Abstract
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1859-1922 |
| Number of pages | 64 |
| Journal | The Lancet |
| Volume | 392 |
| Issue number | 10159 |
| DOIs | |
| State | Published - Nov 10 2018 |
| Externally published | Yes |
Bibliographical note
Generated from Scopus record by KAUST IRTS on 2021-03-16ASJC Scopus subject areas
- General Medicine
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Dive into the research topics of 'Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017'. Together they form a unique fingerprint.Cite this
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In: The Lancet, Vol. 392, No. 10159, 10.11.2018, p. 1859-1922.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
AU - Kyu, Hmwe Hmwe
AU - Abate, Degu
AU - Abate, Kalkidan Hassen
AU - Abay, Solomon M.
AU - Abbafati, Cristiana
AU - Abbasi, Nooshin
AU - Abbastabar, Hedayat
AU - Abd-Allah, Foad
AU - Abdela, Jemal
AU - Abdelalim, Ahmed
AU - Abdollahpour, Ibrahim
AU - Abdulkader, Rizwan Suliankatchi
AU - Abebe, Molla
AU - Abebe, Zegeye
AU - Abil, Olifan Zewdie
AU - Aboyans, Victor
AU - Abrham, Aklilu Roba
AU - Abu-Raddad, Laith Jamal
AU - Abu-Rmeileh, Niveen M.E.
AU - Accrombessi, Manfred Mario Kokou
AU - Acharya, Dilaram
AU - Acharya, Pawan
AU - Ackerman, Ilana N.
AU - Adamu, Abdu A.
AU - Adebayo, Oladimeji M.
AU - Adekanmbi, Victor
AU - Ademi, Zanfina
AU - Adetokunboh, Olatunji O.
AU - Adib, Mina G.
AU - Adsuar, Jose C.
AU - Afanvi, Kossivi Agbelenko
AU - Afarideh, Mohsen
AU - Afshin, Ashkan
AU - Agarwal, Gina
AU - Agesa, Kareha M.
AU - Aggarwal, Rakesh
AU - Aghayan, Sargis Aghasi
AU - Agrawal, Anurag
AU - Ahmadi, Alireza
AU - Ahmadi, Mehdi
AU - Ahmadieh, Hamid
AU - Ahmed, Muktar Beshir
AU - Ahmed, Sayem
AU - Aichour, Amani Nidhal
AU - Aichour, Ibtihel
AU - Aichour, Miloud Taki Eddine
AU - Akinyemiju, Tomi
AU - Akseer, Nadia
AU - Al-Aly, Ziyad
AU - Al-Eyadhy, Ayman
AU - Al-Mekhlafi, Hesham M.
AU - Al-Raddadi, Rajaa M.
AU - Alahdab, Fares
AU - Alam, Khurshid
AU - Alam, Tahiya
AU - Alashi, Alaa
AU - Alavian, Seyed Moayed
AU - Alene, Kefyalew Addis
AU - Alijanzadeh, Mehran
AU - Alizadeh-Navaei, Reza
AU - Aljunid, Syed Mohamed
AU - Alkerwi, Ala'A
AU - Alla, François
AU - Allebeck, Peter
AU - Alonso, Jordi
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AU - Altirkawi, Khalid
AU - Alvis-Guzman, Nelson
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AU - Amini, Erfan
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AU - Ammar, Walid
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AU - Andrei, Catalina Liliana
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AU - Animut, Megbaru Debalkie
AU - Anjomshoa, Mina
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AU - Artaman, Al
AU - Aryal, Krishna K.
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AU - Ataro, Zerihun
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AU - Avila-Burgos, Leticia
AU - Avokpaho, Euripide F.G.A.
AU - Awasthi, Ashish
AU - Ayala Quintanilla, Beatriz Paulina
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AU - Beghi, Ettore
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AU - Bell, Michelle L.
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AU - Bensenor, Isabela M.
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AU - Haj-Mirzaian, Arya
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AU - Kanchan, Tanuj
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N1 - Generated from Scopus record by KAUST IRTS on 2021-03-16
PY - 2018/11/10
Y1 - 2018/11/10
N2 - Background: How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted lifeyears (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severityof ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-speci?c mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Sociodemographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9-6·7), from 57·0 years (54·6-59·1) in 1990 to 63·3 years (60·5-65·7) in 2017. The increase varied from 3·8 years (3·4-4·1) in high SDI countries to 10·5 years (9·8-11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4-1·7) in Saint Vincent and the Grenadines (62·4 years [59·9-64·7] in 1990 to 63·5 years [60·9-65·8] in 2017) to 23·7 years (21·9-25·6) in Eritrea (30·7 years [28·9-32·2] in 1990 to 54·4 years [51·5-57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6-2·3) in Algeria to 11·9 years (10·9-12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4-78·7]) and males (72·6 years [69·8-75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7-50·2] for females and 42·8 years [40·1-45·6] for males). Globally, in 2017, the ?ve leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8-43·5) for communicable diseases and by 49·8% (47·9-51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8-43·0), although age-standardised DALY rates decreased by 18·1% (16·0-20·2). Interpretation With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low SDI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health.
AB - Background: How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted lifeyears (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severityof ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-speci?c mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Sociodemographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9-6·7), from 57·0 years (54·6-59·1) in 1990 to 63·3 years (60·5-65·7) in 2017. The increase varied from 3·8 years (3·4-4·1) in high SDI countries to 10·5 years (9·8-11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4-1·7) in Saint Vincent and the Grenadines (62·4 years [59·9-64·7] in 1990 to 63·5 years [60·9-65·8] in 2017) to 23·7 years (21·9-25·6) in Eritrea (30·7 years [28·9-32·2] in 1990 to 54·4 years [51·5-57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6-2·3) in Algeria to 11·9 years (10·9-12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4-78·7]) and males (72·6 years [69·8-75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7-50·2] for females and 42·8 years [40·1-45·6] for males). Globally, in 2017, the ?ve leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8-43·5) for communicable diseases and by 49·8% (47·9-51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8-43·0), although age-standardised DALY rates decreased by 18·1% (16·0-20·2). Interpretation With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low SDI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health.
UR - https://linkinghub.elsevier.com/retrieve/pii/S0140673618323353
UR - http://www.scopus.com/inward/record.url?scp=85056187313&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(18)32335-3
DO - 10.1016/S0140-6736(18)32335-3
M3 - Article
SN - 1474-547X
VL - 392
SP - 1859
EP - 1922
JO - The Lancet
JF - The Lancet
IS - 10159
ER -