Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
Journal article, 2018
Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings: Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs 1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). Interpretation: Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury.
Author
Spencer L. James
University of Washington
Degu Abate
Haramaya University
Kalkidan Hassen Abate
Jimma University
Solomon M. Abay
Addis Ababa University
Cristiana Abbafati
Sapienza University of Rome
Nooshin Abbasi
Montreal Neuroimaging Center
Non-Communicable Diseases Research Center
Hedayat Abbastabar
Imam Khomeini International University
Foad Abd-Allah
Cairo University
Jemal Abdela
School of Pharmacy
Ahmed Abdelalim
Cairo University
Ibrahim Abdollahpour
Arak University of Medical Sciences
Multiple Sclerosis Research Center
Rizwan Suliankatchi Abdulkader
Manonmaniam Sundaranar University
Zegeye Abebe
Human Nutrition Department
Semaw F. Abera
University of Hohenheim
School of Public Health
Olifan Zewdie Abil
University of Medical Sciences
Haftom Niguse Abraha
Clinical Pharmacy Unit
Laith J. Abu-Raddad
Weill Cornell Medicine-Qatar
Niveen M.E. Abu-Rmeileh
Birzeit University
Manfred Mario Kokou Accrombessi
Bénin Clinical Research Institute
Dilaram Acharya
Kathmandu University
Dongguk University
Pawan Acharya
Nepal Development Society
Ilana N. Ackerman
School of Public Health and Preventive Medicine
Abdu A Adamu
Cochrane South Africa
Oladimeji M. Adebayo
University College Hospital
Victor Adekanmbi
Cardiff University
Olatunji Adetokunboh
Cochrane South Africa
Mina G. Adib
Saint Mark Hospital
Jose C. Adsuar
Sport Science Department
Kossivi Agbelenko Afanvi
University of Lomé
Ministry of Health and Social Protection
Mohsen Afarideh
Tehran University of Medical Sciences
Ashkan Afshin
University of Washington
Gina Agarwal
McMaster University
Kareha M. Agesa
University of Washington
Rakesh Aggarwal
McMaster University
Sargis Aghasi Aghayan
Yerevan State University
Scientific Center of Zoology and Hydroecology
Sutapa Agrawal
Vital Strategies
Public Health Foundation of India
Alireza Ahmadi
Kermanshah University of Medical Sciences
Mehdi Ahmadi
Environmental Technologies Research Center
Hamid Ahmadieh
Shahid Beheshti University of Medical Sciences
Muktar Beshir Ahmed
Jimma University
Amani Nidhal Aichour
University Ferhat Abbas of Setif
Ibtihel Aichour
University Ferhat Abbas of Setif
Miloud Taki Eddine Aichour
High National School of Veterinary Medicine
Tomi F. Akinyemiju
University of Kentucky
Nadia Akseer
Hospital for Sick Children University of Toronto
Ziyad Al-Aly
Washington University in St. Louis
VA St Louis Health Care System
Ayman Al-Eyadhy
Pediatric Intensive Care Unit
Hesham M. Al-Mekhlafi
Sana'a University
Medical Research Center
Rajaa Al-Raddadi
King Abdulaziz University
Fares Alahdab
Mayo Clinic
Khurshid Alam
School of Population Health
Tahiya Alam
University of Washington
Alaa Alashi
Cleveland Clinic Foundation
Seyed Moayed Alavian
Baqiyatallah University of Medical Sciences
Kefyalew Addis Alene
Institute of Public Health
Research School of Population Health
Mehran Alijanzadeh
Qazvin University of Medical Sciences
Reza Alizadeh-Navaei
Gastrointestinal Cancer Research Center
Syed M. Aljunid
University of Kuwait
National University of Malaysia
Ala'A Alkerwi
Luxembourg Institute of Health
François Alla
University of Bordeaux
Peter Allebeck
Forte
Mohamed M.L. Alouani
University Ferhat Abbas of Setif
Khalid Altirkawi
King Saud University
Nelson Alvis-Guzman
University of the Coast
University of Cartagena
Azmeraw T. Amare
Bahar Dar University
Sansom Institute
Leopold N. Aminde
School of Public Health
Walid Ammar
Federal Ministry of Health
American University of Beirut
Yaw Ampem Amoako
Komfo Anokye Teaching Hospital
Nahla Anber
Mansoura Faculty of Medicine
Mansoura University
Catalina Liliana Andrei
Carol Davila University of Medicine and Pharmacy
Sofia Androudi
University of Thessaly
Megbaru Debalkie Animut
Arba Minch University
Mina Anjomshoa
Rafsanjan University of Medical Sciences
Mustafa Geleto Ansha
Debre Berhan University
Carl Abelardo T. Antonio
Department of Health Manila
Palwasha Anwari
Independent Consultant
Jalal Arabloo
Health Management and Economics Research Center
Antonio Arauz
Instituto Nacional de Neurología y Neurocirugía
Olatunde Aremu
Birmingham City University
Filippo Ariani
CeRIMP
Bahram Armoon
Saveh University of Medical Sciences
Johan Ärnlöv
Dalarna university
Amit Arora
Oral Health Services
Faculty of Medicine and Health Sciences
Al Artaman
University of Manitoba
Krishna Kumar Aryal
Abt Associates Nepal
Hamid Asayesh
School of Paramedical
Rana Jawad Asghar
South Asian Public Health Forum
Zerihun Ataro
Haramaya University
Sachin R. Atre
Dr. D. Y. Patil Medical College, Hospital & Research Centre
Centre for Clinical Global Health Education
Marcel Ausloos
University of Newcastle Business School
Leticia Avila-Burgos
Center for Health Systems Research
Euripide Frinel G. Arthur Avokpaho
Bénin Clinical Research Institute
Contrôle Des Maladies Infectieuses
Ashish Awasthi
Public Health Foundation of India
Indian Institute of Public Health
Beatriz Paulina Ayala Quintanilla
Judith Lumley Centre
National Institutes of Health, Bethesda
Rakesh Ayer
University of Tokyo
Peter S. Azzopardi
Burnet Institute
Australia Bahir Dar University
Arefeh Babazadeh
Center for Infectious Diseases Research
Hamid Badali
Mazandaran University of Medical Sciences
Alaa Badawi
Public Health Agency of Canada
Ayele Geleto Bali
School of Public Health
Mohsen Mazidi
Chalmers, Biology and Biological Engineering, Food and Nutrition Science
The Lancet
0140-6736 (ISSN) 1474-547X (eISSN)
Vol. 392 10159 1789-1858Subject Categories
Psychiatry
Environmental Health and Occupational Health
Public Health, Global Health, Social Medicine and Epidemiology
DOI
10.1016/S0140-6736(18)32279-7
PubMed
30496104