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Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Kyu, Hmwe Hmwe and Abate, Degu and Abate, Kalkidan Hassen and Abay, Solomon M and Abbafati, Cristiana and Abbasi, Nooshin and Abbastabar, Hedayat and Abd-Allah, Foad and Abdela, Jemal and Abdelalim, Ahmed and Abdollahpour, Ibrahim and Abdulkader, Rizwan Suliankatchi and Abebe, Molla and Abebe, Zegeye and Abil, Olifan Zewdie and Aboyans, Victor and Abrham, Aklilu Roba and Abu-Raddad, Laith Jamal and Abu-Rmeileh, Niveen M E and Accrombessi, Manfred Mario Kokou and Acharya, Dilaram and Acharya, Pawan and Ackerman, Ilana N and Adamu, Abdu A and Adebayo, Oladimeji M and Adekanmbi, Victor and Ademi, Zanfina and Adetokunboh, Olatunji O and Adib, Mina G and Adsuar, Jose C and Afanvi, Kossivi Agbelenko and Afarideh, Mohsen and Afshin, Ashkan and Agarwal, Gina and Agesa, Kareha M and Aggarwal, Rakesh and Aghayan, Sargis Aghasi and Agrawal, Anurag and Ahmadi, Alireza and Ahmadi, Mehdi and Ahmadieh, Hamid and Ahmed, Muktar Beshir and Ahmed, Sayem and Aichour, Amani Nidhal and Aichour, Ibtihel and Aichour, Miloud Taki Eddine and Akinyemiju, Tomi and Akseer, Nadia and Al-Aly, Ziyad and Al-Eyadhy, Ayman and Al-Mekhlafi, Hesham M and Al-Raddadi, Rajaa M and Alahdab, Fares and Alam, Khurshid and Alam, Tahiya and Alashi, Alaa and Alavian, Seyed Moayed and Alene, Kefyalew Addis and Alijanzadeh, Mehran and Alizadeh-Navaei, Reza and Aljunid, Syed Mohamed and Alkerwi, Ala'a and Alla, François and Allebeck, Peter and Alonso, Jordi and Alsharif, Ubai and Altirkawi, Khalid and Alvis-Guzman, Nelson and Aminde, Leopold N and Amini, Erfan and Amiresmaili, Mohammadreza and Ammar, Walid and Amoako, Yaw Ampem and Anber, Nahla Hamed and Andrei, Catalina Liliana and Androudi, Sofia and Animut, Megbaru Debalkie and Anjomshoa, Mina and Ansha, Mustafa Geleto and Antonio, Carl Abelardo T and Anwari, Palwasha and Arabloo, Jalal and Aremu, Olatunde and Ärnlöv, Johan and Arora, Amit and Arora, Megha and Artaman, Al and Aryal, Krishna K and Asayesh, Hamid and Ataro, Zerihun and Ausloos, Marcel and Avila-Burgos, Leticia and Avokpaho, Euripide F G A and Awasthi, Ashish and Ayala Quintanilla, Beatriz Paulina and Ayer, Rakesh and Azzopardi, Peter S and Babazadeh, Arefeh and Badali, Hamid and Balakrishnan, Kalpana and Bali, Ayele Geleto and Banach, Maciej and Banoub, Joseph Adel Mattar and Barac, Aleksandra and Barboza, Miguel A and Barker-Collo, Suzanne Lyn and Bärnighausen, Till Winfried and Barquera, Simon and Barrero, Lope H and Bazargan-Hejazi, Shahrzad and Bedi, Neeraj and Beghi, Ettore and Behzadifar, Masoud and Behzadifar, Meysam and Bekele, Bayu Begashaw and Bekru, Eyasu Tamru and Belachew, Abate Bekele and Belay, Yihalem Abebe and Bell, Michelle L and Bello, Aminu K and Bennett, Derrick A and Bensenor, Isabela M and Berhane, Adugnaw and Bernabe, Eduardo and Bernstein, Robert S and Beuran, Mircea and Beyranvand, Tina and Bhala, Neeraj and Bhatt, Samir and Bhaumik, Soumyadeep and