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Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Christopher J L Murray, Theo Vos, Rafael Lozano, Mohsen Naghavi, Abraham D Flaxman, Catherine Michaud, Majid Ezzati, Kenji Shibuya, Joshua A Salomon, Safa Abdalla, Victor Aboyans, Jerry Abraham, Ilana Ackerman, Rakesh Aggarwal, Stephanie Y Ahn, Mohammed K Ali, Miriam Alvarado, H Ross Anderson, Laurie M Anderson, Kathryn G Andrews, Charles Atkinson, Larry M Baddour, Adil N Bahalim, Suzanne Barker-Collo, Lope H Barrero, David H Bartels, Maria-Gloria Basáñez, Amanda Baxter, Michelle L Bell, Emelia J Benjamin, Derrick Bennett, Eduardo Bernabé, Kavi Bhalla, Bishal Bhandari, Boris Bikbov, Aref Bin Abdulhak, Gretchen Birbeck, James A Black, Hannah Blencowe, Jed D Blore, Fiona Blyth, Ian Bolliger, Audrey Bonaventure, Soufiane Boufous, Rupert Bourne, Michel Boussinesq, Tasanee Braithwaite, Carol Brayne, Lisa Bridgett, Simon Brooker, Peter Brooks, Traolach S Brugha, Claire Bryan-Hancock, Chiara Bucello, Rachelle Buchbinder, Geoffrey Buckle, Christine M Budke, Michael Burch, Peter Burney, Roy Burstein, Bianca Calabria, Benjamin Campbell, Charles E Canter, Hélène Carabin, Jonathan Carapetis, Loreto Carmona, Claudia Cella, Fiona Charlson, Honglei Chen, Andrew Tai-Ann Cheng, David Chou, Sumeet S Chugh, Luc E Coffeng, Steven D Colan, Samantha Colquhoun, K Ellicott Colson, John Condon, Myles D Connor, Leslie T Cooper, Matthew Corriere, Monica Cortinovis, Karen Courville de Vaccaro, William Couser, Benjamin C Cowie, Michael H Criqui, Marita Cross, Kaustubh C Dabhadkar, Manu Dahiya, Nabila Dahodwala, James Damsere-Derry, Goodarz Danaei, Adrian Davis, Diego De Leo, Louisa Degenhardt, Robert Dellavalle, Allyne Delossantos, Julie Denenberg, Sarah Derrett, Don C Des Jarlais, Samath D Dharmaratne, Mukesh Dherani, Cesar Diaz-Torne, Helen Dolk, E Ray Dorsey, Tim Driscoll, Herbert Duber, Beth Ebel, Karen Edmond, Alexis Elbaz, Suad Eltahir Ali, Holly Erskine, Patricia J Erwin, Patricia Espindola, Stalin E Ewoigbokhan, Farshad Farzadfar, Valery Feigin, David T Felson, Alize Ferrari, Cleusa P Ferri, Eric M Fèvre, Mariel M Finucane, Seth Flaxman, Louise Flood, Kyle Foreman, Mohammad H Forouzanfar, Francis Gerry R Fowkes, Marlene Fransen, Michael K Freeman, Belinda Gabbe Orcid Logo, Sherine E Gabriel, Emmanuela Gakidou, Hammad A Ganatra, Bianca Garcia, Flavio Gaspari, Richard F Gillum, Gerhard Gmel, Diego Gonzalez-Medina, Richard Gosselin, Rebecca Grainger, Justina Groeger, Francis Guillemin, David Gunnell, Ramyani Gupta, Juanita Haagsma, Holly Hagan, Yara A Halasa, Wayne Hall, Diana Haring, Josep Maria Haro, James E Harrison, Rasmus Havmoeller, Roderick J Hay, Hideki Higashi, Catherine Hill, Bruno Hoen, Howard Hoffman, Peter J Hotez, Damian Hoy, John J Huang, Sydney E Ibeanusi, Kathryn H Jacobsen, Spencer L James, Deborah Jarvis, Rashmi Jasrasaria, Sudha Jayaraman, Nicole Johns, Jost B Jonas, Ganesan Karthikeyan, Nicholas Kassebaum, Norito Kawakami, Andre Keren, Jon-Paul Khoo, Charles H King, Lisa Marie Knowlton, Olive Kobusingye, Adofo Koranteng, Rita Krishnamurthi, Francine Laden, Ratilal Lalloo, Laura L Laslett, Tim Lathlean, Janet L Leasher, Yong Yi Lee, James Leigh, Daphna Levinson, Stephen S Lim, Elizabeth Limb, John Kent Lin, Michael Lipnick, Steven E Lipshultz, Wei Liu, Maria