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
Artikel i vetenskaplig tidskrift, 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.


[Person b8832ded-2b55-43cc-856d-195bc2a32083 not found]

[Person f18c945a-7bf6-422a-8dfa-a268a57902d5 not found]

[Person 274581fd-1050-4c2d-9740-9d3d87027d3a not found]

[Person 90d3eae5-8ed6-402d-b0c9-50904882bf89 not found]

[Person 1a2c1046-54fd-42ac-b937-fd348d702bcf not found]

[Person b51b3ed3-9652-4296-bf88-a1300e54252d not found]

[Person 9bdea2c0-9f5f-417e-93f1-ac6cb705bca8 not found]

[Person 9a0d07a7-cc85-4083-aaf5-200f4f08a43b not found]

[Person df4b2e3e-b7c5-4117-9b14-0bc907f606d7 not found]

[Person 0f948493-b946-4b5b-a96d-7d2f09e34136 not found]

[Person 01928b45-824a-40bf-8dee-618946aa9a51 not found]

[Person 701bc79a-e38f-489c-b19b-aba17318ebf1 not found]

[Person 6cafa6de-1cee-4955-a857-756de9fef401 not found]

[Person 99c5cd5a-d86f-4af9-bf06-ce1242428067 not found]

[Person 017d6725-6947-4864-9e3e-e3aaff32ef24 not found]

[Person 1c9071a6-d8a4-4fd5-b5a6-e9c49a61b17b not found]

[Person 859bc786-9ad2-4eb5-8198-a5455fdd20ef not found]

[Person 7380c366-1c49-49d7-8779-c12716d0a404 not found]

[Person a5dc8ffa-8abe-4456-9fa8-58d900b17a8e not found]

[Person c93b21b4-e7b7-4bf8-865f-ed88400f8c6d not found]

[Person 9d596e88-10bc-48f7-9b94-759f9f7210d5 not found]

[Person 0e00eea1-b72d-4f24-984f-1e15e27ee297 not found]

[Person 5abd07df-7a6a-4927-983d-ac6fea59125c not found]

[Person 6f3600b7-5c2b-462d-9dd8-4294f6f013ea not found]

[Person b00653be-0a74-4aad-837a-3c0258ae335a not found]

[Person fb63cda8-63a6-4665-8504-8015cf82f681 not found]

[Person 18ed3488-389e-4814-b480-aaeff3ede42d not found]

[Person 27fc52a4-a580-4af4-b5ea-73a297a2255a not found]

[Person e75399db-1639-4d0a-af6a-3641d7dda18a not found]

[Person ebf7903d-ae22-40c6-ae65-5ab485924fb1 not found]

[Person 103dff5a-239b-427d-8e2f-62ea28eb0b27 not found]

[Person 22fb9747-8a65-43ba-bb3c-d51be759f96f not found]

[Person 18c11ca4-bf62-469a-970f-43f51304f75a not found]

[Person 2ae617b9-ebec-420d-986e-139dbf467933 not found]

[Person a4b42c93-60e1-43e8-a415-9b763c1e146a not found]

[Person edce7fe9-7831-4ce6-939c-07728f4efdc7 not found]

[Person ddac2cd7-07b7-4406-b999-d7d4ad5b1ddf not found]

[Person fe6b6b4f-c96c-4d05-b6fe-b5353da568d8 not found]

[Person 39233848-a5b3-4819-9259-54d1e9759398 not found]

[Person 40b27e08-3c23-4f71-8b92-7cad756e0ce2 not found]

[Person e9677f67-b829-4f21-81dc-dbf747cf374b not found]

[Person 26b5e2aa-ff32-46a9-92ec-617ea469cef9 not found]

[Person acd17ec9-18d1-45e8-bb7f-167b8e9849db not found]

[Person d3a7b12d-834c-4608-9a91-7e7e356eafe2 not found]

[Person 5f10fdfd-6a83-409a-8718-1a781930f2d8 not found]

[Person dd425ee5-2288-4bfc-b199-620c4bb5168f not found]

[Person dab7afaa-5009-481f-8a87-46e0b430107e not found]

[Person edd4db3c-1143-4d24-bbe9-f271de4c32f3 not found]

[Person 89c79837-986c-4bcc-98c3-8be52a89cef1 not found]

[Person 0273cc29-3ab1-4a58-8eae-a6539ff4728b not found]

[Person c30f1627-61fb-49e5-acc5-32961579e4ac not found]

