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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 Publisher Pubmed



Murray CJL1 ; Barber RM1 ; Foreman KJ1, 6 ; Ozgoren AA7 ; Abdallah F9 ; Abera SF10, 11 ; Aboyans V12 ; Abraham JP13, 14, 16 ; Abubakar I19 ; Aburaddad LJ20 ; Aburmeileh NM21 ; Achoki T1 ; Ackerman IN24 ; Ademi Z24, 25, 27 Show All Authors
Authors
  1. Murray CJL1
  2. Barber RM1
  3. Foreman KJ1, 6
  4. Ozgoren AA7
  5. Abdallah F9
  6. Abera SF10, 11
  7. Aboyans V12
  8. Abraham JP13, 14, 16
  9. Abubakar I19
  10. Aburaddad LJ20
  11. Aburmeileh NM21
  12. Achoki T1
  13. Ackerman IN24
  14. Ademi Z24, 25, 27
  15. Adou AK28
  16. Adsuar JC29
  17. Afshin A1, 30
  18. Agardh EE32
  19. Alam SS33
  20. Alasfoor D34
  21. Albittar MI35
  22. Alegretti MA36
  23. Alemu ZA38
  24. Alfonsocristancho R4
  25. Alhabib S39
  26. Ali R41
  27. Alla F43
  28. Allebeck P44
  29. Almazroa MA49
  30. Alsharif U50
  31. Alvarez E51
  32. Alvisguzman N52
  33. Amare AT53, 54, 55
  34. Ameh EA56
  35. Amini H25, 57
  36. Ammar W58
  37. Anderson HR59
  38. Anderson BO4
  39. Antonio CAT60
  40. Anwari P62
  41. Arnlov J63, 64
  42. Arsenijevic VSA65, 66
  43. Artaman A67
  44. Asghar RJ68
  45. Assadi R69
  46. Atkins LS70
  47. Avila MA71
  48. Awuah B72
  49. Bachman VF1
  50. Badawi A73
  51. Bahit MC74
  52. Balakrishnan K75
  53. Banerjee A76
  54. Barkercollo SL77
  55. Barquera S71
  56. Barregard L79
  57. Barrero LH80
  58. Basu A81
  59. Basu S83
  60. Basulaiman MO49
  61. Beardsley J84
  62. Bedi N85
  63. Beghi E86
  64. Bekele T87
  65. Bell ML88
  66. Benjet C89
  67. Bennett DA41
  68. Bensenor IM90
  69. Benzian H18, 91
  70. Bernabe E94
  71. Bertozzivilla A1
  72. Beyene TJ96
  73. Bhala N97, 98
  74. Bhalla A99
  75. Bhutta ZA100
  76. Bienhoff K1
  77. Bikbov B102, 103
  78. Biryukov S1
  79. Blore JD1, 24
  80. Blosser CD4
  81. Blyth FM105
  82. Bohensky MA24
  83. Bolliger IW1
  84. Basara BB106
  85. Bornstein NM108
  86. Bose D109
  87. Boufous S110
  88. Bourne RRA113
  89. Boyers LN114
  90. Brainin M115
  91. Brayne CE116
  92. Brazinova A117
  93. Breitborde NJK119, 120
  94. Brenner H122
  95. Briggs AD41
  96. Brooks PM24
  97. Brown JC1
  98. Brugha TS123
  99. Buchbinder R124, 125
  100. Buckle GC128
  101. Budke CM129
  102. Bulchis A1
  103. Bulloch AG130
  104. Camposnonato IR17, 71
  105. Carabin H131
  106. Carapetis JR132
  107. Cardenas R133
  108. Carpenter DO134
  109. Caso V135
  110. Castanedaorjuela CA136, 137
  111. Castro RE138
  112. Catalalopez F139, 140
  113. Cavalleri F37
  114. Cavlin A7
  115. Chadha VK141
  116. Chang JC142
  117. Charlson FJ146
  118. Chen H147
  119. Chen W465
  120. Chiang PP22
  121. Chimedochir O150
  122. Chowdhury R151
  123. Christensen H152
  124. Christophi CA153
  125. Cirillo M154
  126. Coates MM1
  127. Coffeng LE1
  128. Coggeshall MS1
  129. Colistro V155, 156
  130. Colquhoun SM24, 157
  131. Cooke GS6
  132. Cooper C158
  133. Cooper LT160
  134. Coppola LM161
  135. Cortinovis M86