Loane, Summer Lockett Ohno, Ronan Lyons Orcid Logo, Jacqueline Mabweijano, Michael F MacIntyre, Reza Malekzadeh, Leslie Mallinger, Sivabalan Manivannan, Wagner Marcenes, Lyn March, David J Margolis, Guy B Marks, Robin Marks, Akira Matsumori, Richard Matzopoulos, Bongani M Mayosi, John H McAnulty, Mary M McDermott, Neil McGill, John McGrath, Maria Elena Medina-Mora, Michele Meltzer, George A Mensah, Tony R Merriman, Ana-Claire Meyer, Valeria Miglioli, Matthew Miller, Ted R Miller, Philip B Mitchell, Charles Mock, Ana Olga Mocumbi, Terrie E Moffitt, Ali A Mokdad, Lorenzo Monasta, Marcella Montico, Maziar Moradi-Lakeh, Andrew Moran, Lidia Morawska, Rintaro Mori, Michele E Murdoch, Michael K Mwaniki, Kovin Naidoo, M Nathan Nair, Luigi Naldi, K M Venkat Narayan, Paul K Nelson, Robert G Nelson, Michael C Nevitt, Charles R Newton, Sandra Nolte, Paul Norman, Rosana Norman, Martin O'Donnell, Simon O'Hanlon, Casey Olives, Saad B Omer, Katrina Ortblad, Richard Osborne, Doruk Ozgediz, Andrew Page, Bishnu Pahari, Jeyaraj Durai Pandian, Andrea Panozo Rivero, Scott B Patten, Neil Pearce, Rogelio Perez Padilla, Fernando Perez-Ruiz, Norberto Perico, Konrad Pesudovs, David Phillips, Michael R Phillips, Kelsey Pierce, Sébastien Pion, Guilherme V Polanczyk, Suzanne Polinder, C Arden Pope, Svetlana Popova, Esteban Porrini, Farshad Pourmalek, Martin Prince, Rachel L Pullan, Kapa D Ramaiah, Dharani Ranganathan, Homie Razavi, Mathilda Regan, Jürgen T Rehm, David B Rein, Guiseppe Remuzzi, Kathryn Richardson, Frederick P Rivara, Thomas Roberts, Carolyn Robinson, Felipe Rodriguez De Leòn, Luca Ronfani, Robin Room, Lisa C Rosenfeld, Lesley Rushton, Ralph L Sacco, Sukanta Saha, Uchechukwu Sampson, Lidia Sanchez-Riera, Ella Sanman, David C Schwebel, James Graham Scott, Maria Segui-Gomez, Saeid Shahraz, Donald S Shepard, Hwashin Shin, Rupak Shivakoti, David Singh, Gitanjali M Singh, Jasvinder A Singh, Jessica Singleton, David A Sleet, Karen Sliwa, Emma Smith, Jennifer L Smith, Nicolas JC Stapelberg, Andrew Steer, Timothy Steiner, Wilma A Stolk, Lars Jacob Stovner, Christopher Sudfeld, Sana Syed, Giorgio Tamburlini, Mohammad Tavakkoli, Hugh R Taylor, Jennifer A Taylor, William J Taylor, Bernadette Thomas, W Murray Thomson, George D Thurston, Imad M Tleyjeh, Marcello Tonelli, Jeffrey A Towbin, Thomas Truelsen, Miltiadis K Tsilimbaris, Clotilde Ubeda, Eduardo A Undurraga, Marieke J van der Werf, Os Jim van, Monica S Vavilala, N Venketasubramanian, Mengru Wang, Wenzhi Wang, Kerrianne Watt, David J Weatherall, Martin A Weinstock, Robert Weintraub, Marc G Weisskopf, Myrna M Weissman, Richard A White, Harvey Whiteford, Natasha Wiebe, Steven T Wiersma, James D Wilkinson, Hywel C Williams, Sean RM Williams, Emma Witt, Frederick Wolfe, Anthony D Woolf, Sarah Wulf, Pon-Hsiu Yeh, Anita KM Zaidi, Zhi-Jie Zheng, David Zonies, Alan D Lopez, Bridget Grant

The Lancet, Volume: 380, Issue: 9859, Pages: 2197 - 2223

Swansea University Authors: Belinda Gabbe Orcid Logo, Ronan Lyons Orcid Logo

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Abstract

Background Measuring disease and injury burden in populations requires a composite metric that captures bothpremature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposeddisability-adjusted life years (DALYs) to measure disease burden. No comprehe...

