Abstract
Background: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither eff ort quantified uncertainty in prevalence or years lived with disability (YLDs). Methods: Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis. Findings: Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350 000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated (correlation coefficient -0·37). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. The main contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes or endocrine diseases. The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. Age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar compared with years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, and anaemia were important causes of YLDs in sub-Saharan Africa. Interpretation: Rates of YLDs per 100 000 people have remained largely constant over time but rise steadily with age. Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalences of the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, have not decreased. Health systems will need to address the needs of the rising numbers of individuals with a range of disorders that largely cause disability but not mortality. Quantification of the burden of non-fatal health outcomes will be crucial to understand how well health systems are responding to these challenges. Eff ective and aff ordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world.
Original language | English |
---|---|
Pages (from-to) | 2163-2196 |
Number of pages | 34 |
Journal | Lancet |
Volume | 380 |
Issue number | 9859 |
DOIs | |
Publication status | Published - 2012 |
Access to Document
Fingerprint
Dive into the research topics of 'Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010'. Together they form a unique fingerprint.Cite this
- APA
- Author
- BIBTEX
- Harvard
- Standard
- RIS
- Vancouver
}
Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. / Lim, Stephen; Vos, Theo; Flaxman, Abraham; Danaei, Goodarz; Shibuya, Kenji; AlMazroa, Mohammad; Anderson, Ross; Andrews, Kathryn; Atkinson, Charles; Bahalim, Adil; Barker-Collo, Suzanne; Baxter, Amanda; Bell, Michelle; Blore, Jed; Blyth, Fiona; Bourne, Rupert; Boussinesq, Michael; Brooks, Peter; Bryan-Hancock, Claire; Bucello, Chiara; Buchbinder, Rachelle; Calabria, Bianca; Carapetis, J; Charlson, Fiona; Chen, Honglei; Cheng, Andrew; Colson, K; Cowie, Benjamin; Davis, Adrian; Dergenhardt, Louisa; Des Jarlais, Don; Dorsey, E; Driscoll, Tim; Edmond, Karen; Ali, Suad; Erwin, Patricia; Farzadfar, Farshad; Finucane, Mariel; Flaxman, Seth; Fowkes, Francis Gerry; Freeman, Michael; Gakidou, Emmanuela; Gmel, Gerhard; Grainger, Rebecca; Gunnell, David; Hall, Wayne; Hoy, Damian; Ibeanusi, Sydney; Jasrasaria, Rashmi; Jonas, Jost; Kassebaum, Nicholas; Kawakami, Norito; Khoo, Jon-Paul; Lalloo, Ratilal; Leasher, Janet; Leigh, James; Lin, John; Lipshultz, Steven; Lozano, Rafael; Abdalla, Safa; Aboyans, Victor; Abraham, Jerry; Malekzadeh, Reza; Ackerman, Ilana; Mallinger, Leslie; Aggarwal, Rakesh; Marcenes, Wagner; Ahn, Stephanie; March, Lyn