scholarly journals Global, Regional, National, and Subnational Big Data to Inform Health Equity Research: Perspectives from the Global Burden of Disease Study 2017

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 159-172 ◽  
Author(s):  
Ali H. Mokdad ◽  
George A. Mensah ◽  
Varsha Krish ◽  
Scott D. Glenn ◽  
Molly K. Miller-Petrie ◽  
...  

Objectives: Everyone deserves a long and healthy life, but in reality, health outcomes differ across populations. We use results from the Global Burden of Disease Study 2017 (GBD 2017) to report patterns in the burden of diseases, injuries, and risks at the global, regional, national, and subnational level, and by sociodemographic index (SDI), from 1990 to 2017.Design: GBD 2017 undertook a systematic analysis of published studies and available data providing information on prevalence, incidence, remission, and excess mortal­ity. We computed prevalence, incidence, mortality, life expectancy, healthy life expectancy, years of life lost due to prema­ture mortality, years lived with disability, and disability-adjusted life years with 95% uncertainty intervals for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries from 1990 to 2017. We also computed SDI, a summary indicator combining measures of income, education, and fertility.Results: There were wide disparities in the burden of disease by SDI, with smaller burdens in affluent countries and in specific regions within countries. Select diseases and risks, such as drug use disorders, high blood pressure, high body mass index, diet, high fasting plasma glucose, smoking, and alco­hol use disorders warrant increased global attention and indicate a need for greater investment in prevention and treatment across the life course.Conclusions: Policymakers need a com­prehensive picture of what risks and causes result in disability and death. The GBD provides the means to quantify health loss: these findings can be used to examine root causes of disparities and develop pro­grams to improve health and health equity.Ethn Dis. 2019;29(Suppl 1): 159-172; doi:10.18865/ed.29.S1.159.

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 159-172
Author(s):  
Ali H. Mokdad ◽  
George A. Mensah ◽  
Varsha Krish ◽  
Scott D. Glenn ◽  
Molly K. Miller-Petrie ◽  
...  

Objectives: Everyone deserves a long and healthy life, but in reality, health outcomes differ across populations. We use results from the Global Burden of Disease Study 2017 (GBD 2017) to report patterns in the burden of diseases, injuries, and risks at the global, regional, national, and subnational level, and by sociodemographic index (SDI), from 1990 to 2017.Design: GBD 2017 undertook a systematic analysis of published studies and available data providing information on prevalence, incidence, remission, and excess mortal­ity. We computed prevalence, incidence, mortality, life expectancy, healthy life expectancy, years of life lost due to prema­ture mortality, years lived with disability, and disability-adjusted life years with 95% uncertainty intervals for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries from 1990 to 2017. We also computed SDI, a summary indicator combining measures of income, education, and fertility.Results: There were wide disparities in the burden of disease by SDI, with smaller burdens in affluent countries and in specific regions within countries. Select diseases and risks, such as drug use disorders, high blood pressure, high body mass index, diet, high fasting plasma glucose, smoking, and alco­hol use disorders warrant increased global attention and indicate a need for greater investment in prevention and treatment across the life course.Conclusions: Policymakers need a com­prehensive picture of what risks and causes result in disability and death. The GBD provides the means to quantify health loss: these findings can be used to examine root causes of disparities and develop pro­grams to improve health and health equity.Ethn Dis. 2019;29(Suppl 1): 159-172; doi:10.18865/ed.29.S1.159.


2018 ◽  
Vol 52 (5) ◽  
pp. 483-490 ◽  
Author(s):  
Liliana G Ciobanu ◽  
Alize J Ferrari ◽  
Holly E Erskine ◽  
Damian F Santomauro ◽  
Fiona J Charlson ◽  
...  

