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, 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, Rakesh Aggarwal, Stephanie Y. Ahn, Mohammed K. Ali, Miriam Alvarado, H. Ross Anderson, Laurie M. Anderson, Kathryn G. Andrews & 339 others Charles Atkinson, Larry M. Baddour, Adil N. Bahalim, Suzanne Barker-Collo, Lope H. Barrero, David H. Bartels, Maria Gloria Basáñez, Amanda Baxter, Michelle L. Bell, Emelia J. Benjamin, Derrick Bennett, Eduardo Bernabé, Kavi Bhalla, Bishal Bhandari, Boris 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 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, Hélène 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 Corriere, Monica Cortinovis, Karen Courville De Vaccaro, William Couser, Benjamin C. Cowie, Michael H. Criqui, Marita Cross, Kaustubh C. Dabhadkar, Manu Dahiya, Nabila Dahodwala, James Damsere-Derry, Goodarz Danaei, Adrian Davis, Diego De Leo, Louisa Degenhardt, Robert Dellavalle, Allyne Delossantos, Julie Denenberg, Sarah Derrett, Don C. Des Jarlais, Don Des Jarlais, Mukesh Dherani, Cesar Diaz-Torne, Helen Dolk, E. Ray Dorsey, Tim Driscoll, Herbert 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 M. Fèvre, Mariel M. Finucane, Seth Flaxman, Louise Flood, Kyle Foreman, Mohammad H. Forouzanfar, Francis Gerry R Fowkes, Marlene Fransen, Michael K. Freeman, Belinda J. Gabbe, Sherine E. Gabriel, Emmanuela Gakidou, Hammad A. 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 Haagsma, Holly Hagan, Holly Hagan, 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 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 Kassebaum, Norito Kawakami, Andre Keren, Jon Paul Khoo, Charles H. King, Lisa Marie Knowlton, Olive Kobusingye, Adofo Koranteng, Rita Krishnamurthi, Francine Laden, Ratilal Lalloo, Laura L. Laslett, Tim Lathlean, Janet L. Leasher, Yong Yi Lee, James Leigh, Daphna Levinson, Stephen S. Lim, Elizabeth Limb, John Kent Lin, Michael Lipnick, Steven E. Lipshultz, Wei Liu, Maria Loane, Summer Lockett Ohno, Ronan Lyons, Jacqueline 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 M. Mayosi, John H. McAnulty, Mary M. McDermott, Neil McGill, John McGrath, Maria Elena Medina-Mora, Michele Meltzer, 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, M. Nathan Nair, Luigi Naldi, K. M 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 Osborne, Doruk 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, Sébastien 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, Jürgen T. Rehm, David B. Rein, Guiseppe Remuzzi, Kathryn Richardson, Frederick P. Rivara, Thomas Roberts, Carolyn Robinson, Felipe Rodriguez De Leòn, 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, N. 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 Zonies, Alan D. Lopez

Research output: Contribution to journalArticle

Abstract

Background 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-specific 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 definitions and methods. YLLs were calculated from age-sex-country-time-specific 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-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific 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 Pacific, western Europe, high-income North America, and Australasia); rising to over 80% of DALYs in sub-Saharan Africa. In 1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from non-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010; (up from fourth rank in 1990, increasing by 29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs); stroke; (fifth in 1990; 19% increase); diarrhoeal diseases; (second in 1990; 51% decrease); and HIV/AIDS (33rd in 1990; 351% increase). Major depressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34% increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions. Interpretation Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results.

Original languageEnglish (US)
Pages (from-to)2197-2223
Number of pages27
JournalThe Lancet
Volume380
Issue number9859
DOIs
StatePublished - 2012

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Quality-Adjusted Life Years
Wounds and Injuries
Nutrition Disorders
Premature Mortality
Africa South of the Sahara
Uncertainty
Mortality
Global Burden of Disease
Health
Mothers
Australasia
Weights and Measures
Major Depressive Disorder
North America
Life Expectancy
Mental Disorders
Respiratory Tract Infections
Myocardial Ischemia
Cause of Death
Acquired Immunodeficiency Syndrome

ASJC Scopus subject areas

  • Medicine(all)