  136. Criqui MH159
  137. Crump JA162
  138. Cuevasnasu L71
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  142. Dansereau E1
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  158. Diaztorne C183
  159. Dicker D1
  160. Ding EL16
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  163. Driscoll TR104
  164. Duan L297
  165. Duber HC1
  166. Ebel BE2
  167. Edmond KM186
  168. Elshrek YM187
  169. Endres M50
  170. Ermakov SP188, 189
  171. Erskine HE146
  172. Eshrati B190
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  174. Estep K1
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  177. Fay DF170
  178. Feigin VL195
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  180. Fereshtehnejad SM45
  181. Fernandes JG198
  182. Ferrari AJ146
  183. Fitzmaurice C1
  184. Flaxman AD1
  185. Fleming TD1
  186. Foigt N199
  187. Forouzanfar MH1
  188. Fowkes FGR200
  189. Paleo UF29
  190. Franklin RC201
  191. Furst T5
  192. Gabbe B127
  193. Gaffikin L82
  194. Gankpe FG202, 203
  195. Geleijnse JM204
  196. Gessner BD205
  197. Gething P40
  198. Gibney KB42, 127
  199. Giroud M206
  200. Giussani G86
  201. Dantes HG71
  202. Gona P207
  203. Gonzalezmedina D1
  204. Gosselin RA128
  205. Gotay CC209
  206. Goto A210
  207. Gouda HN146
  208. Graetz N1
  209. Gugnani HC211
  210. Gupta R212
  211. Gupta R212
  212. Gutierrez RA89
  213. Haagsma J1
  214. Hafezinejad N191
  215. Hagan H93
  216. Halasa YA214
  217. Hamadeh RR215
  218. Hamavid H1
  219. Hammami M216
  220. Hancock J1
  221. Hankey GJ186
  222. Hansen GM1
  223. Hao Y217
  224. Harb HL58
  225. Haro JM219, 220
  226. Havmoeller R48
  227. Hay SI1, 41
  228. Hay RJ94, 221
  229. Herediapi IB71
  230. Heuton KR1
  231. Heydarpour P192
  232. Higashi H1
  233. Hijar M222
  234. Hoek HW54, 223
  235. Hoffman HJ225
  236. Hosgood HD228, 229
  237. Hossain M230
  238. Hotez PJ231
  239. Hoy DG143, 232
  240. Hsairi M233
  241. Hu G234
  242. Huang C235
  243. Huang JJ88
  244. Husseini A236
  245. Huynh C1
  246. Iannarone ML1
  247. Iburg KM237
  248. Innos K238
  249. Inoue M239
  250. Islami F242
  251. Jacobsen KH243
  252. Jarvis DL6
  253. Jassal SK159
  254. Jee SH244
  255. Jeemon P245
  256. Jensen PN4
  257. Jha V99
  258. Jiang G246
  259. Jiang Y148, 149, 150
  260. Jonas JB247
  261. Juel K248
  262. Kan H250
  263. Karch A251, 252
  264. Karema CK253
  265. Karimkhani C254
  266. Karthikeyan G255
  267. Kassebaum NJ1, 3
  268. Kaul A256
  269. Kawakami N240
  270. Kazanjan K257
  271. Kemp AH90, 105
  272. Kengne AP258, 261
  273. Keren A262
  274. Khader YS263
  275. Khalifa SEA264
  276. Khan EA265, 266
  277. Khan G267
  278. Khang YH268
  279. Kieling C269
  280. Kim D270
  281. Kim S271
  282. Kim Y272
  283. Kinfu Y273
  284. Kinge JM275
  285. Kivipelto M47
  286. Knibbs LD144
  287. Knudsen AK274
  288. Kokubo Y276
  289. Kosen S277
  290. Krishnaswami S278
  291. Defo BK279
  292. Bicer BK8
  293. Kuipers EJ280
  294. Kulkarni C281
  295. Kulkarni VS282