[Person cf9c7fba-79a8-4b2b-a40b-1d3be536aa83 not found]

[Person d498aa07-6eca-4de1-bb0c-d3ac03801c15 not found]

[Person 0de663b8-7f18-47d9-8eb3-07f784359440 not found]

[Person 79574a3e-6022-4708-9b42-45cb7233a971 not found]

[Person dbadd393-19f5-4cbe-b8a5-c30b323b4278 not found]

[Person 82b070f8-02d2-4391-bccf-57d80cb792f0 not found]

[Person adcfd761-d703-4898-b200-c993998d8a7d not found]

[Person 6f340932-8c62-448d-9fce-f98e620ccb99 not found]

[Person 7591d996-75a2-469f-acd4-c45d08916229 not found]

[Person d03946ef-1bdd-46d2-8e71-3b4be75ec695 not found]

[Person a4dcfc47-36d0-468f-a98b-6003550d2661 not found]

[Person f2fcd7c3-f0c6-4a18-891d-01722860dc96 not found]

[Person a22bac1c-31fe-4223-905c-39d9ec961c1f not found]

[Person 9092399f-5e50-44f3-9165-f92efc2e6f1c not found]

[Person ea97db5b-ed5a-4484-ba6b-481b4bda605a not found]

[Person 6ec27009-7c3e-4b55-960d-eb0e06984a13 not found]

[Person 9077f948-1ccf-464a-baa9-7edcb061295a not found]

[Person 1d283df9-c21b-41bd-9aac-b7401e7215fd not found]

[Person 65aaf264-355e-4ad1-b2e9-512f0054b0aa not found]

[Person 3a360317-ce84-44d7-9ce4-6264771450b7 not found]

[Person e4881537-d8af-4940-b411-bf12220381fe not found]

[Person 2d37806c-88ff-4960-97ac-10e5c776d5fa not found]

[Person 3b859c1b-e11f-413a-86b2-82e16ea58a81 not found]

[Person 615d5204-d420-437e-91e0-fcf031f0cc13 not found]

[Person 2d2a7857-5ba6-49a0-a407-d48f06db272e not found]

[Person 9bd8009f-7a0e-4274-a99e-40543775a4e4 not found]

[Person 2f923d4d-ceb1-4a90-bf46-13830606db70 not found]

[Person b8b022eb-23fd-40db-830b-8dd2dd7ea674 not found]

[Person 611eaa4a-73be-42c5-86a2-780d0f723e6a not found]

[Person f2cafabc-2483-49d8-a4e5-64b5f45cce26 not found]

[Person 649040d4-e070-4afc-a5b8-0f68cf846356 not found]

[Person 62b963f9-4805-45b7-a428-55ce54221ce9 not found]

[Person c294576a-b111-4bd2-a8b8-2c9ad468e89b not found]

[Person 38afedde-648b-497b-b8d5-e8e4b2a36575 not found]

[Person 2feadfdf-2f3e-43ef-b230-f8b4bbc8aa74 not found]

[Person 529e5163-a0cc-463f-9ea2-73efd815d795 not found]

[Person 5c0a61cf-9a73-4169-b8f5-22ef5bc6163c not found]

[Person c7d7066e-0e37-4d4f-bde1-a23de7ff5b6a not found]

[Person 16e25a29-e9df-4416-96ae-a1c4cfa94779 not found]

[Person 8fb35f68-829c-441d-abdc-7182a9dbd48f not found]

[Person 44c80589-4c4a-44fa-acc4-b135727566b7 not found]

[Person 23d30f00-6065-43fd-be01-f2bc83dbc5d5 not found]

[Person ce03e561-6f78-4464-9b5d-dab94b55a0d1 not found]

[Person 7c7e1979-640f-47c6-8d58-c24afafa6b2d not found]

[Person bd0e6299-7229-4281-8251-ccbebc975ab4 not found]

[Person d8333c23-0e00-4075-a34d-bd3cb5431588 not found]

[Person 5cd4e3d1-3830-472c-bdfc-abafee665702 not found]

[Person 08b09295-d57e-4f1a-aded-437b48701c39 not found]

[Person a00e653f-272e-4a4f-a88c-69848cb1e70d not found]

[Person b463649d-bf6c-4dc5-996c-6379567b735f not found]

The Lancet

0140-6736 (ISSN) 1474-547X (eISSN)

Vol. 392 10159 1789-1858



Miljömedicin och yrkesmedicin

Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi





Mer information

Senast uppdaterat