Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015

a systematic analysis for the Global Burden of Disease Study 2015

Nicholas J. Kassebaum, Megha Arora, Ryan M. Barber, Zulfiqar A. Bhutta, Jonathan Brown, Austin Carter, Daniel C. Casey, Fiona J. Charlson, Matthew M. Coates, Megan Coggeshall, Leslie Cornaby, Lalit Dandona, Daniel J. Dicker, Holly E. Erskine, Alize J. Ferrari, Christina Fitzmaurice, Kyle Foreman, Mohammad H. Forouzanfar, Nancy Fullman, Peter W. Gething & 590 others Ellen M. Goldberg, Nicholas Graetz, Juanita A. Haagsma, Catherine O. Johnson, Laura Kemmer, Ibrahim A. Khalil, Yohannes Kinfu, Michael J. Kutz, Hmwe H. Kyu, Janni Leung, Xiaofeng Liang, Stephen S. Lim, Rafael Lozano, George A. Mensah, Joe Mikesell, Ali H. Mokdad, Meghan D. Mooney, Mohsen Naghavi, Grant Nguyen, Elaine Nsoesie, David M. Pigott, Christine Pinho, Zane Rankin, Nikolas Reinig, Joshua A. Salomon, Logan Sandar, Alison Smith, Reed J.D. Sorensen, Jeffrey Stanaway, Caitlyn Steiner, Stephanie Teeple, Bernadette A. Thomas, Chris Troeger, Amelia VanderZanden, Joseph A. Wagner, Valentine Wanga, Harvey A. Whiteford, Maigeng Zhou, Leo Zoeckler, Amanuel Alemu Abajobir, Kalkidan Hassen Abate, Cristiana Abbafati, Kaja M. Abbas, Foad Abd-Allah, Biju Abraham, Ibrahim Abubakar, Laith J. Abu-Raddad, Niveen M.E. Abu-Rmeileh, Tom Achoki, Ilana N. Ackerman, Akindele Olupelumi Adebiyi, Isaac Akinkunmi Adedeji, José C. Adsuar, Kossivi Agbelenko Afanvi, Ashkan Afshin, Emilie Elisabet Agardh, Arnav Agarwal, Sanjay Kumar Agarwal, Muktar Beshir Ahmed, Aliasghar Ahmad Kiadaliri, Hamid Ahmadieh, Nadia Akseer, Ziyad Al-Aly, Khurshid Alam, Noore K.M. Alam, Saleh Fahed Aldhahri, Miguel Angel Alegretti, Alicia V. Aleman, Zewdie Aderaw Alemu, Lily T. Alexander, Raghib Ali, Ala'a Alkerwi, François Alla, Peter Allebeck, Ubai Alsharif, Khalid A. Altirkawi, Elena Alvarez Martin, Nelson Alvis-Guzman, Azmeraw T. Amare, Alemayehu Amberbir, Adeladza Kofi Amegah, Heresh Amini, Walid Ammar, Stephen Marc Amrock, Gregory M. Anderson, Benjamin O. Anderson, Carl Abelardo T. Antonio, Palwasha Anwari, Johan Ärnlöv, Valentina S.Arsic Arsenijevic, Al Artaman, Hamid Asayesh, Rana Jawad Asghar, Euripide Frinel G.Arthur Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Peter Azzopardi, Umar Bacha, Alaa Badawi, Kalpana Balakrishnan, Amitava Banerjee, Aleksandra Barac, Suzanne L. Barker-Collo, Till Bärnighausen, Lars Barregard, Lope H. Barrero, Sanjay Basu, Tigist Assefa Bayou, Justin Beardsley, Neeraj Bedi, Ettore Beghi, Brent Bell, Michelle L. Bell, Laith Aburaddad, Derrick A. Bennett, Isabela M. Bensenor, Adugnaw Berhane, Eduardo Bernabé, Balem Demtsu Betsu, Addisu Shunu Beyene, Neeraj Bhala, Anil Bhansali, Samir Bhatt, Sibhatu Biadgilign, Kelly Bienhoff, Boris Bikbov, Aref A.Bin Abdulhak, Donal Bisanzio, Espen Bjertness, Jed D. Blore, Rohan Borschmann, Soufiane Boufous, Rupert R.A. Bourne, Michael Brainin, Alexandra Brazinova, Nicholas J.K. Breitborde, Traolach S. Brugha, Rachelle Buchbinder, Geoffrey Colin Buckle, Zahid A. Butt, Bianca Calabria, Ismael Ricardo Campos-Nonato, Julio Cesar Campuzano, Hélène Carabin, Jonathan R. Carapetis, Rosario Cárdenas, Juan Jesus Carrero, Carlos A. Castañeda-Orjuela, Jacqueline Castillo Rivas, Ferrán Catalá-López, Fiorella Cavalleri, Jung Chen Chang, Peggy Pei Chia Chiang, Mirriam Chibalabala, Chioma Ezinne Chibueze, Vesper Hichilombwe Chisumpa, Jee Young Jasmine Choi, Lincoln Choudhury, Hanne Christensen, Liliana G. Ciobanu, Valentina Colistro, Mercedes Colomar, Samantha M. Colquhoun, Monica Cortinovis, John A. Crump, Albertino Damasceno, Rakhi Dandona, Paul I. Dargan, José das Neves, Gail Davey, Adrian C. Davis, Diego De Leo, Louisa Degenhardt, Liana C.Del Gobbo, Sarah Derrett, Don C.Des Jarlais, Gabrielle A. deVeber, Samath D. Dharmaratne, Preet K. Dhillon, Eric L. Ding, Kerrie E. Doyle, Tim R. Driscoll, Leilei Duan, Manisha Dubey, Bruce Bartholow Duncan, Hedyeh Ebrahimi, Richard G. Ellenbogen, Iqbal Elyazar, Aman Yesuf Endries, Sergey Petrovich Ermakov, Babak Eshrati, Alireza Esteghamati, Kara Estep, Saman Fahimi, Talha A. Farid, Carla Sofia e.Sa Farinha, André Faro, Maryam S. Farvid, Farshad Farzadfar, Valery L. Feigin, Seyed Mohammad Fereshtehnejad, Jefferson G. Fernandes, Joao C. Fernandes, Florian Fischer, Joseph R.A. Fitchett, Nataliya Foigt, F. Gerry R. Fowkes, Richard C. Franklin, Joseph Friedman, Joseph Frostad, Thomas Fürst, Neal D. Futran, Belinda Gabbe, Fortuné Gbètoho Gankpé, Alberto L. Garcia-Basteiro, Tsegaye Tewelde Gebrehiwot, Amanuel Tesfay Gebremedhin, Johanna M. Geleijnse, Katherine B. Gibney, Richard F. Gillum, Ibrahim Abdelmageem Mohamed Ginawi, Ababi Zergaw Giref, Maurice Giroud, Melkamu Dedefo Gishu, William W. Godwin, Hector Gomez-Dantes, Philimon Gona, Amador Goodridge, Sameer Vali Gopalani, Carolyn C. Gotay, Atsushi Goto, Hebe N. Gouda, Yuming Guo, Rahul Gupta, Rajeev Gupta, Vipin Gupta, Reyna A. Gutiérrez, Nima Hafezi-Nejad, Demewoz Haile, Alemayehu Desalegne Hailu, Gessessew Bugssa Hailu, Yara A. Halasa, Randah Ribhi Hamadeh, Samer Hamidi, Mouhanad Hammami, Alexis J. Handal, Graeme J. Hankey, Hilda L. Harb, Sivadasanpillai Harikrishnan, Josep Maria Haro, Mohammad Sadegh Hassanvand, Tahir Ahmed Hassen, Rasmus Havmoeller, Roderick J. Hay, Mohammad T. Hedayati, Ileana Beatriz Heredia-Pi, Pouria Heydarpour, Hans W. Hoek, Daniel J. Hoffman, Masako Horino, Nobuyuki Horita, H. Dean Hosgood, Damian G. Hoy, Mohamed Hsairi, Hsiang Huang, John J. Huang, Kim Moesgaard Iburg, Bulat T. Idrisov, Kaire Innos, Manami Inoue, Kathryn H. Jacobsen, Alejandra Jauregui, Achala Upendra Jayatilleke, Panniyammakal Jeemon, Vivekanand Jha, Guohong Jiang, Ying Jiang, Tariku Jibat, Aida Jimenez-Corona, Ye Jin, Jost B. Jonas, Zubair Kabir, Dan K. Kajungu, Yogeshwar Kalkonde, Ritul Kamal, Haidong Kan, Amit Kandel, André Karch, Corine Kakizi Karema, Chante Karimkhani, Amir Kasaeian, Marzieh Katibeh, Anil Kaul, Norito Kawakami, Dhruv S. Kazi, Peter Njenga Keiyoro, Andrew Haddon Kemp, Andre Pascal Kengne, Andre Keren, Chandrasekharan Nair Kesavachandran, Yousef Saleh Khader, Abdur Rahman Khan, Ejaz Ahmad Khan, Young Ho Khang, Tawfik Ahmed Muthafer Khoja, Jagdish Khubchandani, Christian Kieling, Cho il Kim, Daniel Kim, Yun Jin Kim, Niranjan Kissoon, Miia Kivipelto, Luke D. Knibbs, Ann Kristin Knudsen, Yoshihiro Kokubo, Dhaval Kolte, Jacek A. Kopec, Parvaiz A. Koul, Ai Koyanagi, Barthelemy Kuate Defo, Ricardo S. Kuchenbecker, Burcu Kucuk Bicer, Ernst J. Kuipers, G. Anil Kumar, Gene F. Kwan, Ratilal Lalloo, Tea Lallukka, Anders Larsson, Asma Abdul Latif, Pablo M. Lavados, Alicia Elena Beatriz Lawrynowicz, Janet L. Leasher, James Leigh, Ricky Leung, Yichong Li, Yongmei Li, Steven E. Lipshultz, Patrick Y. Liu, Yang Liu, Belinda K. Lloyd, Giancarlo Logroscino, Katharine J. Looker, Paulo A. Lotufo, Robyn M. Lucas, Raimundas Lunevicius, Ronan A. Lyons, Hassan Magdy Abd El Razek, Mahdi Mahdavi, Marek Majdan, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Wagner Marcenes, Jose Martinez-Raga, Felix Masiye, Amanda J. Mason-Jones, Richard Matzopoulos, Bongani M. Mayosi, John J. McGrath, Martin McKee, Peter A. Meaney, Alem Mehari, Yohannes Adama Melaku, Peter Memiah, Ziad A. Memish, Walter Mendoza, Atte Meretoja, Tuomo J. Meretoja, Yonatan Moges Mesfin, Francis Apolinary Mhimbira, Ted R. Miller, Edward J. Mills, Mojde Mirarefin, Erkin M. Mirrakhimov, Philip B. Mitchell, Charles N. Mock, Karzan Abdulmuhsin Mohammad, Alireza Mohammadi, Shafiu Mohammed, Lorenzo Monasta, Julio Cesar Montañez Hernandez, Marcella Montico, Maziar Moradi-Lakeh, Rintaro Mori, Ulrich O. Mueller, John Everett Mumford, Michele E. Murdoch, Gudlavalleti Venkata Satyanarayana Murthy, Jean B. Nachega, Aliya Naheed, Luigi Naldi, Vinay Nangia, John N. Newton, Marie Ng, Frida Namnyak Ngalesoni, Quyen Le Nguyen, Muhammad Imran Nisar, Patrick Martial Nkamedjie Pete, Joan M. Nolla, Ole F. Norheim, Rosana E. Norman, Bo Norrving, Carla Makhlouf Obermeyer, Felix Akpojene Ogbo, In Hwan Oh, Olanrewaju Oladimeji, Pedro R. Olivares, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Eyal Oren, Alberto Ortiz, Erika Ota, Abayomi Samuel Oyekale, Mahesh PA, Eun Kee Park, Mahboubeh Parsaeian, Scott B. Patten, George C. Patton, João Mário Pedro, David M. Pereira, Norberto Perico, Konrad Pesudovs, Max Petzold, Michael Robert Phillips, Frédéric B. Piel, Julian David Pillay, Farhad Pishgar, Dietrich Plass, Suzanne Polinder, Svetlana Popova, Richie G. Poulton, Farshad Pourmalek, Noela M. Prasad, Mostafa Qorbani, Rynaz H.S. Rabiee, Amir Radfar, Anwar Rafay, Kazem Rahimi, Vafa Rahimi-Movaghar, Mahfuzar Rahman, Mohammad Hifz Ur Rahman, Sajjad Ur Rahman, Dheeraj Rai, Rajesh Kumar Rai, Sasa Rajsic, Murugesan Raju, Usha Ram, Kavitha Ranganathan, Amany H. Refaat, Marissa B. Reitsma, Giuseppe Remuzzi, Serge Resnikoff, Alex Reynolds, Antonio L. Ribeiro, Stefano Ricci, Hirbo Shore Roba, David Rojas-Rueda, Luca Ronfani, Gholamreza Roshandel, Gregory A. Roth, Ambuj Roy, Ben Benasco Sackey, Rajesh Sagar, Juan R. Sanabria, Maria Dolores Sanchez-Niño, Itamar S. Santos, João Vasco Santos, Rodrigo Sarmiento-Suarez, Benn Sartorius, Maheswar Satpathy, Miloje Savic, Monika Sawhney, Maria Inês Schmidt, Ione J.C. Schneider, Aletta E. Schutte, David C. Schwebel, Soraya Seedat, Sadaf G. Sepanlou, Edson E. Servan-Mori, Saeid Shahraz, Masood Ali Shaikh, Rajesh Sharma, Jun She, Sara Sheikhbahaei, Jiabin Shen, Kevin N. Sheth, Kenji Shibuya, Mika Shigematsu, Min Jeong Shin, Rahman Shiri, Inga Dora Sigfusdottir, Diego Augusto Santos Silva, Jonathan I. Silverberg, Edgar P. Simard, Abhishek Singh, Jasvinder A. Singh, Prashant Kumar Singh, Vegard Skirbekk, Jens Christoffer Skogen, Michael Soljak, Kjetil Søreide, Reed J.D. Sorensen, Chandrashekhar T. Sreeramareddy, Vasiliki Stathopoulou, Nicholas Steel, Dan J. Stein, Murray B. Stein, Timothy J. Steiner, Lars Jacob Stovner, Saverio Stranges, Konstantinos Stroumpoulis, Bruno F. Sunguya, Patrick J. Sur, Soumya Swaminathan, Bryan L. Sykes, Cassandra E.I. Szoeke, Rafael Tabarés-Seisdedos, Nikhil Tandon, David Tanne, Mohammad Tavakkoli, Bineyam Taye, Hugh R. Taylor, Braden J.Te Ao, Teketo Kassaw Tegegne, Dejen Yemane Tekle, Abdullah Sulieman Terkawi, Gizachew Assefa Tessema, J. S. Thakur, Alan J. Thomson, Andrew L. Thorne-Lyman, Amanda G. Thrift, George D. Thurston, Ruoyan Tobe-Gai, Marcello Tonelli, Roman Topor-Madry, Fotis Topouzis, Bach Xuan Tran, Zacharie Tsala Dimbuene, Miltiadis Tsilimbaris, Abera Kenay Tura, Emin Murat Tuzcu, Stefanos Tyrovolas, Kingsley N. Ukwaja, Eduardo A. Undurraga, Chigozie Jesse Uneke, Olalekan A. Uthman, Coen H. van Gool, Jim van Os, Tommi Vasankari, Ana Maria Nogales Vasconcelos, Narayanaswamy Venketasubramanian, Francesco S. Violante, Vasiliy Victorovich Vlassov, Stein Emil Vollset, Gregory R. Wagner, Mitchell T. Wallin, Linhong Wang, Scott Weichenthal, Elisabete Weiderpass, Robert G. Weintraub, Andrea Werdecker, Ronny Westerman, Tissa Wijeratne, James D. Wilkinson, Hywel C. Williams, Charles Shey Wiysonge, Solomon Meseret Woldeyohannes, Charles D.A. Wolfe, Sungho Won, Gelin Xu, Ajit Kumar Yadav, Bereket Yakob, Lijing L. Yan, Yuichiro Yano, Mehdi Yaseri, Pengpeng Ye, Paul Yip, Naohiro Yonemoto, Seok Jun Yoon, Mustafa Z. Younis, Chuanhua Yu, Zoubida Zaidi, Maysaa El Sayed Zaki, Hajo Zeeb, Sanjay Zodpey, David Zonies, Liesl Joanna Zuhlke, Theo Vos, Alan D. Lopez, Christopher J.L. Murray