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Published in: The Lancet
ISSN: 0140-6736
Published: 2012
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa13940
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2020-07-20T15:06:55.6672481</datestamp><bib-version>v2</bib-version><id>13940</id><entry>2013-01-21</entry><title>Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990&#x2013;2010: a systematic analysis for the Global Burden of Disease Study 2010</title><swanseaauthors><author><sid>4bdcc94332b2bd10530c5e71ceb04f14</sid><ORCID>0000-0001-7096-7688</ORCID><firstname>Belinda</firstname><surname>Gabbe</surname><name>Belinda Gabbe</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>83efcf2a9dfcf8b55586999d3d152ac6</sid><ORCID>0000-0001-5225-000X</ORCID><firstname>Ronan</firstname><surname>Lyons</surname><name>Ronan Lyons</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2013-01-21</date><deptcode>FGMHL</deptcode><abstract>Background Measuring disease and injury burden in populations requires a composite metric that captures bothpremature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposeddisability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burdenworldwide incorporating a systematic reassessment of disease and injury-specifi c epidemiology has been donesince the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and2010 with methods to enable meaningful comparisons over time.Methods We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYswere calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional andglobal estimates of disease burden for three points in time with strictly comparable defi nitions and methods. YLLswere calculated from age-sex-country-time-specifi c estimates of mortality by cause, with death by standardised lost life expectancy at each age. YLDs were calculated as prevalence of 1160 disabling sequelae, by age, sex, and cause, andweighted by new disability weights for each health state. Neither YLLs nor YLDs were age-weighted or discounted.Uncertainty around cause-specifi c DALYs was calculated incorporating uncertainty in levels of all-cause mortality,cause-specifi c mortality, prevalence, and disability weights.Findings Global DALYs remained stable from 1990 (2&#xB7;503 billion) to 2010 (2&#xB7;490 billion). Crude DALYs per 1000 decreasedby 23% (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution ofdeaths and disability among children (younger than 5 years of age) declining from 41% of global DALYs in 1990 to 25%in 2010. YLLs typically account for about half of disease burden in more developed regions (high-income Asia Pacifi c,western Europe, high-income North America, and Australasia), rising to over 80% of DALYs in sub-Saharan Africa. In1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% fromnon-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively.Ischaemic heart disease was the leading cause of DALYs worldwide in 2010 (up from fourth rank in 1990, increasing by29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs), stroke (fi fth in 1990; 19%increase), diarrhoeal diseases (second in 1990; 51% decrease), and HIV/AIDS (33rd in 1990; 351% increase). Majordepressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34%increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions.Interpretation Global disease burden has continued to shift away from communicable to non-communicable diseasesand from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable,maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden frommental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on healthsystems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goalsand targets for the post-2015 agenda taking such patterns into account. Because of improved defi nitions, methods,and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results.