Bhutta, Zulfiqar A and Biadgo, Belete and Biehl, Molly H and Bijani, Ali and Bikbov, Boris and Bilano, Ver and Bililign, Nigus and Bin Sayeed, Muhammad Shahdaat and Bisanzio, Donal and Bjørge, Tone and Bleyer, Archie and Bobasa, Eshetu Mulisa and Bou-Orm, Ibrahim R and Boufous, Soufiane and Bourne, Rupert and Brady, Oliver J and Brant, Luisa C and Brayne, Carol and Brazinova, Alexandra and Breitborde, Nicholas J K and Brenner, Hermann and Briant, Paul Svitil and Briko, Andrey Nikolaevich and Britton, Gabrielle and Brugha, Traolach and Buchbinder, Rachelle and Busse, Reinhard and Butt, Zahid A and Cahuana-Hurtado, Lucero and Campuzano Rincon, Julio Cesar and Cano, Jorge and Cárdenas, Rosario and Carrero, Juan J and Carter, Austin and Carvalho, Félix and Castañeda-Orjuela, Carlos A and Castillo Rivas, Jacqueline and Castro, Franz and Catalá-López, Ferrán and Cercy, Kelly M and Cerin, Ester and Chaiah, Yazan and Chang, Jung-Chen and Charlson, Fiona J and Chattu, Vijay Kumar and Chiang, Peggy Pei-Chia and Chitheer, Abdulaal and Choi, Jee-Young J and Christensen, Hanne and Christopher, Devasahayam J and Chung, Sheng-Chia and Cicuttini, Flavia M and Cirillo, Massimo and Collado-Mateo, Daniel and Cooper, Cyrus and Cortesi, Paolo Angelo and Cortinovis, Monica and Cousin, Ewerton and Criqui, Michael H and Cromwell, Elizabeth A and Cross, Marita and Crump, John A and Daba, Alemneh Kabeta and Dachew, Berihun Assefa and Dadi, Abel Fekadu and Dandona, Lalit and Dandona, Rakhi and Dargan, Paul I and Daryani, Ahmad and Das Gupta, Rajat and Das Neves, José and Dasa, Tamirat Tesfaye and Davitoiu, Dragos Virgil and De La Hoz, Fernando Pio and De Leo, Diego and De Neve, Jan-Walter and De Steur, Hans and Degefa, Meaza Girma and Degenhardt, Louisa and Deiparine, Selina and Demoz, Gebre Teklemariam and Denova-Gutiérrez, Edgar and Deribe, Kebede and Dervenis, Nikolaos and Des Jarlais, Don C and Dey, Subhojit and Dharmaratne, Samath D and Dhimal, Meghnath and Dinberu, Mesfin Tadese and Dirac, M Ashworth and Djalalinia, Shirin and Doan, Linh and Dokova, Klara and Doku, David Teye and Dorsey, E Ray and Doyle, Kerrie E and Driscoll, Tim Robert and Dubey, Manisha and Dubljanin, Eleonora and Duken, Eyasu Ejeta and Duncan, Bruce B and Duraes, Andre R and Ebrahimi, Hedyeh and Ebrahimpour, Soheil and Echko, Michelle M and Edessa, Dumessa and Edvardsson, David and Effiong, Andem and Eggen, Anne Elise and Ehrlich, Joshua R and El Bcheraoui, Charbel and El-Khatib, Ziad and Elyazar, Iqbal R F and Enayati, Ahmadali and Endalifer, Melese Linger and Endries, Aman Yesuf and Er, Benjamin and Erskine, Holly E and Eskandarieh, Sharareh and Esteghamati, Alireza and Esteghamati, Sadaf and Fakhim, Hamed and Faramarzi, Mahbobeh and Fareed, Mohammad and Farhadi, Farzaneh and Farid, Talha A and Farinha, Carla Sofia E sá and Farioli, Andrea and Faro, Andre and Farzadfar, Farshad and Fazaeli, Ali Akbar and Feigin, Valery L and Fentahun, Netsanet and Fereshtehnejad, Seyed-Mohammad and Fernandes, Eduarda and