A recent article in The Lancet used the published Global Burden of Disease 2013 data for age-specific mortality, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) to calculate disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) for 1990, 1995, 2000, 2005, 2010, and 2013 for 188 countries. Worldwide, from 1990 to 2013, life expectancy at birth rose by 6.2 years, from 65.3 years in 1990 to 71.5 years in 2013, HALE at birth rose by 5.4 years, from 56.9 years to 62.3 years, total DALYs fell by 3.6%, and age-standardised DALY rates per 100 000 people fell by 26.7%. For communicable, maternal, neonatal, and nutritional disorders, global DALY numbers, crude rates, and age-standardised rates have all declined between 1990 and 2013, whereas for non?communicable diseases, global DALYs have been increasing.
They conclude that global health is improving. Population growth and ageing have driven up numbers of DALYs, but crude rates have remained relatively constant, showing that progress in health does not mean fewer demands on health systems. The notion of an epidemiological transition?in which increasing sociodemographic status brings structured change in disease burden?is useful, but there is tremendous variation in burden of disease that is not associated with sociodemographic status. This further underscores the need for country-specific assessments of DALYs and HALE to appropriately inform health policy decisions and attendant actions.
Here’s the PubMed citation:
Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition. Lancet. 2015 Nov 28;386(10009):2145-91. doi: 10.1016/S0140-6736(15)61340-X. Epub 2015 Aug 28. PubMed PMID: 26321261; PubMed Central PMCID: PMC4673910.