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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. / Murray, Christopher J L; Vos, Theo; Lozano, Rafael; Naghavi, Mohsen; Flaxman, Abraham D.; 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.; Basáñez, Maria Gloria; Baxter, Amanda; Bell, Michelle L.; Benjamin, Emelia J.; Bennett, Derrick; Bernabé, Eduardo; Bhalla, Kavi; Bhandari, Bishal; Bikbov, Boris; Abdulhak, Aref Bin; Birbeck, Gretchen; Black, James A.; Blencowe, Hannah; Blore, Jed D.; Blyth, Fiona; Bolliger, Ian; Bonaventure, Audrey; Boufous, Soufiane; 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, Geoffrey; Budke, Christine M.; Burch, Michael; Burney, Peter; Burstein, Roy; Calabria, Bianca; Campbell, Benjamin; Canter, Charles E.; Carabin, Hélène; 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.; Des Jarlais, Don; 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.; Fèvre, Eric M.; Finucane, Mariel M.; Flaxman, Seth; Flood, Louise; Foreman, Kyle; Forouzanfar, Mohammad H.; Fowkes, Francis Gerry R; 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; Gonzalez-Medina, Diego; Gosselin, Richard; Grainger, Rebecca; Grant, Bridget; Groeger, Justina; Guillemin, Francis; Gunnell, David; Gupta, Ramyani; Haagsma, Juanita; Hagan, Holly; Hagan, Holly; Hall, Wayne; Haring, Diana; Haro, Josep Maria; 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; Laden, Francine; Lalloo, Ratilal; Laslett, Laura L.; Lathlean, Tim; Leasher, Janet L.; Lee, Yong Yi; Leigh, James; Levinson, Daphna; Lim, Stephen S.; Limb, Elizabeth; Lin, John Kent; Lipnick, Michael; Lipshultz, Steven E.; Liu, Wei; Loane, Maria; Ohno, Summer Lockett; Lyons, Ronan; 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; Medina-Mora, Maria Elena; Meltzer, Michele; Mensah, George A.; Merriman, Tony R.; Meyer, Ana Claire; Miglioli, Valeria; Miller, Matthew; Miller, Ted R.; Mitchell, Philip B.; Mock, Charles; 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, K. M 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; Padilla, Rogelio Perez; Perez-Ruiz, Fernando; Perico, Norberto; Pesudovs, Konrad; Phillips, David; Phillips, Michael R.; Pierce, Kelsey; Pion, Sébastien; 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, Jürgen T.; Rein, David B.; Remuzzi, Guiseppe; Richardson, Kathryn; Rivara, Frederick P.; Roberts, Thomas; Robinson, Carolyn; De Leòn, 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 J C; 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, Jeffrey 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; Wiebe, Natasha; Wiersma, Steven T.; Wilkinson, James D.; Williams, Hywel C.; Williams, Sean R M; Witt, Emma; Wolfe, Frederick; Woolf, Anthony D.; Wulf, Sarah; Yeh, Pon Hsiu; Zaidi, Anita K M; Zheng, Zhi Jie; Zonies, David; Lopez, Alan D.

In: The Lancet, Vol. 380, No. 9859, 2012, p. 2197-2223.

