scholarly journals Measuring the Burden of Disease in Korea, 2008-2018

2021 ◽  
Vol 54 (5) ◽  
pp. 293-300
Author(s):  
Yoon-Sun Jung ◽  
Young-Eun Kim ◽  
Hyesook Park ◽  
In-Hwan Oh ◽  
Min-Woo Jo ◽  
...  

The study aims to examine the current status and differences in the burden of disease in Korea during 2008-2018. We calculated the burden of disease for Koreans from 2008 to 2018 using an incidence-based approach. Disability adjusted life years (DALYs) were expressed in units per 100 000 population by adding years of life lost (YLLs) and years lived with disability (YLDs). DALY calculation results were presented by gender, age group, disease, region, and income level. To explore differences in DALYs by region and income level, we used administrative district and insurance premium information from the National Health Insurance Service claims data. The burden of disease among Koreans showed an increasing trend from 2008 to 2018. By 2017, the burden of disease among men was higher than that among women. Diabetes mellitus, low back pain, and chronic lower respiratory disease were ranked high in the burden of disease; the sum of DALY rates for these diseases accounted for 18.4% of the total burden of disease among Koreans in 2018. The top leading causes associated with a high burden of disease differed slightly according to gender, age group, and income level. In this study, we measured the health status of Koreans and differences in the population health level according to gender, age group, region, and income level. This data can be used as an indicator of health equity, and the results derived from this study can be used to guide community-centered (or customized) health promotion policies and projects, and for setting national health policy goals.

Author(s):  
Grant Wyper ◽  
Ian Grant ◽  
Eilidh Fletcher ◽  
Gerry McCartney ◽  
Diane Stockton

BackgroundA criticism of Burden of Disease (BOD) estimates has been that they only provide evidence for national policy and aren’t relevant for local needs. This has led to a growing call for BOD studies to provide more granular estimates for sub-national geographies, particularly within European countries, to help support local policy makers with evidence-based decision making. AimTo develop local BOD estimates and investigate inequalities in BOD within and across local areas of Scotland. MethodsEstimates of Years Lived with Disability (YLD), Years of Life Lost (YLL), DALYs (Disability-adjusted Life Years), prevalent cases and mortality counts were developed for 68 conditions. Morbidity estimates were calculated based on a three-year average of 5-year age-group, sex and deprivation decile rates per person (from the SBOD 2016 study) which were applied to 2016 mid-year local population estimates. Mortality estimates were based on a three-year average (2014-16) sourced from the National Records of Scotland register of deaths. Direct age-standardised rates and numbers were produced for regions (3), NHS boards (14) and local authorities (32) by age-group and sex. ResultsAcross local authorities the male rate of all-cause DALYs ranged from 20,996 (per 100,000 population) to 33,442 and the female rate of all-cause DALYs ranged from 19,889 to 27,684. Inequalities in age-group (15-24; 25-44; 45-64; and 65+ years) differences between all-cause DALYs rates in the area with the highest and lowest rates ranged from 58.4% to 98.0% in males. Comparable estimates were slightly lower for females, but inequalities in rates were wider (41.4% to 87.4%). ConclusionInequalities in BOD across areas highlight the need for action at all levels. These local estimates provide a huge opportunity to work towards and beyond the 2020 vision of the Scottish Government by ensuring that we have the right workforce and services to achieve a healthier Scotland.


2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Periklis Charalampous ◽  
Elena Pallari ◽  
Stefanos Tyrovolas ◽  
Nicos Middleton ◽  
Mary Economou ◽  
...  