</abstract><type>Journal Article</type><journal>The Lancet</journal><volume>380</volume><journalNumber>9859</journalNumber><paginationStart>2197</paginationStart><paginationEnd>2223</paginationEnd><publisher/><issnPrint>0140-6736</issnPrint><keywords/><publishedDay>15</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2012</publishedYear><publishedDate>2012-12-15</publishedDate><doi>10.1016/S0140-6736(12)61689-4</doi><url/><notes/><college>COLLEGE NANME</college><department>Medicine, Health and Life Science - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGMHL</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2020-07-20T15:06:55.6672481</lastEdited><Created>2013-01-21T11:18:51.3463263</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Christopher J L</firstname><surname>Murray</surname><order>1</order></author><author><firstname>Theo</firstname><surname>Vos</surname><order>2</order></author><author><firstname>Rafael</firstname><surname>Lozano</surname><order>3</order></author><author><firstname>Mohsen</firstname><surname>Naghavi</surname><order>4</order></author><author><firstname>Abraham D</firstname><surname>Flaxman</surname><order>5</order></author><author><firstname>Catherine</firstname><surname>Michaud</surname><order>6</order></author><author><firstname>Majid</firstname><surname>Ezzati</surname><order>7</order></author><author><firstname>Kenji</firstname><surname>Shibuya</surname><order>8</order></author><author><firstname>Joshua A</firstname><surname>Salomon</surname><order>9</order></author><author><firstname>Safa</firstname><surname>Abdalla</surname><order>10</order></author><author><firstname>Victor</firstname><surname>Aboyans</surname><order>11</order></author><author><firstname>Jerry</firstname><surname>Abraham</surname><order>12</order></author><author><firstname>Ilana</firstname><surname>Ackerman</surname><order>13</order></author><author><firstname>Rakesh</firstname><surname>Aggarwal</surname><order>14</order></author><author><firstname>Stephanie Y</firstname><surname>Ahn</surname><order>15</order></author><author><firstname>Mohammed K</firstname><surname>Ali</surname><order>16</order></author><author><firstname>Miriam</firstname><surname>Alvarado</surname><order>17</order></author><author><firstname>H Ross</firstname><surname>Anderson</surname><order>18</order></author><author><firstname>Laurie M</firstname><surname>Anderson</surname><order>19</order></author><author><firstname>Kathryn 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spelling 2020-07-20T15:06:55.6672481 v2 13940 2013-01-21 Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010 4bdcc94332b2bd10530c5e71ceb04f14 0000-0001-7096-7688 Belinda Gabbe Belinda Gabbe true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 2013-01-21 FGMHL Background Measuring disease and injury burden in populations requires a composite metric that captures bothpremature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposeddisability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burdenworldwide incorporating a systematic reassessment of disease and injury-specifi c epidemiology has been donesince the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and2010 with methods to enable meaningful comparisons over time.Methods We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYswere calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional andglobal estimates of disease burden for three points in time with strictly comparable defi nitions and methods. YLLswere calculated from age-sex-country-time-specifi c estimates of mortality by cause, with death by standardised lost life expectancy at each age. YLDs were calculated as prevalence of 1160 disabling sequelae, by age, sex, and cause, andweighted by new disability weights for each health state. Neither YLLs nor YLDs were age-weighted or discounted.Uncertainty around cause-specifi c DALYs was calculated incorporating uncertainty in levels of all-cause mortality,cause-specifi c mortality, prevalence, and disability weights.Findings Global DALYs remained stable from 1990 (2·503 billion) to 2010 (2·490 billion). Crude DALYs per 1000 decreasedby 23% (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution ofdeaths and disability among children (younger than 5 years of age) declining from 41% of global DALYs in 1990 to 25%in 2010. YLLs typically account for about half of disease burden in more developed regions (high-income Asia Pacifi c,western Europe, high-income North America, and Australasia), rising to over 80% of DALYs in sub-Saharan Africa. In1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% fromnon-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively.Ischaemic heart disease was the leading cause of DALYs worldwide in 2010 (up from fourth rank in 1990, increasing by29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs), stroke (fi fth in 1990; 19%increase), diarrhoeal diseases (second in 1990; 51% decrease), and HIV/AIDS (33rd in 1990; 