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Cited by 13,220Global Health and EpidemiologyInsurance, Mortality, Demography, Risk ManagementChronic Disease Management Strategies

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

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Vos, Theo, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abdulkader, Rizwan Suliankatchi, Abdulle, Abdishakur M +719 more·2017·The Lancet
DOI 10.1016/s0140-6736(17)32154-2PMC PMC5605509
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Abstract

BACKGROUND: As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016. METHODS: We estimated prevalence and incidence for 328 diseases and injuries and 2982 sequelae, their non-fatal consequences. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between incidence, prevalence, remission, and cause of death rates for each condition. For some causes, we used alternative modelling strategies if incidence or prevalence needed to be derived from other data. YLDs were estimated as the product of prevalence and a disability weight for all mutually exclusive sequelae, corrected for comorbidity and aggregated to cause level. We updated the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. GBD 2016 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). FINDINGS: Globally, low back pain, migraine, age-related and other hearing loss, iron-deficiency anaemia, and major depressive disorder were the five leading causes of YLDs in 2016, contributing 57·6 million (95% uncertainty interval [UI] 40·8-75·9 million [7·2%, 6·0-8·3]), 45·1 million (29·0-62·8 million [5·6%, 4·0-7·2]), 36·3 million (25·3-50·9 million [4·5%, 3·8-5·3]), 34·7 million (23·0-49·6 million [4·3%, 3·5-5·2]), and 34·1 million (23·5-46·0 million [4·2%, 3·2-5·3]) of total YLDs, respectively. Age-standardised rates of YLDs for all causes combined decreased between 1990 and 2016 by 2·7% (95% UI 2·3-3·1). Despite mostly stagnant age-standardised rates, the absolute number of YLDs from non-communicable diseases has been growing rapidly across all SDI quintiles, partly because of population growth, but also the ageing of populations. The largest absolute increases in total numbers of YLDs globally were between the ages of 40 and 69 years. Age-standardised YLD rates for all conditions combined were 10·4% (95% UI 9·0-11·8) higher in women than in men. Iron-deficiency anaemia, migraine, Alzheimer's disease and other dementias, major depressive disorder, anxiety, and all musculoskeletal disorders apart from gout were the main conditions contributing to higher YLD rates in women. Men had higher age-standardised rates of substance use disorders, diabetes, cardiovascular diseases, cancers, and all injuries apart from sexual violence. Globally, we noted much less geographical variation in disability than has been documented for premature mortality. In 2016, there was a less than two times difference in age-standardised YLD rates for all causes between the location with the lowest rate (China, 9201 YLDs per 100 000, 95% UI 6862-11943) and highest rate (Yemen, 14 774 YLDs per 100 000, 11 018-19 228). INTERPRETATION: The decrease in death rates since 1990 for most causes has not been matched by a similar decline in age-standardised YLD rates. For many large causes, YLD rates have either been stagnant or have increased for some causes, such as diabetes. As populations are ageing, and the prevalence of disabling disease generally increases steeply with age, health systems will face increasing demand for services that are generally costlier than the interventions that have led to declines in mortality in childhood or for the major causes of mortality in adults. Up-to-date information about the trends of disease and how this varies between countries is essential to plan for an adequate health-system response. FUNDING: Bill & Melinda Gates Foundation, and the National Institute on Aging and the National Institute of Mental Health of the National Institutes of Health.

