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

GBD 2016 Disease and Injury Incidence and Prevalence Collaborators

Research output: Contribution to journalArticle

911 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1211-1259
Number of pages49
JournalThe Lancet
Volume390
Issue number10100
DOIs
StatePublished - Sep 16 2017

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Uncertainty
Mortality
Incidence
Wounds and Injuries
Iron-Deficiency Anemias
Major Depressive Disorder
Migraine Disorders
Health Systems Plans
National Institute on Aging (U.S.)
Demography
Yemen
Population
National Institute of Mental Health (U.S.)
Premature Mortality
Gout
Birth Rate
Population Growth
Sex Offenses
Health
National Institutes of Health (U.S.)

ASJC Scopus subject areas

  • Medicine(all)

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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. / GBD 2016 Disease and Injury Incidence and Prevalence Collaborators.

In: The Lancet, Vol. 390, No. 10100, 16.09.2017, p. 1211-1259.

Research output: Contribution to journalArticle

@article{a066154d19f4407986b22516ff5eda41,
title = "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",
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.",
author = "{GBD 2016 Disease and Injury Incidence and Prevalence Collaborators} and Abajobir, {Amanuel Alemu} and Abate, {Kalkidan Hassen} and Cristiana Abbafati and Abbas, {Kaja M.} and Foad Abd-Allah and Abdulkader, {Rizwan Suliankatchi} and Abdulle, {Abdishakur M.} and Abebo, {Teshome Abuka} and Abera, {Semaw Ferede} and Victor Aboyans and Abu-Raddad, {Laith J.} and Ackerman, {Ilana N.} and Adamu, {Abdu Abdullahi} and Olatunji Adetokunboh and Mohsen Afarideh and Ashkan Afshin and Agarwal, {Sanjay Kumar} and Rakesh Aggarwal and Anurag Agrawal and Sutapa Agrawal and Hamid Ahmadieh and Ahmed, {Muktar Beshir} and Aichour, {Miloud Taki Eddine} and Aichour, {Amani Nidhal} and Ibtihel Aichour and Sneha Aiyar and Akinyemi, {Rufus Olusola} and Nadia Akseer and {Al Lami}, {Faris Hasan} and Fares Alahdab and Ziyad Al-Aly and Khurshid Alam and Noore Alam and Tahiya Alam and Deena Alasfoor and Alene, {Kefyalew Addis} and Raghib Ali and Reza Alizadeh-Navaei and Ala'a Alkerwi and Fran{\cc}ois Alla and Peter Allebeck and Christine Allen and Fatma Al-Maskari and Rajaa Al-Raddadi and Ubai Alsharif and Shirina Alsowaidi and Altirkawi, {Khalid A.} and Amare, {Azmeraw T.} and Erfan Amini and Hosgood, {Howard D.}",
year = "2017",
month = "9",
day = "16",
doi = "10.1016/S0140-6736(17)32154-2",
language = "English (US)",
volume = "390",
pages = "1211--1259",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier Limited",
number = "10100",

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TY - JOUR

T1 - Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016

T2 - a systematic analysis for the Global Burden of Disease Study 2016

AU - GBD 2016 Disease and Injury Incidence and Prevalence Collaborators

AU - Abajobir, Amanuel Alemu

AU - Abate, Kalkidan Hassen

AU - Abbafati, Cristiana

AU - Abbas, Kaja M.

AU - Abd-Allah, Foad

AU - Abdulkader, Rizwan Suliankatchi

AU - Abdulle, Abdishakur M.

AU - Abebo, Teshome Abuka

AU - Abera, Semaw Ferede

AU - Aboyans, Victor

AU - Abu-Raddad, Laith J.

AU - Ackerman, Ilana N.

AU - Adamu, Abdu Abdullahi

AU - Adetokunboh, Olatunji

AU - Afarideh, Mohsen

AU - Afshin, Ashkan

AU - Agarwal, Sanjay Kumar

AU - Aggarwal, Rakesh

AU - Agrawal, Anurag

AU - Agrawal, Sutapa

AU - Ahmadieh, Hamid

AU - Ahmed, Muktar Beshir

AU - Aichour, Miloud Taki Eddine

AU - Aichour, Amani Nidhal

AU - Aichour, Ibtihel

AU - Aiyar, Sneha

AU - Akinyemi, Rufus Olusola

AU - Akseer, Nadia

AU - Al Lami, Faris Hasan

AU - Alahdab, Fares

AU - Al-Aly, Ziyad

AU - Alam, Khurshid

AU - Alam, Noore

AU - Alam, Tahiya

AU - Alasfoor, Deena

AU - Alene, Kefyalew Addis

AU - Ali, Raghib

AU - Alizadeh-Navaei, Reza

AU - Alkerwi, Ala'a

AU - Alla, François

AU - Allebeck, Peter

AU - Allen, Christine

AU - Al-Maskari, Fatma

AU - Al-Raddadi, Rajaa

AU - Alsharif, Ubai

AU - Alsowaidi, Shirina

AU - Altirkawi, Khalid A.

AU - Amare, Azmeraw T.

AU - Amini, Erfan

AU - Hosgood, Howard D.

PY - 2017/9/16

Y1 - 2017/9/16

N2 - 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.

AB - 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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U2 - 10.1016/S0140-6736(17)32154-2

DO - 10.1016/S0140-6736(17)32154-2

M3 - Article

VL - 390

SP - 1211

EP - 1259

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 10100

ER -