Fernandes, Joao C and Ferrari, Alize J and Ferreira, Manuela L and Filip, Irina and Fischer, Florian and Fitzmaurice, Christina and Foigt, Nataliya A and Foreman, Kyle J and Frank, Tahvi D and Fukumoto, Takeshi and Fullman, Nancy and Fürst, Thomas and Furtado, João M and Gakidou, Emmanuela and Gall, Seana and Gallus, Silvano and Ganji, Morsaleh and Garcia-Basteiro, Alberto L and Gardner, William M and Gebre, Abadi Kahsu and Gebremedhin, Amanuel Tesfay and Gebremichael, Teklu Gebrehiwo and Gelano, Tilayie Feto and Geleijnse, Johanna M and Genova-Maleras, Ricard and Geramo, Yilma Chisha Dea and Gething, Peter W and Gezae, Kebede Embaye and Ghadami, Mohammad Rasoul and Ghadiri, Keyghobad and Ghasemi-Kasman, Maryam and Ghimire, Mamata and Ghoshal, Aloke Gopal and Gill, Paramjit Singh and Gill, Tiffany K and Ginawi, Ibrahim Abdelmageed and Giussani, Giorgia and Gnedovskaya, Elena V and Goldberg, Ellen M and Goli, Srinivas and Gómez-Dantés, Hector and Gona, Philimon N and Gopalani, Sameer Vali and Gorman, Taren M and Goulart, Alessandra C and Goulart, Bárbara Niegia Garcia and Grada, Ayman and Grosso, Giuseppe and Gugnani, Harish Chander and Guillemin, Francis and Guo, Yuming and Gupta, Prakash C and Gupta, Rahul and Gupta, Rajeev and Gupta, Tanush and Gutiérrez, Reyna Alma and Gyawali, Bishal and Haagsma, Juanita A and Hachinski, Vladimir and Hafezi-Nejad, Nima and Haghparast Bidgoli, Hassan and Hagos, Tekleberhan B and Hailegiyorgis, Tewodros Tesfa and Haj-Mirzaian, Arvin and Haj-Mirzaian, Arya and Hamadeh, Randah R and Hamidi, Samer and Handal, Alexis J and Hankey, Graeme J and Hao, Yuantao and Harb, Hilda L and Harikrishnan, Sivadasanpillai and Haririan, Hamidreza and Haro, Josep Maria and Hassankhani, Hadi and Hassen, Hamid Yimam and Havmoeller, Rasmus and Hay, Roderick J and Hay, Simon I and Hedayatizadeh-Omran, Akbar and Heibati, Behzad and Hendrie, Delia and Henok, Andualem and Heredia-Pi, Ileana and Herteliu, Claudiu and Heydarpour, Fatemeh and Heydarpour, Pouria and Hibstu, Desalegn Tsegaw and Hoek, Hans W and Hoffman, Howard J and Hole, Michael K and Homaie Rad, Enayatollah and Hoogar, Praveen and Hosgood, H Dean and Hosseini, Seyed Mostafa and Hosseinzadeh, Mehdi and Hostiuc, Mihaela and Hostiuc, Sorin and Hotez, Peter J and Hoy, Damian G and Hsairi, Mohamed and Htet, Aung Soe and Huang, John J and Iburg, Kim Moesgaard and Ikeda, Chad Thomas and Ilesanmi, Olayinka Stephen and Irvani, Seyed Sina Naghibi and Irvine, Caleb Mackay Salpeter and Islam, Sheikh Mohammed Shariful and Islami, Farhad and Jacobsen, Kathryn H and Jahangiry, Leila and Jahanmehr, Nader and Jain, Sudhir Kumar and Jakovljevic, Mihajlo and James, Spencer L and Jayatilleke, Achala Upendra and Jeemon, Panniyammakal and Jha, Ravi Prakash and Jha, Vivekanand and Ji, John S and Johnson, Catherine O and Jonas, Jost B and Jonnagaddala, Jitendra and Jorjoran Shushtari, Zahra and Joshi, Ankur and Jozwiak, Jacek Jerzy and Jungari, Suresh Banayya and Jürisson, Mikk and Kabir, Zubair and Kadel, Rajendra