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

DALYs, GBD 2015 and Collaborators, HALE and Kassebaum, N.J. and Arora, M. and Barber, R.M. and Brown, J. and Carter, A. and Casey, D.C. and Charlson, F.J. and Coates, M.M. and Coggeshall, M. and Cornaby, L. and Dandona, L. and Dicker, D.J. and Erskine, H.E. and Ferrari, A.J. and Fitzmaurice, C. and Foreman, K. and Forouzanfar, M.H. and Fullman, N. and Goldberg, E.M. and Graetz, N. and Haagsma, J.A. and Hay, S.I. and Johnson, C.O. and Kemmer, L. and Khalil, I.A. and Kinfu, Y. and Kutz, M.J. and Kyu, H.H. and Leung, J. and Lim, S.S. and Lozano, R. and Mikesell, J. and Mokdad, A.H. and Mooney, M.D. and Naghavi, M. and Nguyen, G. and Nsoesie, E. and Pigott, D.M. and Pinho, C. and Rankin, Z. and Reinig, N. and Sandar, L. and Smith, A. and Sorensen, R.J.D. and Stanaway, J. and Steiner, C. and Teeple, S. and Thomas, B.A. and Troeger, C. and VanderZanden, A. and Wagner, J.A. and Wanga, V. and Whiteford, H.A. and Zhou, M. and Zoeckler, L. and Achoki, T. and Afshin, A. and Alexander, L.T. and Allen, C. and Anderson, G.M. and Bell, B. and Bienhoff, K. and Biryukov, S. and Blore, J.D. and Estep, K. and Friedman, J. and Frostad, J. and Godwin, W.W. and Liu, P.Y. and Masiye, F. and Millear, A. and Mirarefin, M. and Moradi-Lakeh, M. and Mumford, J.E. and Ng, M. and Reitsma, M.B. and Reynolds, A. and Roth, G.A. and Sur, P.J. and Vollset, S.E. and Vos, T. and Lopez, A.D. and Murray, C.J.L. and Ellenbogen, R.G. and Mock, C.N. and Anderson, B.O. and Futran, N.D. and Bhutta, Z.A. and Nisar, M.I. and Akseer, N. and deVeber, G.A. and Abajobir, A.A. and Knibbs, L.D. and Lalloo, R. and Alam, N.K.M. and Gouda, H.N. and Guo, Y. and McGrath, J.J. and Jeemon, P. and Dandona, R. and Kumar, G.A. and Gething, P.W. and Bisanzio, D. and Ali, R. and Bennett, D.A. and Jha, V. and Rahimi, K. and Duan, L. and Jin, Y. and Li, Y. and Wang, L. and Ye, P. and Liang, X. and Mensah, G.A. and Salomon, J.A. and Thorne-Lyman, A.L. and Bärnighausen, T. and Campos-Nonato, I.R. and Ding, E.L. and Farvid, M.S. and Wagner, G.R. and Fitchett, J.R.A. and Abate, K.H. and Ahmed, M.B. and Gebrehiwot, T.T. and Gebremedhin, A.T. and Abbafati, C. and Abbas, K.M. and Abd-Allah, F. and Abraham, B. and Abubakar, I. and Banerjee, A. and Abu-Raddad, L.J. and Abu-Rmeileh, N.M. and Ackerman, I.N. and Buchbinder, R. and Gabbe, B. and Thrift, A.G. and Lloyd, B.K. and Adebiyi, A.O. and Adedeji, I.A. and Adsuar, J.C. and Afanvi, K.A. and Agardh, E.E. and Badawi, A. and Popova, S. and Agarwal, A. and Agarwal, S.K. and Roy, A. and Sagar, R. and Satpathy, M. and Tandon, N. and Ahmad Kiadaliri, A. and Norrving, B. and Ahmadieh, H. and Yaseri, M. and Katibeh, M. and Al-Aly, Z. and Alam, K. and Azzopardi, P. and Borschmann, R. and