351% increase). Majordepressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34%increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions.Interpretation Global disease burden has continued to shift away from communicable to non-communicable diseasesand from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable,maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden frommental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on healthsystems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goalsand targets for the post-2015 agenda taking such patterns into account. Because of improved defi nitions, methods,and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results. Journal Article The Lancet 380 9859 2197 2223 0140-6736 15 12 2012 2012-12-15 10.1016/S0140-6736(12)61689-4 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2020-07-20T15:06:55.6672481 2013-01-21T11:18:51.3463263 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Christopher J L Murray 1 Theo Vos 2 Rafael Lozano 3 Mohsen Naghavi 4 Abraham D Flaxman 5 Catherine Michaud 6 Majid Ezzati 7 Kenji Shibuya 8 Joshua A Salomon 9 Safa Abdalla 10 Victor Aboyans 11 Jerry Abraham 12 Ilana Ackerman 13 Rakesh Aggarwal 14 Stephanie Y Ahn 15 Mohammed K Ali 16 Miriam Alvarado 17 H Ross Anderson 18 Laurie M Anderson 19 Kathryn G Andrews 20 Charles Atkinson 21 Larry M Baddour 22 Adil N Bahalim 23 Suzanne Barker-Collo 24 Lope H Barrero 25 David H Bartels 26 Maria-Gloria Basáñez 27 Amanda Baxter 28 Michelle L Bell 29 Emelia J Benjamin 30 Derrick Bennett 31 Eduardo Bernabé 32 Kavi Bhalla 33 Bishal Bhandari 34 Boris Bikbov 35 Aref Bin Abdulhak 36 Gretchen Birbeck 37 James A Black 38 Hannah Blencowe 39 Jed D Blore 40 Fiona Blyth 41 Ian Bolliger 42 Audrey Bonaventure 43 Soufiane Boufous 44 Rupert Bourne 45 Michel Boussinesq 46 Tasanee Braithwaite 47 Carol Brayne 48 Lisa Bridgett 49 Simon Brooker 50 Peter Brooks 51 Traolach S Brugha 52 Claire Bryan-Hancock 53 Chiara Bucello 54 Rachelle Buchbinder 55 Geoffrey Buckle 56 Christine M Budke 57 Michael Burch 58 Peter Burney 59 Roy Burstein 60 Bianca Calabria 61 Benjamin Campbell 62 Charles E Canter 63 Hélène Carabin 64 Jonathan Carapetis 65 Loreto Carmona 66 Claudia Cella 67 Fiona Charlson 68 Honglei Chen 69 Andrew Tai-Ann Cheng 70 David Chou 71 Sumeet S Chugh 72 Luc E Coffeng 73 Steven D Colan 74 Samantha Colquhoun 75 K Ellicott Colson 76 John Condon 77 Myles D Connor 78 Leslie T Cooper 79 Matthew Corriere 80 Monica Cortinovis 81 Karen Courville de Vaccaro 82 William Couser 83 Benjamin C Cowie 84 Michael H Criqui 85 Marita Cross 86 Kaustubh C Dabhadkar 87 Manu Dahiya 88 Nabila Dahodwala 89 James Damsere-Derry 90 Goodarz Danaei 91 Adrian Davis 92 Diego De Leo 93 Louisa Degenhardt 94 Robert Dellavalle 95 Allyne Delossantos 96 Julie Denenberg 97 Sarah Derrett 98 Don C Des Jarlais 99 Samath D Dharmaratne 100 Mukesh Dherani 101 Cesar Diaz-Torne 102 Helen Dolk 103 E Ray Dorsey 104 Tim Driscoll 105 Herbert Duber 106 Beth Ebel 107 Karen Edmond 108 Alexis Elbaz 109 Suad Eltahir Ali 110 Holly Erskine 111 Patricia J Erwin 112 Patricia Espindola 113 Stalin E Ewoigbokhan 114 Farshad Farzadfar 115 Valery Feigin 116 David T Felson 117 Alize Ferrari 118 Cleusa P Ferri 119 Eric M Fèvre 120 Mariel M Finucane 121 Seth Flaxman 122 Louise Flood 123 Kyle Foreman 124 Mohammad H Forouzanfar 125 Francis Gerry R Fowkes 126 Marlene Fransen 127 Michael K Freeman 128 Belinda Gabbe 0000-0001-7096-7688 129 Sherine E Gabriel 130 Emmanuela Gakidou 131 Hammad A Ganatra 132 Bianca Garcia 133 Flavio Gaspari 134 Richard F Gillum 135 Gerhard Gmel 136 Diego Gonzalez-Medina 137 Richard Gosselin 138 Rebecca Grainger 139 Justina Groeger 140 Francis Guillemin 141 David Gunnell 142 Ramyani Gupta 143 Juanita Haagsma 144 Holly Hagan 145 Yara A Halasa 146 Wayne Hall 147 Diana Haring 148 Josep Maria Haro 149 James E Harrison 150 Rasmus Havmoeller 151 Roderick J Hay 152 Hideki Higashi 153 Catherine Hill 154 Bruno Hoen 155 Howard Hoffman 156 Peter J Hotez 157 Damian Hoy 158 John J Huang 159 Sydney E Ibeanusi 160 Kathryn H Jacobsen 161 Spencer L James 162 Deborah Jarvis 163 Rashmi Jasrasaria 164 Sudha Jayaraman 165 Nicole Johns 166 Jost B Jonas 167 Ganesan Karthikeyan 168 Nicholas Kassebaum 169 Norito Kawakami 170 Andre Keren 171 Jon-Paul Khoo 172 Charles H King 173 Lisa Marie Knowlton 174 Olive Kobusingye 175 Adofo Koranteng 176 Rita Krishnamurthi 177 Francine Laden 178 Ratilal Lalloo 179 Laura L Laslett 180 Tim