  296. Kumar GA167
  297. Kyu HH1
  298. Lai T283
  299. Lalloo R173, 284
  300. Lallukka T285, 287
  301. Lam H288
  302. Lan Q289
  303. Lansingh VC290, 291
  304. Larsson A292
  305. Lawrynowicz AEB293
  306. Leasher JL294
  307. Leigh J105
  308. Leung R295
  309. Levitz CE1
  310. Li B296
  311. Li Y297
  312. Li Y297
  313. Lim SS1
  314. Lind M1
  315. Lipshultz SE299
  316. Liu S297
  317. Liu Y301
  318. Lloyd BK126, 302
  319. Lofgren KT1
  320. Logroscino G303
  321. Looker KJ304
  322. Lortettieulent J305
  323. Lotufo PA90
  324. Lozano R1, 71
  325. Lucas RM306
  326. Lunevicius R181, 307
  327. Lyons RA308
  328. Ma S309, 310
  329. Macintyre MF1
  330. Mackay MT312
  331. Majdan M118
  332. Malekzadeh R313, 314
  333. Marcenes W315
  334. Margolis DJ317
  335. Margono C1
  336. Marzan MB318
  337. Masci JR319
  338. Mashal MT320
  339. Matzopoulos R258, 260
  340. Mayosi BM261
  341. Mazorodze TT321
  342. Mcgill NW322
  343. Mcgrath JJ146
  344. Mckee M230
  345. Mclain A1
  346. Meaney PA316, 323
  347. Medina C71
  348. Mehndiratta MM324
  349. Mekonnen W96
  350. Melaku YA325
  351. Meltzer M326
  352. Memish ZA327
  353. Mensah GA226
  354. Meretoja A23, 328
  355. Mhimbira FA329
  356. Micha R30
  357. Miller TR330, 331
  358. Mills EJ332
  359. Mitchell PB112
  360. Mock CN4
  361. Ibrahim NM333
  362. Mohammad KA334
  363. Mokdad AH1
  364. Mola GLD335
  365. Monasta L336
  366. Hernandez JCM71
  367. Montico M336
  368. Montine TJ4
  369. Mooney MD1
  370. Moore AR337
  371. Moradilakeh M1, 338
  372. Moran AE224
  373. Mori R339
  374. Moschandreas J341
  375. Moturi WN342
  376. Moyer ML1
  377. Mozaffarian D30
  378. Msemburi WT1, 258
  379. Mueller UO343
  380. Mukaigawara M344
  381. Mullany EC1
  382. Murdoch ME345
  383. Murray J151
  384. Murthy KS167
  385. Naghavi M1
  386. Naheed A33
  387. Naidoo KS346
  388. Naldi L347
  389. Nand D348
  390. Nangia V349
  391. Narayan KMV301
  392. Nejjari C350
  393. Neupane SP351
  394. Newton CR352
  395. Ng M1
  396. Ngalesoni FN353
  397. Nguyen G1
  398. Nisar MI101
  399. Nolte S354, 355
  400. Norheim OF357
  401. Norman RE358
  402. Norrving B359
  403. Nyakarahuka L360
  404. Oh IH361
  405. Ohkubo T362
  406. Ohno SL1
  407. Olusanya BO363
  408. Opio JN364
  409. Ortblad K1
  410. Ortiz A365
  411. Pain AW1
  412. Pandian JD366
  413. Panelo CIA61
  414. Papachristou C354
  415. Park EK367
  416. Park JH368
  417. Patten SB130
  418. Patton GC24
  419. Paul VK255
  420. Pavlin BI369
  421. Pearce N230
  422. Pereira DM370
  423. Perezpadilla R371
  424. Perezruiz F372, 373
  425. Perico N374
  426. Pervaiz A375
  427. Pesudovs K376
  428. Peterson CB377
  429. Petzold M378, 379
  430. Phillips MR380, 381
  431. Phillips BK1
  432. Phillips DE1
  433. Piel FB41
  434. Plass D382
  435. Poenaru D383, 384
  436. Polinder S280
  437. Pope D182
  438. Popova S385
  439. Poulton RG164
  440. Pourmalek F208
  441. Prabhakaran D245
  442. Prasad NM386
  443. Pullan RL230
  444. Qato DM387
  445. Quistberg DA4