Abstract Background Non-communicable diseases (NCDs) accounted for over 90% of all deaths in the Cypriot population, in 2018. However, a detailed and comprehensive overview of the impact of NCDs on population health of Cyprus over the period of 1990 to 2017, expressed in disability-adjusted life years (DALYs), is currently not available. Knowledge about the drivers of changes in NCD DALYs over time is paramount to identify priorities for the prevention of NCDs in Cyprus and guide evidence-based decision making. The objectives of this paper were to: 1) assess the burden of NCDs in terms of years of life lost (YLLs), years lived with disability (YLDs), and DALYs in Cyprus in 2017, and 2) identify changes in the burden of NCDs in Cyprus over the 28-year period and assess the main drivers of these changes. Methods We performed a secondary database descriptive study using the Global Burden of Disease (GBD) 2017 results on NCDs for Cyprus from 1990 to 2017. We calculated the percentage change of age-standardized DALY rates between 1990 and 2017 and decomposed these time trends to assess the causes of death and disability that were the main drivers of change. Results In Cyprus in 2017, 83% (15,129 DALYs per 100,000; 12,809 to 17,707 95%UI) of total DALYs were due to NCDs. The major contributors to NCD DALYs were cardiovascular diseases (16.5%), neoplasms (16.3%), and musculoskeletal disorders (15.6%). Between 1990 and 2017, age-standardized NCD DALY rates decreased by 23%. For both males and females, the largest decreases in DALY rates were observed in ischemic heart disease and stroke. For Cypriot males, the largest increases in DALY rates were observed for pancreatic cancer, drug use disorders, and acne vulgaris, whereas for Cypriot females these were for acne vulgaris, psoriasis and eating disorders. Conclusion Despite a decrease in the burden of NCDs over the period from 1990 to 2017, NCDs are still a major public health challenge. Implementation of interventions and early detection screening programmes of modifiable NCD risk factors are needed to reduce occurrence and exacerbation of leading causes of NCDs in the Cypriot population.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Cornez ◽  
G Silversmit ◽  
V Gorasso ◽  
I Grant ◽  
G M A Wyper ◽  
...  

Abstract Background Monitoring the health status of a population requires consistent and comparable data on the morbidity and mortality impacts of a disease. The Disability-Adjusted Life Year (DALY) is an increasingly used disease burden indicator, combining healthy life years lost due to living with disease (Years Lived with Disability; YLDs) and due to dying prematurely (Years of Life Lost; YLLs). In Belgium, as in many other developed countries, cancer is a major contributor to the overall burden of disease. To date, however, local estimates of the burden of cancer are lacking. Methods We estimated the burden of 48 cancers in Belgium from 2004 to 2017 in terms of DALYs, using national population-based cancer registry data and international disease models. We developed a microsimulation model to translate incidence- into prevalence-based estimates, and used expert elicitation to integrate the long-term impact of surgical treatment. Results In 2017, in Belgium, breast cancer was the cancer with the highest disease burden among women, followed by lung cancer and colorectal cancer. Among men, lung cancer had the highest disease burden, followed by colorectal cancer and prostate cancer. Between 2004 and 2017, the burden of lung cancer increased by more than 50% in women, while in both sexes, significant increases were observed in melanoma and skin cancer burden. The majority of the cancer burden remained linked to premature mortality. Conclusions Cancer maintains a major impact on the health of the Belgian population. Current resources allocated for their prevention and treatment will need to be maintained to further reduce the cancer burden. Lung cancer remains a crucial challenge, among both men and women, calling for strengthened tobacco control policies. Integrating the current study in the Belgian national burden of disease study (BeBOD) will allow monitoring the burden of cancer over time, highlighting new trends and assessing the impact of public health policies. Key messages Burden of disease studies allow assessing and monitoring the impact of diseases and risk factors in a comparable way. Cancer maintains a major impact on the health of the Belgian population; lung cancer in particular remains a crucial challenge.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract A Burden of Disease (BoD) approach can be used to summarise the debilitating effects of morbidity and premature mortality in a population in a consistent and comparable manner. Summary measures of population health such as the Disability-Adjusted Life Year (DALY) have become key metrics for quantifying burden of disease. DALYs quantify the health gap between a life lived in perfect health and current health status, as the number of healthy life years lost due to illness (Years Lived with Disability, YLDs) and premature death (Years of Life Lost, YLLs). DALYs combine the effects of morbidity and mortality in an equitable way, and can therefore be used to identify the leading causes of disease or injury that cause BoD and to quantify the relative importance of specific risk factors. BoD studies are becoming an increasingly popular way to assess national and local population health as a means to influence national and local policy decisions. The increasing prominence of the burden of disease approach, however, comes at a cost. Calculations of DALYs involve multiple components and as such can be difficult for people to interpret. Burden of disease methodology is complex and highly data intensive, which has led to major disparities across researchers and nations in their capacity to perform studies, to interpret the soundness of available estimates, or to evidence and advocate for the use of particular methodological choices. In this skills-building seminar, we will give an overview of the methodology of calculating the DALY. It will outline the single steps to be undertaken, and the necessary assumptions that have to be taken, on the way to the calculation of the DALYs. This workshop will be supported by technical presentations from burden of disease experts about different choices of estimation methods to calculate both the fatal burden (YLL) and the non-fatal burden (YLD). Throughout the presentations, cerebrovascular disease will be used as a case study, giving a complete, real-life example of how DALYs are calculated. Overall, the aim is to demonstrate the importance of the choices researchers make when designing and interpreting BoD studies as a means of supporting evidence-based decision making. The workshop will foresee ample time for interaction with the audience and discussion of the implications of the different methodological choices. Key messages Although burden of disease methodology is complex, with calculations of DALYs involving multiple components, simple roadmaps can be created to enhance methodological knowledge. The choices and assumptions researchers make are important when designing and interpreting burden of disease studies.