; Ali, Mohammed; Marks, Robin; Alvarado, Miriam; Anderson, Laurie; Baddour, Larry; McGrath, John; Barrero, Lope; Bartels, David; Memish, Z; Basanez, Maria-Gloria; Mensah, George; Benjamin, Emelia; Merriman, Tony; Bennett, Derrick; Bernabe, Eduardo; Michaud, Catherine; Bhalla, Kavi; Bhandari, Bishal; Bikbov, Boris; Mokdad, Ali; Abdulhak, Aref; Morawska, Lidia; Birbeck, Gretchen; Black, James; Blencowe, Hannah; Naghavi, Mohsen; Bolliger, Ian; Bonaventure, Audrey; Nelson, Paul; Boufus, Soufiane; Braithwaite, Tasanee; Norman, Rosana; Brayne, Carol; Olives, Casey; Bridgett, Lisa; Omer, Saad; Brooker, Simon; Brugha, Traolach; Osborne, Richard; Buckle, Geoffrey; Budke, Christine; Page, Andrew; Burch, Michael; Burney, Peter; Burstein, Roy; Campbell, Benjamin; Canter, Charles; Pearce, Neil; Carabin, Helene; Carmona, Loreto; Cella, Claudia; Phillips, Michael; Chou, David; Chugh, Sumeet; Pope III, C; Coffeng, Luc; Colan, Steven; Colquhoun, Samantha; Razavi, Homie; Condon, John; Connor, Myles; Rehm, Jurgen; Cooper, Leslie; Corriere, Matthew; Rivara, Fred; Cortinovis, Monica; Roberts, Thomas; de Vaccaro, Karen; Robinson, Carolyn; Couser, William; Criqui, Michael; Cross, Marita; Room, Robin; Dabhadkar, Kaustubh; Rosenfeld, Lisa; Dahiya, Manu; Dahodwala, Nabila; Rushton, Lesley; Damsere-Derry, James; Salomon, Joshua; De Leo, Diego; Sampson, Uchechukwu; Dellavalle, Robert; Sanchez-Riera, Lidia; Delossantos, Allyne; Sanman, Ella; Denenberg, Julie; Derrett, Sarah; Dharmaratne, Samath; Dherani, Mukesh; Diaz-Torne, Cesar; Shivakoti, Rupak; Dolk, Helen; Singh, Gitanjali; Duber, Herbert; Sleet, David; Lathlean, Timothy; Ebel, Beth; Smith, Emma; Elbaz, Alexis; Erskine, Holly; Espindola, Patricia; Ewoigbokhan, Stalin; Feigin, Valery; Stovner, Lars; Felson, David; Ferrari, Alize; Ferri, Cleusa; Thurston, George; Fevre, Eric; Flood, Louise; Foreman, Kyle; Forouzanfar, Mohammad; Franklin, Richard; Fransen, Marlene; Weintraub, Robert; Gabbe, Belinda; White, Richard; Gabriel, Sherine; Whiteford, Harvey; Ganatra, Hammad; Garcia, Bianca; Wiersma, Steven; Gaspari, Flavio; Wilkinson, James; Gillum, Richard; Williams, Hywel; Gosselin, Richard; Groeger, Justina; Guillemin, Francis; Woolf, Anthony; Gupta, Ramyani; Haagsma, Juanita; Hagan, Holly; Lopez, Alan; Halasa, Yara; Murray, C; Haring, Diana; Ezzati, Majid; Haro, Josep; Harrison, James; Havmoeller, Rasmus; Hay, Roderick; Higashi, Hideki; Hill, Catherine; Hoen, Bruno; Hoffman, Howard; Hotez, Peter; Huang, John; Jacobsen, Kathryn; James, Spencer; Jarvis, Deborah; Jayaraman, Sudha; Johns, Nicole; Karthikeyan, Ganesan; Keren, Andre; King, Charles; Knowlton, Lisa; Kobusingye, Olive; Koranteng, Adofo; Krishnamurthi, Rita; Laslett, Laura; Lee, Yong; Limb, Elizabeth; Lipnick, Michael; Liu, Wei; Loane, Maria; Ohno, Summer; Lyons, Ronan; Ma, Jixiang; Mabweijano, Jacqueline; MacIntyre, Michael; Manivannan, Sivabalan; Margolis, David; Marks, Guy; Matsumori, Akira; Matzopoulos, Richard; Mayosi, Bongani; McAnulty, John; McDermott, Mary; McGill, Neil; Medina-Mora, Maria; Meltzer, Michele; Meyer, Ana-Claire; Migliolicd, Valeria; Miller, Matthew; Miller, Ted; Mitchell, Philip; Mocumbi, Ana; Moffitt, Terrie; Monasta, Lorenzo; Montico, Marcella; Moradi-Lakeh, Mazier; Moran, Andrew; Mori, Rintaro; Murdoch, Michele; Mwaniki, Michael; Naidoo, Kovin; Nair, M; Naldi, Luigi; Narayan, K; Nelson, Robert; Nevitt, Michael; Newton, Charles; Nolte, Sandra; Norman, Paul; O'Donnell, Martin; O'Hanlon, Simon; Ortblad, Katrina; Ozgediz, Doruk; Pahari, Bishnu; Pandian, Jeyaraj; Rivero, Andrea; Patten, Scott; Padilla, Rogelio; Perez-Ruiz, Fernando; Perico, Norberto; Pesudovs, Konrad; Phillips, David; Pierce, Kelsey; Pion, Sebastien; Polanczyk, Guilherme; Polinder, Suzanne; Popova, Svetlana; Porrini, Esteban; Pourmalek, Farshad; Prince, Martin; Pullan, Rachel; Ramajah, Kapa; Ranganathan, Dharani; Regan, Mathilda; Rein, David; Remuzzi, Giuseppe; Richardson, Kathryn; De Leon, Felipe; Ronfani, Luca; Sacco, Ralph; Saha, Sukanta; Schwebel, David; Scott, James; Segui-Gomez, Maria; Shahraz, Saeid; Shepard, Donald; Shin, Hwashin; Singh, David; Singh, Jasvinder; Singleton, Jessica; Sliwa, Karen; Smith, Jennifer; Stapelberg, Nicholas; Steer, Andrew; Steiner, Timothy; Stolk, Wilma; Sudfeld, Christopher; Syed, Sana; Tamburlini, Giorgio; Tavakkoli, Mohammad; Taylor, Hugh; Taylor, Jennifer; Taylor, William; Thomas, Bernadette; Thomson, W; Tleyjeh, Imad; Tonelli, Marcello; Towbin, Jeffrey; Truelsen, Thomas; Tsilimbaris, Miltiadis; Ubeda, Clotilde; Undarraga, Eduardo; van der Werf, Marieke; van Os, Jim; Vavilala, Monica; Venketasubramanian, N; Wang, Mengru; Wang, Wenzhi; Watt, Kerrianne; Weatherall, David; Weinstock, Martin; Weisskopf, Marc; Williams, Sean; Witt, Emma; Wolfe, Frederick; Wulf, Sarah; Yeh, Pon-Hsiu; Zaidi, Anita; Zhenggh, Zhi-Jie; Zonies, David.
In: Lancet, Vol. 380, No. 9859, 2012, p. 2163-2196.Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010
AU - Lim, Stephen
AU - Vos, Theo
AU - Flaxman, Abraham
AU - Danaei, Goodarz
AU - Shibuya, Kenji
AU - AlMazroa, Mohammad
AU - Anderson, Ross
AU - Andrews, Kathryn
AU - Atkinson, Charles
AU - Bahalim, Adil
AU - Barker-Collo, Suzanne
AU - Baxter, Amanda
AU - Bell, Michelle
AU - Blore, Jed
AU - Blyth, Fiona
AU - Bourne, Rupert
AU - Boussinesq, Michael
AU - Brooks, Peter
AU - Bryan-Hancock, Claire
AU - Bucello, Chiara
AU - Buchbinder, Rachelle
AU - Calabria, Bianca
AU - Carapetis, J
AU - Charlson, Fiona
AU - Chen, Honglei
AU - Cheng, Andrew
AU - Colson, K
AU - Cowie, Benjamin
AU - Davis, Adrian
AU - Dergenhardt, Louisa
AU - Des Jarlais, Don
AU - Dorsey, E
AU - Driscoll, Tim
AU - Edmond, Karen
AU - Ali, Suad
AU - Erwin, Patricia
AU - Farzadfar, Farshad
AU - Finucane, Mariel
AU - Flaxman, Seth
AU - Fowkes, Francis Gerry
AU - Freeman, Michael
AU - Gakidou, Emmanuela
AU - Gmel, Gerhard
AU - Grainger, Rebecca
AU - Gunnell, David
AU - Hall, Wayne
AU - Hoy, Damian
AU - Ibeanusi, Sydney
AU - Jasrasaria, Rashmi
AU - Jonas, Jost
AU - Kassebaum, Nicholas
AU - Kawakami, Norito
AU - Khoo, Jon-Paul
AU - Lalloo, Ratilal
AU - Leasher, Janet
AU - Leigh, James
AU - Lin, John
AU - Lipshultz, Steven
AU - Lozano, Rafael
