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, Eric 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, Rajesh Aggarwal, Stephanie Y Ahn, Mohammed K Ali, Mohammed Abdulaziz Al Mazroa, Miriam Alvarado, Hugh Ross Anderson, Laurie M AndersonKathryn G Andrews, Charles Atkinson, Larry M Baddour, Adil N Bahalim, Suzanne Barker-Collo, Lope H Barrero, David H Bartels, Maria-Gloria Basanez, Amanda Baxter, Michelle L Bell, Emelia J Benjamin, Derrick Bennett, Eduardo Bernabe, Kavi Bhalla, Bishal Bhandari, Boris T 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 J 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, Helene 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 A Corriere, Monica Cortinovis, Karen Courville De Vaccaro, William G Couser, Benjamin C Cowie, Michael H Criqui, Marita Cross, Kaustubh C Dabhadkar, Manu Dahiya, Nabila A Dahodwala, James Damsere-Derry, Goodarz Danaei, Adrian Davis, Diego De Leo, Louisa Degenhardt, Robert Dellavalle, Allyne M Delossantos, Julie O Denenberg, Sarah Derrett, Don C Des Jarlais, Samath D Dharmaratne, Mukesh Dherani, Cesar Diaz-Torne, Helen Dolk, E Ray Dorsey, Tim Driscoll, Hubert 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 Fevre, Mariel M Finucane, Seth Flaxman, Louise Flood, Kyle Foreman, Mohammed Hossein Forouzanfar, Francis Gerry R Fowkes, Marlene Fransen, Michael K Freeman, Belinda Jane Gabbe, Sherine E Gabriel, Emmanuela Gakidou, Hammad Ashraf Ganatra, Bianca Garcia, Flavio Gaspari, Richard F Gillum, Gerhard Gmel, Diego Gonzalez-Medina, Richard Gosselin, Rebecca Grainger, Bridget Grant, Justina Groeger, Francis Guillemin, David Gunnell, Ramyani Gupta, Juanita A 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 G 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 J Kassebaum, Norito Kawakami, Andre Keren, Jon-Paul Khoo, Charles King, Lisa Marie Knowlton, Olive Kobusingye, Adofo Koranteng, Rita V M Krishnamurthi, Francine Laden, Ratilal Lalloo, Laura L Laslett, Tim Lathlean, Janet L Leasher, Yong Yi Lee, James Leigh, Daphna Levinson, Stephen S Lim, Elizabeth S Limb, John Kent Lin, Michael Lipnick, Steven E Lipshultz, Wei Liu, Maria Loane, Summer Lockett Ohno, Ronan Lyons, Jacqueline R 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 Mawethu Mayosi, John H McAnulty, Mary M McDermott, Neil McGill, John McGrath, Maria Elena Medina-Mora, Michele Meltzer, Ziad A Memish, 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, Nathan Nair, Luigi Naldi, KM 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 Harry Osborne, Doruk E 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, Sebastien 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, Jurgen T Rehm, David B Rein, Guiseppe Remuzzi, Kathryn Richardson, Frederick P Rivara, Thomas Roberts, Carolyn Robinson, Felipe Rodriguez De Leon, 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 J C 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, Jim Van Os, Monica S Vavilala, Narayanaswamy 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 R M Williams, Emma Witt, Frederick Wolfe, Anthony D Woolf, Sarah Wulf, Pon-Hsiu Yeh, Anita K M Zaidi, Zhi-Jie Zheng, David H Zonies, Alan D Lopez

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6892 Citations (Scopus)

Abstract

Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorporating a systematic reassessment of disease and injury-specifi c epidemiology has been done since the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and 2010 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). DALYs were calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional and global estimates of disease burden for three points in time with strictly comparable defi nitions and methods. YLLs were 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, and weighted 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 decreased by 23 (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution of deaths 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, hi
Original languageEnglish
Pages (from-to)2197 - 2223
Number of pages27
JournalThe Lancet
Volume380
Issue number9859
DOIs
Publication statusPublished - 2012

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