and Kahsay, Amaha and Kalani, Rizwan and Kanchan, Tanuj and Kar, Chittaranjan and Karami, Manoochehr and Karami Matin, Behzad and Karch, André and Karema, Corine and Karimi, Narges and Karimi, Seyed M and Kasaeian, Amir and Kassa, Dessalegn H and Kassa, Getachew Mullu and Kassa, Tesfaye Dessale and Kassebaum, Nicholas J and Katikireddi, Srinivasa Vittal and Kaul, Anil and Kawakami, Norito and Kazemi, Zhila and Karyani, Ali Kazemi and Keighobadi, Masoud Masoud and Keiyoro, Peter Njenga and Kemmer, Laura and Kemp, Grant Rodgers and Kengne, Andre Pascal and Keren, Andre and Khader, Yousef Saleh and Khafaei, Behzad and Khafaie, Morteza Abdullatif and Khajavi, Alireza and Khalid, Nauman and Khalil, Ibrahim A and Khan, Ejaz Ahmad and Khan, Muhammad Shahzeb and Khan, Muhammad Ali and Khang, Young-Ho and Khater, Mona M and Khazaei, Mohammad and Khoja, Abdullah T and Khosravi, Ardeshir and Khosravi, Mohammad Hossein and Kiadaliri, Aliasghar A and Kidanemariam, Zelalem Teklemariam and Kiirithio, Daniel N and Kim, Cho-Il and Kim, Daniel and Kim, Young-Eun and Kim, Yun Jin and Kimokoti, Ruth W and Kinfu, Yohannes and Kisa, Adnan and Kissimova-Skarbek, Katarzyna and Knudsen, Ann Kristin Skrindo and Kocarnik, Jonathan M and Kochhar, Sonali and Kokubo, Yoshihiro and Kolola, Tufa and Kopec, Jacek A and Kosen, Soewarta and Kotsakis, Georgios A and Koul, Parvaiz A and Koyanagi, Ai and Krishan, Kewal and Krishnaswami, Sanjay and Krohn, Kristopher J and Kuate Defo, Barthelemy and Kucuk Bicer, Burcu and Kumar, G Anil and Kumar, Manasi and Kuzin, Igor and Lad, Deepesh P and Lad, Sheetal D and Lafranconi, Alessandra and Lalloo, Ratilal and Lallukka, Tea and Lami, Faris Hasan and Lang, Justin J and Langan, Sinéad M and Lansingh, Van C and Latifi, Arman and Lau, Kathryn Mei-Ming and Lazarus, Jeffrey V and Leasher, Janet L and Ledesma, Jorge R and Lee, Paul H and Leigh, James and Leili, Mostafa and Leshargie, Cheru Tesema and Leung, Janni and Levi, Miriam and Lewycka, Sonia and Li, Shanshan and Li, Yichong and Liang, Xiaofeng and Liao, Yu and Liben, Misgan Legesse and Lim, Lee-Ling and Lim, Stephen S and Limenih, Miteku Andualem and Linn, Shai and Liu, Shiwei and Looker, Katharine J and Lopez, Alan D and Lorkowski, Stefan and Lotufo, Paulo A and Lozano, Rafael and Lucas, Tim C D and Lunevicius, Raimundas and Lyons, Ronan A and Ma, Stefan and Macarayan, Erlyn Rachelle King and Mackay, Mark T and Maddison, Emilie R and Madotto, Fabiana and Maghavani, Dhaval P and Mai, Hue Thi and Majdan, Marek and Majdzadeh, Reza and Majeed, Azeem and Malekzadeh, Reza and Malta, Deborah Carvalho and Mamun, Abdullah A and Manda, Ana-Laura and Manguerra, Helena and Mansournia, Mohammad Ali and Mantilla Herrera, Ana Maria and Mantovani, Lorenzo Giovanni and Maravilla, Joemer C and Marcenes, Wagner and Marks, Ashley and Martins-Melo, Francisco Rogerlândio and Martopullo, Ira and März, Winfried and Marzan, Melvin B and Massano, João and Massenburg, Benjamin Ballard and Mathur, Manu Raj and