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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.

Christopher J L Murray Ryan M Barber 1 Kyle J Foreman Ayse Abbasoglu Ozgoren Foad Abd-Allah Semaw F Abera Victor Aboyans 2, 3 Jerry P Abraham Ibrahim Abubakar Laith J Abu-Raddad 4 Niveen M Abu-Rmeileh Tom Achoki Ilana N Ackerman Zanfina Ademi Arsène K Adou José C Adsuar Ashkan Afshin Emilie E Agardh Sayed Saidul Alam Deena Alasfoor Mohammed I Albittar Miguel A Alegretti Zewdie A Alemu Rafael Alfonso-Cristancho Samia Alhabib Raghib Ali François Alla 5, 6 Peter Allebeck 7 Mohammad A Almazroa Ubai Alsharif Elena Alvarez 8 Nelson Alvis-Guzman Azmeraw T Amare Emmanuel A Ameh Heresh Amini 9 Walid Ammar H Ross Anderson 10 Benjamin O Anderson 11 Carl Abelardo T Antonio Palwasha Anwari Johan Arnlöv Valentina S Arsic Arsenijevic Al Artaman Rana J Asghar Reza Assadi 12 Lydia S Atkins 13 Marco A Avila Baffour Awuah Victoria F Bachman Alaa Badawi Maria C Bahit Kalpana Balakrishnan 14 Amitava Banerjee 15 Suzanne L Barker-Collo Simon Barquera Lars Barregard Lope H Barrero Arindam Basu 16 Sanjay Basu 17 Mohammed O Basulaiman Justin Beardsley Neeraj Bedi Ettore Beghi 18 Tolesa Bekele Michelle L Bell 19 Corina Benjet Derrick A Bennett 20 Isabela M Bensenor Habib Benzian Eduardo Bernabé Amelia Bertozzi-Villa Tariku J Beyene Neeraj Bhala Ashish Bhalla Zulfiqar A Bhutta Kelly Bienhoff Boris Bikbov Stan Biryukov Jed D Blore Christopher D Blosser Fiona M Blyth Megan A Bohensky Ian W Bolliger Berrak Bora Başara Natan M Bornstein 21 Dipan Bose Soufiane Boufous Rupert R A Bourne Lindsay N Boyers Michael Brainin Carol E Brayne 22 Alexandra Brazinova Nicholas J K Breitborde Hermann Brenner Adam D Briggs 23 Peter M Brooks 24 Jonathan C Brown Traolach S Brugha Rachelle Buchbinder Geoffrey C Buckle Christine M Budke 25 Anne Bulchis Andrew G Bulloch Ismael R Campos-Nonato Hélène Carabin Jonathan R Carapetis Rosario Cárdenas David O Carpenter 26 Valeria Caso Carlos A Castañeda-Orjuela Ruben E Castro 27 Ferrán Catalá-López Fiorella Cavalleri Alanur Çavlin Vineet K Chadha 28 Jung-Chen Chang Fiona J Charlson Honglei Chen Wanqing Chen 29 Peggy P Chiang Odgerel Chimed-Ochir Rajiv Chowdhury 30 Hanne Christensen 31 Costas A Christophi 32, 33 Massimo Cirillo Matthew M Coates Luc E Coffeng Megan S Coggeshall Valentina Colistro Samantha M Colquhoun Graham S Cooke 34 Cyrus Cooper 35 Leslie T Cooper Luis M Coppola Monica Cortinovis 36 Michael H Criqui John A Crump Lucia Cuevas-Nasu Hadi Danawi Lalit Dandona Rakhi Dandona Emily Dansereau Paul I Dargan Gail Davey 37 Adrian Davis Dragos V Davitoiu Anand Dayama Diego de Leo Louisa Degenhardt Borja del Pozo-Cruz Robert P Dellavalle Kebede Deribe Sarah Derrett Don C Des Jarlais Muluken Dessalegn Samath D Dharmaratne Mukesh K Dherani Cesar Diaz-Torné Daniel Dicker Eric L Ding Klara Dokova E Ray Dorsey Tim R Driscoll Leilei Duan Herbert C Duber Beth E Ebel Karen M Edmond Yousef M Elshrek Matthias Endres Sergey P Ermakov Holly E Erskine Babak Eshrati Alireza Esteghamati Kara Estep Emerito Jose A Faraon Farshad Farzadfar Derek F Fay Valery L Feigin David T Felson 38 Seyed-Mohammad Fereshtehnejad Jefferson G Fernandes 39 Alize J Ferrari 40 Christina Fitzmaurice Abraham D Flaxman Thomas D Fleming 41 