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dc.contributor.authorHay, Simon I.en_US
dc.contributor.authorAbajobir, Amanuel Alemuen_US
dc.contributor.authorAbate, Kalkidan Hassenen_US
dc.contributor.authorAbbafati, Cristianaen_US
dc.contributor.authorAbbas, Kaja M.en_US
dc.contributor.authorAbd-Allah, Foaden_US
dc.contributor.authorAbdulle, Abdishakur M.en_US
dc.contributor.authorAbebo, Teshome Abukaen_US
dc.contributor.authorAbera, Semaw Feredeen_US
dc.contributor.authorAboyans, Victoren_US
dc.contributor.authorAbu-Raddad, Laith J.en_US
dc.contributor.authorAckerman, Ilana N.en_US
dc.contributor.authorAryal, Krishna Kumaren_US
dc.contributor.authorHailu, Alemayehuen_US
dc.contributor.authorHtet, Aung Soeen_US
dc.contributor.authorKnudsen, Ann Kristinen_US
dc.contributor.authorKisa, Adnanen_US
dc.contributor.authorNorheim, Ole Frithjofen_US
dc.contributor.authorSkirbekk, Vegard Fykseen_US
dc.contributor.authorVollset, Stein Emilen_US
dc.contributor.authorWeiderpass, Elisabeteen_US
dc.date.accessioned2018-02-09T14:11:12Z
dc.date.available2018-02-09T14:11:12Z
dc.date.issued2017-09
dc.identifier.issn1474-547X
dc.identifier.issn0140-6736
dc.identifier.urihttp://hdl.handle.net/1956/17379
dc.description.abstractMETHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. FINDINGS: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. INTERPRETATION: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support.en_US
dc.language.isoengeng
dc.publisherElseviereng
dc.relation.urihttp://www.sciencedirect.com/science/article/pii/S014067361732130X?via%3Dihub
dc.rightsAttribution CC BYeng
dc.rights.urihttp://creativecommons.org/licenses/by/4.0eng
dc.titleGlobal, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016en_US
dc.typePeer reviewed
dc.typeJournal article
dc.subject.nsiVDP::Medisinske fag: 700::Helsefag: 800::Helsetjeneste- og helseadministrasjonsforskning: 806
dc.subject.nsiVDP::Midical sciences: 700::Health sciences: 800::Health service and health administration research: 806
dc.subject.nsiVDP::Medisinske fag: 700
dc.subject.nsiVDP::Midical sciences: 700
dc.date.updated2018-02-02T15:43:59Z
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2017 The Author(s)
dc.identifier.doihttps://doi.org/10.1016/s0140-6736(17)32130-x
dc.identifier.cristin1503698
dc.source.issue10100
dc.source.journalThe Lancet
dc.source.pagenumber1260-1344
dc.source.volume390


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