Research output: Contribution to journalArticle

695 Citations (Scopus)

Abstract

Background Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate. Findings Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2·9 years (95% uncertainty interval 2·9–3·0) for men and 3·5 years (3·4–3·7) for women, while HALE at age 65 years improved by 0·85 years (0·78–0·92) and 1·2 years (1·1–1·3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs. Interpretation Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum. Funding Bill & Melinda Gates Foundation.

Original languageEnglish
Pages (from-to)1603-1658
Number of pages56
JournalThe Lancet
Volume388
Issue number10053
DOIs
Publication statusPublished - 8 Oct 2016

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Quality-Adjusted Life Years
Life Expectancy
Wounds and Injuries
Geography
Demography
Health
Conservation of Natural Resources
Global Burden of Disease
Mortality
Sense Organs
Morbidity
Central America
Benchmarking
Eastern Africa
Africa South of the Sahara
Birth Rate
Population Growth
Health Policy
Research
Violence

ASJC Scopus subject areas

  • Medicine(all)

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Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015 : a systematic analysis for the Global Burden of Disease Study 2015. / Kassebaum, Nicholas J.; Arora, Megha; Barber, Ryan M.; Bhutta, Zulfiqar A.; Brown, Jonathan; Carter, Austin; Casey, Daniel C.; Charlson, Fiona J.; Coates, Matthew M.; Coggeshall, Megan; Cornaby, Leslie; Dandona, Lalit; Dicker, Daniel J.; Erskine, Holly E.; Ferrari, Alize J.; Fitzmaurice, Christina; Foreman, Kyle; Forouzanfar, Mohammad H.; Fullman, Nancy; Gething, Peter W.; Goldberg, Ellen M.; Graetz, Nicholas; Haagsma, Juanita A.; Johnson, Catherine O.; Kemmer, Laura; Khalil, Ibrahim A.; Kinfu, Yohannes; Kutz, Michael J.; Kyu, Hmwe H.; Leung, Janni; Liang, Xiaofeng; Lim, Stephen S.; Lozano, Rafael; Mensah, George A.; Mikesell, Joe; Mokdad, Ali H.; Mooney, Meghan D.; Naghavi, Mohsen; Nguyen, Grant; Nsoesie, Elaine; Pigott, David M.; Pinho, Christine; Rankin, Zane; Reinig, Nikolas; Salomon, Joshua A.; Sandar, Logan; Smith, Alison; Sorensen, Reed J.D.; Stanaway, Jeffrey; Steiner, Caitlyn; Teeple, Stephanie; Thomas, Bernadette A.; Troeger, Chris; VanderZanden, Amelia; Wagner, Joseph A.; Wanga, Valentine; Whiteford, Harvey A.; Zhou, Maigeng; Zoeckler, Leo; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M.; Abd-Allah, Foad; Abraham, Biju; Abubakar, Ibrahim; Abu-Raddad, Laith J.; Abu-Rmeileh, Niveen M.E.; Achoki, Tom; Ackerman, Ilana N.; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Adsuar, José C.; Afanvi, Kossivi Agbelenko; Afshin, Ashkan; Agardh, Emilie Elisabet; Agarwal, Arnav; Agarwal, Sanjay Kumar; Ahmed, Muktar Beshir; Kiadaliri, Aliasghar Ahmad; Ahmadieh, Hamid; Akseer, Nadia; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore K.M.; Aldhahri, Saleh Fahed; Alegretti, Miguel Angel; Aleman, Alicia V.; Alemu, Zewdie Aderaw; Alexander, Lily T.; Ali, Raghib; Alkerwi, Ala'a; Alla, François; Allebeck, Peter; Alsharif, Ubai; Altirkawi, Khalid A.; Martin, Elena Alvarez; Alvis-Guzman, Nelson; Amare, Azmeraw T.; Amberbir, Alemayehu; Amegah, Adeladza Kofi; Amini, Heresh; Ammar, Walid; Amrock, Stephen Marc; Anderson, Gregory M.; Anderson, Benjamin O.; Antonio, Carl Abelardo T.; Anwari, Palwasha; Ärnlöv, Johan; Arsenijevic, Valentina S.Arsic; Artaman, Al; Asayesh, Hamid; Asghar, Rana Jawad; Avokpaho, Euripide Frinel G.Arthur; Awasthi, Ashish; Quintanilla, Beatriz Paulina Ayala; Azzopardi, Peter; Bacha, Umar; Badawi, Alaa; Balakrishnan, Kalpana; Banerjee, Amitava; Barac, Aleksandra; Barker-Collo, Suzanne L.; Bärnighausen, Till; Barregard, Lars; Barrero, Lope H.; Basu, Sanjay; Bayou, Tigist Assefa; Beardsley, Justin; Bedi, Neeraj; Beghi, Ettore; Bell, Brent; Bell, Michelle L.; Aburaddad, Laith; Bennett, Derrick A.; Bensenor, Isabela M.; Berhane, Adugnaw; Bernabé, Eduardo; Betsu, Balem Demtsu; Beyene, Addisu Shunu; Bhala, Neeraj; Bhansali, Anil; Bhatt, Samir; Biadgilign, Sibhatu; Bienhoff, Kelly; Bikbov, Boris; Abdulhak, Aref A.Bin; Bisanzio, Donal; Bjertness, Espen; Blore, Jed D.; Borschmann, Rohan; Boufous, Soufiane; Bourne, Rupert R.A.; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas J.K.; Brugha, Traolach S.; Buchbinder, Rachelle; Buckle, Geoffrey Colin; Butt, Zahid A.; Calabria, Bianca; Campos-Nonato, Ismael Ricardo; Campuzano, Julio Cesar; Carabin, Hélène; Carapetis, Jonathan R.; Cárdenas, Rosario; Carrero, Juan Jesus; Castañeda-Orjuela, Carlos A.; Rivas, Jacqueline Castillo; Catalá-López, Ferrán; Cavalleri, Fiorella; Chang, Jung Chen; Chiang, Peggy Pei Chia; Chibalabala, Mirriam; Chibueze, Chioma Ezinne; Chisumpa, Vesper Hichilombwe; Choi, Jee Young Jasmine; Choudhury, Lincoln; Christensen, Hanne; Ciobanu, Liliana G.; Colistro, Valentina; Colomar, Mercedes; Colquhoun, Samantha M.; Cortinovis, Monica; Crump, John A.; Damasceno, Albertino; Dandona, Rakhi; Dargan, Paul I.; das Neves, José; Davey, Gail; Davis, Adrian C.; Leo, Diego De; Degenhardt, Louisa; Gobbo, Liana C.Del; Derrett, Sarah; Jarlais, Don C.Des; deVeber, Gabrielle A.; Dharmaratne, Samath D.; Dhillon, Preet K.; Ding, Eric L.; Doyle, Kerrie E.; Driscoll, Tim R.; Duan, Leilei; Dubey, Manisha; Duncan, Bruce Bartholow; Ebrahimi, Hedyeh; Ellenbogen, Richard G.; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Eshrati, Babak; Esteghamati, Alireza; Estep, Kara; Fahimi, Saman; Farid, Talha A.; Farinha, Carla Sofia e.Sa; Faro, André; Farvid, Maryam S.; Farzadfar, Farshad; Feigin, Valery L.; Fereshtehnejad, Seyed Mohammad; Fernandes, Jefferson G.; Fernandes, Joao C.; Fischer, Florian; Fitchett, Joseph R.A.; Foigt, Nataliya; Fowkes, F. Gerry R.; Franklin, Richard C.; Friedman, Joseph; Frostad, Joseph; Fürst, Thomas; Futran, Neal D.; Gabbe, Belinda; Gankpé, Fortuné Gbètoho; Garcia-Basteiro, Alberto L.; Gebrehiwot, Tsegaye Tewelde; Gebremedhin, Amanuel Tesfay; Geleijnse, Johanna M.; Gibney, Katherine B.; Gillum, Richard F.; Ginawi, Ibrahim Abdelmageem Mohamed; Giref, Ababi Zergaw; Giroud, Maurice; Gishu, Melkamu Dedefo; Godwin, William W.; Gomez-Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Gotay, Carolyn C.; Goto, Atsushi; Gouda, Hebe N.; Guo, Yuming; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Gutiérrez, Reyna A.; Hafezi-Nejad, Nima; Haile, Demewoz; Hailu, Alemayehu Desalegne; Hailu, Gessessew Bugssa; Halasa, Yara A.; Hamadeh, Randah Ribhi; Hamidi, Samer; Hammami, Mouhanad; Handal, Alexis J.; Hankey, Graeme J.; Harb, Hilda L.; Harikrishnan, Sivadasanpillai; Haro, Josep Maria; Hassanvand, Mohammad Sadegh; Hassen, Tahir Ahmed; Havmoeller, Rasmus; Hay, Roderick J.; Hedayati, Mohammad T.; Heredia-Pi, Ileana Beatriz; Heydarpour, Pouria; Hoek, Hans W.; Hoffman, Daniel J.; Horino, Masako; Horita, Nobuyuki; Hosgood, H. Dean; Hoy, Damian G.; Hsairi, Mohamed; Huang, Hsiang; Huang, John J.; Iburg, Kim Moesgaard; Idrisov, Bulat T.; Innos, Kaire; Inoue, Manami; Jacobsen, Kathryn H.; Jauregui, Alejandra; Jayatilleke, Achala Upendra; Jeemon, Panniyammakal; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jibat, Tariku; Jimenez-Corona, Aida; Jin, Ye; Jonas, Jost B.; Kabir, Zubair; Kajungu, Dan K.; Kalkonde, Yogeshwar; Kamal, Ritul; Kan, Haidong; Kandel, Amit; Karch, André; Karema, Corine Kakizi; Karimkhani, Chante; Kasaeian, Amir; Katibeh, Marzieh; Kaul, Anil; Kawakami, Norito; Kazi, Dhruv S.; Keiyoro, Peter Njenga; Kemp, Andrew Haddon; Kengne, Andre Pascal; Keren, Andre; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khang, Young Ho; Khoja, Tawfik Ahmed Muthafer; Khubchandani, Jagdish; Kieling, Christian; Kim, Cho il; Kim, Daniel; Kim, Yun Jin; Kissoon, Niranjan; Kivipelto, Miia; Knibbs, Luke D.; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kolte, Dhaval; Kopec, Jacek A.; Koul, Parvaiz A.; Koyanagi, Ai; Defo, Barthelemy Kuate; Kuchenbecker, Ricardo S.; Bicer, Burcu Kucuk; Kuipers, Ernst J.; Kumar, G. Anil; Kwan, Gene F.; Lalloo, Ratilal; Lallukka, Tea; Larsson, Anders; Latif, Asma Abdul; Lavados, Pablo M.; Lawrynowicz, Alicia Elena Beatriz; Leasher, Janet L.; Leigh, James; Leung, Ricky; Li, Yichong; Li, Yongmei; Lipshultz, Steven E.; Liu, Patrick Y.; Liu, Yang; Lloyd, Belinda K.; Logroscino, Giancarlo; Looker, Katharine J.; Lotufo, Paulo A.; Lucas, Robyn M.; Lunevicius, Raimundas; Lyons, Ronan A.; Razek, Hassan Magdy Abd El; Mahdavi, Mahdi; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Malta, Deborah Carvalho; Marcenes, Wagner; Martinez-Raga, Jose; Masiye, Felix; Mason-Jones, Amanda J.; Matzopoulos, Richard; Mayosi, Bongani M.; McGrath, John J.; McKee, Martin; Meaney, Peter A.; Mehari, Alem; Melaku, Yohannes Adama; Memiah, Peter; Memish, Ziad A.; Mendoza, Walter; Meretoja, Atte; Meretoja, Tuomo J.; Mesfin, Yonatan Moges; Mhimbira, Francis Apolinary; Miller, Ted R.; Mills, Edward J.; Mirarefin, Mojde; Mirrakhimov, Erkin M.; Mitchell, Philip B.; Mock, Charles N.; Mohammad, Karzan Abdulmuhsin; Mohammadi, Alireza; Mohammed, Shafiu; Monasta, Lorenzo; Hernandez, Julio Cesar Montañez; Montico, Marcella; Moradi-Lakeh, Maziar; Mori, Rintaro; Mueller, Ulrich O.; Mumford, John Everett; Murdoch, Michele E.; Murthy, Gudlavalleti Venkata Satyanarayana; Nachega, Jean B.; Naheed, Aliya; Naldi, Luigi; Nangia, Vinay; Newton, John N.; Ng, Marie; Ngalesoni, Frida Namnyak; Nguyen, Quyen Le; Nisar, Muhammad Imran; Pete, Patrick Martial Nkamedjie; Nolla, Joan M.; Norheim, Ole F.; Norman, Rosana E.; Norrving, Bo; Obermeyer, Carla Makhlouf; Ogbo, Felix Akpojene; Oh, In Hwan; Oladimeji, Olanrewaju; Olivares, Pedro R.; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Oren, Eyal; Ortiz, Alberto; Ota, Erika; Oyekale, Abayomi Samuel; PA, Mahesh; Park, Eun Kee; Parsaeian, Mahboubeh; Patten, Scott B.; Patton, George C.; Pedro, João Mário; Pereira, David M.; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Piel, Frédéric B.; Pillay, Julian David; Pishgar, Farhad; Plass, Dietrich; Polinder, Suzanne; Popova, Svetlana; Poulton, Richie G.; Pourmalek, Farshad; Prasad, Noela M.; Qorbani, Mostafa; Rabiee, Rynaz H.S.; Radfar, Amir; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Dheeraj; Rai, Rajesh Kumar; Rajsic, Sasa; Raju, Murugesan; Ram, Usha; Ranganathan, Kavitha; Refaat, Amany H.; Reitsma, Marissa B.; Remuzzi, Giuseppe; Resnikoff, Serge; Reynolds, Alex; Ribeiro, Antonio L.; Ricci, Stefano; Roba, Hirbo Shore; Rojas-Rueda, David; Ronfani, Luca; Roshandel, Gholamreza; Roth, Gregory A.; Roy, Ambuj; Sackey, Ben Benasco; Sagar, Rajesh; Sanabria, Juan R.; Sanchez-Niño, Maria Dolores; Santos, Itamar S.; Santos, João Vasco; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Schmidt, Maria Inês; Schneider, Ione J.C.; Schutte, Aletta E.; Schwebel, David C.; Seedat, Soraya; Sepanlou, Sadaf G.; Servan-Mori, Edson E.; Shahraz, Saeid; Shaikh, Masood Ali; Sharma, Rajesh; She, Jun; Sheikhbahaei, Sara; Shen, Jiabin; Sheth, Kevin N.; Shibuya, Kenji; Shigematsu, Mika; Shin, Min Jeong; Shiri, Rahman; Sigfusdottir, Inga Dora; Silva, Diego Augusto Santos; Silverberg, Jonathan I.; Simard, Edgar P.; Singh, Abhishek; Singh, Jasvinder A.; Singh, Prashant Kumar; Skirbekk, Vegard; Skogen, Jens Christoffer; Soljak, Michael; Søreide, Kjetil; Sorensen, Reed J.D.; Sreeramareddy, Chandrashekhar T.; Stathopoulou, Vasiliki; Steel, Nicholas; Stein, Dan J.; Stein, Murray B.; Steiner, Timothy J.; Stovner, Lars Jacob; Stranges, Saverio; Stroumpoulis, Konstantinos; Sunguya, Bruno F.; Sur, Patrick J.; Swaminathan, Soumya; Sykes, Bryan L.; Szoeke, Cassandra E.I.; Tabarés-Seisdedos, Rafael; Tandon, Nikhil; Tanne, David; Tavakkoli, Mohammad; Taye, Bineyam; Taylor, Hugh R.; Ao, Braden J.Te; Tegegne, Teketo Kassaw; Tekle, Dejen Yemane; Terkawi, Abdullah Sulieman; Tessema, Gizachew Assefa; Thakur, J. S.; Thomson, Alan J.; Thorne-Lyman, Andrew L.; Thrift, Amanda G.; Thurston, George D.; Tobe-Gai, Ruoyan; Tonelli, Marcello; Topor-Madry, Roman; Topouzis, Fotis; Tran, Bach Xuan; Dimbuene, Zacharie Tsala; Tsilimbaris, Miltiadis; Tura, Abera Kenay; Tuzcu, Emin Murat; Tyrovolas, Stefanos; Ukwaja, Kingsley N.; Undurraga, Eduardo A.; Uneke, Chigozie Jesse; Uthman, Olalekan A.; van Gool, Coen H.; van Os, Jim; Vasankari, Tommi; Vasconcelos, Ana Maria Nogales; Venketasubramanian, Narayanaswamy; Violante, Francesco S.; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Wagner, Gregory R.; Wallin, Mitchell T.; Wang, Linhong; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G.; Werdecker, Andrea; Westerman, Ronny; Wijeratne, Tissa; Wilkinson, James D.; Williams, Hywel C.; Wiysonge, Charles Shey; Woldeyohannes, Solomon Meseret; Wolfe, Charles D.A.; Won, Sungho; Xu, Gelin; Yadav, Ajit Kumar; Yakob, Bereket; Yan, Lijing L.; Yano, Yuichiro; Yaseri, Mehdi; Ye, Pengpeng; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok Jun; Younis, Mustafa Z.; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zeeb, Hajo; Zodpey, Sanjay; Zonies, David; Zuhlke, Liesl Joanna; Vos, Theo; Lopez, Alan D.; Murray, Christopher J.L.