  446. Rafay A388, 391
  447. Rahimi K41
  448. Rahman SU389
  449. Raju M390
  450. Rana SM391, 392
  451. Razavi H393
  452. Reddy KS167
  453. Refaat A394
  454. Remuzzi G395
  455. Resnikoff S111, 396
  456. Ribeiro AL397
  457. Richardson L1
  458. Richardus JH280
  459. Roberts DA1
  460. Rojasrueda D398
  461. Ronfani L336
  462. Roth GA1
  463. Rothenbacher D399
  464. Rothstein DH400
  465. Rowley JT401
  466. Roy N44, 402
  467. Ruhago GM403
  468. Saeedi MY49
  469. Saha S404
  470. Sahraian MA192
  471. Sampson UKA227
  472. Sanabria JR405, 406
  473. Sandar L1
  474. Santos IS90
  475. Satpathy M255
  476. Sawhney M407
  477. Scarborough P41
  478. Schneider IJ408
  479. Schottker B121
  480. Schumacher AE1
  481. Schwebel DC409
  482. Scott JG145
  483. Seedat S410
  484. Sepanlou SG193
  485. Serina PT1
  486. Servanmori EE71
  487. Shackelford KA1
  488. Shaheen A411
  489. Shahraz S412
  490. Levy TS71
  491. Shangguan S31, 413
  492. She J249
  493. Sheikhbahaei S191
  494. Shi P31
  495. Shibuya K241
  496. Shinohara Y414
  497. Shiri R286, 415
  498. Shishani K416
  499. Shiue I417, 418
  500. Shrime MG17
  501. Sigfusdottir ID419
  502. Silberberg DH317
  503. Simard EP300
  504. Sindi S48
  505. Singh A420
  506. Singh JA409
  507. Singh L1
  508. Skirbekk V275
  509. Slepak EL1
  510. Sliwa K259
  511. Soneji S421
  512. Soreide K422
  513. Soshnikov S423
  514. Sposato LA424
  515. Sreeramareddy CT425
  516. Stanaway JD1
  517. Stathopoulou V426
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  520. Steiner C1
  521. Steiner TJ428
  522. Stevens A1
  523. Stewart A1
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  528. Swaroop M433
  529. Sykes BL434
  530. Tabb KM435
  531. Takahashi K149, 150
  532. Tandon N255
  533. Tanne D436, 437
  534. Tanner M26
  535. Tavakkoli M438
  536. Taylor HR24
  537. Te Ao BJ196
  538. Tediosi F26
  539. Temesgen AM1
  540. Templin T1
  541. Ten Have M439
  542. Tenkorang EY440
  543. Terkawi AS441, 442, 443
  544. Thomson B1
  545. Thornelyman AL15, 444
  546. Thrift AG127
  547. Thurston GD92
  548. Tillmann T230
  549. Tonelli M130
  550. Topouzis F445
  551. Toyoshima H446
  552. Traebert J447
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  554. Trillini M374
  555. Truelsen T450
  556. Tsilimbaris M340
  557. Tuzcu EM451
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  559. Ukwaja KN453
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  561. Uzun SB107
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  564. Van Gool CH456
  565. Van Os J457
  566. Vasankari TJ458
  567. Venketasubramanian N459
  568. Violante FS460
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  576. Wang J130
  577. Wang L297
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  592. Wurtz B1
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Source: The Lancet Published:2015


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. © 2015 Elsevier Ltd.
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