2021 ◽  
Author(s):  
Vanessa Gorasso ◽  
Geert Silversmit ◽  
Marc Arbyn ◽  
Astrid Cornez ◽  
Robby De Pauw ◽  
...  

Abstract Background The importance of assessing and monitoring the health status of a population has grown in the last decades. Consistent and high quality data on the morbidity and mortality impact of a disease represent the key element for this assessment. Being increasingly used in global and national burden of diseases (BoD) studies, the Disability-Adjusted Life Year (DALY) is an indicator that combines healthy life years lost due to living with disease (Years Lived with Disability; YLD) and due to dying prematurely (Years of Life Lost; YLL). As a step towards a comprehensive national burden of disease study, this study aims to estimate the non-fatal burden of cancer in Belgium using national data. Methods We estimated the Belgian cancer burden from 2004 to 2018 in terms of YLD, using national population-based cancer registry data and international disease models. We developed a microsimulation model to translate incidence- into prevalence-based estimates, and used expert elicitation to integrate the long-term impact of increased disability due to surgical treatment. Results The age-standardized non-fatal burden of cancer increased from 2004 to 2018 by 6% and 2% respectively for incidence- and prevalence-based YLDs. In 2018, in Belgium, breast cancer had the highest morbidity impact among women, followed by colorectal and non-melanoma skin cancer. Among men, prostate cancer had the highest morbidity impact, followed by colorectal and non-melanoma skin cancer. Between 2004 and 2018, non-melanoma skin cancer significantly increased for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 48 to 107 for men and from 15 to 37 for women. Important decreases were seen for colorectal cancer for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 104 to 85 for men and from 52 to 46 for women. Conclusions Breast and prostate cancers represent the greatest proportion of cancer morbidity, while for both sexes the morbidity burden of skin cancer has shown an important increase from 2004 onwards. Integrating the current study in the Belgian national burden of disease study will allow monitoring of the burden of cancer over time, highlighting new trends and assessing the impact of public health policies.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246635
Author(s):  
Juyoung Kim ◽  
Seok-Jun Yoon ◽  
Min-Woo Jo