In: The Lancet, Vol. 388, No. 10053, 08.10.2016, p. 1603-1658.

Research output: Contribution to journalArticle

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Kassebaum, Nicholas J. ; Arora, Megha ; Barber, Ryan M. ; Bhutta, Zulfiqar A. ; Brown, Jonathan ; Carter, Austin ; Casey, Daniel C. ; Charlson, Fiona J. ; Coates, Matthew M. ; Coggeshall, Megan ; Cornaby, Leslie ; Dandona, Lalit ; Dicker, Daniel J. ; Erskine, Holly E. ; Ferrari, Alize J. ; Fitzmaurice, Christina ; Foreman, Kyle ; Forouzanfar, Mohammad H. ; Fullman, Nancy ; Gething, Peter W. ; Goldberg, Ellen M. ; Graetz, Nicholas ; Haagsma, Juanita A. ; Johnson, Catherine O. ; Kemmer, Laura ; Khalil, Ibrahim A. ; Kinfu, Yohannes ; Kutz, Michael J. ; Kyu, Hmwe H. ; Leung, Janni ; Liang, Xiaofeng ; Lim, Stephen S. ; Lozano, Rafael ; Mensah, George A. ; Mikesell, Joe ; Mokdad, Ali H. ; Mooney, Meghan D. ; Naghavi, Mohsen ; Nguyen, Grant ; Nsoesie, Elaine ; Pigott, David M. ; Pinho, Christine ; Rankin, Zane ; Reinig, Nikolas ; Salomon, Joshua A. ; Sandar, Logan ; Smith, Alison ; Sorensen, Reed J.D. ; Stanaway, Jeffrey ; Steiner, Caitlyn ; Teeple, Stephanie ; Thomas, Bernadette A. ; Troeger, Chris ; VanderZanden, Amelia ; Wagner, Joseph A. ; Wanga, Valentine ; Whiteford, Harvey A. ; Zhou, Maigeng ; Zoeckler, Leo ; Abajobir, Amanuel Alemu ; Abate, Kalkidan Hassen ; Abbafati, Cristiana ; Abbas, Kaja M. ; Abd-Allah, Foad ; Abraham, Biju ; Abubakar, Ibrahim ; Abu-Raddad, Laith J. ; Abu-Rmeileh, Niveen M.E. ; Achoki, Tom ; Ackerman, Ilana N. ; Adebiyi, Akindele Olupelumi ; Adedeji, Isaac Akinkunmi ; Adsuar, José C. ; Afanvi, Kossivi Agbelenko ; Afshin, Ashkan ; Agardh, Emilie Elisabet ; Agarwal, Arnav ; Agarwal, Sanjay Kumar ; Ahmed, Muktar Beshir ; Kiadaliri, Aliasghar Ahmad ; Ahmadieh, Hamid ; Akseer, Nadia ; Al-Aly, Ziyad ; Alam, Khurshid ; Alam, Noore K.M. ; Aldhahri, Saleh Fahed ; Alegretti, Miguel Angel ; Aleman, Alicia V. ; Alemu, Zewdie Aderaw ; Alexander, Lily T. ; Ali, Raghib ; Alkerwi, Ala'a ; Alla, François ; Allebeck, Peter ; Alsharif, Ubai ; Altirkawi, Khalid A. ; Martin, Elena Alvarez ; Alvis-Guzman, Nelson ; Amare, Azmeraw T. ; Amberbir, Alemayehu ; Amegah, Adeladza Kofi ; Amini, Heresh ; Ammar, Walid ; Amrock, Stephen Marc ; Anderson, Gregory M. ; Anderson, Benjamin O. ; Antonio, Carl Abelardo T. ; Anwari, Palwasha ; Ärnlöv, Johan ; Arsenijevic, Valentina S.Arsic ; Artaman, Al ; Asayesh, Hamid ; Asghar, Rana Jawad ; Avokpaho, Euripide Frinel G.Arthur ; Awasthi, Ashish ; Quintanilla, Beatriz Paulina Ayala ; Azzopardi, Peter ; Bacha, Umar ; Badawi, Alaa ; Balakrishnan, Kalpana ; Banerjee, Amitava ; Barac, Aleksandra ; Barker-Collo, Suzanne L. ; Bärnighausen, Till ; Barregard, Lars ; Barrero, Lope H. ; Basu, Sanjay ; Bayou, Tigist Assefa ; Beardsley, Justin ; Bedi, Neeraj ; Beghi, Ettore ; Bell, Brent ; Bell, Michelle L. ; Aburaddad, Laith ; Bennett, Derrick A. ; Bensenor, Isabela M. ; Berhane, Adugnaw ; Bernabé, Eduardo ; Betsu, Balem Demtsu ; Beyene, Addisu Shunu ; Bhala, Neeraj ; Bhansali, Anil ; Bhatt, Samir ; Biadgilign, Sibhatu ; Bienhoff, Kelly ; Bikbov, Boris ; Abdulhak, Aref A.Bin ; Bisanzio, Donal ; Bjertness, Espen ; Blore, Jed D. ; Borschmann, Rohan ; Boufous, Soufiane ; Bourne, Rupert R.A. ; Brainin, Michael ; Brazinova, Alexandra ; Breitborde, Nicholas J.K. ; Brugha, Traolach S. ; Buchbinder, Rachelle ; Buckle, Geoffrey Colin ; Butt, Zahid A. ; Calabria, Bianca ; Campos-Nonato, Ismael Ricardo ; Campuzano, Julio Cesar ; Carabin, Hélène ; Carapetis, Jonathan R. ; Cárdenas, Rosario ; Carrero, Juan Jesus ; Castañeda-Orjuela, Carlos A. ; Rivas, Jacqueline Castillo ; Catalá-López, Ferrán ; Cavalleri, Fiorella ; Chang, Jung Chen ; Chiang, Peggy Pei Chia ; Chibalabala, Mirriam ; Chibueze, Chioma Ezinne ; Chisumpa, Vesper Hichilombwe ; Choi, Jee Young Jasmine ; Choudhury, Lincoln ; Christensen, Hanne ; Ciobanu, Liliana G. ; Colistro, Valentina ; Colomar, Mercedes ; Colquhoun, Samantha M. ; Cortinovis, Monica ; Crump, John A. ; Damasceno, Albertino ; Dandona, Rakhi ; Dargan, Paul I. ; das Neves, José ; Davey, Gail ; Davis, Adrian C. ; Leo, Diego De ; Degenhardt, Louisa ; Gobbo, Liana C.Del ; Derrett, Sarah ; Jarlais, Don C.Des ; deVeber, Gabrielle A. ; Dharmaratne, Samath D. ; Dhillon, Preet K. ; Ding, Eric L. ; Doyle, Kerrie E. ; Driscoll, Tim R. ; Duan, Leilei ; Dubey, Manisha ; Duncan, Bruce Bartholow ; Ebrahimi, Hedyeh ; Ellenbogen, Richard G. ; Elyazar, Iqbal ; Endries, Aman Yesuf ; Ermakov, Sergey Petrovich ; Eshrati, Babak ; Esteghamati, Alireza ; Estep, Kara ; Fahimi, Saman ; Farid, Talha A. ; Farinha, Carla Sofia e.Sa ; Faro, André ; Farvid, Maryam S. ; Farzadfar, Farshad ; Feigin, Valery L. ; Fereshtehnejad, Seyed Mohammad ; Fernandes, Jefferson G. ; Fernandes, Joao C. ; Fischer, Florian ; Fitchett, Joseph R.A. ; Foigt, Nataliya ; Fowkes, F. Gerry R. ; Franklin, Richard C. ; Friedman, Joseph ; Frostad, Joseph ; Fürst, Thomas ; Futran, Neal D. ; Gabbe, Belinda ; Gankpé, Fortuné Gbètoho ; Garcia-Basteiro, Alberto L. ; Gebrehiwot, Tsegaye Tewelde ; Gebremedhin, Amanuel Tesfay ; Geleijnse, Johanna M. ; Gibney, Katherine B. ; Gillum, Richard F. ; Ginawi, Ibrahim Abdelmageem Mohamed ; Giref, Ababi Zergaw ; Giroud, Maurice ; Gishu, Melkamu Dedefo ; Godwin, William W. ; Gomez-Dantes, Hector ; Gona, Philimon ; Goodridge, Amador ; Gopalani, Sameer Vali ; Gotay, Carolyn C. ; Goto, Atsushi ; Gouda, Hebe N. ; Guo, Yuming ; Gupta, Rahul ; Gupta, Rajeev ; Gupta, Vipin ; Gutiérrez, Reyna A. ; Hafezi-Nejad, Nima ; Haile, Demewoz ; Hailu, Alemayehu Desalegne ; Hailu, Gessessew Bugssa ; Halasa, Yara A. ; Hamadeh, Randah Ribhi ; Hamidi, Samer ; Hammami, Mouhanad ; Handal, Alexis J. ; Hankey, Graeme J. ; Harb, Hilda L. ; Harikrishnan, Sivadasanpillai ; Haro, Josep Maria ; Hassanvand, Mohammad Sadegh ; Hassen, Tahir Ahmed ; Havmoeller, Rasmus ; Hay, Roderick J. ; Hedayati, Mohammad T. ; Heredia-Pi, Ileana Beatriz ; Heydarpour, Pouria ; Hoek, Hans W. ; Hoffman, Daniel J. ; Horino, Masako ; Horita, Nobuyuki ; Hosgood, H. Dean ; Hoy, Damian G. ; Hsairi, Mohamed ; Huang, Hsiang ; Huang, John J. ; Iburg, Kim Moesgaard ; Idrisov, Bulat T. ; Innos, Kaire ; Inoue, Manami ; Jacobsen, Kathryn H. ; Jauregui, Alejandra ; Jayatilleke, Achala Upendra ; Jeemon, Panniyammakal ; Jha, Vivekanand ; Jiang, Guohong ; Jiang, Ying ; Jibat, Tariku ; Jimenez-Corona, Aida ; Jin, Ye ; Jonas, Jost B. ; Kabir, Zubair ; Kajungu, Dan K. ; Kalkonde, Yogeshwar ; Kamal, Ritul ; Kan, Haidong ; Kandel, Amit ; Karch, André ; Karema, Corine Kakizi ; Karimkhani, Chante ; Kasaeian, Amir ; Katibeh, Marzieh ; Kaul, Anil ; Kawakami, Norito ; Kazi, Dhruv S. ; Keiyoro, Peter Njenga ; Kemp, Andrew Haddon ; Kengne, Andre Pascal ; Keren, Andre ; Kesavachandran, Chandrasekharan Nair ; Khader, Yousef Saleh ; Khan, Abdur Rahman ; Khan, Ejaz Ahmad ; Khang, Young Ho ; Khoja, Tawfik Ahmed Muthafer ; Khubchandani, Jagdish ; Kieling, Christian ; Kim, Cho il ; Kim, Daniel ; Kim, Yun Jin ; Kissoon, Niranjan ; Kivipelto, Miia ; Knibbs, Luke D. ; Knudsen, Ann Kristin ; Kokubo, Yoshihiro ; Kolte, Dhaval ; Kopec, Jacek A. ; Koul, Parvaiz A. ; Koyanagi, Ai ; Defo, Barthelemy Kuate ; Kuchenbecker, Ricardo S. ; Bicer, Burcu Kucuk ; Kuipers, Ernst J. ; Kumar, G. Anil ; Kwan, Gene F. ; Lalloo, Ratilal ; Lallukka, Tea ; Larsson, Anders ; Latif, Asma Abdul ; Lavados, Pablo M. ; Lawrynowicz, Alicia Elena Beatriz ; Leasher, Janet L. ; Leigh, James ; Leung, Ricky ; Li, Yichong ; Li, Yongmei ; Lipshultz, Steven E. ; Liu, Patrick Y. ; Liu, Yang ; Lloyd, Belinda K. ; Logroscino, Giancarlo ; Looker, Katharine J. ; Lotufo, Paulo A. ; Lucas, Robyn M. ; Lunevicius, Raimundas ; Lyons, Ronan A. ; Razek, Hassan Magdy Abd El ; Mahdavi, Mahdi ; Majdan, Marek ; Majeed, Azeem ; Malekzadeh, Reza ; Malta, Deborah Carvalho ; Marcenes, Wagner ; Martinez-Raga, Jose ; Masiye, Felix ; Mason-Jones, Amanda J. ; Matzopoulos, Richard ; Mayosi, Bongani M. ; McGrath, John J. ; McKee, Martin ; Meaney, Peter A. ; Mehari, Alem ; Melaku, Yohannes Adama ; Memiah, Peter ; Memish, Ziad A. ; Mendoza, Walter ; Meretoja, Atte ; Meretoja, Tuomo J. ; Mesfin, Yonatan Moges ; Mhimbira, Francis Apolinary ; Miller, Ted R. ; Mills, Edward J. ; Mirarefin, Mojde ; Mirrakhimov, Erkin M. ; Mitchell, Philip B. ; Mock, Charles N. ; Mohammad, Karzan Abdulmuhsin ; Mohammadi, Alireza ; Mohammed, Shafiu ; Monasta, Lorenzo ; Hernandez, Julio Cesar Montañez ; Montico, Marcella ; Moradi-Lakeh, Maziar ; Mori, Rintaro ; Mueller, Ulrich O. ; Mumford, John Everett ; Murdoch, Michele E. ; Murthy, Gudlavalleti Venkata Satyanarayana ; Nachega, Jean B. ; Naheed, Aliya ; Naldi, Luigi ; Nangia, Vinay ; Newton, John N. ; Ng, Marie ; Ngalesoni, Frida Namnyak ; Nguyen, Quyen Le ; Nisar, Muhammad Imran ; Pete, Patrick Martial Nkamedjie ; Nolla, Joan M. ; Norheim, Ole F. ; Norman, Rosana E. ; Norrving, Bo ; Obermeyer, Carla Makhlouf ; Ogbo, Felix Akpojene ; Oh, In Hwan ; Oladimeji, Olanrewaju ; Olivares, Pedro R. ; Olusanya, Bolajoko Olubukunola ; Olusanya, Jacob Olusegun ; Oren, Eyal ; Ortiz, Alberto ; Ota, Erika ; Oyekale, Abayomi Samuel ; PA, Mahesh ; Park, Eun Kee ; Parsaeian, Mahboubeh ; Patten, Scott B. ; Patton, George C. ; Pedro, João Mário ; Pereira, David M. ; Perico, Norberto ; Pesudovs, Konrad ; Petzold, Max ; Phillips, Michael Robert ; Piel, Frédéric B. ; Pillay, Julian David ; Pishgar, Farhad ; Plass, Dietrich ; Polinder, Suzanne ; Popova, Svetlana ; Poulton, Richie G. ; Pourmalek, Farshad ; Prasad, Noela M. ; Qorbani, Mostafa ; Rabiee, Rynaz H.S. ; Radfar, Amir ; Rafay, Anwar ; Rahimi, Kazem ; Rahimi-Movaghar, Vafa ; Rahman, Mahfuzar ; Rahman, Mohammad Hifz Ur ; Rahman, Sajjad Ur ; Rai, Dheeraj ; Rai, Rajesh Kumar ; Rajsic, Sasa ; Raju, Murugesan ; Ram, Usha ; Ranganathan, Kavitha ; Refaat, Amany H. ; Reitsma, Marissa B. ; Remuzzi, Giuseppe ; Resnikoff, Serge ; Reynolds, Alex ; Ribeiro, Antonio L. ; Ricci, Stefano ; Roba, Hirbo Shore ; Rojas-Rueda, David ; Ronfani, Luca ; Roshandel, Gholamreza ; Roth, Gregory A. ; Roy, Ambuj ; Sackey, Ben Benasco ; Sagar, Rajesh ; Sanabria, Juan R. ; Sanchez-Niño, Maria Dolores ; Santos, Itamar S. ; Santos, João Vasco ; Sarmiento-Suarez, Rodrigo ; Sartorius, Benn ; Satpathy, Maheswar ; Savic, Miloje ; Sawhney, Monika ; Schmidt, Maria Inês ; Schneider, Ione J.C. ; Schutte, Aletta E. ; Schwebel, David C. ; Seedat, Soraya ; Sepanlou, Sadaf G. ; Servan-Mori, Edson E. ; Shahraz, Saeid ; Shaikh, Masood Ali ; Sharma, Rajesh ; She, Jun ; Sheikhbahaei, Sara ; Shen, Jiabin ; Sheth, Kevin N. ; Shibuya, Kenji ; Shigematsu, Mika ; Shin, Min Jeong ; Shiri, Rahman ; Sigfusdottir, Inga Dora ; Silva, Diego Augusto Santos ; Silverberg, Jonathan I. ; Simard, Edgar P. ; Singh, Abhishek ; Singh, Jasvinder A. ; Singh, Prashant Kumar ; Skirbekk, Vegard ; Skogen, Jens Christoffer ; Soljak, Michael ; Søreide, Kjetil ; Sorensen, Reed J.D. ; Sreeramareddy, Chandrashekhar T. ; Stathopoulou, Vasiliki ; Steel, Nicholas ; Stein, Dan J. ; Stein, Murray B. ; Steiner, Timothy J. ; Stovner, Lars Jacob ; Stranges, Saverio ; Stroumpoulis, Konstantinos ; Sunguya, Bruno F. ; Sur, Patrick J. ; Swaminathan, Soumya ; Sykes, Bryan L. ; Szoeke, Cassandra E.I. ; Tabarés-Seisdedos, Rafael ; Tandon, Nikhil ; Tanne, David ; Tavakkoli, Mohammad ; Taye, Bineyam ; Taylor, Hugh R. ; Ao, Braden J.Te ; Tegegne, Teketo Kassaw ; Tekle, Dejen Yemane ; Terkawi, Abdullah Sulieman ; Tessema, Gizachew Assefa ; Thakur, J. S. ; Thomson, Alan J. ; Thorne-Lyman, Andrew L. ; Thrift, Amanda G. ; Thurston, George D. ; Tobe-Gai, Ruoyan ; Tonelli, Marcello ; Topor-Madry, Roman ; Topouzis, Fotis ; Tran, Bach Xuan ; Dimbuene, Zacharie Tsala ; Tsilimbaris, Miltiadis ; Tura, Abera Kenay ; Tuzcu, Emin Murat ; Tyrovolas, Stefanos ; Ukwaja, Kingsley N. ; Undurraga, Eduardo A. ; Uneke, Chigozie Jesse ; Uthman, Olalekan A. ; van Gool, Coen H. ; van Os, Jim ; Vasankari, Tommi ; Vasconcelos, Ana Maria Nogales ; Venketasubramanian, Narayanaswamy ; Violante, Francesco S. ; Vlassov, Vasiliy Victorovich ; Vollset, Stein Emil ; Wagner, Gregory R. ; Wallin, Mitchell T. ; Wang, Linhong ; Weichenthal, Scott ; Weiderpass, Elisabete ; Weintraub, Robert G. ; Werdecker, Andrea ; Westerman, Ronny ; Wijeratne, Tissa ; Wilkinson, James D. ; Williams, Hywel C. ; Wiysonge, Charles Shey ; Woldeyohannes, Solomon Meseret ; Wolfe, Charles D.A. ; Won, Sungho ; Xu, Gelin ; Yadav, Ajit Kumar ; Yakob, Bereket ; Yan, Lijing L. ; Yano, Yuichiro ; Yaseri, Mehdi ; Ye, Pengpeng ; Yip, Paul ; Yonemoto, Naohiro ; Yoon, Seok Jun ; Younis, Mustafa Z. ; Yu, Chuanhua ; Zaidi, Zoubida ; Zaki, Maysaa El Sayed ; Zeeb, Hajo ; Zodpey, Sanjay ; Zonies, David ; Zuhlke, Liesl Joanna ; Vos, Theo ; Lopez, Alan D. ; Murray, Christopher J.L. / Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015 : a systematic analysis for the Global Burden of Disease Study 2015. In: The Lancet. 2016 ; Vol. 388, No. 10053. pp. 1603-1658.
@article{43bb76063ae444cc9a35ebabb2781360,
title = "Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015",
abstract = "Background Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate. Findings Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2·9 years (95{\%} uncertainty interval 2·9–3·0) for men and 3·5 years (3·4–3·7) for women, while HALE at age 65 years improved by 0·85 years (0·78–0·92) and 1·2 years (1·1–1·3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs. Interpretation Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum. Funding Bill & Melinda Gates Foundation.",
