Years lived with disability (YLDs) for 1,160 sequelae of 289 diseases and injuries, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Individuals, households, and health systems devote enormous resources to curing, preventing, and eliminating non‐fatal, disabling health conditions. Therefore, it is essential that some form of measuring and tracking of non‐fatal burdens be available for policy and planning purposes.

 

The primary goal of this study was to quantify disability from all major diseases and injuries by country and over time. In the GBD, non‐fatal health experience is quantified using years lived with disability (YLDs). YLDs are the prevalence of condition multiplied by the disability weight for that condition. Disability weight is a measure of severity.

This publication presents estimates of YLDs by region, age, and sex over time from 1990 to 2010. Of the 291 diseases on the GBD cause list, 289 of them cause disability. The 289 diseases and injuries cause 1,160 different disabling sequelae. Sequelae are health conditions that result from those diseases and injuries. The authors analyzed the following factors: prevalence, incidence, remission, duration, excess mortality, and cause‐specific mortality. Sources included published studies, case notification, population‐based cancer registries, other disease registries, antenatal clinic sero‐surveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies.

 

For the majority of the non‐fatal but disabling health conditions, the authors used research methods designed to address key barriers in data, including missing information, inconsistency, and large methodological variation between data sources. For some conditions, natural history models, geospatial models, back‐calculation models, or registration completeness models were used. Disability weights for 220 unique health states were used to capture the severity of health loss.

As people around the world live longer, they are spending more years with illnesses. With a few exceptions, many of these illnesses are not major causes of death, concluding that what ails you is not necessarily what kills you.

 

Musculoskeletal disorders are causing a surprisingly large share of the disease burden around the world. In every region, regardless of income or other demographic factors, low back pain and neck pain rank high on the list of causes of YLDs. Low back pain is the leading or second leading cause of YLDs in 17 of the 21 regions.

 

Mental and behavioral disorders are also major causes of disability. Major depressive disorder is one of the top four causes of YLDs in every region. Anxiety disorders, drug use disorders, alcohol use disorders, schizophrenia, and bipolar affective disorder all rank in the top 25 causes of disability in every region, far higher than other conditions. By age 5, mental and behavioral disorders become an important and soon dominant cause of YLDs, peaking between ages 20 to 29, when they account for 36% of all health loss.