Research output: Contribution to journalArticle

Murray, CJL, Vos, T, Lozano, R, Naghavi, M, Flaxman, AD, Michaud, C, Ezzati, M, Shibuya, K, Salomon, JA, Abdalla, S, Aboyans, V, Abraham, J, Ackerman, I, Aggarwal, R, Ahn, SY, Ali, MK, Alvarado, M, Anderson, HR, Anderson, LM, Andrews, KG, Atkinson, C, Baddour, LM, Bahalim, AN, Barker-Collo, S, Barrero, LH, Bartels, DH, Basáñez, MG, Baxter, A, Bell, ML, Benjamin, EJ, Bennett, D, Bernabé, E, Bhalla, K, Bhandari, B, Bikbov, B, Abdulhak, AB, Birbeck, G, Black, JA, Blencowe, H, Blore, JD, Blyth, F, Bolliger, I, Bonaventure, A, Boufous, S, Bourne, R, Boussinesq, M, Braithwaite, T, Brayne, C, Bridgett, L, Brooker, S, Brooks, P, Brugha, TS, Bryan-Hancock, C, Bucello, C, Buchbinder, R, Buckle, G, Budke, CM, Burch, M, Burney, P, Burstein, R, Calabria, B, Campbell, B, Canter, CE, Carabin, H, Carapetis, J, Carmona, L, Cella, C, Charlson, F, Chen, H, Cheng, ATA, Chou, D, Chugh, SS, Coffeng, LE, Colan, SD, Colquhoun, S, Colson, KE, Condon, J, Connor, MD, Cooper, LT, Corriere, M, Cortinovis, M, De Vaccaro, KC, Couser, W, Cowie, BC, Criqui, MH, Cross, M, Dabhadkar, KC, Dahiya, M, Dahodwala, N, Damsere-Derry, J, Danaei, G, Davis, A, De Leo, D, Degenhardt, L, Dellavalle, R, Delossantos, A, Denenberg, J, Derrett, S, Des Jarlais, DC, Des Jarlais, D, Dherani, M, Diaz-Torne, C, Dolk, H, Dorsey, ER, Driscoll, T, Duber, H, Ebel, B, Edmond, K, Elbaz, A, Ali, SE, Erskine, H, Erwin, PJ, Espindola, P, Ewoigbokhan, SE, Farzadfar, F, Feigin, V, Felson, DT, Ferrari, A, Ferri, CP, Fèvre, EM, Finucane, MM, Flaxman, S, Flood, L, Foreman, K, Forouzanfar, MH, Fowkes, FGR, Fransen, M, Freeman, MK, Gabbe, BJ, Gabriel, SE, Gakidou, E, Ganatra, HA, Garcia, B, Gaspari, F, Gillum, RF, Gmel, G, Gonzalez-Medina, D, Gosselin, R, Grainger, R, Grant, B, Groeger, J, Guillemin, F, Gunnell, D, Gupta, R, Haagsma, J, Hagan, H, Hagan, H, Hall, W, Haring, D, Haro, JM, Harrison, JE, Havmoeller, R, Hay, RJ, Higashi, H, Hill, C, Hoen, B, Hoffman, H, Hotez, PJ, Hoy, D, Huang, JJ, Ibeanusi, SE, Jacobsen, KH, James, SL, Jarvis, D, Jasrasaria, R, Jayaraman, S, Johns, N, Jonas, JB, Karthikeyan, G, Kassebaum, N, Kawakami, N, Keren, A, Khoo, JP, King, CH, Knowlton, LM, Kobusingye, O, Koranteng, A, Krishnamurthi, R, Laden, F, Lalloo, R, Laslett, LL, Lathlean, T, Leasher, JL, Lee, YY, Leigh, J, Levinson, D, Lim, SS, Limb, E, Lin, JK, Lipnick, M, Lipshultz, SE, Liu, W, Loane, M, Ohno, SL, Lyons, R, Mabweijano, J, MacIntyre, MF, Malekzadeh, R, Mallinger, L, Manivannan, S, Marcenes, W, March, L, Margolis, DJ, Marks, GB, Marks, R, Matsumori, A, Matzopoulos, R, Mayosi, BM, McAnulty, JH, McDermott, MM, McGill, N, McGrath, J, Medina-Mora, ME, Meltzer, M, Mensah, GA, Merriman, TR, Meyer, AC, Miglioli, V, Miller, M, Miller, TR, Mitchell, PB, Mock, C, Mocumbi, AO, Moffitt, TE, Mokdad, AA, Monasta, L, Montico, M, Moradi-Lakeh, M, Moran, A, Morawska, L, Mori, R, Murdoch, ME, Mwaniki, MK, Naidoo, K, Nair, MN, Naldi, L, Narayan, KMV, Nelson, PK, Nelson, RG, Nevitt, MC, Newton, CR, Nolte, S, Norman, P, Norman, R, O'Donnell, M, O'Hanlon, S, Olives, C, Omer, SB, Ortblad, K, Osborne, R, Ozgediz, D, Page, A, Pahari, B, Pandian, JD, Rivero, AP, Patten, SB, Pearce, N, Padilla, RP, Perez-Ruiz, F, Perico, N, Pesudovs, K, Phillips, D, Phillips, MR, Pierce, K, Pion, S, Polanczyk, GV, Polinder, S, Pope, CA, Popova, S, Porrini, E, Pourmalek, F, Prince, M, Pullan, RL, Ramaiah, KD, Ranganathan, D, Razavi, H, Regan, M, Rehm, JT, Rein, DB, Remuzzi, G, Richardson, K, Rivara, FP, Roberts, T, Robinson, C, De Leòn, FR, Ronfani, L, Room, R, Rosenfeld, LC, Rushton, L, Sacco, RL, Saha, S, Sampson, U, Sanchez-Riera, L, Sanman, E, Schwebel, DC, Scott, JG, Segui-Gomez, M, Shahraz, S, Shepard, DS, Shin, H, Shivakoti, R, Singh, D, Singh, GM, Singh, JA, Singleton, J, Sleet, DA, Sliwa, K, Smith, E, Smith, JL, Stapelberg, NJC, Steer, A, Steiner, T, Stolk, WA, Stovner, LJ, Sudfeld, C, Syed, S, Tamburlini, G, Tavakkoli, M, Taylor, HR, Taylor, JA, Taylor, WJ, Thomas, B, Thomson, WM, Thurston, GD, Tleyjeh, IM, Tonelli, M, Towbin, JA, Truelsen, T, Tsilimbaris, MK, Ubeda, C, Undurraga, EA, Van Der Werf, MJ, Van Os, J, Vavilala, MS, Venketasubramanian, N, Wang, M, Wang, W, Watt, K, Weatherall, DJ, Weinstock, MA, Weintraub, R, Weisskopf, MG, Weissman, MM, White, RA, Whiteford, H, Wiebe, N, Wiersma, ST, Wilkinson, JD, Williams, HC, Williams, SRM, Witt, E, Wolfe, F, Woolf, AD, Wulf, S, Yeh, PH, Zaidi, AKM, Zheng, ZJ, Zonies, D & Lopez, AD 2012, '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', The Lancet, vol. 380, no. 9859, pp. 2197-2223. https://doi.org/10.1016/S0140-6736(12)61689-4
Murray, Christopher J L ; Vos, Theo ; Lozano, Rafael ; Naghavi, Mohsen ; Flaxman, Abraham D. ; 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. ; Basáñez, Maria Gloria ; Baxter, Amanda ; Bell, Michelle L. ; Benjamin, Emelia J. ; Bennett, Derrick ; Bernabé, Eduardo ; Bhalla, Kavi ; Bhandari, Bishal ; Bikbov, Boris ; Abdulhak, Aref Bin ; Birbeck, Gretchen ; Black, James A. ; Blencowe, Hannah ; Blore, Jed D. ; Blyth, Fiona ; Bolliger, Ian ; Bonaventure, Audrey ; Boufous, Soufiane ; 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, Geoffrey ; Budke, Christine M. ; Burch, Michael ; Burney, Peter ; Burstein, Roy ; Calabria, Bianca ; Campbell, Benjamin ; Canter, Charles E. ; Carabin, Hélène ; 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. ; Des Jarlais, Don ; 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. ; Fèvre, Eric M. ; Finucane, Mariel M. ; Flaxman, Seth ; Flood, Louise ; Foreman, Kyle ; Forouzanfar, Mohammad H. ; Fowkes, Francis Gerry R ; 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 ; Gonzalez-Medina, Diego ; Gosselin, Richard ; Grainger, Rebecca ; Grant, Bridget ; Groeger, Justina ; Guillemin, Francis ; Gunnell, David ; Gupta, Ramyani ; Haagsma, Juanita ; Hagan, Holly ; Hagan, Holly ; Hall, Wayne ; Haring, Diana ; Haro, Josep Maria ; 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 ; Laden, Francine ; Lalloo, Ratilal ; Laslett, Laura L. ; Lathlean, Tim ; Leasher, Janet L. ; Lee, Yong Yi ; Leigh, James ; Levinson, Daphna ; Lim, Stephen S. ; Limb, Elizabeth ; Lin, John Kent ; Lipnick, Michael ; Lipshultz, Steven E. ; Liu, Wei ; Loane, Maria ; Ohno, Summer Lockett ; Lyons, Ronan ; 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 ; Medina-Mora, Maria Elena ; Meltzer, Michele ; Mensah, George A. ; Merriman, Tony R. ; Meyer, Ana Claire ; Miglioli, Valeria ; Miller, Matthew ; Miller, Ted R. ; Mitchell, Philip B. ; Mock, Charles ; 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, K. M 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 ; Padilla, Rogelio Perez ; Perez-Ruiz, Fernando ; Perico, Norberto ; Pesudovs, Konrad ; Phillips, David ; Phillips, Michael R. ; Pierce, Kelsey ; Pion, Sébastien ; 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, Jürgen T. ; Rein, David B. ; Remuzzi, Guiseppe ; Richardson, Kathryn ; Rivara, Frederick P. ; Roberts, Thomas ; Robinson, Carolyn ; De Leòn, 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 J C ; 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, Jeffrey 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 ; Wiebe, Natasha ; Wiersma, Steven T. ; Wilkinson, James D. ; Williams, Hywel C. ; Williams, Sean R M ; Witt, Emma ; Wolfe, Frederick ; Woolf, Anthony D. ; Wulf, Sarah ; Yeh, Pon Hsiu ; Zaidi, Anita K M ; Zheng, Zhi Jie ; Zonies, David ; Lopez, Alan D. / 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. In: The Lancet. 2012 ; Vol. 380, No. 9859. pp. 2197-2223.
@article{d9d5cd8c1f404bd58fd9943c99f2aa00,
title = "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",
abstract = "Background 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-specific 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 definitions and methods. YLLs were calculated from age-sex-country-time-specific 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-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific 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 Pacific, western Europe, high-income North America, and Australasia); rising to over 80{\%} of DALYs in sub-Saharan Africa. In 1990, 47{\%} of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43{\%} from non-communicable diseases, and 10{\%} from injuries. By 2010, this had shifted to 35{\%}, 54{\%}, and 11{\%}, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010; (up from fourth rank in 1990, increasing by 29{\%}), followed by lower respiratory infections (top rank in 1990; 44{\%} decline in DALYs); stroke; (fifth in 1990; 19{\%} increase); diarrhoeal diseases; (second in 1990; 51{\%} decrease); and HIV/AIDS (33rd in 1990; 351{\%} increase). Major depressive disorder increased from 15th to 11th rank (37{\%} increase) and road injury from 12th to 10th rank (34{\%} increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions. Interpretation Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results.",
author = "Murray, {Christopher J L} and Theo Vos and Rafael Lozano and Mohsen Naghavi and Flaxman, {Abraham D.} and Catherine Michaud and Majid Ezzati and Kenji Shibuya and Salomon, {Joshua A.} and Safa Abdalla and Victor Aboyans and Jerry Abraham and Ilana Ackerman and Rakesh Aggarwal and Ahn, {Stephanie Y.} and Ali, {Mohammed K.} and Miriam Alvarado and Anderson, {H. Ross} and Anderson, {Laurie M.} and Andrews, {Kathryn G.} and Charles Atkinson and Baddour, {Larry M.} and Bahalim, {Adil N.} and Suzanne Barker-Collo and Barrero, {Lope H.} and Bartels, {David H.} and Bas{\'a}{\~n}ez, {Maria Gloria} and Amanda Baxter and Bell, {Michelle L.} and Benjamin, {Emelia J.} and Derrick Bennett and Eduardo Bernab{\'e} and Kavi Bhalla and Bishal Bhandari and Boris Bikbov and Abdulhak, {Aref Bin} and Gretchen Birbeck and Black, {James A.} and Hannah Blencowe and Blore, {Jed D.} and Fiona Blyth and Ian Bolliger and Audrey Bonaventure and Soufiane Boufous and Rupert Bourne and Michel Boussinesq and Tasanee Braithwaite and Carol Brayne and Lisa Bridgett and Simon Brooker and Peter Brooks and Brugha, {Traolach S.} and Claire Bryan-Hancock and Chiara Bucello and Rachelle Buchbinder and Geoffrey Buckle and Budke, {Christine M.} and Michael Burch and Peter Burney and Roy Burstein and Bianca Calabria and Benjamin Campbell and Canter, {Charles E.} and H{\'e}l{\`e}ne Carabin and Jonathan Carapetis and Loreto Carmona and Claudia Cella and Fiona Charlson and Honglei Chen and Cheng, {Andrew Tai Ann} and David Chou and Chugh, {Sumeet S.} and Coffeng, {Luc E.} and Colan, {Steven D.} and Samantha Colquhoun and Colson, {K. Ellicott} and John Condon and Connor, {Myles D.} and Cooper, {Leslie T.} and Matthew Corriere and Monica Cortinovis and {De Vaccaro}, {Karen Courville} and William Couser and Cowie, {Benjamin C.} and Criqui, {Michael H.} and Marita Cross and Dabhadkar, {Kaustubh C.} and Manu Dahiya and Nabila Dahodwala and James Damsere-Derry and Goodarz Danaei and Adrian Davis and {De Leo}, Diego and Louisa Degenhardt and Robert Dellavalle and Allyne Delossantos and Julie Denenberg and Sarah Derrett and {Des Jarlais}, {Don C.} and {Des Jarlais}, Don and Mukesh Dherani and Cesar Diaz-Torne and Helen Dolk and Dorsey, {E. Ray} and Tim Driscoll and Herbert Duber and Beth Ebel and Karen Edmond and Alexis Elbaz and Ali, {Suad Eltahir} and Holly Erskine and Erwin, {Patricia J.