie E.
Alam, Sayed S.
Alasfoor, Deena
Albittar, Mohammed I.
Alegretti, Miguel A.
Alemu, Zewdie Aderaw
Alfonso-Cristancho, Rafael
Alhabib, Samia
Ali, Raghib
Alla, François
Allebeck, Peter
AlMazroa, Mohammad AbdulAziz
Alsharif, Ubai
Alvarez, Elena
Alvis-Guzman, Nelson
Amare, Azmeraw T.
Ameh, Emmanuel A.
Amini, Heresh
Ammar, Walid
Anderson, H. Ross
Anderson, Benjamin O.
Antonio, Carl A. T.
Anwari, Palwasha
Arnlöv, Johan
Arsic Arsenijevic, Valentina S.
Artaman, Al
Asghar, Rana J.
Assadi, Reza
Atkins, Lydia S.
Avila, Marco A.
Awuah, Baffour
Bachman, Victoria F.
Badawi, Alaa
Bahit, Maria C.
Balakrishnan, Kalpana
Banerjee, Amitava
Barker-Collo, Suzanne L.
Barquera, Simon
Barregard, Lars
Barrero, Lope H.
Basu, Arindam
Basu, Sanjay
Basulaiman, Mohammed O.
Beardsley, Justin
Bedi, Neeraj
Beghi, Ettore
Bekele, Tolesa
Bell, Michelle L.
Benjet, Corina
Bennett, Derrick A.
Bensenor, Isabela M.
Benzian, Habib
Bernabé, Eduardo
Bertozzi-Villa, Amelia
Beyene, Tariku J.
Bhala, Neeraj
Bhalla, Ashish
Bhutta, Zulfiqar A.
Bienhoff, Kelly
Bikbov, Boris
Biryukov, Stan
Blore, Jed D.
Blosser, Christopher D.
Blyth, Fiona M.
Bohensky, Megan A.
Bolliger, Ian W.
Bora Ba
şara, Berrak
Bornstein, Natan M.
Bose, Dipan
Boufous, Soufiane
Bourne, Rupert R. A.
Boyers, Lindsay N.
Brainin, Michael
Brayne, Carol
Brazinova, Alexandra
Breitborde, Nicholas
Brenner, Hermann
Briggs, Adam D.
Brooks, Peter M.
Brown, Jonathan C.
Brugha, Traolach S.
Buchbinder, Rachelle
Buckle, Geoffrey C.
Budke, Christine M.
Bulchis, Anne
Bulloch, Andrew G.
Campos-Nonato, Ismael R.
Carabin, H
élène
Carapetis, Jonathan R.
Cárdenas, Rosario
Carpenter, David O.
Caso, Valeria
Castañeda-Orjuela, Carlos A.
Castro, Ruben Estanislao
Catalá-López, Ferrán
Cavalleri, Fiorella
Çavlin, Alanur
Chadha, Vineet K.
Chang, Jung-Chen
Charlson, Fiona J.
Chen, Honglei
Chen, Wanqing
Chiang, Peggy Pei-Chia
Chimed-Ochir, Odgerel
Chowdhury, Rajiv
Christensen, Hanne
Christophi, Costas A.
Cirillo, Massimo
Coates, Matthew M.
Coffeng, Luc E.
Coggeshall, Megan S.
Colistro, Valentina
Colquhoun, Samantha M.
Cooke, Graham S.
Cooper, Cyrus
Cooper, Leslie Trumbull
Coppola, Luis M.
Cortinovis, Monica
Criqui, Michael H.
Crump, John A.
Cuevas-Nasu, Lucia
Danawi, Hadi
Dandona, Lalit
Dandona, Rakhi
Dansereau, Emily
Dargan, Paul I.
Davey, Gail
Davis, Adrian
Davitoiu, Dragos V.
Dayama, Anand
De Leo, Diego
Degenhardt, Louisa
Del Pozo-Cruz, Borja
Dellavalle, Robert P.
Deribe, Kebede
Derrett, Sarah
Des Jarlais, Don C.
Dessalegn, Muluken
Dharmaratne, Samath D.
Dherani, Mukesh K.
Diaz-Torné, Cesar
Dicker, Daniel
Ding, Eric L.
Dokova, Klara
Dorsey, E. Ray
Driscoll, Tim R.
Duan, Leilei
