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
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Flaxman, Abraham D
Naghavi, Mohsen
Lozano, Rafael
Michaud, Catherine
Ezzati, Majid
Shibuya, Kenji
Salomon, Joshua A
Abdalla, Safa
Aboyans, Victor
Abraham, Jerry
Ackerman, Ilana
Aggarwal, Rakesh
Ahn, Stephanie Y
Ali, Mohammed K
Alvarado, Miriam
Anderson, H Ross
Anderson, Laurie M
Andrews, Kathryn G
Atkinson, Charles
Baddour, Larry M
Bahalim, Adil N
Barker-Collo, Suzanne
Barrero, Lope H
Bartels, David H
Basanez, Maria-Gloria
Baxter, Amanda
Bell, Michelle L
Benjamin, Emelia J
Bennett, Derrick
Bernabe, Eduardo
Bhalla, Kavi
Bhandari, Bishal
Bikbov, Boris
Bin Abdulhak, Aref
Birbeck, Gretchen
Black, James A
Blencowe, Hannah
Blore, Jed D
Blyth, Fiona
Bolliger, Ian
Bonaventure, Audrey
Boufous, Soufi Ane
Bourne, Rupert
Boussinesq, Michel
Braithwaite, Tasanee
Brayne, Carol
Bridgett, Lisa
Brooker, Simon
Brooks, Peter
Brugha, Traolach S
Bryan-Hancock, Claire
Bucello, Chiara
Buchbinder, Rachelle
Buckle, Geoff Rey
Budke, Christine M
Burch, Michael
Burney, Peter
Burstein, Roy
Calabria, Bianca
Campbell, Benjamin
Canter, Charles E
Carabin, Helene
Carapetis, Jonathan
Carmona, Loreto
Cella, Claudia
Charlson, Fiona
Chen, Honglei
Cheng, Andrew Tai-Ann
Chou, David
Chugh, Sumeet S
Coffeng, Luc E
Colan, Steven D
Colquhoun, Samantha
Colson, K Ellicott
Condon, John
Connor, Myles D
Cooper, Leslie T
Corriere, Matthew
Cortinovis, Monica
de Vaccaro, Karen Courville
Couser, William
Cowie, Benjamin C
Criqui, Michael H
Cross, Marita
Dabhadkar, Kaustubh C
Dahiya, Manu
Dahodwala, Nabila
Damsere-Derry, James
Danaei, Goodarz
Davis, Adrian
De Leo, Diego
Degenhardt, Louisa
Dellavalle, Robert
Delossantos, Allyne
Denenberg, Julie
Derrett, Sarah
Des Jarlais, Don C
Dharmaratne, Samath D
Dherani, Mukesh
Diaz-Torne, Cesar
Dolk, Helen
Dorsey, E Ray
Driscoll, Tim
Duber, Herbert
Ebel, Beth
Edmond, Karen
Elbaz, Alexis
Ali, Suad Eltahir
Erskine, Holly
Erwin, Patricia J
Espindola, Patricia
Ewoigbokhan, Stalin E
Farzadfar, Farshad
Feigin, Valery
Felson, David T
Ferrari, Alize
Ferri, Cleusa P
Fevre, Eric M
Finucane, Mariel M
Flaxman, Seth
Flood, Louise
Foreman, Kyle
Forouzanfar, Mohammad H
Fowkes, Francis Gerry R
Franklin, Richard
Fransen, Marlene
Freeman, Michael K
Gabbe, Belinda J
Gabriel, Sherine E
Gakidou, Emmanuela
Ganatra, Hammad A
Garcia, Bianca
Gaspari, Flavio
Gillum, Richard F
Gmel, Gerhard
Gosselin, Richard
Grainger, Rebecca
Groeger, Justina
Guillemin, Francis
Gunnell, David
Gupta, Ramyani
Haagsma, Juanita
Hagan, Holly
Halasa, Yara A
Hall, Wayne
Haring, Diana
Maria Haro, Josep
Harrison, James E
Havmoeller, Rasmus
Hay, Roderick J
Higashi, Hideki
Hill, Catherine
Hoen, Bruno
Hoffman, Howard
Hotez, Peter J
Hoy, Damian
Huang, John J
Ibeanusi, Sydney E
Jacobsen, Kathryn H
James, Spencer L
Jarvis, Deborah
Jasrasaria, Rashmi
Jayaraman, Sudha
Johns, Nicole
Jonas, Jost B
Karthikeyan, Ganesan
Kassebaum, Nicholas
Kawakami, Norito
Keren, Andre
Khoo, Jon-Paul
King, Charles H
Knowlton, Lisa Marie
Kobusingye, Olive
Koranteng, Adofo
Krishnamurthi, Rita
Lalloo, Ratilal
Laslett, Laura L
Lathlean, Tim
Leasher, Janet L
Lee, Yong Yi
Leigh, James
Lim, Stephen S
Limb, Elizabeth
Lin, John Kent
Lipnick, Michael
Lipshultz, Steven E
Liu, Wei
Loane, Maria
Ohno, Summer Lockett
Lyons, Ronan
Ma, Jixiang
Mabweijano, Jacqueline
MacIntyre, Michael F
Malekzadeh, Reza