Maulik, Pallab K and Mazidi, Mohsen and McAlinden, Colm and McGrath, John J and McKee, Martin and McMahon, Brian J and Mehata, Suresh and Mehrotra, Ravi and Mehta, Kala M and Mehta, Varshil and Mejia-Rodriguez, Fabiola and Mekonen, Tesfa and Melese, Addisu and Melku, Mulugeta and Memiah, Peter T N and Memish, Ziad A and Mendoza, Walter and Mengistu, Getnet and Mensah, George A and Mereta, Seid Tiku and Meretoja, Atte and Meretoja, Tuomo J and Mestrovic, Tomislav and Miazgowski, Bartosz and Miazgowski, Tomasz and Millear, Anoushka I and Miller, Ted R and Mini, G K and Mirarefin, Mojde and Mirica, Andreea and Mirrakhimov, Erkin M and Misganaw, Awoke Temesgen and Mitchell, Philip B and Mitiku, Habtamu and Moazen, Babak and Mohajer, Bahram and Mohammad, Karzan Abdulmuhsin and Mohammadi, Moslem and Mohammadifard, Noushin and Mohammadnia-Afrouzi, Mousa and Mohammed, Mohammed A and Mohammed, Shafiu and Mohebi, Farnam and Mokdad, Ali H and Molokhia, Mariam and Monasta, Lorenzo and Montañez, Julio Cesar and Moosazadeh, Mahmood and Moradi, Ghobad and Moradi, Mahmoudreza and Moradi-Lakeh, Maziar and Moradinazar, Mehdi and Moraga, Paula and Morawska, Lidia and Moreno Velásquez, Ilais and Morgado-Da-Costa, Joana and Morrison, Shane Douglas and Moschos, Marilita M and Mousavi, Seyyed Meysam and Mruts, Kalayu Brhane and Muche, Achenef Asmamaw and Muchie, Kindie Fentahun and Mueller, Ulrich Otto and Muhammed, Oumer Sada and Mukhopadhyay, Satinath and Muller, Kate and Mumford, John Everett and Murthy, G V S and Musa, Kamarul Imran and Mustafa, Ghulam and Nabhan, Ashraf F and Nagata, Chie and Nagel, Gabriele and Naghavi, Mohsen and Naheed, Aliya and Nahvijou, Azin and Naik, Gurudatta and Najafi, Farid and Nam, Hae Sung and Nangia, Vinay and Nansseu, Jobert Richie and Neamati, Nahid and Negoi, Ionut and Negoi, Ruxandra Irina and Neupane, Subas and Newton, Charles Richard James and Ngunjiri, Josephine W and Nguyen, Anh Quynh and Nguyen, Grant and Nguyen, Ha Thu and Nguyen, Huong Lan Thi and Nguyen, Huong Thanh and Nguyen, Long Hoang and Nguyen, Minh and Nguyen, Nam Ba and Nguyen, Son Hoang and Nichols, Emma and Ningrum, Dina Nur Anggraini and Nixon, Molly R and Nomura, Shuhei and Noroozi, Mehdi and Norrving, Bo and Noubiap, Jean Jacques and Nouri, Hamid Reza and Shiadeh, Malihe Nourollahpour and Nowroozi, Mohammad Reza and Nsoesie, Elaine O and Nyasulu, Peter S and Odell, Christopher M and Ofori-Asenso, Richard and Ogbo, Felix Akpojene and Oh, In-Hwan and Oladimeji, Olanrewaju and Olagunju, Andrew T and Olagunju, Tinuke O and Olivares, Pedro R and Olsen, Helen Elizabeth and Olusanya, Bolajoko Olubukunola and Olusanya, Jacob Olusegun and Ong, Kanyin L and Ong, Sok King and Oren, Eyal and Ortiz, Alberto and Ota, Erika and Otstavnov, Stanislav S and Øverland, Simon and Owolabi, Mayowa Ojo and P A, Mahesh and Pacella, Rosana and Pakhare, Abhijit P and Pakpour, Amir H and Pana, Adrian and Panda-Jonas, Songhomitra and Park, Eun-Kee and Park, James and Parry, Charles D H and Parsian, Hadi