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
Journal
The Lancet
Journal Volume
390
Journal Issue
10100
Pages
1211-1259
Date Issued
2017
Author(s)
Vos T.
Abajobir A.A.
Abbafati C.
Abbas K.M.
Abate K.H.
Abd-Allah F.
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.
Ahmad Kiadaliri A.
Ahmadieh H.
Ahmed M.B.
Aichour A.N.
Aichour I.
Aichour M.T.E.
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.
?rnl?v 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.
Avokpaho E.F.G.A.
Awasthi A.
Ayala Quintanilla B.P.
Ba Saleem H.O.
Bacha U.
Badawi A.
Balakrishnan K.
Banerjee A.
Bannick M.S.
Barac A.
Barber R.M.
Barker-Collo S.L.
B?rnighausen 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.
B?jot Y.
Bekele B.B.
Bell M.L.
Bennett D.A.
Bensenor I.M.
Benson J.
Berhane A.
Berhe D.F.
Bernab? E.
Betsu B.D.
Beuran M.
Beyene A.S.
Bhala N.
Bhansali A.
Bhatt S.
Bhutta Z.A.
Biadgilign S.
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.
C?rdenas R.
Carpenter D.O.
Carrero J.J.
Carter A.
Carvalho F.
Casey D.C.
Caso V.
Casta?eda-Orjuela C.A.
Castle C.D.
Catal?-L?pez F.
Chang H.-Y.
Charlson F.J.
Chen H.
Chibalabala M.
Chibueze C.E.
Chisumpa V.H.
Chitheer A.A.
Christopher D.J.
Ciobanu L.G.
Cirillo M.
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Cooper C.
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Murray C.J.L.
GBD 2016 Disease and Injury Incidence and Prevalence Collaborators
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-todate information about the trends of disease and how this varies between countries is essential to plan for an adequate health-system response. ? The Author(s). Published by Elsevier Ltd.
Other Subjects
abdominal wall hernia; abortion; accidental injury; accommodation; acne vulgaris; acute glomerulonephritis; acute hepatitis; acute hepatitis A; acute leukemia; acute lymphoblastic leukemia; acute myeloid leukemia; adult; adverse drug reaction; African trypanosomiasis; aged; aging; airway; alcohol consumption; alcoholic cardiomyopathy; alcoholism; alopecia areata; Alzheimer disease; amphetamine dependence; anemia; anorexia nervosa; anxiety disorder; appendicitis; Article; asbestosis; ascariasis; Asperger syndrome; assault; asthma; atrial fibrillation; attention deficit disorder; autism; automutilation; biliary tract cancer; biliary tract disease; bipolar disorder; bladder cancer; bleeding; brain cancer; brain disease; brain hemorrhage; brain ischemia; breast cancer; bronchus cancer; bulimia; cannabis addiction; cardiomyopathy; cardiovascular disease; cataract; cause of death; cellulitis; cerebrovascular disease; Chagas disease; chickenpox; chlamydiasis; chromosome aberration; chronic kidney failure; chronic liver disease; chronic lymphatic leukemia; chronic myeloid leukemia; chronic obstructive lung disease; chronic respiratory tract disease; cocaine dependence; cold exposure; colon cancer; comorbidity; conduct disorder; conflict; congenital heart malformation; congenital malformation; cutaneous melanoma; cyclist; cysticercosis; deciduous tooth; decubitus; dementia; demography; dengue; dental caries; depression; dermatitis; dermatomycosis; diabetes mellitus; diarrhea; diphtheria; disability; disability severity; Down syndrome; dracunculiasis; drowning; drug dependence; drug resistant tuberculosis; duodenitis; dysthymia; dystocia; eating disorder; Ebola hemorrhagic fever; echinococcosis; ectopic pregnancy; encephalitis; endocarditis; endocrine disease; endometriosis; enteropathy; environmental exposure; epilepsy; esophagus cancer; extensively drug resistant tuberculosis; falling; female; female infertility; femoral hernia; fertility; foreign body; gallbladder cancer; gallbladder disease; gastritis; gastrointestinal disease; gastrointestinal malformation; genital herpes; geography; glaucoma; global disease burden; glomerulonephritis; glucose 6 phosphate dehydrogenase deficiency; gonorrhea; gout; Guillain Barre syndrome; gunshot injury; gynecologic