Objectives: Timely and accurate assessments of disease burden are essential for developing effective national health policies. We used the Global Burden of Disease Study 2015 to examine burden due to mental and substance use disorders in Australia. Methods: For each of the 20 mental and substance use disorders included in Global Burden of Disease Study 2015, systematic reviews of epidemiological data were conducted, and data modelled using a Bayesian meta-regression tool to produce prevalence estimates by age, sex, geography and year. Prevalence for each disorder was then combined with a disorder-specific disability weight to give years lived with disability, as a measure of non-fatal burden. Fatal burden was measured as years of life lost due to premature mortality which were calculated by combining the number of deaths due to a disorder with the life expectancy remaining at the time of death. Disability-adjusted life years were calculated by summing years lived with disability and years of life lost to give a measure of total burden. Uncertainty was calculated around all burden estimates. Results: Mental and substance use disorders were the leading cause of non-fatal burden in Australia in 2015, explaining 24.3% of total years lived with disability, and were the second leading cause of total burden, accounting for 14.6% of total disability-adjusted life years. There was no significant change in the age-standardised disability-adjusted life year rates for mental and substance use disorders from 1990 to 2015. Conclusion: Global Burden of Disease Study 2015 found that mental and substance use disorders were leading contributors to disease burden in Australia. Despite several decades of national reform, the burden of mental and substance use disorders remained largely unchanged between 1990 and 2015. To reduce this burden, effective population-level preventions strategies are required in addition to effective interventions of sufficient duration and coverage.


BMJ ◽  
2020 ◽  
pp. m234 ◽  
Author(s):  
Xiaochen Li ◽  
Xiaopei Cao ◽  
Mingzhou Guo ◽  
Min Xie ◽  
Xiansheng Liu

AbstractObjectiveTo describe the temporal and spatial trends of mortality and disability adjusted life years (DALYs) due to chronic respiratory diseases, by age and sex, across the world during 1990-2017 using data from the Global Burden of Disease Study 2017.DesignSystematic analysis.Data sourceThe Global Burden of Diseases, Injuries, and Risk Factors Study 2017.MethodsMortality and DALYs from chronic respiratory diseases were estimated from the Global Burden of Disease Study 2017 using DisMod-MR 2.1, a Bayesian meta-regression tool. The estimated annual percentage change of the age standardised mortality rate was calculated using a generalised linear model with a Gaussian distribution. Mortality and DALYs were stratified according to the Socio-demographic index. The strength and direction of the association between the Socio-demographic index and mortality rate were measured using the Spearman rank order correlation. Risk factors for chronic respiratory diseases were analysed from exposure data.ResultsBetween 1990 and 2017, the total number of deaths due to chronic respiratorydiseases increased by 18.0%, from 3.32 (95% uncertainty interval 3.01 to 3.43) million in 1990 to 3.91 (3.79 to 4.04) million in 2017. The age standardised mortality rate of chronic respiratory diseases decreased by an average of 2.41% (2.28% to 2.55%) annually. During the 27 years, the annual decline in mortality rates of chronic obstructive pulmonary disease (COPD; 2.36%, uncertainty interval 2.21% to 2.50%) and pneumoconiosis (2.56%, 2.44% to 2.68%) has been slow, whereas the mortality rate for interstitial lung disease and pulmonary sarcoidosis (0.97%, 0.92% to 1.03%) has increased. Reductions in DALYs for asthma and pneumoconiosis have been seen, but DALYs due to COPD, and interstitial lung disease and pulmonary sarcoidosis have increased. Mortality and the annual change in mortality rate due to chronic respiratory diseases varied considerably across 195 countries. Assessment of the factors responsible for regional variations in mortality and DALYs and the unequal distribution of improvements during the 27 years showed negative correlations between the Socio-demographic index and the mortality rates of COPD, pneumoconiosis, and asthma. Regions with a low Socio-demographic index had the highest mortality and DALYs. Smoking remained the major risk factor for mortality due to COPD and asthma. Pollution from particulate matter was the major contributor to deaths from COPD in regions with a low Socio-demographic index. Since 2013, a high body mass index has become the principal risk factor for asthma.ConclusionsRegions with a low Socio-demographic index had the greatest burden of disease. The estimated contribution of risk factors (such as smoking, environmental pollution, and a high body mass index) to mortality and DALYs supports the need for urgent efforts to reduce exposure to them.