Lathlean 181 Janet L Leasher 182 Yong Yi Lee 183 James Leigh 184 Daphna Levinson 185 Stephen S Lim 186 Elizabeth Limb 187 John Kent Lin 188 Michael Lipnick 189 Steven E Lipshultz 190 Wei Liu 191 Maria Loane 192 Summer Lockett Ohno 193 Ronan Lyons 0000-0001-5225-000X 194 Jacqueline Mabweijano 195 Michael F MacIntyre 196 Reza Malekzadeh 197 Leslie Mallinger 198 Sivabalan Manivannan 199 Wagner Marcenes 200 Lyn March 201 David J Margolis 202 Guy B Marks 203 Robin Marks 204 Akira Matsumori 205 Richard Matzopoulos 206 Bongani M Mayosi 207 John H McAnulty 208 Mary M McDermott 209 Neil McGill 210 John McGrath 211 Maria Elena Medina-Mora 212 Michele Meltzer 213 George A Mensah 214 Tony R Merriman 215 Ana-Claire Meyer 216 Valeria Miglioli 217 Matthew Miller 218 Ted R Miller 219 Philip B Mitchell 220 Charles Mock 221 Ana Olga Mocumbi 222 Terrie E Moffitt 223 Ali A Mokdad 224 Lorenzo Monasta 225 Marcella Montico 226 Maziar Moradi-Lakeh 227 Andrew Moran 228 Lidia Morawska 229 Rintaro Mori 230 Michele E Murdoch 231 Michael K Mwaniki 232 Kovin Naidoo 233 M Nathan Nair 234 Luigi Naldi 235 K M Venkat Narayan 236 Paul K Nelson 237 Robert G Nelson 238 Michael C Nevitt 239 Charles R Newton 240 Sandra Nolte 241 Paul Norman 242 Rosana Norman 243 Martin O'Donnell 244 Simon O'Hanlon 245 Casey Olives 246 Saad B Omer 247 Katrina Ortblad 248 Richard Osborne 249 Doruk Ozgediz 250 Andrew Page 251 Bishnu Pahari 252 Jeyaraj Durai Pandian 253 Andrea Panozo Rivero 254 Scott B Patten 255 Neil Pearce 256 Rogelio Perez Padilla 257 Fernando Perez-Ruiz 258 Norberto Perico 259 Konrad Pesudovs 260 David Phillips 261 Michael R Phillips 262 Kelsey Pierce 263 Sébastien Pion 264 Guilherme V Polanczyk 265 Suzanne Polinder 266 C Arden Pope 267 Svetlana Popova 268 Esteban Porrini 269 Farshad Pourmalek 270 Martin Prince 271 Rachel L Pullan 272 Kapa D Ramaiah 273 Dharani Ranganathan 274 Homie Razavi 275 Mathilda Regan 276 Jürgen T Rehm 277 David B Rein 278 Guiseppe Remuzzi 279 Kathryn Richardson 280 Frederick P Rivara 281 Thomas Roberts 282 Carolyn Robinson 283 Felipe Rodriguez De Leòn 284 Luca Ronfani 285 Robin Room 286 Lisa C Rosenfeld 287 Lesley Rushton 288 Ralph L Sacco 289 Sukanta Saha 290 Uchechukwu Sampson 291 Lidia Sanchez-Riera 292 Ella Sanman 293 David C Schwebel 294 James Graham Scott 295 Maria Segui-Gomez 296 Saeid Shahraz 297 Donald S Shepard 298 Hwashin Shin 299 Rupak Shivakoti 300 David Singh 301 Gitanjali M Singh 302 Jasvinder A Singh 303 Jessica Singleton 304 David A Sleet 305 Karen Sliwa 306 Emma Smith 307 Jennifer L Smith 308 Nicolas JC Stapelberg 309 Andrew Steer 310 Timothy Steiner 311 Wilma A Stolk 312 Lars Jacob Stovner 313 Christopher Sudfeld 314 Sana Syed 315 Giorgio Tamburlini 316 Mohammad Tavakkoli 317 Hugh R Taylor 318 Jennifer A Taylor 319 William J Taylor 320 Bernadette Thomas 321 W Murray Thomson 322 George D Thurston 323 Imad M Tleyjeh 324 Marcello Tonelli 325 Jeffrey A Towbin 326 Thomas Truelsen 327 Miltiadis K Tsilimbaris 328 Clotilde Ubeda 329 Eduardo A Undurraga 330 Marieke J van der Werf 331 Os Jim van 332 Monica S Vavilala 333 N Venketasubramanian 334 Mengru Wang 335 Wenzhi Wang 336 Kerrianne Watt 337 David J Weatherall 338 Martin A Weinstock 339 Robert Weintraub 340 Marc G Weisskopf 341 Myrna M Weissman 342 Richard A White 343 Harvey Whiteford 344 Natasha Wiebe 345 Steven T Wiersma 346 James D Wilkinson 347 Hywel C Williams 348 Sean RM Williams 349 Emma Witt 350 Frederick Wolfe 351 Anthony D Woolf 352 Sarah Wulf 353 Pon-Hsiu Yeh 354 Anita KM Zaidi 355 Zhi-Jie Zheng 356 David Zonies 357 Alan D Lopez 358 Bridget Grant 359
title Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010
spellingShingle Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010
Belinda Gabbe
Ronan Lyons
title_short Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010
title_full Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010
title_fullStr Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010
title_full_unstemmed Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010
title_sort Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010
author_id_str_mv 4bdcc94332b2bd10530c5e71ceb04f14
83efcf2a9dfcf8b55586999d3d152ac6
author_id_fullname_str_mv 4bdcc94332b2bd10530c5e71ceb04f14_***_Belinda Gabbe
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
author Belinda Gabbe
Ronan Lyons
author2 Christopher J L Murray
Theo Vos
Rafael Lozano
Mohsen Naghavi
Abraham D Flaxman
Catherine Michaud