} and Patricia Espindola and Ewoigbokhan, {Stalin E.} and Farshad Farzadfar and Valery Feigin and Felson, {David T.} and Alize Ferrari and Ferri, {Cleusa P.} and F{\`e}vre, {Eric M.} and Finucane, {Mariel M.} and Seth Flaxman and Louise Flood and Kyle Foreman and Forouzanfar, {Mohammad H.} and Fowkes, {Francis Gerry R} and Marlene Fransen and Freeman, {Michael K.} and Gabbe, {Belinda J.} and Gabriel, {Sherine E.} and Emmanuela Gakidou and Ganatra, {Hammad A.} and Bianca Garcia and Flavio Gaspari and Gillum, {Richard F.} and Gerhard Gmel and Diego Gonzalez-Medina and Richard Gosselin and Rebecca Grainger and Bridget Grant and Justina Groeger and Francis Guillemin and David Gunnell and Ramyani Gupta and Juanita Haagsma and Holly Hagan and Holly Hagan and Wayne Hall and Diana Haring and Haro, {Josep Maria} and Harrison, {James E.} and Rasmus Havmoeller and Hay, {Roderick J.} and Hideki Higashi and Catherine Hill and Bruno Hoen and Howard Hoffman and Hotez, {Peter J.} and Damian Hoy and Huang, {John J.} and Ibeanusi, {Sydney E.} and Jacobsen, {Kathryn H.} and James, {Spencer L.} and Deborah Jarvis and Rashmi Jasrasaria and Sudha Jayaraman and Nicole Johns and Jonas, {Jost B.} and Ganesan Karthikeyan and Nicholas Kassebaum and Norito Kawakami and Andre Keren and Khoo, {Jon Paul} and King, {Charles H.} and Knowlton, {Lisa Marie} and Olive Kobusingye and Adofo Koranteng and Rita Krishnamurthi and Francine Laden and Ratilal Lalloo and Laslett, {Laura L.} and Tim Lathlean and Leasher, {Janet L.} and Lee, {Yong Yi} and James Leigh and Daphna Levinson and Lim, {Stephen S.} and Elizabeth Limb and Lin, {John Kent} and Michael Lipnick and Lipshultz, {Steven E.} and Wei Liu and Maria Loane and Ohno, {Summer Lockett} and Ronan Lyons and Jacqueline Mabweijano and MacIntyre, {Michael F.} and Reza Malekzadeh and Leslie Mallinger and Sivabalan Manivannan and Wagner Marcenes and Lyn March and Margolis, {David J.} and Marks, {Guy B.} and Robin Marks and Akira Matsumori and Richard Matzopoulos and Mayosi, {Bongani M.} and McAnulty, {John H.} and McDermott, {Mary M.} and Neil McGill and John McGrath and Medina-Mora, {Maria Elena} and Michele Meltzer and Mensah, {George A.} and Merriman, {Tony R.} and Meyer, {Ana Claire} and Valeria Miglioli and Matthew Miller and Miller, {Ted R.} and Mitchell, {Philip B.} and Charles Mock and Mocumbi, {Ana Olga} and Moffitt, {Terrie E.} and Mokdad, {Ali A.} and Lorenzo Monasta and Marcella Montico and Maziar Moradi-Lakeh and Andrew Moran and Lidia Morawska and Rintaro Mori and Murdoch, {Michele E.} and Mwaniki, {Michael K.} and Kovin Naidoo and Nair, {M. Nathan} and Luigi Naldi and Narayan, {K. M Venkat} and Nelson, {Paul K.} and Nelson, {Robert G.} and Nevitt, {Michael C.} and Newton, {Charles R.} and Sandra Nolte and Paul Norman and Rosana Norman and Martin O'Donnell and Simon O'Hanlon and Casey Olives and Omer, {Saad B.} and Katrina Ortblad and Richard Osborne and Doruk Ozgediz and Andrew Page and Bishnu Pahari and Pandian, {Jeyaraj Durai} and Rivero, {Andrea Panozo} and Patten, {Scott B.} and Neil Pearce and Padilla, {Rogelio Perez} and Fernando Perez-Ruiz and Norberto Perico and Konrad Pesudovs and David Phillips and Phillips, {Michael R.} and Kelsey Pierce and S{\'e}bastien Pion and Polanczyk, {Guilherme V.} and Suzanne Polinder and Pope, {C. Arden} and Svetlana Popova and Esteban Porrini and Farshad Pourmalek and Martin Prince and Pullan, {Rachel L.} and Ramaiah, {Kapa D.} and Dharani Ranganathan and Homie Razavi and Mathilda Regan and Rehm, {J{\"u}rgen T.} and Rein, {David B.} and Guiseppe Remuzzi and Kathryn Richardson and Rivara, {Frederick P.} and Thomas Roberts and Carolyn Robinson and {De Le{\`o}n}, {Felipe Rodriguez} and Luca Ronfani and Robin Room and Rosenfeld, {Lisa C.} and Lesley Rushton and Sacco, {Ralph L.} and Sukanta Saha and Uchechukwu Sampson and Lidia Sanchez-Riera and Ella Sanman and Schwebel, {David C.} and Scott, {James Graham} and Maria Segui-Gomez and Saeid Shahraz and Shepard, {Donald S.} and Hwashin Shin and Rupak Shivakoti and David Singh and Singh, {Gitanjali M.} and Singh, {Jasvinder A.} and Jessica Singleton and Sleet, {David A.} and Karen Sliwa and Emma Smith and Smith, {Jennifer L.} and Stapelberg, {Nicolas J C} and Andrew Steer and Timothy Steiner and Stolk, {Wilma A.} and Stovner, {Lars Jacob} and Christopher Sudfeld and Sana Syed and Giorgio Tamburlini and Mohammad Tavakkoli and Taylor, {Hugh R.} and Taylor, {Jennifer A.} and Taylor, {William J.} and Bernadette Thomas and Thomson, {W. Murray} and Thurston, {George D.} and Tleyjeh, {Imad M.} and Marcello Tonelli and Towbin, {Jeffrey A.} and Thomas Truelsen and Tsilimbaris, {Miltiadis K.} and Clotilde Ubeda and Undurraga, {Eduardo A.} and {Van Der Werf}, {Marieke J.} and {Van Os}, Jim and Vavilala, {Monica S.} and N. Venketasubramanian and Mengru Wang and Wenzhi Wang and Kerrianne Watt and Weatherall, {David J.} and Weinstock, {Martin A.} and Robert Weintraub and Weisskopf, {Marc G.} and Weissman, {Myrna M.} and White, {Richard A.} and Harvey Whiteford and Natasha Wiebe and Wiersma, {Steven T.} and Wilkinson, {James D.} and Williams, {Hywel C.} and Williams, {Sean R M} and Emma Witt and Frederick Wolfe and Woolf, {Anthony D.} and Sarah Wulf and Yeh, {Pon Hsiu} and Zaidi, {Anita K M} and Zheng, {Zhi Jie} and David Zonies and Lopez, {Alan D.}",
year = "2012",
doi = "10.1016/S0140-6736(12)61689-4",
language = "English (US)",
volume = "380",
pages = "2197--2223",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier Limited",
number = "9859",