2017 ◽  
Vol 44 (3) ◽  
pp. 192-198 ◽  
Author(s):  
Carl Tollef Solberg ◽  
Ole Frithjof Norheim ◽  
Mathias Barra

In the Global Burden of Disease study, disease burden is measured as disability-adjusted life years (DALYs). The paramount assumption of the DALY is that it makes sense to aggregate years lived with disability (YLDs) and years of life lost (YLLs). However, this is not smooth sailing. Whereas morbidity (YLD) is something that happens to an individual, loss of life itself (YLL) occurs when that individual’s life has ended. YLLs quantify something that involves no experience and does not take place among living individuals. This casts doubt on whether the YLL is an individual burden at all. If not, then YLDs and YLLs are incommensurable. There are at least three responses to this problem, only one of which is tenable: a counterfactual account of harm. Taking this strategy necessitates a re-examination of how we count YLLs, particularly at the beginning of life.


2020 ◽  
Author(s):  
VALÉRIA MARIA DE AZEREDO PASSOS ◽  
Ana Paula Silva Champs ◽  
Renato Teixeira ◽  
Maria Fernanda Furtado Lima-Costa ◽  
Renata Kirkwood ◽  
...  

Abstract Background Brazil is the world’s fifth most populous nation, and is currently experimenting a fast demographic ageing process in a context of scarce resources and social inequalities. To understand the health profile of older adults in Brazil is fundamental for planning public policies. Methods The estimates were derived from data obtained through the collaboration between Brazilian Ministry of Health with the Institute of Health Metrics and Evaluation of the University of Washington. The Brazilian Institute of Geography and Statistics provided the population estimates. Data on causes of death came from the Mortality Information System. To calculate morbidity, population-based studies on the prevalence of diseases in Brazil were comprehensively searched, in addition to information obtained from national databases such as the Hospital Information System, the Outpatient Information System, and the Injury Information System. We presented the Global Burden of Disease (GBD) 2017 estimates among Brazilian older adults (60 + years old) for life expectancy at birth (LE), healthy life expectancy (HALE), cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs), from 2000 to 2017. Results LE at birth significantly increased from 71.3 years (95%UI to 70.9–71.8) to 75.2 years (95%UI 74.7–75.7). There was a trend of increasing HALE, from 62.2 years (95%UI 59.54–64.5) to 65.5 years (95%UI 62.6–68.0). The proportion of DALYs among older adults increased from 7.3–10.3%. Chronic noncommunicable diseases are the leading cause of death among middle-aged and older adults, while Alzheimer's disease is a leading cause only among older adults. Mood disorders, musculoskeletal pain and hearing or vision losses are among the leading causes of disability. Conclusions The increase in LE and the decrease of the DALYs rates are probably results of the improvement of social conditions and health policies. However, the smaller increase of HALE than LE means that despite living more, people spend a substantial time of their old age with disability and illness. Preventable or potentially controllable diseases are responsible for most of the burden of disease among Brazilian older adults. Health investments are necessary to obtain longevity with quality of life in Brazil.


2009 ◽  
Vol 25 (6) ◽  
pp. 1234-1244 ◽  
Author(s):  
Andreia Ferreira de Oliveira ◽  
Joaquim Gonçalves Valente ◽  
Iuri da Costa Leite ◽  
Joyce Mendes de Andrade Schramm ◽  
Anne S. Renteria de Azevedo ◽  
...  

Type II diabetes mellitus accounts for 90% of all cases of diabetes, and its inclusion in health evaluation has shown that its complications have a considerable impact on the population's quality of life. The current article presents the results of the Global Burden of Disease Study in Brazil for the year 1998, with an emphasis on diabetes mellitus and its complications. The indicator used was disability-adjusted life years (DALY), using a discount rate of 3%. In Brazil, ischemic heart disease, stroke, and diabetes accounted for 14.7% of total lost DALYs. Brazil showed a higher proportion of years lived with disability (YLDs) among total DALYs for diabetes as compared to other countries. Retinopathy and neuropathy were the complications that contributed most to YLDs. According to forecasts, diabetes mellitus will have an increasing impact on years of life lost due to premature death and disability in the world, shifting from the 11th to 7th cause of death by 2030. It is thus urgent to implement effective measures for prevention, early diagnosis, counseling, and adequate follow-up of patients with diabetes mellitus.