Mallinger, Leslie
Manivannan, Sivabalan
Marcenes, Wagner
March, Lyn
Margolis, David J
Marks, Guy B
Marks, Robin
Matsumori, Akira
Matzopoulos, Richard
Mayosi, Bongani M
McAnulty, John H
McDermott, Mary M
McGill, Neil
McGrath, John
Elena Medina-Mora, Maria
Meltzer, Michele
Mensah, George A
Merriman, Tony R
Meyer, Ana-Claire
Miglioli, Valeria
Miller, Matthew
Miller, Ted R
Mitchell, Philip B
Mocumbi, Ana Olga
Moffitt, Terrie E
Mokdad, Ali A
Monasta, Lorenzo
Montico, Marcella
Moradi-Lakeh, Maziar
Moran, Andrew
Morawska, Lidia
Mori, Rintaro
Murdoch, Michele E
Mwaniki, Michael K
Naidoo, Kovin
Nair, M Nathan
Naldi, Luigi
Narayan, KM Venkat
Nelson, Paul K
Nelson, Robert G
Nevitt, Michael C
Newton, Charles R
Nolte, Sandra
Norman, Paul
Norman, Rosana
O'Donnell, Martin
O'Hanlon, Simon
Olives, Casey
Omer, Saad B
Ortblad, Katrina
Osborne, Richard
Ozgediz, Doruk
Page, Andrew
Pahari, Bishnu
Pandian, Jeyaraj Durai
Rivero, Andrea Panozo
Patten, Scott B
Pearce, Neil
Perez Padilla, Rogelio
Perez-Ruiz, Fernando
Perico, Norberto
Pesudovs, Konrad
Phillips, David
Phillips, Michael R
Pierce, Kelsey
Pion, Sebastien
Polanczyk, Guilherme V
Polinder, Suzanne
Pope, C Arden
Popova, Svetlana
Porrini, Esteban
Pourmalek, Farshad
Prince, Martin
Pullan, Rachel L
Ramaiah, Kapa D
Ranganathan, Dharani
Razavi, Homie
Regan, Mathilda
Rehm, Juergen T
Rein, David B
Remuzzi, Guiseppe
Richardson, Kathryn
Rivara, Frederick P
Roberts, Thomas
Robinson, Carolyn
De Leon, Felipe Rodriguez
Ronfani, Luca
Room, Robin
Rosenfeld, Lisa C
Rushton, Lesley
Sacco, Ralph L
Saha, Sukanta
Sampson, Uchechukwu
Sanchez-Riera, Lidia
Sanman, Ella
Schwebel, David C
Scott, James Graham
Segui-Gomez, Maria
Shahraz, Saeid
Shepard, Donald S
Shin, Hwashin
Shivakoti, Rupak
Singh, David
Singh, Gitanjali M
Singh, Jasvinder A
Singleton, Jessica
Sleet, David A
Sliwa, Karen
Smith, Emma
Smith, Jennifer L
Stapelberg, Nicolas JC
Steer, Andrew
Steiner, Timothy
Stolk, Wilma A
Stovner, Lars Jacob
Sudfeld, Christopher
Syed, Sana
Tamburlini, Giorgio
Tavakkoli, Mohammad
Taylor, Hugh R
Taylor, Jennifer A
Taylor, William J
Thomas, Bernadette
Thomson, W Murray
Thurston, George D
Tleyjeh, Imad M
Tonelli, Marcello
Towbin, Jeff Rey A
Truelsen, Thomas
Tsilimbaris, Miltiadis K
Ubeda, Clotilde
Undurraga, Eduardo A
van der Werf, Marieke J
van Os, Jim
Vavilala, Monica S
Venketasubramanian, N
Wang, Mengru
Wang, Wenzhi
Watt, Kerrianne
Weatherall, David J
Weinstock, Martin A
Weintraub, Robert
Weisskopf, Marc G
Weissman, Myrna M
White, Richard A
Whiteford, Harvey
Wiersma, Steven T
Wilkinson, James D
Williams, Hywel C
Williams, Sean RM
Witt, Emma
Wolfe, Frederick
Woolf, Anthony D
Wulf, Sarah
Yeh, Pon-Hsiu
Zaidi, Anita KM
Zheng, Zhi-Jie
Zonies, David
Lopez, Alan D
Murray, Christopher JL
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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 quantifi ed 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 notifi cation, 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. Effective and affordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world.
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The Lancet
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380
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9859
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Biomedical and clinical sciences
Epidemiology not elsewhere classified