Background The burden of diabetes is considerable not only globally but also nationally within Korea. The Global Burden of Disease study derived the disability-adjusted life years (DALYs) of diabetes depending on its complications as individual severity using prevalence-based approach from 2017. Conversely, the Korean National Burden of Disease study based on an incidence-based approach does not incorporate the severity of diseases. This study aimed to simulate incidence-based DALYs of type 2 diabetes mellitus (T2DM), given diabetic complications as disease severity using a Markov model. Methods We developed a model with six Markov states, including incident and existing prevalent cases of diabetes and its complications and death. We assumed that diabetes and its complications would not be cured. The cycle length was one year, and the endpoint of the simulation was 100 years. A 5% discount rate was adopted in the analysis. Transition cases were counted by 5-year age groups above 30 years of age. Age- and sex-specific transition probabilities were calculated based on the incident rate. Results The total DALY estimates of T2DM were 5,417 and 3,934 per 100,000 population in men and women, respectively. The years of life lost in men were relatively higher than those in women in most age groups except the 80–84 age group. The distribution of years lived with disability by gender and age group showed a bell shape, peaking in the 55–59 age group in men and 65–69 age group in women. Conclusions The burden of T2DM considering its complications was larger compared to the outcomes from previous studies, with more precise morbid duration using the Markov model.


2022 ◽  
Author(s):  
Declan P Moran ◽  
Sara Montero Pires ◽  
Grant MA Wyper ◽  
Brecht Devleesschauwer ◽  
Sarah Cuschieri ◽  
...  

Objectives Burden of Disease frameworks facilitate estimation of the health impact of diseases to be translated into a single measure, such as the Disability-Adjusted-Life-Year (DALY). Methods DALYs were calculated as the sum of Years of Life Lost (YLL) and Years Lived with Disability (YLD) directly associated with COVID-19 in the Republic of Ireland (RoI) from March 01, 2020, to February 28, 2021. Life expectancy is based on the Global Burden of Disease (GBD) Study life tables for 2019. Results There were 220,273 confirmed cases with a total of 4,500 deaths as a direct result of COVID-19. DALYs were estimated to be 51,532.1 (95% Uncertainty Intervals [UI] 50,671.6, 52,294.3). Overall, YLL contributed to 98.7% of the DALYs. Of total symptomatic cases, 6.5% required hospitalisation and of those hospitalised 10.8% required intensive care unit treatment. COVID-19 was likely to be the second highest cause of death over our study's duration. Conclusion Estimating the burden of a disease at national level is useful for comparing its impact with other diseases in the population and across populations. This work sets out to standardise a COVID-19 BoD methodology framework for the RoI and comparable nations in the EU.


Author(s):  
Andreas Mogensen

In quantifying the global burden of disease in terms of Disability-Adjusted Life Years (DALYs), we must determine both Years of Life Lost (YLLs) and Years Lost to Disability (YLDs). In setting priorities for global health, many have felt that YLLs should not always simply equal life expectancy at death. To this end, Dean Jamison and colleagues recommend the use of a DALY metric that incorporates Acquisition of Life Potential (ALP). When an individual dies, the YLLs that we would otherwise count are multiplied by the value of the ALP function, which rises gradually from 0 to 1 during the first stages of an individual’s life. Jamison et al. do not provide a detailed philosophical justification for the use of gradual ALP. In this chapter I explain why I believe the Time-Relative Interest Account represents the most plausible ethical basis for the ALP approach and describe how we might model ALP in light of this account.


Biomedicines ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 99 ◽  
Author(s):  
Jürgen Rehm ◽  
Kevin D. Shield

Alcohol use is a major risk factor for burden of mortality and morbidity. Alcoholic liver disease (ALD) and alcohol use disorders (AUDs) are important disease outcomes caused by alcohol use. We will describe the global mortality and burden of disease in disability-adjusted life years for ALD and AUDs, based on data from the comparative risk assessment of the World Health Organization for 2016. AUDs have a limited impact on mortality in this assessment, since alcohol poisonings are almost the only disease category directly attributable to AUDs; most other alcohol-related deaths are indirect, and the cause which directly led to the death, such as liver cirrhosis, is the one recorded on the death certificate. Burden of disease for AUDs is thus mainly due to disability resulting from alcohol use. In contrast to AUDs, ALD is one of the major lethal outcomes of alcohol use, and burden of disease is mainly due to (premature) years of life lost. Many of the negative outcomes attributable to both AUDs and ALD are due to their interactions with other factors, most notably economic wealth. To avoid alcohol-attributable morbidity and mortality, measures should be taken to reduce the AUDs and ALD burden globally, especially among the poor.


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