Colquhoun, S.M. and Patton, G.C. and Weintraub, R.G. and Meretoja, A. and Szoeke, C.E.I. and Taylor, H.R. and Wijeratne, T. and Driscoll, T.R. and Leigh, J. and Kemp, A.H. and Aldhahri, S.F. and Altirkawi, K.A. and Terkawi, A.S. and Alegretti, M.A. and Aleman, A.V. and Cavalleri, F. and Colistro, V. and Alemu, Z.A. and Tegegne, T.K. and Alkerwi, A. and Alla, F. and Allebeck, P. and Rabiee, R.H.S. and Carrero, J.J. and Fereshtehnejad, S.M. and Kivipelto, M. and Weiderpass, E. and Havmoeller, R. and Sindi, S. and Alsharif, U. and Alvarez, E. and Alvis-Guzman, N. and Amare, A.T. and Melaku, Y.A. and Ciobanu, L.G. and Tessema, G.A. and Amberbir, A. and Amegah, A.K. and Ameh, E.A. and Amini, H. and Fürst, T. and Karema, C.K. and Ammar, W. and Harb, H.L. and Amrock, S.M. and Zonies, D. and Antonio, C.A.T. and Anwari, P. and �rnlöv, J. and Larsson, A. and Arsic, V.S. and Barac, A. and Artaman, A. and Asayesh, H. and Asghar, R.J. and Avokpaho, E.F.G.A. and Gankpé, F.G. and Awasthi, A. and Ayala, B.P. and Bacha, U. and Balakrishnan, K. and Barker-Collo, S.L. and Mohammed, S. and Barregard, L. and Petzold, M. and Barrero, L.H. and Basu, S. and Del, L.C. and Bayou, T.A. and Betsu, B.D. and Hailu, G.B. and Tekle, D.Y. and Beardsley, J. and Bedi, N. and Beghi, E. and Sheth, K.N. and Bell, M.L. and Huang, J.J. and Benjet, C. and Gutiérrez, R.A. and Santos, I.S. and Bensenor, I.M. and Lotufo, P.A. and Berhane, A. and Wolfe, C.D. and Bernabé, E. and Hay, R.J. and Roba, H.S. and Beyene, A.S. and Hassen, T.A. and Mesfi, Y.M. and Bhala, N. and Bhansali, A. and Piel, F.B. and Steiner, T.J. and Bhatt, S. and Majeed, A. and Soljak, M. and Biadgilign, S. and Bikbov, B. and Bin, A.A. and Bjertness, E. and Bourne, R.R.A. and Brainin, M. and Brazinova, A. and Majdan, M. and Shen, J. and Breitborde, N.J.K. and Brenner, H. and Brugha, T.S. and Buckle, G.C. and Butt, Z.A. and Calabria, B. and Lucas, R.M. and Boufous, S. and Degenhardt, L. and Resnikoff, S. and Mitchell, P.B. and Campuzano, J.C. and Gomez-Dantes, H. and Heredia-Pi, I.B. and Jauregui, A. and Montañez Hernandez, J.C. and Servan-Mori, E.E. and Carabin, H. and Carapetis, J.R. and Cárdenas, R. and Castañeda-Orjuela, C.A. and Castillo Rivas, J. and Catalá-López, F. and Chang, J. and Chiang, P.P. and Chibalabala, M. and Chibueze, C.E. and Mori, R. and Chisumpa, V.H. and Choi, J.J. and Choudhury, L. and Christensen, H. and Colomar, M. and Crump, J.A. and Derrett, S. and Poulton, R.G. and Giussani, G. and Cortinovis, M. and Perico, N. and Remuzzi, G. and Damasceno, A. and Dargan, P.I. and das Neves, J. and Pedro, J.M. and Santos, J.V. and Davey, G. and Davis, A.C. and Newton, J.N. and Steel, N. and De Leo, D. and Des Jarlais, D.C. and Dharmaratne, S.D. and Dhillon, P.K. and Zodpey, S. and