Nataliya Foigt Mohammad H Forouzanfar F Gerry R Fowkes Urbano Fra Paleo Richard C Franklin Thomas Fürst Belinda Gabbe Lynne Gaffikin Fortuné G Gankpé Johanna M Geleijnse 42 Bradford D Gessner Peter Gething 43 Katherine B Gibney Maurice Giroud Giorgia Giussani 18 Hector Gomez Dantes Philimon Gona Diego González-Medina Richard A Gosselin Carolyn C Gotay Atsushi Goto Hebe N Gouda Nicholas Graetz Harish C Gugnani Rahul Gupta 44 Rajeev Gupta 44 Reyna A Gutiérrez 45 Juanita Haagsma Nima Hafezi-Nejad Holly Hagan Yara A Halasa Randah R Hamadeh Hannah Hamavid Mouhanad Hammami 46 Jamie Hancock 47 Graeme J Hankey Gillian M Hansen 48 Yuantao Hao Hilda L Harb 49 Josep Maria Haro Rasmus Havmoeller Simon I Hay Roderick J Hay Ileana B Heredia-Pi Kyle R Heuton Pouria Heydarpour 50 Hideki Higashi Martha Hijar Hans W Hoek Howard J Hoffman H Dean Hosgood Mazeda Hossain 51 Peter J Hotez Damian G Hoy 52 Mohamed Hsairi Guoqing Hu 53 Cheng Huang 54 John J Huang Abdullatif Husseini Chantal Huynh Marissa L Iannarone Kim M Iburg Kaire Innos Manami Inoue Farhad Islami Kathryn H Jacobsen Deborah L Jarvis 55 Simerjot K Jassal Sun Ha Jee Panniyammakal Jeemon Paul N Jensen 56 Vivekanand Jha Guohong Jiang 57 Ying Jiang 58 Jost B Jonas 59 Knud Juel Haidong Kan André Karch Corine K Karema Chante Karimkhani Ganesan Karthikeyan Nicholas J Kassebaum Anil Kaul 60 Norito Kawakami Konstantin Kazanjan Andrew H Kemp 61 Andre P Kengne 62 Andre Keren Yousef S Khader Shams Eldin A Khalifa 63 Ejaz A Khan Gulfaraz Khan Young-Ho Khang Christian Kieling Daniel Kim Sungroul Kim 64 Yunjin Kim Yohannes Kinfu Jonas M Kinge Miia Kivipelto 65 Luke D Knibbs Ann Kristin Knudsen 66 Yoshihiro Kokubo Soewarta Kosen Sanjay Krishnaswami Barthelemy Kuate Defo Burcu Kucuk Bicer Ernst J Kuipers 67 Chanda Kulkarni Veena S Kulkarni 68 G Anil Kumar Hmwe H Kyu Taavi Lai 69 Ratilal Lalloo Tea Lallukka 70 Hilton Lam 71 Qing Lan van C Lansingh Anders Larsson 72 Alicia E B Lawrynowicz Janet L Leasher James Leigh Ricky Leung Carly E Levitz Bin Li 73, 74 Yichong Li Yongmei Li Stephen S Lim 75 Maggie Lind 76 Steven E Lipshultz Shiwei Liu Yang Liu 77 Belinda K Lloyd Katherine T Lofgren Giancarlo Logroscino 78 Katharine J Looker Joannie Lortet-Tieulent Paulo A Lotufo Rafael Lozano 79 Robyn M Lucas Raimundas Lunevicius Ronan A Lyons 80 Stefan Ma Michael F Macintyre Mark T Mackay 81 Marek Majdan 82 Reza Malekzadeh Wagner Marcenes 83 David J Margolis 84, 85 Christopher Margono Melvin B Marzan Joseph R Masci 86 Mohammad T Mashal Richard Matzopoulos Bongani M Mayosi Tasara T Mazorodze Neil W Mcgill 87 John J Mcgrath Martin Mckee 88 Abigail Mclain Peter A Meaney Catalina Medina Man Mohan Mehndiratta Wubegzier Mekonnen Yohannes A Melaku Michele Meltzer Ziad A Memish 89, 90 George A Mensah 91 Atte Meretoja Francis A Mhimbira Renata Micha 92, 93 Ted R Miller Edward J Mills 94 Philip B Mitchell Charles N Mock Norlinah Mohamed Ibrahim Karzan A Mohammad 95 Ali H Mokdad Glen L D Mola Lorenzo Monasta Julio C Montañez Hernandez Marcella Montico 96 Thomas J Montine Meghan D Mooney Ami R Moore 97 Maziar Moradi-Lakeh Andrew E Moran Rintaro Mori Joanna Moschandreas Wilkister N Moturi Madeline L Moyer Dariush Mozaffarian 92, 98 William T Msemburi Ulrich O Mueller Mitsuru Mukaigawara Erin C Mullany