Majid Ezzati
Kenji Shibuya
Joshua A Salomon
Safa Abdalla
Victor Aboyans
Jerry Abraham
Ilana Ackerman
Rakesh Aggarwal
Stephanie Y Ahn
Mohammed K Ali
Miriam Alvarado
H Ross Anderson
Laurie M Anderson
Kathryn G Andrews
Charles Atkinson
Larry M Baddour
Adil N Bahalim
Suzanne Barker-Collo
Lope H Barrero
David H Bartels
Maria-Gloria Basáñez
Amanda Baxter
Michelle L Bell
Emelia J Benjamin
Derrick Bennett
Eduardo Bernabé
Kavi Bhalla
Bishal Bhandari
Boris Bikbov
Aref Bin Abdulhak
Gretchen Birbeck
James A Black
Hannah Blencowe
Jed D Blore
Fiona Blyth
Ian Bolliger
Audrey Bonaventure
Soufiane Boufous
Rupert Bourne
Michel Boussinesq
Tasanee Braithwaite
Carol Brayne
Lisa Bridgett
Simon Brooker
Peter Brooks
Traolach S Brugha
Claire Bryan-Hancock
Chiara Bucello
Rachelle Buchbinder
Geoffrey Buckle
Christine M Budke
Michael Burch
Peter Burney
Roy Burstein
Bianca Calabria
Benjamin Campbell
Charles E Canter
Hélène Carabin
Jonathan Carapetis
Loreto Carmona
Claudia Cella
Fiona Charlson
Honglei Chen
Andrew Tai-Ann Cheng
David Chou
Sumeet S Chugh
Luc E Coffeng
Steven D Colan
Samantha Colquhoun
K Ellicott Colson
John Condon
Myles D Connor
Leslie T Cooper
Matthew Corriere
Monica Cortinovis
Karen Courville de Vaccaro
William Couser
Benjamin C Cowie
Michael H Criqui
Marita Cross
Kaustubh C Dabhadkar
Manu Dahiya
Nabila Dahodwala
James Damsere-Derry
Goodarz Danaei
Adrian Davis
Diego De Leo
Louisa Degenhardt
Robert Dellavalle
Allyne Delossantos
Julie Denenberg
Sarah Derrett
Don C Des Jarlais
Samath D Dharmaratne
Mukesh Dherani
Cesar Diaz-Torne
Helen Dolk
E Ray Dorsey
Tim Driscoll
Herbert Duber
Beth Ebel
Karen Edmond
Alexis Elbaz
Suad Eltahir Ali
Holly Erskine
Patricia J Erwin
Patricia Espindola
Stalin E Ewoigbokhan
Farshad Farzadfar
Valery Feigin
David T Felson
Alize Ferrari
Cleusa P Ferri
Eric M Fèvre
Mariel M Finucane
Seth Flaxman
Louise Flood
Kyle Foreman
Mohammad H Forouzanfar
Francis Gerry R Fowkes
Marlene Fransen
Michael K Freeman
Belinda Gabbe
Sherine E Gabriel
Emmanuela Gakidou
Hammad A Ganatra
Bianca Garcia
Flavio Gaspari
Richard F Gillum
Gerhard Gmel
Diego Gonzalez-Medina
Richard Gosselin
Rebecca Grainger
Justina Groeger
Francis Guillemin
David Gunnell
Ramyani Gupta
Juanita Haagsma
Holly Hagan
Yara A Halasa
Wayne Hall
Diana Haring
Josep Maria Haro
James E Harrison
Rasmus Havmoeller
Roderick J Hay
Hideki Higashi
Catherine Hill
Bruno Hoen
Howard Hoffman
Peter J Hotez
Damian Hoy
John J Huang
Sydney E Ibeanusi
Kathryn H Jacobsen
Spencer L James
Deborah Jarvis
Rashmi Jasrasaria
Sudha Jayaraman
Nicole Johns
Jost B Jonas
Ganesan Karthikeyan
Nicholas Kassebaum
Norito Kawakami
Andre Keren
Jon-Paul Khoo
Charles H King
Lisa Marie Knowlton
Olive Kobusingye
Adofo Koranteng
Rita Krishnamurthi
Francine Laden
Ratilal Lalloo
Laura L Laslett
Tim Lathlean
Janet L Leasher
Yong Yi Lee
James Leigh
Daphna Levinson
Stephen S Lim
Elizabeth Limb
John Kent Lin
Michael Lipnick
Steven E Lipshultz
Wei Liu
Maria Loane
Summer Lockett Ohno
Ronan Lyons
Jacqueline Mabweijano
Michael F MacIntyre
Reza Malekzadeh
Leslie Mallinger
Sivabalan Manivannan
Wagner Marcenes
Lyn March
David J Margolis
Guy B Marks
Robin Marks
Akira Matsumori
Richard Matzopoulos
Bongani M Mayosi
John H McAnulty
Mary M McDermott
Neil McGill
John McGrath
Maria Elena Medina-Mora
Michele Meltzer
George A Mensah
Tony R Merriman
Ana-Claire Meyer
Valeria Miglioli
Matthew Miller
Ted R Miller
Philip B Mitchell
Charles Mock
Ana Olga Mocumbi
Terrie E Moffitt
Ali A Mokdad
Lorenzo Monasta
Marcella Montico
Maziar Moradi-Lakeh
Andrew Moran
Lidia Morawska
Rintaro Mori
Michele E Murdoch
Michael K Mwaniki
Kovin Naidoo
M Nathan Nair
Luigi Naldi
K M Venkat Narayan
Paul K Nelson
Robert G Nelson
Michael C Nevitt
Charles R Newton
Sandra Nolte
Paul Norman
Rosana Norman
Martin O'Donnell
Simon O'Hanlon
Casey Olives
Saad B Omer
Katrina Ortblad
Richard Osborne
Doruk Ozgediz
Andrew Page
Bishnu Pahari
Jeyaraj Durai Pandian
Andrea Panozo Rivero
Scott B Patten
Neil Pearce
Rogelio Perez Padilla
Fernando Perez-Ruiz
Norberto Perico
Konrad Pesudovs
David Phillips
Michael R Phillips
Kelsey Pierce
Sébastien Pion
Guilherme V Polanczyk
Suzanne Polinder
C Arden Pope
Svetlana Popova
Esteban Porrini
Farshad Pourmalek
Martin Prince
Rachel L Pullan
Kapa D Ramaiah
Dharani Ranganathan
Homie Razavi
Mathilda Regan
Jürgen T Rehm
David B Rein
Guiseppe Remuzzi
Kathryn Richardson
Frederick P Rivara
Thomas Roberts
Carolyn Robinson
Felipe Rodriguez De Leòn
Luca Ronfani
Robin Room
Lisa C Rosenfeld