AU - Abdalla, Safa
AU - Aboyans, Victor
AU - Abraham, Jerry
AU - Malekzadeh, Reza
AU - Ackerman, Ilana
AU - Mallinger, Leslie
AU - Aggarwal, Rakesh
AU - Marcenes, Wagner
AU - Ahn, Stephanie
AU - March, Lyn
AU - Ali, Mohammed
AU - Marks, Robin
AU - Alvarado, Miriam
AU - Anderson, Laurie
AU - Baddour, Larry
AU - McGrath, John
AU - Barrero, Lope
AU - Bartels, David
AU - Memish, Z
AU - Basanez, Maria-Gloria
AU - Mensah, George
AU - Benjamin, Emelia
AU - Merriman, Tony
AU - Bennett, Derrick
AU - Bernabe, Eduardo
AU - Michaud, Catherine
AU - Bhalla, Kavi
AU - Bhandari, Bishal
AU - Bikbov, Boris
AU - Mokdad, Ali
AU - Abdulhak, Aref
AU - Morawska, Lidia
AU - Birbeck, Gretchen
AU - Black, James
AU - Blencowe, Hannah
AU - Naghavi, Mohsen
AU - Bolliger, Ian
AU - Bonaventure, Audrey
AU - Nelson, Paul
AU - Boufus, Soufiane
AU - Braithwaite, Tasanee
AU - Norman, Rosana
AU - Brayne, Carol
AU - Olives, Casey
AU - Bridgett, Lisa
AU - Omer, Saad
AU - Brooker, Simon
AU - Brugha, Traolach
AU - Osborne, Richard
AU - Buckle, Geoffrey
AU - Budke, Christine
AU - Page, Andrew
AU - Burch, Michael
AU - Burney, Peter
AU - Burstein, Roy
AU - Campbell, Benjamin
AU - Canter, Charles
AU - Pearce, Neil
AU - Carabin, Helene
AU - Carmona, Loreto
AU - Cella, Claudia
AU - Phillips, Michael
AU - Chou, David
AU - Chugh, Sumeet
AU - Pope III, C
AU - Coffeng, Luc
AU - Colan, Steven
AU - Colquhoun, Samantha
AU - Razavi, Homie
AU - Condon, John
AU - Connor, Myles
AU - Rehm, Jurgen
AU - Cooper, Leslie
AU - Corriere, Matthew
AU - Rivara, Fred
AU - Cortinovis, Monica
AU - Roberts, Thomas
AU - de Vaccaro, Karen
AU - Robinson, Carolyn
AU - Couser, William
AU - Criqui, Michael
AU - Cross, Marita
AU - Room, Robin
AU - Dabhadkar, Kaustubh
AU - Rosenfeld, Lisa
AU - Dahiya, Manu
AU - Dahodwala, Nabila
AU - Rushton, Lesley
AU - Damsere-Derry, James
AU - Salomon, Joshua
AU - De Leo, Diego
AU - Sampson, Uchechukwu
AU - Dellavalle, Robert
AU - Sanchez-Riera, Lidia
AU - Delossantos, Allyne
AU - Sanman, Ella
AU - Denenberg, Julie
AU - Derrett, Sarah
AU - Dharmaratne, Samath
AU - Dherani, Mukesh
AU - Diaz-Torne, Cesar
AU - Shivakoti, Rupak
AU - Dolk, Helen
AU - Singh, Gitanjali
AU - Duber, Herbert
AU - Sleet, David
AU - Lathlean, Timothy
AU - Ebel, Beth
AU - Smith, Emma
AU - Elbaz, Alexis
AU - Erskine, Holly
AU - Espindola, Patricia
AU - Ewoigbokhan, Stalin
AU - Feigin, Valery
AU - Stovner, Lars
AU - Felson, David
AU - Ferrari, Alize
AU - Ferri, Cleusa
AU - Thurston, George
AU - Fevre, Eric
AU - Flood, Louise
AU - Foreman, Kyle
AU - Forouzanfar, Mohammad
AU - Franklin, Richard
AU - Fransen, Marlene
AU - Weintraub, Robert
AU - Gabbe, Belinda
AU - White, Richard
AU - Gabriel, Sherine
AU - Whiteford, Harvey
AU - Ganatra, Hammad
AU - Garcia, Bianca
AU - Wiersma, Steven
AU - Gaspari, Flavio
AU - Wilkinson, James
AU - Gillum, Richard
AU - Williams, Hywel
AU - Gosselin, Richard
AU - Groeger, Justina
AU - Guillemin, Francis
AU - Woolf, Anthony
AU - Gupta, Ramyani
AU - Haagsma, Juanita
AU - Hagan, Holly
AU - Lopez, Alan
AU - Halasa, Yara
AU - Murray, C
AU - Haring, Diana
AU - Ezzati, Majid