author = "Kassebaum, {Nicholas J.} and Megha Arora and Barber, {Ryan M.} and Bhutta, {Zulfiqar A.} and Jonathan Brown and Austin Carter and Casey, {Daniel C.} and Charlson, {Fiona J.} and Coates, {Matthew M.} and Megan Coggeshall and Leslie Cornaby and Lalit Dandona and Dicker, {Daniel J.} and Erskine, {Holly E.} and Ferrari, {Alize J.} and Christina Fitzmaurice and Kyle Foreman and Forouzanfar, {Mohammad H.} and Nancy Fullman and Gething, {Peter W.} and Goldberg, {Ellen M.} and Nicholas Graetz and Haagsma, {Juanita A.} and Johnson, {Catherine O.} and Laura Kemmer and Khalil, {Ibrahim A.} and Yohannes Kinfu and Kutz, {Michael J.} and Kyu, {Hmwe H.} and Janni Leung and Xiaofeng Liang and Lim, {Stephen S.} and Rafael Lozano and Mensah, {George A.} and Joe Mikesell and Mokdad, {Ali H.} and Mooney, {Meghan D.} and Mohsen Naghavi and Grant Nguyen and Elaine Nsoesie and Pigott, {David M.} and Christine Pinho and Zane Rankin and Nikolas Reinig and Salomon, {Joshua A.} and Logan Sandar and Alison Smith and Sorensen, {Reed J.D.} and Jeffrey Stanaway and Caitlyn Steiner and Stephanie Teeple and Thomas, {Bernadette A.} and Chris Troeger and Amelia VanderZanden and Wagner, {Joseph A.} and Valentine Wanga and Whiteford, {Harvey A.} and Maigeng Zhou and Leo Zoeckler and Abajobir, {Amanuel Alemu} and Abate, {Kalkidan Hassen} and Cristiana Abbafati and Abbas, {Kaja M.} and Foad Abd-Allah and Biju Abraham and Ibrahim Abubakar and Abu-Raddad, {Laith J.} and Abu-Rmeileh, {Niveen M.E.} and Tom Achoki and Ackerman, {Ilana N.} and Adebiyi, {Akindele Olupelumi} and Adedeji, {Isaac Akinkunmi} and Adsuar, {Jos{\'e} C.} and Afanvi, {Kossivi Agbelenko} and Ashkan Afshin and Agardh, {Emilie Elisabet} and Arnav Agarwal and Agarwal, {Sanjay Kumar} and Ahmed, {Muktar Beshir} and Kiadaliri, {Aliasghar Ahmad} and Hamid Ahmadieh and Nadia Akseer and Ziyad Al-Aly and Khurshid Alam and Alam, {Noore K.M.} and Aldhahri, {Saleh Fahed} and Alegretti, {Miguel Angel} and Aleman, {Alicia V.} and Alemu, {Zewdie Aderaw} and Alexander, {Lily T.} and Raghib Ali and Ala'a Alkerwi and Fran{\cc}ois Alla and Peter Allebeck and Ubai Alsharif and Altirkawi, {Khalid A.} and Martin, {Elena Alvarez} and Nelson Alvis-Guzman and Amare, {Azmeraw T.} and Alemayehu Amberbir and Amegah, {Adeladza Kofi} and Heresh Amini and Walid Ammar and Amrock, {Stephen Marc} and Anderson, {Gregory M.} and Anderson, {Benjamin O.} and Antonio, {Carl Abelardo T.} and Palwasha Anwari and Johan {\"A}rnl{\"o}v and Arsenijevic, {Valentina S.Arsic} and Al Artaman and Hamid Asayesh and Asghar, {Rana Jawad} and Avokpaho, {Euripide Frinel G.Arthur} and Ashish Awasthi and Quintanilla, {Beatriz Paulina Ayala} and Peter Azzopardi and Umar Bacha and Alaa Badawi and Kalpana Balakrishnan and Amitava Banerjee and Aleksandra Barac and Barker-Collo, {Suzanne L.} and Till B{\"a}rnighausen and Lars Barregard and Barrero, {Lope H.} and Sanjay Basu and Bayou, {Tigist Assefa} and Justin Beardsley and Neeraj Bedi and Ettore Beghi and Brent Bell and Bell, {Michelle L.} and Laith Aburaddad and Bennett, {Derrick A.} and Bensenor, {Isabela M.} and Adugnaw Berhane and Eduardo Bernab{\'e} and Betsu, {Balem Demtsu} and Beyene, {Addisu Shunu} and Neeraj Bhala and Anil Bhansali and Samir Bhatt and Sibhatu Biadgilign and Kelly Bienhoff and Boris Bikbov and Abdulhak, {Aref A.Bin} and Donal Bisanzio and Espen Bjertness and Blore, {Jed D.} and Rohan Borschmann and Soufiane Boufous and Bourne, {Rupert R.A.} and Michael Brainin and Alexandra Brazinova and Breitborde, {Nicholas J.K.} and Brugha, {Traolach S.} and Rachelle Buchbinder and Buckle, {Geoffrey Colin} and Butt, {Zahid A.} and Bianca Calabria and Campos-Nonato, {Ismael Ricardo} and Campuzano, {Julio Cesar} and H{\'e}l{\`e}ne Carabin and Carapetis, {Jonathan R.} and Rosario C{\'a}rdenas and Carrero, {Juan Jesus} and Casta{\~n}eda-Orjuela, {Carlos A.} and Rivas, {Jacqueline Castillo} and Ferr{\'a}n Catal{\'a}-L{\'o}pez and Fiorella Cavalleri and Chang, {Jung Chen} and Chiang, {Peggy Pei Chia} and Mirriam Chibalabala and Chibueze, {Chioma Ezinne} and Chisumpa, {Vesper Hichilombwe} and Choi, {Jee Young Jasmine} and Lincoln Choudhury and Hanne Christensen and Ciobanu, {Liliana G.} and Valentina Colistro and Mercedes Colomar and Colquhoun, {Samantha M.} and Monica Cortinovis and Crump, {John A.} and Albertino Damasceno and Rakhi Dandona and Dargan, {Paul I.} and {das Neves}, Jos{\'e} and Gail Davey and Davis, {Adrian C.} and Leo, {Diego De} and Louisa Degenhardt and Gobbo, {Liana C.Del} and Sarah Derrett and Jarlais, {Don C.Des} and deVeber, {Gabrielle A.} and Dharmaratne, {Samath D.} and Dhillon, {Preet K.} and Ding, {Eric L.} and Doyle, {Kerrie E.} and Driscoll, {Tim R.} and Leilei Duan and Manisha Dubey and Duncan, {Bruce Bartholow} and Hedyeh Ebrahimi and Ellenbogen, {Richard G.} and Iqbal Elyazar and Endries, {Aman Yesuf} and Ermakov, {Sergey Petrovich} and Babak Eshrati and Alireza Esteghamati and Kara Estep and Saman Fahimi and Farid, {Talha A.} and Farinha, {Carla Sofia e.Sa} and Andr{\'e} Faro and Farvid, {Maryam S.} and Farshad Farzadfar and Feigin, {Valery L.} and Fereshtehnejad, {Seyed Mohammad} and Fernandes, {Jefferson G.} and Fernandes, {Joao C.} and Florian Fischer and Fitchett, {Joseph R.A.} and Nataliya Foigt and Fowkes, {F. Gerry R.} and Franklin, {Richard C.} and Joseph Friedman and Joseph Frostad and Thomas F{\"u}rst and Futran, {Neal D.} and Belinda Gabbe and Gankp{\'e}, {Fortun{\'e} Gb{\`e}toho} and Garcia-Basteiro, {Alberto L.} and Gebrehiwot, {Tsegaye Tewelde} and Gebremedhin, {Amanuel Tesfay} and Geleijnse, {Johanna M.} and Gibney, {Katherine B.} and Gillum, {Richard F.} and Ginawi, {Ibrahim Abdelmageem Mohamed} and Giref, {Ababi Zergaw} and Maurice Giroud and Gishu, {Melkamu Dedefo} and Godwin, {William W.} and Hector Gomez-Dantes and Philimon Gona and Amador Goodridge and Gopalani, {Sameer Vali} and Gotay, {Carolyn C.} and Atsushi Goto and Gouda, {Hebe N.} and Yuming Guo and Rahul Gupta and Rajeev Gupta and Vipin Gupta and Guti{\'e}rrez, {Reyna A.} and Nima Hafezi-Nejad and Demewoz Haile and Hailu, {Alemayehu Desalegne} and Hailu, {Gessessew Bugssa} and Halasa, {Yara A.} and Hamadeh, {Randah Ribhi} and Samer Hamidi and Mouhanad Hammami and Handal, {Alexis J.} and Hankey, {Graeme J.} and Harb, {Hilda L.} and Sivadasanpillai Harikrishnan and Haro, {Josep Maria} and Hassanvand, {Mohammad Sadegh} and Hassen, {Tahir Ahmed} and Rasmus Havmoeller and Hay, {Roderick J.} and Hedayati, {Mohammad T.} and Heredia-Pi, {Ileana Beatriz} and Pouria Heydarpour and Hoek, {Hans W.} and Hoffman, {Daniel J.} and Masako Horino and Nobuyuki Horita and Hosgood, {H. Dean} and Hoy, {Damian G.} and Mohamed Hsairi and Hsiang Huang and Huang, {John J.} and Iburg, {Kim Moesgaard} and Idrisov, {Bulat T.} and Kaire Innos and Manami Inoue and Jacobsen, {Kathryn H.} and Alejandra Jauregui and Jayatilleke, {Achala Upendra} and Panniyammakal Jeemon and Vivekanand Jha and Guohong Jiang and Ying Jiang and Tariku Jibat and Aida Jimenez-Corona and Ye Jin and Jonas, {Jost B.} and Zubair Kabir and Kajungu, {Dan K.} and Yogeshwar Kalkonde and Ritul Kamal and Haidong Kan and Amit Kandel and Andr{\'e} Karch and Karema, {Corine Kakizi} and Chante Karimkhani and Amir Kasaeian and Marzieh Katibeh and Anil Kaul and Norito Kawakami and Kazi, {Dhruv S.