Michele E Murdoch Joseph Murray 99 Kinnari S Murthy Mohsen Naghavi Aliya Naheed Kovin S Naidoo 100, 101 Luigi Naldi 102 Devina Nand Vinay Nangia K M Venkat Narayan Chakib Nejjari 103 Sudan P Neupane Charles R Newton Marie Ng 104 Frida N Ngalesoni Grant Nguyen 105 Muhammad I Nisar Sandra Nolte Ole F Norheim Rosana E Norman Bo Norrving 106 Luke Nyakarahuka In-Hwan Oh Takayoshi Ohkubo Summer L Ohno Bolajoko O Olusanya John Nelson Opio Katrina Ortblad Alberto Ortiz 107, 108, 109 Amanda W Pain Jeyaraj D Pandian Carlo Irwin A Panelo Christina Papachristou 110 Eun-Kee Park Jae-Hyun Park Scott B Patten George C Patton 111 Vinod K Paul Boris I Pavlin 112 Neil Pearce David M Pereira Rogelio Perez-Padilla Fernando Perez-Ruiz Norberto Perico Aslam Pervaiz Konrad Pesudovs Carrie B Peterson Max Petzold 113 Michael R Phillips 114 Bryan K Phillips 115 David E Phillips Frédéric B Piel 116 Dietrich Plass Dan Poenaru 117 Suzanne Polinder Daniel Pope Svetlana Popova Richie G Poulton 118 Farshad Pourmalek Dorairaj Prabhakaran 119 Noela M Prasad 120 Rachel L Pullan Dima M Qato D Alex Quistberg Anwar Rafay Kazem Rahimi 121 Sajjad U Rahman 122 Murugesan Raju Saleem M Rana Homie Razavi K Srinath Reddy 123 Amany Refaat Giuseppe Remuzzi 124 Serge Resnikoff Antonio L Ribeiro 125 Lee Richardson Jan Hendrik Richardus 126 D Allen Roberts David Rojas-Rueda Luca Ronfani Gregory A Roth 127 Dietrich Rothenbacher 128 David H Rothstein Jane T Rowley Nobhojit Roy 129 George M Ruhago Mohammad Y Saeedi Sukanta Saha 130 Mohammad Ali Sahraian Uchechukwu K A Sampson Juan R Sanabria Logan Sandar Itamar S Santos 131 Maheswar Satpathy Monika Sawhney Peter Scarborough Ione J Schneider 132 Ben Schöttker Austin E Schumacher David C Schwebel James G Scott Soraya Seedat Sadaf G Sepanlou Peter T Serina Edson E Servan-Mori Katya A Shackelford Amira Shaheen Saeid Shahraz Teresa Shamah Levy Siyi Shangguan Jun She Sara Sheikhbahaei Peilin Shi 133 Kenji Shibuya Yukito Shinohara Rahman Shiri Kawkab Shishani Ivy Shiue Mark G Shrime Inga D Sigfusdottir Donald H Silberberg Edgar P Simard Shireen Sindi Abhishek Singh 134 Jasvinder A Singh Lavanya Singh 135, 136 Vegard Skirbekk Erica Leigh Slepak Karen Sliwa 137 Samir Soneji Kjetil Søreide Sergey Soshnikov Luciano A Sposato Chandrashekhar T Sreeramareddy Jeffrey D Stanaway Vasiliki Stathopoulou Dan J Stein Murray B Stein 138 Caitlyn Steiner Timothy J Steiner Antony Stevens Andrea Stewart 139 Lars J Stovner Konstantinos Stroumpoulis Bruno F Sunguya Soumya Swaminathan Mamta Swaroop Bryan L Sykes Karen M Tabb Ken Takahashi 140 Nikhil Tandon 141 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Abstract : 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. 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. 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. 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. Bill & Melinda Gates Foundation.
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Citation

Christopher J L Murray, Ryan M Barber, Kyle J Foreman, Ayse Abbasoglu Ozgoren, Foad Abd-Allah, et al.. 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, Elsevier, 2015, 386 (10009), pp.2145-91. ⟨10.1016/S0140-6736(15)61340-X⟩. ⟨hal-01262808⟩

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