Lesley Rushton
Ralph L Sacco
Sukanta Saha
Uchechukwu Sampson
Lidia Sanchez-Riera
Ella Sanman
David C Schwebel
James Graham Scott
Maria Segui-Gomez
Saeid Shahraz
Donald S Shepard
Hwashin Shin
Rupak Shivakoti
David Singh
Gitanjali M Singh
Jasvinder A Singh
Jessica Singleton
David A Sleet
Karen Sliwa
Emma Smith
Jennifer L Smith
Nicolas JC Stapelberg
Andrew Steer
Timothy Steiner
Wilma A Stolk
Lars Jacob Stovner
Christopher Sudfeld
Sana Syed
Giorgio Tamburlini
Mohammad Tavakkoli
Hugh R Taylor
Jennifer A Taylor
William J Taylor
Bernadette Thomas
W Murray Thomson
George D Thurston
Imad M Tleyjeh
Marcello Tonelli
Jeffrey A Towbin
Thomas Truelsen
Miltiadis K Tsilimbaris
Clotilde Ubeda
Eduardo A Undurraga
Marieke J van der Werf
Os Jim van
Monica S Vavilala
N Venketasubramanian
Mengru Wang
Wenzhi Wang
Kerrianne Watt
David J Weatherall
Martin A Weinstock
Robert Weintraub
Marc G Weisskopf
Myrna M Weissman
Richard A White
Harvey Whiteford
Natasha Wiebe
Steven T Wiersma
James D Wilkinson
Hywel C Williams
Sean RM Williams
Emma Witt
Frederick Wolfe
Anthony D Woolf
Sarah Wulf
Pon-Hsiu Yeh
Anita KM Zaidi
Zhi-Jie Zheng
David Zonies
Alan D Lopez
Bridget Grant
format Journal article
container_title The Lancet
container_volume 380
container_issue 9859
container_start_page 2197
publishDate 2012
institution Swansea University
issn 0140-6736
doi_str_mv 10.1016/S0140-6736(12)61689-4
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description Background Measuring disease and injury burden in populations requires a composite metric that captures bothpremature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposeddisability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burdenworldwide incorporating a systematic reassessment of disease and injury-specifi c epidemiology has been donesince the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and2010 with methods to enable meaningful comparisons over time.Methods We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYswere calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional andglobal estimates of disease burden for three points in time with strictly comparable defi nitions and methods. YLLswere calculated from age-sex-country-time-specifi c estimates of mortality by cause, with death by standardised lost life expectancy at each age. YLDs were calculated as prevalence of 1160 disabling sequelae, by age, sex, and cause, andweighted by new disability weights for each health state. Neither YLLs nor YLDs were age-weighted or discounted.Uncertainty around cause-specifi c DALYs was calculated incorporating uncertainty in levels of all-cause mortality,cause-specifi c mortality, prevalence, and disability weights.Findings Global DALYs remained stable from 1990 (2·503 billion) to 2010 (2·490 billion). Crude DALYs per 1000 decreasedby 23% (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution ofdeaths and disability among children (younger than 5 years of age) declining from 41% of global DALYs in 1990 to 25%in 2010. YLLs typically account for about half of disease burden in more developed regions (high-income Asia Pacifi c,western Europe, high-income North America, and Australasia), rising to over 80% of DALYs in sub-Saharan Africa. In1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% fromnon-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively.Ischaemic heart disease was the leading cause of DALYs worldwide in 2010 (up from fourth rank in 1990, increasing by29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs), stroke (fi fth in 1990; 19%increase), diarrhoeal diseases (second in 1990; 51% decrease), and HIV/AIDS (33rd in 1990; 351% increase). Majordepressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34%increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions.Interpretation Global disease burden has continued to shift away from communicable to non-communicable diseasesand from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable,maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden frommental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on healthsystems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goalsand targets for the post-2015 agenda taking such patterns into account. Because of improved defi nitions, methods,and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results.
published_date 2012-12-15T03:15:57Z
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