AU - Haro, Josep
AU - Harrison, James
AU - Havmoeller, Rasmus
AU - Hay, Roderick
AU - Higashi, Hideki
AU - Hill, Catherine
AU - Hoen, Bruno
AU - Hoffman, Howard
AU - Hotez, Peter
AU - Huang, John
AU - Jacobsen, Kathryn
AU - James, Spencer
AU - Jarvis, Deborah
AU - Jayaraman, Sudha
AU - Johns, Nicole
AU - Karthikeyan, Ganesan
AU - Keren, Andre
AU - King, Charles
AU - Knowlton, Lisa
AU - Kobusingye, Olive
AU - Koranteng, Adofo
AU - Krishnamurthi, Rita
AU - Laslett, Laura
AU - Lee, Yong
AU - Limb, Elizabeth
AU - Lipnick, Michael
AU - Liu, Wei
AU - Loane, Maria
AU - Ohno, Summer
AU - Lyons, Ronan
AU - Ma, Jixiang
AU - Mabweijano, Jacqueline
AU - MacIntyre, Michael
AU - Manivannan, Sivabalan
AU - Margolis, David
AU - Marks, Guy
AU - Matsumori, Akira
AU - Matzopoulos, Richard
AU - Mayosi, Bongani
AU - McAnulty, John
AU - McDermott, Mary
AU - McGill, Neil
AU - Medina-Mora, Maria
AU - Meltzer, Michele
AU - Meyer, Ana-Claire
AU - Migliolicd, Valeria
AU - Miller, Matthew
AU - Miller, Ted
AU - Mitchell, Philip
AU - Mocumbi, Ana
AU - Moffitt, Terrie
AU - Monasta, Lorenzo
AU - Montico, Marcella
AU - Moradi-Lakeh, Mazier
AU - Moran, Andrew
AU - Mori, Rintaro
AU - Murdoch, Michele
AU - Mwaniki, Michael
AU - Naidoo, Kovin
AU - Nair, M
AU - Naldi, Luigi
AU - Narayan, K
AU - Nelson, Robert
AU - Nevitt, Michael
AU - Newton, Charles
AU - Nolte, Sandra
AU - Norman, Paul
AU - O'Donnell, Martin
AU - O'Hanlon, Simon
AU - Ortblad, Katrina
AU - Ozgediz, Doruk
AU - Pahari, Bishnu
AU - Pandian, Jeyaraj
AU - Rivero, Andrea
AU - Patten, Scott
AU - Padilla, Rogelio
AU - Perez-Ruiz, Fernando
AU - Perico, Norberto
AU - Pesudovs, Konrad
AU - Phillips, David
AU - Pierce, Kelsey
AU - Pion, Sebastien
AU - Polanczyk, Guilherme
AU - Polinder, Suzanne
AU - Popova, Svetlana
AU - Porrini, Esteban
AU - Pourmalek, Farshad
AU - Prince, Martin
AU - Pullan, Rachel
AU - Ramajah, Kapa
AU - Ranganathan, Dharani
AU - Regan, Mathilda
AU - Rein, David
AU - Remuzzi, Giuseppe
AU - Richardson, Kathryn
AU - De Leon, Felipe
AU - Ronfani, Luca
AU - Sacco, Ralph
AU - Saha, Sukanta
AU - Schwebel, David
AU - Scott, James
AU - Segui-Gomez, Maria
AU - Shahraz, Saeid
AU - Shepard, Donald
AU - Shin, Hwashin
AU - Singh, David
AU - Singh, Jasvinder
AU - Singleton, Jessica
AU - Sliwa, Karen
AU - Smith, Jennifer
AU - Stapelberg, Nicholas
AU - Steer, Andrew
AU - Steiner, Timothy
AU - Stolk, Wilma
AU - Sudfeld, Christopher
AU - Syed, Sana
AU - Tamburlini, Giorgio
AU - Tavakkoli, Mohammad
AU - Taylor, Hugh
AU - Taylor, Jennifer
AU - Taylor, William
AU - Thomas, Bernadette
AU - Thomson, W
AU - Tleyjeh, Imad
AU - Tonelli, Marcello
AU - Towbin, Jeffrey
AU - Truelsen, Thomas
AU - Tsilimbaris, Miltiadis
AU - Ubeda, Clotilde
AU - Undarraga, Eduardo
AU - van der Werf, Marieke
AU - van Os, Jim
AU - Vavilala, Monica
AU - Venketasubramanian, N
AU - Wang, Mengru
AU - Wang, Wenzhi
AU - Watt, Kerrianne
AU - Weatherall, David
AU - Weinstock, Martin
AU - Weisskopf, Marc
AU - Williams, Sean
AU - Witt, Emma
AU - Wolfe, Frederick
AU - Wulf, Sarah
AU - Yeh, Pon-Hsiu
AU - Zaidi, Anita
AU - Zhenggh, Zhi-Jie