}

TY - JOUR

T1 - Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010

T2 - A systematic analysis for the Global Burden of Disease Study 2010

AU - Murray, Christopher J L

AU - Vos, Theo

AU - Lozano, Rafael

AU - Naghavi, Mohsen

AU - Flaxman, Abraham D.

AU - Michaud, Catherine

AU - Ezzati, Majid

AU - Shibuya, Kenji

AU - Salomon, Joshua A.

AU - Abdalla, Safa

AU - Aboyans, Victor

AU - Abraham, Jerry

AU - Ackerman, Ilana

AU - Aggarwal, Rakesh

AU - Ahn, Stephanie Y.

AU - Ali, Mohammed K.

AU - Alvarado, Miriam

AU - Anderson, H. Ross

AU - Anderson, Laurie M.

AU - Andrews, Kathryn G.

AU - Atkinson, Charles

AU - Baddour, Larry M.

AU - Bahalim, Adil N.

AU - Barker-Collo, Suzanne

AU - Barrero, Lope H.

AU - Bartels, David H.

AU - Basáñez, Maria Gloria

AU - Baxter, Amanda

AU - Bell, Michelle L.

AU - Benjamin, Emelia J.

AU - Bennett, Derrick

AU - Bernabé, Eduardo

AU - Bhalla, Kavi

AU - Bhandari, Bishal

AU - Bikbov, Boris

AU - Abdulhak, Aref Bin

AU - Birbeck, Gretchen

AU - Black, James A.

AU - Blencowe, Hannah

AU - Blore, Jed D.

AU - Blyth, Fiona

AU - Bolliger, Ian

AU - Bonaventure, Audrey

AU - Boufous, Soufiane

AU - Bourne, Rupert

AU - Boussinesq, Michel

AU - Braithwaite, Tasanee

AU - Brayne, Carol

AU - Bridgett, Lisa

AU - Brooker, Simon

AU - Brooks, Peter

AU - Brugha, Traolach S.

AU - Bryan-Hancock, Claire

AU - Bucello, Chiara

AU - Buchbinder, Rachelle

AU - Buckle, Geoffrey

AU - Budke, Christine M.

AU - Burch, Michael

AU - Burney, Peter

AU - Burstein, Roy

AU - Calabria, Bianca

AU - Campbell, Benjamin

AU - Canter, Charles E.

AU - Carabin, Hélène

AU - Carapetis, Jonathan

AU - Carmona, Loreto

AU - Cella, Claudia

AU - Charlson, Fiona

AU - Chen, Honglei

AU - Cheng, Andrew Tai Ann

AU - Chou, David

AU - Chugh, Sumeet S.

AU - Coffeng, Luc E.

AU - Colan, Steven D.

AU - Colquhoun, Samantha

AU - Colson, K. Ellicott

AU - Condon, John

AU - Connor, Myles D.

AU - Cooper, Leslie T.

AU - Corriere, Matthew

AU - Cortinovis, Monica

AU - De Vaccaro, Karen Courville

AU - Couser, William

AU - Cowie, Benjamin C.

AU - Criqui, Michael H.

AU - Cross, Marita

AU - Dabhadkar, Kaustubh C.