Doyle, K.E. and Dubey, M. and Rahman, M.H.U. and Ram, U. and Singh, A. and Yadav, A.K. and Duncan, B.B. and Kieling, C. and Schmidt, M.I. and Ebrahimi, H. and Esteghamati, A. and Farzadfar, F. and Hafezi-Nejad, N. and Kasaeian, A. and Parsaeian, M. and Pishgar, F. and Sheikhbahaei, S. and Fahimi, S. and Malekzadeh, R. and Roshandel, G. and Sepanlou, S.G. and Hassanvand, M.S. and Heydarpour, P. and Rahimi-Movaghar, V. and Elyazar, I. and Endries, A.Y. and Ermakov, S.P. and Eshrati, B. and Farid, T.A. and Khan, A.R. and Farinha, C.S.E.S. and Faro, A. and Feigin, V.L. and Te, B.J. and Fernandes, J.G. and Fernandes, J.C. and Fischer, F. and Foigt, N. and Fowkes, F.G.R. and Franklin, R.C. and Garcia-Basteiro, A.L. and Geleijnse, J.M. and Jibat, T. and Gibney, K.B. and Gillum, R.F. and Mehari, A. and Ginawi, I.A. and Hailu, A.D. and Giref, A.Z. and Haile, D. and Giroud, M. and Gishu, M.D. and Tura, A.K. and Gona, P. and Goodridge, A. and Gopalani, S.V. and Gotay, C.C. and Kissoon, N. and Kopec, J.A. and Pourmalek, F. and Goto, A. and Inoue, M. and Gugnani, H. and Gupta, R. and Gupta, R. and Gupta, V. and Knudsen, A.K. and Norheim, O.F. and Halasa, Y.A. and Undurraga, E.A. and Hamadeh, R.R. and Hamidi, S. and Hammami, M. and Handal, A.J. and Hankey, G.J. and Hankey, G.J. and Haro, J.M. and Hedayati, M.T. and Hoek, H.W. and Skirbekk, V. and Hoff, D.J. and Horino, M. and Horita, N. and Hosgood, H.D. and Hoy, D.G. and Hsairi, M. and Huang, H. and Iburg, K.M. and Idrisov, B.T. and Kwan, G.F. and Innos, K. and Kawakami, N. and Shibuya, K. and Jacobsen, K.H. and Jayatilleke, A.U. and Jiang, G. and Jiang, Y. and Jimenez-Corona, A. and Jonas, J.B. and Kabir, Z. and Kajungu, D.K. and Kalkonde, Y. and Kamal, R. and Kesavachandran, C.N. and She, J. and Kan, H. and Kandel, A. and Karch, A. and Karimkhani, C. and Kaul, A. and Kazi, D.S. and Keiyoro, P.N. and Lyons, R.A. and Kengne, A.P. and Matzopoulos, R. and Wiysonge, C.S. and Stein, D.J. and Mayosi, B.M. and Keren, A. and Khader, Y.S. and Khan, E.A. and Khang, Y.H. and Won, S. and Khoja, T.A.M. and Khubchandani, J. and Kim, C. and Kim, D. and Kim, Y.J. and Skogen, J.C. and Savic, M. and Kokubo, Y. and Kolte, D. and Koul, P.A. and Koyanagi, A. and Kuate, B. and Kuchenbecker, R.S. and Kucuk, B. and Kuipers, E.J. and Lallukka, T. and Shiri, R. and Meretoja, T.J. and Latif, A.A. and Lavados, P.M. and Lawrynowicz, A.E.B. and Leasher, J.L. and Leung, R. and Li, Y. and Lipshultz, S.E. and Wilkinson, J.D. and Simard, E.P. and Liu, Y. and Phillips, M.R. and Logroscino, G. and Looker, K.J. and Rai, D. and Lunevicius, R. and Magdy, H. and Mahdavi, M. and Malta, D.C. and Marcenes, W. and Martinez-Raga, J. and Mason-Jones, A.J. and McKee, M. and Murthy, G.V.S. and Meaney, P.A. and Memiah, P. and