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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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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The record
- Venue
- The Lancet
- Topic
- Cerebral Palsy and Movement Disorders
- Field
- Medicine
- Canadian institutions
- —
- Funders
- Institute of GeneticsEunice Kennedy Shriver National Institute of Child Health and Human DevelopmentFogarty International CenterNational Institute of Allergy and Infectious DiseasesNational Heart, Lung, and Blood InstituteNational Institute on AgingNorwegian Institute of Public HealthInstitute of Genetics and Developmental Biology, Chinese Academy of SciencesCollege of Medicine, Seoul National UniversityNational Institute for Health and Care ResearchUniversity of QueenslandCenters for Disease Control and PreventionNational Institutes of HealthGeorge Institute for Global HealthHáskólinn í ReykjavíkKing Fahad Medical CityFakultet Medicinskih Nauka, Univerziteta U KragujevcuNational Center for Child Health and DevelopmentMedizinische Universität GrazKing Khalid UniversityUniversidade Federal de Minas GeraisUniversity of Cape TownUniversidade Federal de Santa CatarinaMedical Research CouncilTartu ÜlikoolGeorge Mason UniversityChinese Center for Disease Control and PreventionUppsala UniversitetCentro de Investigación Biomédica en Red de Salud MentalFundação Oswaldo CruzUniversity of HaifaBaylor UniversityHacettepe ÜniversitesiRigshospitaletUniversidade de LisboaInyuvesi Yakwazulu-NataliUniversity of California, IrvineMax-Planck-GesellschaftSamara UniversityNational Cerebral and Cardiovascular CenterJordan University of Science and TechnologyMinistry of Health and Medical EducationFudan UniversityEconomic and Social Research CouncilSeventh Framework ProgrammeKorea UniversityUniversity Hospitals Bristol NHS Foundation TrustBrown UniversityNational Center for Advancing Translational SciencesBundesministerium für Bildung und ForschungErasmus Universiteit RotterdamUniversity of MichiganUniversity of CanberraInstitut National de la Santé et de la Recherche MédicaleCentral South UniversitySeattle Children's Research InstituteKarl-Franzens-Universität GrazNHLBI Division of Intramural ResearchSimmons CollegePublic Health WalesUniversity of BristolUniversity College CorkCleveland ClinicSchweizerischer Nationalfonds zur Förderung der Wissenschaftlichen ForschungUniversity of GlasgowAteneo de Manila UniversityUniversity of East AngliaEconomic Growth Center, Yale UniversityFriedrich-Schiller-Universität JenaPublic Health EnglandLondon School of Economics and Political ScienceUniwersytet Medyczny im. Piastów Slaskich we WroclawiuInternational Medical UniversityWellcome TrustUniversitat de ValènciaIndian Council of Medical ResearchUniwersytet Jagielloński Collegium MedicumSixth Framework ProgrammeIndian Institute of Technology RoparOklahoma State UniversityNorges Teknisk-Naturvitenskapelige UniversitetSouth African Medical Research CouncilAswan UniversityUniversity of AberdeenDeutsches KrebsforschungszentrumNova Southeastern UniversityVirginia Commonwealth UniversityUniversity of BernBall State UniversityFifth Framework ProgrammeXiamen UniversityEmory UniversityAmerican University of BeirutAarhus UniversitetEuropean CommissionNational Institute of Mental HealthCase Western Reserve UniversityUniversity of the Western CapeSandia National LaboratoriesWashington State UniversityChinese Academy of SciencesBill and Melinda Gates FoundationNational Cancer InstitutePeking UniversitySeoul National UniversityHelsingin YliopistoRensselaer Polytechnic InstituteCentro de Investigação em Tecnologias e Serviços de SaúdeUniversity of Balamand
- Keywords
- Incidence (geometry)MedicineBurden of diseaseDiseaseEnvironmental healthDemographyPathology
- Has abstract in OpenAlex
- yes