AU - Dahiya, Manu

AU - Dahodwala, Nabila

AU - Damsere-Derry, James

AU - Danaei, Goodarz

AU - Davis, Adrian

AU - De Leo, Diego

AU - Degenhardt, Louisa

AU - Dellavalle, Robert

AU - Delossantos, Allyne

AU - Denenberg, Julie

AU - Derrett, Sarah

AU - Des Jarlais, Don C.

AU - Des Jarlais, Don

AU - Dherani, Mukesh

AU - Diaz-Torne, Cesar

AU - Dolk, Helen

AU - Dorsey, E. Ray

AU - Driscoll, Tim

AU - Duber, Herbert

AU - Ebel, Beth

AU - Edmond, Karen

AU - Elbaz, Alexis

AU - Ali, Suad Eltahir

AU - Erskine, Holly

AU - Erwin, Patricia J.

AU - Espindola, Patricia

AU - Ewoigbokhan, Stalin E.

AU - Farzadfar, Farshad

AU - Feigin, Valery

AU - Felson, David T.

AU - Ferrari, Alize

AU - Ferri, Cleusa P.

AU - Fèvre, Eric M.

AU - Finucane, Mariel M.

AU - Flaxman, Seth

AU - Flood, Louise

AU - Foreman, Kyle

AU - Forouzanfar, Mohammad H.

AU - Fowkes, Francis Gerry R

AU - Fransen, Marlene

AU - Freeman, Michael K.

AU - Gabbe, Belinda J.

AU - Gabriel, Sherine E.

AU - Gakidou, Emmanuela

AU - Ganatra, Hammad A.

AU - Garcia, Bianca

AU - Gaspari, Flavio

AU - Gillum, Richard F.

AU - Gmel, Gerhard

AU - Gonzalez-Medina, Diego

AU - Gosselin, Richard

AU - Grainger, Rebecca

AU - Grant, Bridget

AU - Groeger, Justina

AU - Guillemin, Francis

AU - Gunnell, David

AU - Gupta, Ramyani

AU - Haagsma, Juanita

AU - Hagan, Holly

AU - Hagan, Holly

AU - Hall, Wayne

AU - Haring, Diana

AU - Haro, Josep Maria

AU - Harrison, James E.

AU - Havmoeller, Rasmus

AU - Hay, Roderick J.

AU - Higashi, Hideki

AU - Hill, Catherine

AU - Hoen, Bruno

AU - Hoffman, Howard

AU - Hotez, Peter J.

AU - Hoy, Damian

AU - Huang, John J.

AU - Ibeanusi, Sydney E.

AU - Jacobsen, Kathryn H.

AU - James, Spencer L.

AU - Jarvis, Deborah

AU - Jasrasaria, Rashmi

AU - Jayaraman, Sudha

AU - Johns, Nicole

AU - Jonas, Jost B.

AU - Karthikeyan, Ganesan

AU - Kassebaum, Nicholas

AU - Kawakami, Norito

AU - Keren, Andre

AU - Khoo, Jon Paul

AU - King, Charles H.

AU - Knowlton, Lisa Marie

AU - Kobusingye, Olive

AU - Koranteng, Adofo

AU - Krishnamurthi, Rita

AU - Laden, Francine

AU - Lalloo, Ratilal

AU - Laslett, Laura L.

AU - Lathlean, Tim

AU - Leasher, Janet L.

AU - Lee, Yong Yi

AU - Leigh, James

AU - Levinson, Daphna

AU - Lim, Stephen S.

AU - Limb, Elizabeth

AU - Lin, John Kent

AU - Lipnick, Michael

AU - Lipshultz, Steven E.

AU - Liu, Wei

AU - Loane, Maria

AU - Ohno, Summer Lockett

AU - Lyons, Ronan

AU - Mabweijano, Jacqueline

AU - MacIntyre, Michael F.

AU - Malekzadeh, Reza

AU - Mallinger, Leslie

AU - Manivannan, Sivabalan

AU - Marcenes, Wagner

AU - March, Lyn

AU - Margolis, David J.

AU - Marks, Guy B.

AU - Marks, Robin

AU - Matsumori, Akira

AU - Matzopoulos, Richard

AU - Mayosi, Bongani M.

AU - McAnulty, John H.

AU - McDermott, Mary M.

AU - McGill, Neil

AU - McGrath, John

AU - Medina-Mora, Maria Elena

AU - Meltzer, Michele

AU - Mensah, George A.

AU - Merriman, Tony R.

AU - Meyer, Ana Claire

AU - Miglioli, Valeria

AU - Miller, Matthew

AU - Miller, Ted R.

AU - Mitchell, Philip B.

AU - Mock, Charles

AU - Mocumbi, Ana Olga

AU - Moffitt, Terrie E.

AU - Mokdad, Ali A.

AU - Monasta, Lorenzo

AU - Montico, Marcella

AU - Moradi-Lakeh, Maziar

AU - Moran, Andrew

AU - Morawska, Lidia

AU - Mori, Rintaro

AU - Murdoch, Michele E.

AU - Mwaniki, Michael K.

AU - Naidoo, Kovin

AU - Nair, M. Nathan

AU - Naldi, Luigi

AU - Narayan, K. M Venkat

AU - Nelson, Paul K.

AU - Nelson, Robert G.

AU - Nevitt, Michael C.

AU - Newton, Charles R.