and Pasdar, Yahya and Patel, Shanti and Patil, Snehal T and Patle, Ajay and Patton, George C and Paturi, Vishnupriya Rao and Paudel, Deepak and Paulson, Katherine R and Pearce, Neil and Pereira, Alexandre and Pereira, David M and Perico, Norberto and Pesudovs, Konrad and Petzold, Max and Pham, Hai Quang and Phillips, Michael R and Pigott, David M and Pillay, Julian David and Piradov, Michael A and Pirsaheb, Meghdad and Pishgar, Farhad and Plana-Ripoll, Oleguer and Polinder, Suzanne and Popova, Svetlana and Postma, Maarten J and Pourshams, Akram and Poustchi, Hossein and Prabhakaran, Dorairaj and Prakash, Swayam and Prakash, V and Prasad, Narayan and Purcell, Caroline A and Qorbani, Mostafa and Quistberg, D Alex and Radfar, Amir and Rafay, Anwar and Rafiei, Alireza and Rahim, Fakher and Rahimi, Kazem and Rahimi, Zohreh and Rahimi-Movaghar, Afarin and Rahimi-Movaghar, Vafa and Rahman, Mahfuzar and Rahman, Mohammad Hifz Ur and Rahman, Muhammad Aziz and Rahman, Sajjad Ur and Rai, Rajesh Kumar and Rajati, Fatemeh and Ranjan, Prabhat and Rao, Puja C and Rasella, Davide and Rawaf, David Laith and Rawaf, Salman and Reddy, K Srinath and Reiner, Robert C and Reitsma, Marissa Bettay and Remuzzi, Giuseppe and Renzaho, Andre M N and Resnikoff, Serge and Rezaei, Satar and Rezai, Mohammad Sadegh and Ribeiro, Antonio Luiz P and Roberts, Nicholas L S and Robinson, Stephen R and Roever, Leonardo and Ronfani, Luca and Roshandel, Gholamreza and Rostami, Ali and Roth, Gregory A and Rothenbacher, Dietrich and Rubagotti, Enrico and Sachdev, Perminder S and Sadat, Nafis and Sadeghi, Ehsan and Saeedi Moghaddam, Sahar and Safari, Hosein and Safari, Yahya and Safari-Faramani, Roya and Safdarian, Mahdi and Safi, Sare and Safiri, Saeid and Sagar, Rajesh and Sahebkar, Amirhossein and Sahraian, Mohammad Ali and Sajadi, Haniye Sadat and Salam, Nasir and Salama, Joseph S and Salamati, Payman and Saleem, Zikria and Salimi, Yahya and Salimzadeh, Hamideh and Salomon, Joshua A and Salvi, Sundeep Santosh and Salz, Inbal and Samy, Abdallah M and Sanabria, Juan and Sanchez-Niño, Maria Dolores and Santomauro, Damian Francesco and Santos, Itamar S and Santos, João Vasco and Santric Milicevic, Milena M and Sao Jose, Bruno Piassi and Sardana, Mayank and Sarker, Abdur Razzaque and Sarmiento-Suárez, Rodrigo and Sarrafzadegan, Nizal and Sartorius, Benn and Sarvi, Shahabeddin and Sathian, Brijesh and Satpathy, Maheswar and Sawant, Arundhati R and Sawhney, Monika and Saxena, Sonia and Schaeffner, Elke and Schmidt, Maria Inês and Schneider, Ione J C and Schutte, Aletta Elisabeth and Schwebel, David C and Schwendicke, Falk and Scott, James G and Sekerija, Mario and Sepanlou, Sadaf G and Serván-Mori, Edson and Seyedmousavi, Seyedmojtaba and Shabaninejad, Hosein and Shafieesabet, Azadeh and Shahbazi, Mehdi and Shaheen, Amira A and Shaikh, Masood Ali and Shams-Beyranvand, Mehran and Shamsi, Mohammadbagher and Sharafi, Heidar and Sharafi, Kiomars and Sharif, Mehdi and Sharif-Alhoseini, Mahdi and