Memish, Z.A. and Mendoza, W. and Mhimbira, F.A. and Miller, T.R. and Mills, E.J. and Mirrakhimov, E.M. and Mohammad, K.A. and Mohammadi, A. and Monasta, L. and Montico, M. and Ronfani, L. and Werdecker, A. and Mueller, U.O. and Westerman, R. and Murdoch, M.E. and Nachega, J.B. and Seedat, S. and Tran, B.X. and Naheed, A. and Naldi, L. and Nangia, V. and Ngalesoni, F.N. and Nguyen, Q.L. and Nkamedjie, P.M. and Nolla, J.M. and Norman, R.E. and Obermeyer, C.M. and Ogbo, F.A. and Oh, I. and Oladimeji, O. and Sartorius, B. and Olivares, P.R. and Olusanya, B.O. and Olusanya, J.O. and Oren, E. and Ortiz, A. and Ota, E. and Schutte, A.E. and Oyekale, A.S. and Pa, M. and Park, E. and Patten, S.B. and Tonelli, M. and Pereira, D.M. and Pesudovs, K. and Pillay, J.D. and Plass, D. and Polinder, S. and Prasad, N.M. and Qorbani, M. and Radfar, A. and Rafay, A. and Rahman, M. and Rahman, S.U. and Rai, R.K. and Rajsic, S. and Raju, M. and Ranganathan, K. and Refaat, A.H. and Ribeiro, A.L. and Ricci, S. and Rojas-Rueda, D. and Sackey, B.B. and Sanabria, J.R. and Sanchez-Niño, M.D. and Sarmiento-Suarez, R. and Sawhney, M. and Schneider, I.J.C. and Silva, D.A.S. and Schwebel, D.C. and Singh, J.A. and Shahraz, S. and Shaikh, M.A. and Sharma, R. and Shigematsu, M. and Shin, M. and Yoon, S. and Sigfusdottir, I.D. and Silverberg, J.I. and Yano, Y. and Singh, P.K. and Søreide, K. and Sreeramareddy, C.T. and Stathopoulou, V. and Stein, M.B. and Stovner, L.J. and Stranges, S. and Stroumpoulis, K. and Sunguya, B.F. and Swaminathan, S. and Sykes, B.L. and Tabarés-Seisdedos, R. and Tanne, D. and Tavakkoli, M. and Taye, B. and Tuzcu, E.M. and Thakur, J. and Thomson, A.J. and Thurston, G.D. and Tobe-Gai, R. and Topor-Madry, R. and Topouzis, F. and Truelsen, T. and Tsala, Z. and Tsilimbaris, M. and Tyrovolas, S. and Ukwaja, K.N. and Uneke, C.J. and Uthman, O.A. and van Gool, C.H. and van Os, J. and Vasankari, T. and Vasconcelos, A.M.N. and Venketasubramanian, N. and Violante, F.S. and Vlassov, V.V. and Wallin, M.T. and Weichenthal, S. and Williams, H.C. and Woldeyohannes, S.M. and Xu, G. and Yakob, B. and Yan, L.L. and Yip, P. and Yonemoto, N. and Younis, M.Z. and Yu, C. and Zaidi, Z. and Zaki, M.E. and Zeeb, H. and Zuhlke, L.J. 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. This online publication has been corrected.

Preview

Text Global-regional-and-national-disabilityadjusted-lifeyears-DALYs-for-315-diseases-and-injuries-and-healthy-life-expectancy-HALE-19902015-a-systematic-analysis-for-the-Global-Burden-of-Disease-Study-20152016The-Lanc.pdf Download (7MB) | Preview

Abstract

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. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license

Actions (login required)

View Item