AU - Zonies, David
PY - 2012
Y1 - 2012
N2 - Background: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither eff ort quantified uncertainty in prevalence or years lived with disability (YLDs). Methods: Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis. Findings: Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350 000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated (correlation coefficient -0·37). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. The main contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes or endocrine diseases. The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. Age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar compared with years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, and anaemia were important causes of YLDs in sub-Saharan Africa. Interpretation: Rates of YLDs per 100 000 people have remained largely constant over time but rise steadily with age. Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalences of the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, have not decreased. Health systems will need to address the needs of the rising numbers of individuals with a range of disorders that largely cause disability but not mortality. Quantification of the burden of non-fatal health outcomes will be crucial to understand how well health systems are responding to these challenges. Eff ective and aff ordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world.
AB - Background: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither eff ort quantified uncertainty in prevalence or years lived with disability (YLDs). Methods: Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis. Findings: Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350 000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated (correlation coefficient -0·37). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. The main contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes or endocrine diseases. The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. Age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar compared with years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, and anaemia were important causes of YLDs in sub-Saharan Africa. Interpretation: Rates of YLDs per 100 000 people have remained largely constant over time but rise steadily with age. Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalences of the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, have not decreased. Health systems will need to address the needs of the rising numbers of individuals with a range of disorders that largely cause disability but not mortality. Quantification of the burden of non-fatal health outcomes will be crucial to understand how well health systems are responding to these challenges. Eff ective and aff ordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world.
U2 - 10.1016/S0140-6736(12)61729-2
DO - 10.1016/S0140-6736(12)61729-2
M3 - Article
VL - 380
SP - 2163
EP - 2196
JO - Lancet
JF - Lancet
SN - 0140-6736
IS - 9859
ER -