Duber, Herbert C.
Ebel, Beth E.
Edmond, Karen M.
Elshrek, Yousef M.
Endres, Matthias
Ermakov, Sergei Petrovich
Erskine, Holly E.
Eshrati, Babak
Esteghamati, Alireza
Estep, Kara
Faraon, Emerito Jose A.
Farzadfar, Farshad
Fay, Derek F. J.
Feigin, Valery L.
Felson, David T.
Fereshtehnejad, Seyed-Mohammad
Fernandes, Jefferson G.
Ferrari, Alize J.
Fitzmaurice, Christina
Flaxman, Abraham D.
Fleming, Thomas D.
Foigt, Nataliya
Forouzanfar, Mohammad H.
Fowkes, F. Gerry
Paleo, Urbano F.
Franklin, Richard C.
Fürst, Thomas
Gabbe, Belinda
Gaffikin, Lynne
Gankpé, Fortuné G.
Geleijnse, Johanna M.
Gessner, Bradford D.
Gething, Peter W.
Gibney, Katherine B.
Giroud, Maurice
Giussani, Giorgia
Gomez Dantes, Hector
Gona, Philimon
González-Medina, Diego
Gosselin, Richard A.
Gotay, Carolyn C.
Goto, Atsushi
Gouda, Hebe N.
Graetz, Nicholas
Gugnani, Harish C.
Gupta, Rahul
Gupta, Rajeev
Gutiérrez, Reyna A.
Haagsma, Juanita
Hafezi-Nejad, Nima
Hagan, Holly
Halasa, Yara A.
Hamadeh, Randah R.
Hamavid, Hannah
Hammami, Mouhanad
Hancock, Jamie
Hankey, Graeme J.
Hansen, Gillian M.
Hao, Yuantao
Harb, Hilda L.
Haro, Josep M.
Havmoeller, Rasmus
Hay, Simon I.
Hay, Roderick J.
Heredia-Pi, Ileana B.
Heuton, Kyle R.
Heydarpour, Pouria
Higashi, Hideki
Hijar, Martha
Hoek, Hans W.
Hoffman, Howard J.
Hosgood, H. Dean
Hossain, Mazeda
Hotez, Peter J.
Hoy, Damian G.
Hsairi, Mohamed
Hu, Guoqing
Huang, Cheng
Huang, John J.
Husseini, Abdullatif
Huynh, Chantal
Iannarone, Marissa L.
Iburg, Kim M.
Innos, Kaire
Inoue, Manami
Islami, Farhad
Jacobsen, Kathryn H.
Jarvis, Deborah L.
Jassal, Simerjot K.
Jee, Sun Ha
Jeemon, Panniyammakal
Jensen, Paul N.
Jha, Vivekanand
Jiang, Guohong
Jiang, Ying
Jonas, Jost B.
Juel, Knud
Kan, Haidong
Karch, André
Karema, Corine K.
Karimkhani, Chante
Karthikeyan, Ganesan
Kassebaum, Nicholas J.
Kaul, Anil
Kawakami, Norito
Kazanjan, Konstantin
Kemp, Andrew H.
Kengne, Andre P.
Keren, Andre
Khader, Yousef S.
Khalifa, Shams Eldin A.
Khan, Ejaz A.
Khan, Gulfaraz
Khang, Young-Ho
Kieling, Christian
Kim, Daniel
Kim, Sungroul
Kim, Yunjin
Kinfu, Yohannes
Kinge, Jonas M.
Kivipelto, Miia
Knibbs, Luke D.
Knudsen, Ann K.
Kokubo, Yoshihiro
Kosen, Soewarta
Krishnaswami, Sanjay
Kuate Defo, Barthelemy
Kucuk Bicer, Burcu
Kuipers, Ernst J.
Kulkarni, Chanda
Kulkarni, Veena S.
Kumar, G. Anil
Kyu, Hmwe H.
Lai, Taavi
Lalloo, Ratilal
Lallukka, Tea
Lam, Hilton
Lan, Qing
Lansingh, Van C.
Larsson, Anders
Lawrynowicz, Alicia E. B.
Leasher, Janet L.
Leigh, James
Leung, Ricky
Levitz, Carly E.
Li, Bin
Li, Yichong
Li, Yongmei
Lim, Stephen S.
Lind, Maggie
Lipshultz, Steven E.
Liu, Shiwei
Liu, Yang
Lloyd, Belinda K.