AU - Nolte, Sandra

AU - Norman, Paul

AU - Norman, Rosana

AU - O'Donnell, Martin

AU - O'Hanlon, Simon

AU - Olives, Casey

AU - Omer, Saad B.

AU - Ortblad, Katrina

AU - Osborne, Richard

AU - Ozgediz, Doruk

AU - Page, Andrew

AU - Pahari, Bishnu

AU - Pandian, Jeyaraj Durai

AU - Rivero, Andrea Panozo

AU - Patten, Scott B.

AU - Pearce, Neil

AU - Padilla, Rogelio Perez

AU - Perez-Ruiz, Fernando

AU - Perico, Norberto

AU - Pesudovs, Konrad

AU - Phillips, David

AU - Phillips, Michael R.

AU - Pierce, Kelsey

AU - Pion, Sébastien

AU - Polanczyk, Guilherme V.

AU - Polinder, Suzanne

AU - Pope, C. Arden

AU - Popova, Svetlana

AU - Porrini, Esteban

AU - Pourmalek, Farshad

AU - Prince, Martin

AU - Pullan, Rachel L.

AU - Ramaiah, Kapa D.

AU - Ranganathan, Dharani

AU - Razavi, Homie

AU - Regan, Mathilda

AU - Rehm, Jürgen T.

AU - Rein, David B.

AU - Remuzzi, Guiseppe

AU - Richardson, Kathryn

AU - Rivara, Frederick P.

AU - Roberts, Thomas

AU - Robinson, Carolyn

AU - De Leòn, Felipe Rodriguez

AU - Ronfani, Luca

AU - Room, Robin

AU - Rosenfeld, Lisa C.

AU - Rushton, Lesley

AU - Sacco, Ralph L.

AU - Saha, Sukanta

AU - Sampson, Uchechukwu

AU - Sanchez-Riera, Lidia

AU - Sanman, Ella

AU - Schwebel, David C.

AU - Scott, James Graham

AU - Segui-Gomez, Maria

AU - Shahraz, Saeid

AU - Shepard, Donald S.

AU - Shin, Hwashin

AU - Shivakoti, Rupak

AU - Singh, David

AU - Singh, Gitanjali M.

AU - Singh, Jasvinder A.

AU - Singleton, Jessica

AU - Sleet, David A.

AU - Sliwa, Karen

AU - Smith, Emma

AU - Smith, Jennifer L.

AU - Stapelberg, Nicolas J C

AU - Steer, Andrew

AU - Steiner, Timothy

AU - Stolk, Wilma A.

AU - Stovner, Lars Jacob

AU - Sudfeld, Christopher

AU - Syed, Sana

AU - Tamburlini, Giorgio

AU - Tavakkoli, Mohammad

AU - Taylor, Hugh R.

AU - Taylor, Jennifer A.

AU - Taylor, William J.

AU - Thomas, Bernadette

AU - Thomson, W. Murray

AU - Thurston, George D.

AU - Tleyjeh, Imad M.

AU - Tonelli, Marcello

AU - Towbin, Jeffrey A.

AU - Truelsen, Thomas

AU - Tsilimbaris, Miltiadis K.

AU - Ubeda, Clotilde

AU - Undurraga, Eduardo A.

AU - Van Der Werf, Marieke J.

AU - Van Os, Jim

AU - Vavilala, Monica S.

AU - Venketasubramanian, N.

AU - Wang, Mengru

AU - Wang, Wenzhi

AU - Watt, Kerrianne

AU - Weatherall, David J.

AU - Weinstock, Martin A.

AU - Weintraub, Robert

AU - Weisskopf, Marc G.

AU - Weissman, Myrna M.

AU - White, Richard A.

AU - Whiteford, Harvey

AU - Wiebe, Natasha

AU - Wiersma, Steven T.

AU - Wilkinson, James D.

AU - Williams, Hywel C.

AU - Williams, Sean R M

AU - Witt, Emma

AU - Wolfe, Frederick

AU - Woolf, Anthony D.

AU - Wulf, Sarah

AU - Yeh, Pon Hsiu

AU - Zaidi, Anita K M

AU - Zheng, Zhi Jie

AU - Zonies, David

AU - Lopez, Alan D.

PY - 2012

Y1 - 2012

N2 - Background 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-specific 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 definitions and methods. YLLs were calculated from age-sex-country-time-specific 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-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific 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 Pacific, western Europe, high-income North America, and Australasia); rising to over 80% of DALYs in sub-Saharan Africa. In 1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from non-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010; (up from fourth rank in 1990, increasing by 29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs); stroke; (fifth in 1990; 19% increase); diarrhoeal diseases; (second in 1990; 51% decrease); and HIV/AIDS (33rd in 1990; 351% increase). Major depressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34% increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions. Interpretation Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results.

AB - Background 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-specific 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 definitions and methods. YLLs were calculated from age-sex-country-time-specific 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-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific 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 Pacific, western Europe, high-income North America, and Australasia); rising to over 80% of DALYs in sub-Saharan Africa. In 1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from non-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010; (up from fourth rank in 1990, increasing by 29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs); stroke; (fifth in 1990; 19% increase); diarrhoeal diseases; (second in 1990; 51% decrease); and HIV/AIDS (33rd in 1990; 351% increase). Major depressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34% increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions. Interpretation Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results.

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U2 - 10.1016/S0140-6736(12)61689-4

DO - 10.1016/S0140-6736(12)61689-4

M3 - Article

VL - 380

SP - 2197

EP - 2223

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 9859

ER -