} and Keiyoro, {Peter Njenga} and Kemp, {Andrew Haddon} and Kengne, {Andre Pascal} and Andre Keren and Kesavachandran, {Chandrasekharan Nair} and Khader, {Yousef Saleh} and Khan, {Abdur Rahman} and Khan, {Ejaz Ahmad} and Khang, {Young Ho} and Khoja, {Tawfik Ahmed Muthafer} and Jagdish Khubchandani and Christian Kieling and Kim, {Cho il} and Daniel Kim and Kim, {Yun Jin} and Niranjan Kissoon and Miia Kivipelto and Knibbs, {Luke D.} and Knudsen, {Ann Kristin} and Yoshihiro Kokubo and Dhaval Kolte and Kopec, {Jacek A.} and Koul, {Parvaiz A.} and Ai Koyanagi and Defo, {Barthelemy Kuate} and Kuchenbecker, {Ricardo S.} and Bicer, {Burcu Kucuk} and Kuipers, {Ernst J.} and Kumar, {G. Anil} and Kwan, {Gene F.} and Ratilal Lalloo and Tea Lallukka and Anders Larsson and Latif, {Asma Abdul} and Lavados, {Pablo M.} and Lawrynowicz, {Alicia Elena Beatriz} and Leasher, {Janet L.} and James Leigh and Ricky Leung and Yichong Li and Yongmei Li and Lipshultz, {Steven E.} and Liu, {Patrick Y.} and Yang Liu and Lloyd, {Belinda K.} and Giancarlo Logroscino and Looker, {Katharine J.} and Lotufo, {Paulo A.} and Lucas, {Robyn M.} and Raimundas Lunevicius and Lyons, {Ronan A.} and Razek, {Hassan Magdy Abd El} and Mahdi Mahdavi and Marek Majdan and Azeem Majeed and Reza Malekzadeh and Malta, {Deborah Carvalho} and Wagner Marcenes and Jose Martinez-Raga and Felix Masiye and Mason-Jones, {Amanda J.} and Richard Matzopoulos and Mayosi, {Bongani M.} and McGrath, {John J.} and Martin McKee and Meaney, {Peter A.} and Alem Mehari and Melaku, {Yohannes Adama} and Peter Memiah and Memish, {Ziad A.} and Walter Mendoza and Atte Meretoja and Meretoja, {Tuomo J.} and Mesfin, {Yonatan Moges} and Mhimbira, {Francis Apolinary} and Miller, {Ted R.} and Mills, {Edward J.} and Mojde Mirarefin and Mirrakhimov, {Erkin M.} and Mitchell, {Philip B.} and Mock, {Charles N.} and Mohammad, {Karzan Abdulmuhsin} and Alireza Mohammadi and Shafiu Mohammed and Lorenzo Monasta and Hernandez, {Julio Cesar Monta{\~n}ez} and Marcella Montico and Maziar Moradi-Lakeh and Rintaro Mori and Mueller, {Ulrich O.} and Mumford, {John Everett} and Murdoch, {Michele E.} and Murthy, {Gudlavalleti Venkata Satyanarayana} and Nachega, {Jean B.} and Aliya Naheed and Luigi Naldi and Vinay Nangia and Newton, {John N.} and Marie Ng and Ngalesoni, {Frida Namnyak} and Nguyen, {Quyen Le} and Nisar, {Muhammad Imran} and Pete, {Patrick Martial Nkamedjie} and Nolla, {Joan M.} and Norheim, {Ole F.} and Norman, {Rosana E.} and Bo Norrving and Obermeyer, {Carla Makhlouf} and Ogbo, {Felix Akpojene} and Oh, {In Hwan} and Olanrewaju Oladimeji and Olivares, {Pedro R.} and Olusanya, {Bolajoko Olubukunola} and Olusanya, {Jacob Olusegun} and Eyal Oren and Alberto Ortiz and Erika Ota and Oyekale, {Abayomi Samuel} and Mahesh PA and Park, {Eun Kee} and Mahboubeh Parsaeian and Patten, {Scott B.} and Patton, {George C.} and Pedro, {Jo{\~a}o M{\'a}rio} and Pereira, {David M.} and Norberto Perico and Konrad Pesudovs and Max Petzold and Phillips, {Michael Robert} and Piel, {Fr{\'e}d{\'e}ric B.} and Pillay, {Julian David} and Farhad Pishgar and Dietrich Plass and Suzanne Polinder and Svetlana Popova and Poulton, {Richie G.} and Farshad Pourmalek and Prasad, {Noela M.} and Mostafa Qorbani and Rabiee, {Rynaz H.S.} and Amir Radfar and Anwar Rafay and Kazem Rahimi and Vafa Rahimi-Movaghar and Mahfuzar Rahman and Rahman, {Mohammad Hifz Ur} and Rahman, {Sajjad Ur} and Dheeraj Rai and Rai, {Rajesh Kumar} and Sasa Rajsic and Murugesan Raju and Usha Ram and Kavitha Ranganathan and Refaat, {Amany H.} and Reitsma, {Marissa B.} and Giuseppe Remuzzi and Serge Resnikoff and Alex Reynolds and Ribeiro, {Antonio L.} and Stefano Ricci and Roba, {Hirbo Shore} and David Rojas-Rueda and Luca Ronfani and Gholamreza Roshandel and Roth, {Gregory A.} and Ambuj Roy and Sackey, {Ben Benasco} and Rajesh Sagar and Sanabria, {Juan R.} and Sanchez-Ni{\~n}o, {Maria Dolores} and Santos, {Itamar S.} and Santos, {Jo{\~a}o Vasco} and Rodrigo Sarmiento-Suarez and Benn Sartorius and Maheswar Satpathy and Miloje Savic and Monika Sawhney and Schmidt, {Maria In{\^e}s} and Schneider, {Ione J.C.} and Schutte, {Aletta E.} and Schwebel, {David C.} and Soraya Seedat and Sepanlou, {Sadaf G.} and Servan-Mori, {Edson E.} and Saeid Shahraz and Shaikh, {Masood Ali} and Rajesh Sharma and Jun She and Sara Sheikhbahaei and Jiabin Shen and Sheth, {Kevin N.} and Kenji Shibuya and Mika Shigematsu and Shin, {Min Jeong} and Rahman Shiri and Sigfusdottir, {Inga Dora} and Silva, {Diego Augusto Santos} and Silverberg, {Jonathan I.} and Simard, {Edgar P.} and Abhishek Singh and Singh, {Jasvinder A.} and Singh, {Prashant Kumar} and Vegard Skirbekk and Skogen, {Jens Christoffer} and Michael Soljak and Kjetil S{\o}reide and Sorensen, {Reed J.D.} and Sreeramareddy, {Chandrashekhar T.} and Vasiliki Stathopoulou and Nicholas Steel and Stein, {Dan J.} and Stein, {Murray B.} and Steiner, {Timothy J.} and Stovner, {Lars Jacob} and Saverio Stranges and Konstantinos Stroumpoulis and Sunguya, {Bruno F.} and Sur, {Patrick J.} and Soumya Swaminathan and Sykes, {Bryan L.} and Szoeke, {Cassandra E.I.} and Rafael Tabar{\'e}s-Seisdedos and Nikhil Tandon and David Tanne and Mohammad Tavakkoli and Bineyam Taye and Taylor, {Hugh R.} and Ao, {Braden J.Te} and Tegegne, {Teketo Kassaw} and Tekle, {Dejen Yemane} and Terkawi, {Abdullah Sulieman} and Tessema, {Gizachew Assefa} and Thakur, {J. S.} and Thomson, {Alan J.} and Thorne-Lyman, {Andrew L.} and Thrift, {Amanda G.} and Thurston, {George D.} and Ruoyan Tobe-Gai and Marcello Tonelli and Roman Topor-Madry and Fotis Topouzis and Tran, {Bach Xuan} and Dimbuene, {Zacharie Tsala} and Miltiadis Tsilimbaris and Tura, {Abera Kenay} and Tuzcu, {Emin Murat} and Stefanos Tyrovolas and Ukwaja, {Kingsley N.} and Undurraga, {Eduardo A.} and Uneke, {Chigozie Jesse} and Uthman, {Olalekan A.} and {van Gool}, {Coen H.} and {van Os}, Jim and Tommi Vasankari and Vasconcelos, {Ana Maria Nogales} and Narayanaswamy Venketasubramanian and Violante, {Francesco S.} and Vlassov, {Vasiliy Victorovich} and Vollset, {Stein Emil} and Wagner, {Gregory R.} and Wallin, {Mitchell T.} and Linhong Wang and Scott Weichenthal and Elisabete Weiderpass and Weintraub, {Robert G.} and Andrea Werdecker and Ronny Westerman and Tissa Wijeratne and Wilkinson, {James D.} and Williams, {Hywel C.} and Wiysonge, {Charles Shey} and Woldeyohannes, {Solomon Meseret} and Wolfe, {Charles D.A.} and Sungho Won and Gelin Xu and Yadav, {Ajit Kumar} and Bereket Yakob and Yan, {Lijing L.} and Yuichiro Yano and Mehdi Yaseri and Pengpeng Ye and Paul Yip and Naohiro Yonemoto and Yoon, {Seok Jun} and Younis, {Mustafa Z.} and Chuanhua Yu and Zoubida Zaidi and Zaki, {Maysaa El Sayed} and Hajo Zeeb and Sanjay Zodpey and David Zonies and Zuhlke, {Liesl Joanna} and Theo Vos and Lopez, {Alan D.} and Murray, {Christopher J.L.}",
year = "2016",
month = "10",
day = "8",
doi = "10.1016/S0140-6736(16)31460-X",
language = "English",
volume = "388",
pages = "1603--1658",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier Limited",
number = "10053",