disease; Haemophilus infection; hearing impairment; heart atrium flutter; heart failure; hematologic disease; hemoglobinopathy; hemolytic anemia; hepatitis; hepatitis B; hepatitis C; hepatitis E; herpes zoster; Hodgkin disease; hookworm infection; human; Human immunodeficiency virus infection; hypertension; idiopathic disease; immune deficiency; incidence; income; infertility; inflammatory bowel disease; inguinal hernia; injury; intellectual impairment; interstitial lung disease; interstitial nephritis; intestine infection; intestine obstruction; intoxication; iodine deficiency; iron deficiency anemia; ischemic heart disease; kidney cancer; Klinefelter syndrome; larynx cancer; latent tuberculosis; leishmaniasis; leprosy; leukemia; limb malformation; lip cancer; liver cancer; liver cirrhosis; low back pain; lower respiratory tract infection; lung cancer; lung sarcoidosis; lymphatic filariasis; macular degeneration; major clinical study; major depression; malaria; male; male infertility; malignant neoplasm; maternal disease; maternal hypertension; measles; meningococcosis; mental disease; mesothelioma; metabolic disorder; migraine; mortality rate; motor neuron disease; motor vehicle; motorcyclist; mouth cancer; mouth disease; multidrug resistant tuberculosis; multiple myeloma; multiple sclerosis; musculoskeletal disease; myocarditis; nasopharynx cancer; neck pain; nematodiasis; nervous system cancer; neural tube defect; neurologic disease; newborn; newborn disease; newborn infection; newborn jaundice; newborn sepsis; non communicable disease; non melanoma skin cancer; nonhodgkin lymphoma; nutritional deficiency; nutritional disorder; onchocerciasis; opiate addiction; osteoarthritis; otitis media; ovary cancer; ovary polycystic disease; pancreas cancer; pancreatitis; paralytic ileus; paratyphoid fever; Parkinson disease; pedestrian; pelvic inflammatory disease; pelvic organ prolapse; peptic ulcer; perinatal asphyxia; periodontal disease; peripheral vascular disease; permanent tooth; pertussis; pharynx cancer; physical disease; pneumococcal meningitis; pneumoconiosis; poisonous animal; population growth; practice guideline; premature labor; premature mortality; premenstrual syndrome; prevalence; priority journal; prostate cancer; prostate hypertrophy; protein calorie malnutrition; pruritus; psoriasis; pulmonary aspiration; pyoderma; rabies; rectum cancer; refraction error; remission; retinol deficiency; rheumatic heart disease; rheumatoid arthritis; scabies; schistosomiasis; schizophrenia; school; sensory dysfunction; sepsis; sex difference; sexual violence; sexually transmitted disease; sickle cell anemia; sickle cell trait; silicosis; skin leishmaniasis; social status; spontaneous abortion; squamous cell skin carcinoma; stomach cancer; suffocation; syphilis; tension headache; terrorism; testis cancer; tetanus; thalassemia; thermal exposure; thyroid cancer; trachea cancer; trachoma; traffic accident; trichomoniasis; trichuriasis; tropical disease; tuberculosis; Turner syndrome; typhoid fever; upper respiratory tract infection; urinary tract disease; urinary tract infection; urogenital tract malformation; urolithiasis; urticaria; uterine cervix cancer; uterus cancer; uterus myoma; uterus rupture; viral skin disease; visceral leishmaniasis; visual impairment; yellow fever; Zika fever; adolescent; age distribution; child; communicable disease; disabled person; global disease burden; global health; infant; injury; middle aged; mortality; non communicable disease; preschool child; sex ratio; statistics and numerical data; trends; very elderly; young adult; Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Cause of Death; Child; Child, Preschool; Communicable Diseases; Disabled Persons; Female; Global Burden of Disease; Global Health; Humans; Incidence; Infant; Infant, Newborn; Male; Middle Aged; Noncommunicable Diseases; Prevalence; Sex Distribution; Wounds and Injuries; Young Adult