2020 ◽  
Vol 18 (S1) ◽  
Author(s):  
Valéria Maria de Azeredo Passos ◽  
Ana Paula Silva Champs ◽  
Renato Teixeira ◽  
Maria Fernanda Furtado Lima-Costa ◽  
Renata Kirkwood ◽  
...  

Abstract Background Brazil is the world’s fifth most populous nation, and is currently experimenting a fast demographic aging process in a context of scarce resources and social inequalities. To understand the health profile of older adults in Brazil is fundamental for planning public policies. Methods The estimates were derived from data obtained through the collaboration between the Brazilian Ministry of Health and the Institute of Health Metrics and Evaluation of the University of Washington. The Brazilian Institute of Geography and Statistics provided the population estimates. Data on causes of death came from the Mortality Information System. To calculate morbidity, population-based studies on the prevalence of diseases in Brazil were comprehensively searched, in addition to information obtained from national databases such as the Hospital Information System, the Outpatient Information System, and the Injury Information System. We presented the Global Burden of Disease (GBD) 2017 estimates among Brazilian older adults (60+ years old) for life expectancy at birth (LE), healthy life expectancy (HALE), cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs), from 2000 to 2017. Results LE at birth significantly increased from 71.3 years (95% UI to 70.9-71.8) to 75.2 years (95% UI 74.7-75.7). There was a trend of increasing HALE, from 62.2 years (95% UI 59.54-64.5) to 65.5 years (95% UI 62.6-68.0). The proportion of DALYs among older adults increased from 7.3 to 10.3%. Chronic noncommunicable diseases are the leading cause of death among middle aged and older adults, while Alzheimer’s disease is a leading cause only among older adults. Mood disorders, musculoskeletal pain, and hearing or vision losses are among the leading causes of disability. Conclusions The increase in LE and the decrease of the DALYs rates are probably results of the improvement of social conditions and health policies. However, the smaller increase of HALE than LE means that despite living more, people spend a substantial time of their old age with disability and illness. Preventable or potentially controllable diseases are responsible for most of the burden of disease among Brazilian older adults. Health investments are necessary to obtain longevity with quality of life in Brazil.


2020 ◽  
Author(s):  
Fei Liu ◽  
Xiangjie Lin ◽  
Mao Zhang

Abstract IntroductionHealth system planning requires careful assessment of accidental carbon monoxide poisoning (ACOP) epidemiology, but data of this disease are scarce or non-existent in many countries. This article investigates the global burden of ACOP based on the Global Burden of Disease Study 2019 (GBD 2019) and the World Bank database.Materials and MethodsNumbers and age-standardized rates (ASR) of ACOP incidence, prevalence, deaths, Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLDs), and Years of Life Lost (YLLs) were analysed at global, regional, and national level. The estimated annual percentage change (EAPC) of age-standardized rates (ASR) was calculated by generalizing the linear model with a Gaussian distribution. Age, sex, and economics parameters are included to access their internal relevance.ResultsGlobally, in 2019, there were approximately 0.97 million ACOP incidence cases (95% CI 0.66 million to 1.4 million), and 41,142 (95%UI 32957 to 45934) people died from it. Compared with 1990, the morbidity and mortality of ACOP in 2019 are on a downward trend. By sexes, from 1990 to 2019, females have a higher morbidity and lower mortality. This article also finds that the relevant parameters of ACOP are closely related to the economic parameters. This correlation enables us to evaluate the level and status of public health services in various countries.DiscussionACOP is the most common toxic disease in the world. In 2019, the number of patients who die from ACOP exceeded that of patients poisoned by all other means. In global health decision-making, especially in regions with high-middle and high SDI, more attention should be paid.ConclusionAs the population ageing in areas with High-middle SDI and High SDI increases, the potential burden of ACOP is increasing, presenting the governments with an increasing demand for acute care, rehabilitation, and support services. The results of this study can be used by the health authorities to consider the burden of ACOP that could be addressed with preventive and therapeutic measures.


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