}

TY - JOUR

T1 - Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015

T2 - a systematic analysis for the Global Burden of Disease Study 2015

AU - Kassebaum, Nicholas J.

AU - Arora, Megha

AU - Barber, Ryan M.

AU - Bhutta, Zulfiqar A.

AU - Brown, Jonathan

AU - Carter, Austin

AU - Casey, Daniel C.

AU - Charlson, Fiona J.

AU - Coates, Matthew M.

AU - Coggeshall, Megan

AU - Cornaby, Leslie

AU - Dandona, Lalit

AU - Dicker, Daniel J.

AU - Erskine, Holly E.

AU - Ferrari, Alize J.

AU - Fitzmaurice, Christina

AU - Foreman, Kyle

AU - Forouzanfar, Mohammad H.

AU - Fullman, Nancy

AU - Gething, Peter W.

AU - Goldberg, Ellen M.

AU - Graetz, Nicholas

AU - Haagsma, Juanita A.

AU - Johnson, Catherine O.

AU - Kemmer, Laura

AU - Khalil, Ibrahim A.

AU - Kinfu, Yohannes

AU - Kutz, Michael J.

AU - Kyu, Hmwe H.

AU - Leung, Janni

AU - Liang, Xiaofeng

AU - Lim, Stephen S.

AU - Lozano, Rafael

AU - Mensah, George A.

AU - Mikesell, Joe

AU - Mokdad, Ali H.

AU - Mooney, Meghan D.

AU - Naghavi, Mohsen

AU - Nguyen, Grant

AU - Nsoesie, Elaine

AU - Pigott, David M.

AU - Pinho, Christine

AU - Rankin, Zane

AU - Reinig, Nikolas

AU - Salomon, Joshua A.

AU - Sandar, Logan

AU - Smith, Alison

AU - Sorensen, Reed J.D.

AU - Stanaway, Jeffrey

AU - Steiner, Caitlyn

AU - Teeple, Stephanie

AU - Thomas, Bernadette A.

AU - Troeger, Chris

AU - VanderZanden, Amelia

AU - Wagner, Joseph A.

AU - Wanga, Valentine

AU - Whiteford, Harvey A.

AU - Zhou, Maigeng

AU - Zoeckler, Leo

AU - Abajobir, Amanuel Alemu

AU - Abate, Kalkidan Hassen

AU - Abbafati, Cristiana

AU - Abbas, Kaja M.