Lofgren, Katherine T.
Logroscino, Giancarlo
Looker, Katharine J.
Lortet-Tieulent, Joannie
Lotufo, Paulo A.
Lozano, Rafael
Lucas, Robyn M.
Lunevicius, Raimundas
Lyons, Ronan A.
Ma, Stefan
Macintyre, Michael F.
Mackay, Mark T.
Majdan, Marek
Malekzadeh, Reza
Marcenes, Wagner
Margolis, David J.
Margono, Christopher
Marzan, Melvin B.
Masci, Joseph R.
Mashal, Mohammad T.
Matzopoulos, Richard
Mayosi, Bongani M.
Mazorodze, Tasara T.
Mcgill, Neil W.
Mcgrath, John J.
Mckee, Martin
Mclain, Abigail
Meaney, Peter A.
Medina, Catalina
Mehndiratta, Man Mohan
Mekonnen, Wubegzier
Melaku, Yohannes A.
Meltzer, Michele
Memish, Ziad A.
Mensah, George A.
Meretoja, Atte
Mhimbira, Francis A.
Micha, Renata
Miller, Ted R.
Mills, Edward J.
Mitchell, Philip B.
Mock, Charles N.
Mohamed Ibrahim, Norlinah
Mohammad, Karzan A.
Mokdad, Ali H.
Mola, Glen L. D.
Monasta, Lorenzo
Montañez Hernandez, Julio C.
Montico, Marcella
Montine, Thomas J.
Mooney, Meghan D.
Moore, Ami R.
Moradi-Lakeh, Maziar
Moran, Andrew E.
Mori, Rintaro
Moschandreas, Joanna
Moturi, Wilkister N.
Moyer, Madeline L.
Mozaffarian, Dariush
Msemburi, William T.
Mueller, Ulrich O.
Mukaigawara, Mitsuru
Mullany, Erin C.
Murdoch, Michele E.
Murray, Joseph
Murthy, Kinnari S.
Naghavi, Mohsen
Naheed, Aliya
Naidoo, Kovin S.
Naldi, Luigi
Nand, Devina
Nangia, Vinay
Narayan, K. M. Venkat
Nejjari, Chakib
Neupane, Sudan P.
Newton, Charles R.
Ng, Marie
Ngalesoni, Frida N.
Nguyen, Grant
Nisar, Muhammad I.
Nolte, Sandra
Norheim, Ole F.
Norman, Rosana E.
Norrving, Bo
Nyakarahuka, Luke
Oh, In-Hwan
Ohkubo, Takayoshi
Ohno, Summer L.
Olusanya, Bolajoko O.
Opio, John Nelson
Ortblad, Katrina
Ortiz, Alberto
Pain, Amanda W.
Pandian, Jeyaraj D.
Panelo, Carlo Irwin A.
Papachristou, Christina
Park, Eun-Kee
Park, Jae-Hyun
Patten, Scott B.
Patton, George C.
Paul, Vinod K.
Pavlin, Boris I.
Pearce, Neil
Pereira, David M.
Perez-Padilla, Rogelio
Perez-Ruiz, Fernando
Perico, Norberto
Pervaiz, Aslam
Pesudovs, Konrad
Peterson, Carrie B.
Petzold, Max
Phillips, Michael R.
Phillips, Bryan K.
Phillips, David E.
Piel, Frédéric B.
Plass, Dietrich
Poenaru, Dan
Polinder, Suzanne
Pope, Daniel
Popova, Svetlana
Poulton, Richie G.
Pourmalek, Farshad
Prabhakaran, Dorairaj
Prasad, Noela M.
Pullan, Rachel L.
Qato, Dima M.
Quistberg, D. Alex
Rafay, Anwar
Rahimi, Kazem
Rahman, Sajjad U. R.
Raju, Murugesan
Rana, Saleem M.
Razavi, Homie
Reddy, K. Srinath
Refaat, Amany
Remuzzi, Giuseppe
Resnikoff, Serge
Ribeiro, Antonio L.
Richardson, Lee
Richardus, Jan H.
Roberts, D. Allen
Rojas-Rueda, David
Ronfani, Luca
Roth, Gregory A.
Rothenbacher, Dietrich
Rothstein, David H.
Rowley, Jane T.
Roy, Nobhojit
Ruhago, George M.