Sharma, Jayendra and Sharma, Rajesh and She, Jun and Sheikh, Aziz and Shi, Peilin and Shibuya, Kenji and Shiferaw, Mekonnen Sisay and Shigematsu, Mika and Shiri, Rahman and Shirkoohi, Reza and Shiue, Ivy and Shokoohinia, Yalda and Shokraneh, Farhad and Shoman, Haitham and Shrime, Mark G and Si, Si and Siabani, Soraya and Sibai, Abla Mehio and Siddiqi, Tariq J and Sigfusdottir, Inga Dora and Sigurvinsdottir, Rannveig and Silva, Diego Augusto Santos and Silva, João Pedro and Silveira, Dayane Gabriele Alves and Singam, Narayana Sarma Venkata and Singh, Jasvinder A and Singh, Narinder Pal and Singh, Virendra and Sinha, Dhirendra Narain and Skiadaresi, Eirini and Skirbekk, Vegard and Sliwa, Karen and Smith, David L and Smith, Mari and Soares Filho, Adauto Martins and Sobaih, Badr Hasan and Sobhani, Soheila and Soofi, Moslem and Sorensen, Reed J D and Soyiri, Ireneous N and Sposato, Luciano A and Sreeramareddy, Chandrashekhar T and Srinivasan, Vinay and Stanaway, Jeffrey D and Starodubov, Vladimir I and Stein, Dan J and Steiner, Caitlyn and Steiner, Timothy J and Stokes, Mark A and Stovner, Lars Jacob and Subart, Michelle L and Sudaryanto, Agus and Sufiyan, Mu'awiyyah Babale and Sulo, Gerhard and Sunguya, Bruno F and Sur, Patrick John and Sykes, Bryan L and Sylaja, P N and Sylte, Dillon O and Szoeke, Cassandra E I and Tabarés-Seisdedos, Rafael and Tabuchi, Takahiro and Tadakamadla, Santosh Kumar and Tandon, Nikhil and Tassew, Segen Gebremeskel and Tavakkoli, Mohammad and Taveira, Nuno and Taylor, Hugh R and Tehrani-Banihashemi, Arash and Tekalign, Tigist Gashaw and Tekelemedhin, Shishay Wahdey and Tekle, Merhawi Gebremedhin and Temsah, Mohamad-Hani and Temsah, Omar and Terkawi, Abdullah Sulieman and Tessema, Belay and Teweldemedhin, Mebrahtu and Thankappan, Kavumpurathu Raman and Theis, Andrew and Thirunavukkarasu, Sathish and Thomas, Nihal and Tilahun, Binyam and To, Quyen G and Tonelli, Marcello and Topor-Madry, Roman and Torre, Anna E and Tortajada-Girbés, Miguel and Touvier, Mathilde and Tovani-Palone, Marcos Roberto and Towbin, Jeffrey A and Tran, Bach Xuan and Tran, Khanh Bao and Troeger, Christopher E and Tsadik, Afewerki Gebremeskel and Tsoi, Derrick and Tudor Car, Lorainne and Tyrovolas, Stefanos and Ukwaja, Kingsley Nnanna and Ullah, Irfan and Undurraga, Eduardo A and Updike, Rachel L and Usman, Muhammad Shariq and Uthman, Olalekan A and Vaduganathan, Muthiah and Vaezi, Afsane and Valdez, Pascual R and Varavikova, Elena and Varughese, Santosh and Vasankari, Tommi Juhani and Venketasubramanian, Narayanaswamy and Villafaina, Santos and Violante, Francesco S and Vladimirov, Sergey Konstantinovitch and Vlassov, Vasily and Vollset, Stein Emil and Vos, Theo and Vosoughi, Kia and Vujcic, Isidora S and Wagnew, Fasil Shiferaw and Waheed, Yasir and Wang, Yafeng and Wang, Yuan-Pang and Weiderpass, Elisabete and Weintraub, Robert G and Weiss, Daniel J and Weldegebreal, Fitsum and Weldegwergs, Kidu Gidey and Werdecker, Andrea and West, T Eoin and Westerman, Ronny and