AU - Abd-Allah, Foad

AU - Abraham, Biju

AU - Abubakar, Ibrahim

AU - Abu-Raddad, Laith J.

AU - Abu-Rmeileh, Niveen M.E.

AU - Achoki, Tom

AU - Ackerman, Ilana N.

AU - Adebiyi, Akindele Olupelumi

AU - Adedeji, Isaac Akinkunmi

AU - Adsuar, José C.

AU - Afanvi, Kossivi Agbelenko

AU - Afshin, Ashkan

AU - Agardh, Emilie Elisabet

AU - Agarwal, Arnav

AU - Agarwal, Sanjay Kumar

AU - Ahmed, Muktar Beshir

AU - Kiadaliri, Aliasghar Ahmad

AU - Ahmadieh, Hamid

AU - Akseer, Nadia

AU - Al-Aly, Ziyad

AU - Alam, Khurshid

AU - Alam, Noore K.M.

AU - Aldhahri, Saleh Fahed

AU - Alegretti, Miguel Angel

AU - Aleman, Alicia V.

AU - Alemu, Zewdie Aderaw

AU - Alexander, Lily T.

AU - Ali, Raghib

AU - Alkerwi, Ala'a

AU - Alla, François

AU - Allebeck, Peter

AU - Alsharif, Ubai

AU - Altirkawi, Khalid A.

AU - Martin, Elena Alvarez

AU - Alvis-Guzman, Nelson

AU - Amare, Azmeraw T.

AU - Amberbir, Alemayehu

AU - Amegah, Adeladza Kofi

AU - Amini, Heresh

AU - Ammar, Walid

AU - Amrock, Stephen Marc

AU - Anderson, Gregory M.

AU - Anderson, Benjamin O.

AU - Antonio, Carl Abelardo T.

AU - Anwari, Palwasha

AU - Ärnlöv, Johan

AU - Arsenijevic, Valentina S.Arsic

AU - Artaman, Al

AU - Asayesh, Hamid

AU - Asghar, Rana Jawad

AU - Avokpaho, Euripide Frinel G.Arthur

AU - Awasthi, Ashish

AU - Quintanilla, Beatriz Paulina Ayala

AU - Azzopardi, Peter

AU - Bacha, Umar

AU - Badawi, Alaa

AU - Balakrishnan, Kalpana

AU - Banerjee, Amitava

AU - Barac, Aleksandra

AU - Barker-Collo, Suzanne L.

AU - Bärnighausen, Till

AU - Barregard, Lars

AU - Barrero, Lope H.

AU - Basu, Sanjay

AU - Bayou, Tigist Assefa

AU - Beardsley, Justin

AU - Bedi, Neeraj

AU - Beghi, Ettore

AU - Bell, Brent

AU - Bell, Michelle L.

AU - Aburaddad, Laith

AU - Bennett, Derrick A.

AU - Bensenor, Isabela M.

AU - Berhane, Adugnaw

AU - Bernabé, Eduardo

AU - Betsu, Balem Demtsu

AU - Beyene, Addisu Shunu

AU - Bhala, Neeraj

AU - Bhansali, Anil

AU - Bhatt, Samir

AU - Biadgilign, Sibhatu

AU - Bienhoff, Kelly

AU - Bikbov, Boris

AU - Abdulhak, Aref A.Bin

AU - Bisanzio, Donal

AU - Bjertness, Espen

AU - Blore, Jed D.

AU - Borschmann, Rohan

AU - Boufous, Soufiane

AU - Bourne, Rupert R.A.

AU - Brainin, Michael

AU - Brazinova, Alexandra

AU - Breitborde, Nicholas J.K.

AU - Brugha, Traolach S.

AU - Buchbinder, Rachelle

AU - Buckle, Geoffrey Colin

AU - Butt, Zahid A.

AU - Calabria, Bianca

AU - Campos-Nonato, Ismael Ricardo

AU - Campuzano, Julio Cesar

AU - Carabin, Hélène

AU - Carapetis, Jonathan R.

AU - Cárdenas, Rosario

AU - Carrero, Juan Jesus

AU - Castañeda-Orjuela, Carlos A.

AU - Rivas, Jacqueline Castillo

AU - Catalá-López, Ferrán

AU - Cavalleri, Fiorella

AU - Chang, Jung Chen

AU - Chiang, Peggy Pei Chia

AU - Chibalabala, Mirriam

AU - Chibueze, Chioma Ezinne

AU - Chisumpa, Vesper Hichilombwe

AU - Choi, Jee Young Jasmine

AU - Choudhury, Lincoln

AU - Christensen, Hanne

AU - Ciobanu, Liliana G.

AU - Colistro, Valentina

AU - Colomar, Mercedes

AU - Colquhoun, Samantha M.

AU - Cortinovis, Monica

AU - Crump, John A.

AU - Damasceno, Albertino

AU - Dandona, Rakhi

AU - Dargan, Paul I.

AU - das Neves, José

AU - Davey, Gail

AU - Davis, Adrian C.

AU - Leo, Diego De

AU - Degenhardt, Louisa

AU - Gobbo, Liana C.Del

AU - Derrett, Sarah

AU - Jarlais, Don C.Des

AU - deVeber, Gabrielle A.

AU - Dharmaratne, Samath D.

AU - Dhillon, Preet K.

AU - Ding, Eric L.

AU - Doyle, Kerrie E.

AU - Driscoll, Tim R.

AU - Duan, Leilei

AU - Dubey, Manisha

AU - Duncan, Bruce Bartholow

AU - Ebrahimi, Hedyeh

AU - Ellenbogen, Richard G.

AU - Elyazar, Iqbal

AU - Endries, Aman Yesuf

AU - Ermakov, Sergey Petrovich

AU - Eshrati, Babak

AU - Esteghamati, Alireza

AU - Estep, Kara

AU - Fahimi, Saman

AU - Farid, Talha A.

AU - Farinha, Carla Sofia e.Sa

AU - Faro, André

AU - Farvid, Maryam S.

AU - Farzadfar, Farshad

AU - Feigin, Valery L.

AU - Fereshtehnejad, Seyed Mohammad

AU - Fernandes, Jefferson G.

AU - Fernandes, Joao C.

AU - Fischer, Florian

AU - Fitchett, Joseph R.A.

AU - Foigt, Nataliya

AU - Fowkes, F. Gerry R.

AU - Franklin, Richard C.

AU - Friedman, Joseph

AU - Frostad, Joseph

AU - Fürst, Thomas

AU - Futran, Neal D.

AU - Gabbe, Belinda

AU - Gankpé, Fortuné Gbètoho

AU - Garcia-Basteiro, Alberto L.

AU - Gebrehiwot, Tsegaye Tewelde

AU - Gebremedhin, Amanuel Tesfay

AU - Geleijnse, Johanna M.

AU - Gibney, Katherine B.

AU - Gillum, Richard F.

AU - Ginawi, Ibrahim Abdelmageem Mohamed

AU - Giref, Ababi Zergaw

AU - Giroud, Maurice

AU - Gishu, Melkamu Dedefo

AU - Godwin, William W.

AU - Gomez-Dantes, Hector

AU - Gona, Philimon

AU - Goodridge, Amador

AU - Gopalani, Sameer Vali

AU - Gotay, Carolyn C.

AU - Goto, Atsushi

AU - Gouda, Hebe N.

AU - Guo, Yuming

AU - Gupta, Rahul

AU - Gupta, Rajeev

AU - Gupta, Vipin

AU - Gutiérrez, Reyna A.

AU - Hafezi-Nejad, Nima

AU - Haile, Demewoz

AU - Hailu, Alemayehu Desalegne

AU - Hailu, Gessessew Bugssa

AU - Halasa, Yara A.

AU - Hamadeh, Randah Ribhi

AU - Hamidi, Samer

AU - Hammami, Mouhanad

AU - Handal, Alexis J.

AU - Hankey, Graeme J.

AU - Harb, Hilda L.

AU - Harikrishnan, Sivadasanpillai

AU - Haro, Josep Maria

AU - Hassanvand, Mohammad Sadegh

AU - Hassen, Tahir Ahmed

AU - Havmoeller, Rasmus

AU - Hay, Roderick J.

AU - Hedayati, Mohammad T.

AU - Heredia-Pi, Ileana Beatriz

AU - Heydarpour, Pouria

AU - Hoek, Hans W.

AU - Hoffman, Daniel J.

AU - Horino, Masako

AU - Horita, Nobuyuki

AU - Hosgood, H. Dean

AU - Hoy, Damian G.

AU - Hsairi, Mohamed

AU - Huang, Hsiang

AU - Huang, John J.

AU - Iburg, Kim Moesgaard

AU - Idrisov, Bulat T.

AU - Innos, Kaire

AU - Inoue, Manami

AU - Jacobsen, Kathryn H.

AU - Jauregui, Alejandra

AU - Jayatilleke, Achala Upendra

AU - Jeemon, Panniyammakal

AU - Jha, Vivekanand

AU - Jiang, Guohong

AU - Jiang, Ying

AU - Jibat, Tariku

AU - Jimenez-Corona, Aida

AU - Jin, Ye

AU - Jonas, Jost B.

AU - Kabir, Zubair

AU - Kajungu, Dan K.

AU - Kalkonde, Yogeshwar

AU - Kamal, Ritul

AU - Kan, Haidong

AU - Kandel, Amit

AU - Karch, André

AU - Karema, Corine Kakizi

AU - Karimkhani, Chante

AU - Kasaeian, Amir

AU - Katibeh, Marzieh

AU - Kaul, Anil

AU - Kawakami, Norito

AU - Kazi, Dhruv S.

AU - Keiyoro, Peter Njenga

AU - Kemp, Andrew Haddon

AU - Kengne, Andre Pascal

AU - Keren, Andre

AU - Kesavachandran, Chandrasekharan Nair

AU - Khader, Yousef Saleh

AU - Khan, Abdur Rahman

AU - Khan, Ejaz Ahmad

AU - Khang, Young Ho

AU - Khoja, Tawfik Ahmed Muthafer

AU - Khubchandani, Jagdish

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PY - 2016/10/8

Y1 - 2016/10/8

N2 - Background Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate. Findings Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2·9 years (95% uncertainty interval 2·9–3·0) for men and 3·5 years (3·4–3·7) for women, while HALE at age 65 years improved by 0·85 years (0·78–0·92) and 1·2 years (1·1–1·3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs. Interpretation Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum. Funding Bill & Melinda Gates Foundation.

AB - Background Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate. Findings Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2·9 years (95% uncertainty interval 2·9–3·0) for men and 3·5 years (3·4–3·7) for women, while HALE at age 65 years improved by 0·85 years (0·78–0·92) and 1·2 years (1·1–1·3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs. Interpretation Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum. Funding Bill & Melinda Gates Foundation.

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U2 - 10.1016/S0140-6736(16)31460-X

DO - 10.1016/S0140-6736(16)31460-X

M3 - Article

VL - 388

SP - 1603

EP - 1658

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 10053

ER -