Saeedi, Mohammad Y.
Saha, Sukanta
Sahraian, Mohammad Ali
Sampson, Uchechukwu K. A.
Sanabria, Juan R.
Sandar, Logan
Santos, Itamar S.
Satpathy, Maheswar
Sawhney, Monika
Scarborough, Peter
Schneider, Ione J. C.
Schöttker, Ben
Schumacher, Austin E.
Schwebel, David C.
Scott, James G.
Seedat, Soraya
Sepanlou, Sadaf G.
Serina, Peter T.
Servan-Mori, Edson E.
Shackelford, Katya A.
Shaheen, Amira
Shahraz, Saeid
Shamah Levy, Teresa
Shangguan, Siyi
She, Jun
Sheikhbahaei, Sara
Shi, Peilin
Shibuya, Kenji
Shinohara, Yukito
Shiri, Rahman
Shishani, Kawkab
Shiue, Ivy
Shrime, Mark G.
Sigfusdottir, Inga D.
Silberberg, Donald H.
Simard, Edgar P.
Sindi, Shireen
Singh, Abhishek
Singh, Jasvinder A.
Singh, Lavanya
Skirbekk, Vegard
Slepak, Erica L.
Sliwa, Karen
Soneji, Samir
Søreide, Kjetil
Soshnikov, Sergey S.
Sposato, Luciano A.
Sreeramareddy, Chandrashekhar T.
Stanaway, Jeffrey D.
Stathopoulou, Vasiliki Kalliopi
Stein, Dan J.
Stein, Murray B.
Steiner, Caitlyn
Steiner, Timothy J.
Stevens, Antony
Stewart, Andrea
Stovner, Lars J.
Stroumpoulis, Konstantinos
Sunguya, Bruno F.
Swaminathan, Soumya
Swaroop, Mamta
Sykes, Bryan L.
Tabb, Karen M.
Takahashi, Ken
Tandon, Nikhil
Tanne, David
Tanner, Marcel
Tavakkoli, Mohammad
Taylor, Hugh R.
Te Ao, Braden J.
Tediosi, Fabrizio
Temesgen, Awoke M.
Templin, Tara
Ten Have, Margreet
Tenkorang, Eric Y.
Terkawi, Abdullah S.
Thomson, Blake
Thorne-Lyman, Andrew L.
Thrift, Amanda G.
Thurston, George D.
Tillmann, Taavi
Tonelli, Marcello
Topouzis, Fotis
Toyoshima, Hideaki
Traebert, Jefferson
Tran, Bach X.
Trillini, Matias
Truelsen, Thomas
Tsilimbaris, Miltiadis
Tuzcu, Emin M.
Uchendu, Uche S.
Ukwaja, Kingsley N.
Undurraga, Eduardo A.
Uzun, Selen B.
Van Brakel, Wim H.
Van De Vijver, Steven
van Gool, Coen H.
Van Os, Jim
Vasankari, Tommi J.
Venketasubramanian, N.
Violante, Francesco S.
Vlassov, Vasiliy V.
Vollset, Stein Emil
Wagner, Gregory R.
Wagner, Joseph
Waller, Stephen G.
Wan, Xia
Wang, Haidong
Wang, Jianli
Wang, Linhong
Warouw, Tati S.
Weichenthal, Scott
Weiderpass, Elisabete
Weintraub, Robert G.
Wenzhi, Wang
Werdecker, Andrea
Westerman, Ronny
Whiteford, Harvey A.
Wilkinson, James D.
Williams, Thomas N.
Wolfe, Charles D.
Wolock, Timothy M.
Woolf, Anthony D.
Wulf, Sarah
Wurtz, Brittany
Xu, Gelin
Yan, Lijing L.
Yano, Yuichiro
Ye, Pengpeng
Yentür, Gökalp K.
Yip, Paul
Yonemoto, Naohiro
Yoon, Seok-Jun
Younis, Mustafa Z.
Yu, Chuanhua
Zaki, Maysaa E. S.
Zhao, Yong
Zheng, Yingfeng
Zonies, David
Zou, Xiaonong
Salomon, Joshua A.
Lopez, Alan D.
Vos, Theo

Article Type

Regular

PMCID

PMC4673910

Continent/Country

Nonspecific

ORCiD

Templin - 0000-0003-4984-6472