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Vos, T., Abajobir, A. A., Abate, K. H., Abbafati, C., Abbas, K. M., Abd-Allah, F., Abdulkader, R. S., Abdulle, A. M., Abebo, T. A., Abera, S. F., Aboyans, V., Abu-Raddad, L. J., Ackerman, I. N., Adamu, A. A., Adetokunboh, O., Afarideh, M., Afshin, A., Agarwal, S. K., Aggarwal, R., Agrawal, A., Agrawal, S., Ahmadieh, H., Ahmed, M. B., Aichour, M. T. E., Aichour, A. N., Aichour, I., Aiyar, S., Akinyemi, R. O., Akseer, N., Al Lami, F. H., Alahdab, F., Al-Aly, Z., Alam, K., Alam, N., Alam, T., Alasfoor, D., Alene, K. A., Ali, R., Alizadeh-Navaei, R., Alkerwi, A., Alla, F., Allebeck, P., Allen, C., Al-Maskari, F., Al-Raddadi, R., Alsharif, U., Alsowaidi, S., Altirkawi, K. A., Amare, A. T., Amini, E., Ammar, W., Amoako, Y. A., Andersen, H. H., Antonio, C. A. T., Anwari, P., Ärnlöv, J., Artaman, A., Aryal, K. K., Asayesh, H., Asgedom, S. W., Assadi, R., Atey, T. M., Atnafu, N. T., Atre, S. R., Avila-Burgos, L., Avokphako, E. F. G. A., Awasthi, A., Bacha, U., Badawi, A., Balakrishnan, K., Banerjee, A., Bannick, M. S., Barac, A., Barber, R. M., Barker-Collo, S. L., Bärnighausen, T., Barquera, S., Barregard, L., Barrero, L. H., Basu, S., Battista, B., Battle, K. E., Baune, B. T., Bazargan-Hejazi, S., Beardsley, J., Bedi, N., Beghi, E., Béjot, Y., Bekele, B. B., Bell, M. L., Bennett, D. A., Bensenor, I. M., Benson, J., Berhane, A., Berhe, D. F., Bernabé, E., Betsu, B. D., Beuran, M., Beyene, A. S., Bhala, N., Bhansali, A., Bhatt, S., Bhutta, Z. A., Biadgilign, S., Bicer, B. K., Bienhoff, K., Bikbov, B., Birungi, C., Biryukov, S., Bisanzio, D., Bizuayehu, H. M., Boneya, D. J., Boufous, S., Bourne, R. R. A., Brazinova, A., Brugha, T. S., Buchbinder, R., Bulto, L. N. B., Bumgarner, B. R., Butt, Z. A., Cahuana-Hurtado, L., Cameron, E., Car, M., Carabin, H., Carapetis, J. R., Cárdenas, R., Carpenter, D. O., Carrero, J. J., Carter, A., Carvalho, F., Casey, D. C., Caso, V., Castañeda-Orjuela, C. A., Castle, C. 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ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2017-09
Volume
390
Issue
10100
Pages
1211-1259
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(17)32154-2
PMC
PMC5605509
OpenAlex
W2751884637
Cited by
13,220
References
121
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FWCI
2238.29
Type
journal article
Language
en
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  • PUB – Publications at Bielefeld University (Bielefeld University) (submittedVersion, cc-by)
  • Publikationen an der Universität Bielefeld (Universität Bielefeld) (submittedVersion)
  • Queen Mary Research Online (Queen Mary University of London) (submittedVersion, cc-by)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, cc-by)
  • CEU Repositorio Institucional (Fundación Universitaria San Pablo CEU) (submittedVersion, cc-by-nc-nd)
  • Bristol Research (University of Bristol) (submittedVersion, cc-by)
  • Explore Bristol Research (submittedVersion, cc-by)
  • Griffith Research Online (submittedVersion, cc-by)
  • CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
  • Seoul National University Open Repository (Seoul National University) (submittedVersion)
  • Spiral (Imperial College London) (submittedVersion, other-oa)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-sa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
Funders
  • Sixth Framework Programme (RII-CT-2006-062193, CIT5-CT-2005-028857, CIT4-CT-2006-028812)
  • National Institute of Mental Health (R01MH110163)
  • Bundesministerium für Bildung und Forschung
  • European Commission
  • National Heart, Lung, and Blood Institute
  • Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
  • Economic Growth Center, Yale University
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development
  • Max-Planck-Gesellschaft
  • University of Michigan (P01-HD31921)
  • National Institute on Aging (P01_AG005842, P01_AG08291, P30_AG12815, Y1-AG-4553-01, R21_AG025169, IAG_BSR06-11, OGHA_04-064, U01_AG09740-13S2, HHSN271201300071C, U01AG009740)
  • Bill and Melinda Gates Foundation
  • Seventh Framework Programme (227822, 261982, 211909)
  • Fifth Framework Programme (QLK6-CT-2001-00360)
  • National Institutes of Health (P30AG047845)
Topics
  • Health Sciences › Health Professions › Health Information Management › Global Health and Epidemiology
  • Social Sciences › Demography › Insurance, Mortality, Demography, Risk Management
  • Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
Keywords
global burden of disease, years lived with disability, disease incidence, disease prevalence, disability weights, low back pain, migraine, hearing loss, iron deficiency anemia, major depressive disorder, socio-demographic index, disability-adjusted life years, sequelae, comorbidities
MeSH terms
Global Burden of Disease, Noncommunicable Diseases, Adolescent, Adult, Aged, Aged, 80 and over, Cause of Death, Child, Child, Preschool, Communicable Diseases, Female, Persons with Disabilities, Disabled Persons, Humans, Infant, Infant, Newborn, Male, Middle Aged, Global Health, Wounds and Injuries, Incidence, Prevalence, Age Distribution, Sex Distribution, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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