Whiteford, Harvey A and Widecka, Justyna and Wijeratne, Tissa and Williams, Hywel C and Wilner, Lauren B and Wilson, Shadrach and Winkler, Andrea Sylvia and Wiyeh, Alison B and Wiysonge, Charles Shey and Wolfe, Charles D A and Woolf, Anthony D and Wyper, Grant M A and Xavier, Denis and Xu, Gelin and Yadgir, Simon and Yahyazadeh Jabbari, Seyed Hossein and Yamada, Tomohide and Yan, Lijing L and Yano, Yuichiro and Yaseri, Mehdi and Yasin, Yasin Jemal and Yeshaneh, Alex and Yimer, Ebrahim M and Yip, Paul and Yisma, Engida and Yonemoto, Naohiro and Yoon, Seok-Jun and Yotebieng, Marcel and Younis, Mustafa Z and Yousefifard, Mahmoud and Yu, Chuanhua and Zadnik, Vesna and Zaidi, Zoubida and Zaman, Sojib Bin and Zamani, Mohammad and Zandian, Hamed and Zar, Heather J and Zenebe, Zerihun Menlkalew and Zhou, Maigeng and Zipkin, Ben and Zodpey, Sanjay and Zucker, Inbar and Zuhlke, Liesl Joanna and Murray, Christopher J L. (2018) Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 392 (10159). pp. 1859-1922.

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Abstract

How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted life-years (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severity of ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years.; We used data for age-specific mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Socio-demographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9-6·7), from 57·0 years (54·6-59·1) in 1990 to 63·3 years (60·5-65·7) in 2017. The increase varied from 3·8 years (3·4-4·1) in high SDI countries to 10·5 years (9·8-11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4-1·7) in Saint Vincent and the Grenadines (62·4 years [59·9-64·7] in 1990 to 63·5 years [60·9-65·8] in 2017) to 23·7 years (21·9-25·6) in Eritrea (30·7 years [28·9-32·2] in 1990 to 54·4 years [51·5-57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6-2·3) in Algeria to 11·9 years (10·9-12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4-78·7]) and males (72·6 years [69·8-75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7-50·2] for females and 42·8 years [40·1-45·6] for males). Globally, in 2017, the five leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8-43·5) for communicable diseases and by 49·8% (47·9-51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8-43·0), although age-standardised DALY rates decreased by 18·1% (16·0-20·2). With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low SDI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Health Interventions > Malaria Interventions (Lengeler)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Household Economics and Health Systems Research > Household Health Systems (Mäusezahl)
UniBasel Contributors:Fürst, Thomas
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Elsevier
ISSN:0140-6736
e-ISSN:1474-547X
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:09 Apr 2019 15:06
Deposited On:18 Dec 2018 17:20

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