Maqola

Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Masayuki TeramotoInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USADamian SantomauroInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAAmirali AaliInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAYohannes AbateInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USACristiana AbbafatiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAHedayat AbbastabarInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USASamar Abd ElHafeezInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMichael AbdelmassehInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USASherief Abd‐ElsalamInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAArash AbdollahiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAAuwal AbdullahiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAKedir Hussein AbegazInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USARoberto Ariel Abeldaño ZúñigaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USARichard Gyan AboagyeInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAHassan AbolhassaniInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USALucas Guimarães AbreuInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAHasan AbualruzInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAEman Abu‐GharbiehInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USANiveen ME Abu-RmeilehInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAIlana N. AckermanInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAIsaac Yeboah AddoInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAGiovanni AddoloratoInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAAkindele O. AdebiyiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAVictor Abiola AdepojuInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAHabeeb Omoponle AdewuyiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAShadi AfyouniInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USASaira AfzalInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USASina AfzalInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAAntonella AgodiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAAqeel AhmadInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USADanish AhmadInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAFirdos AhmadInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAShahzaib AhmadInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAAli AhmedInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USALuai A. AhmedInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMuktar Beshir AhmedInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMarjan AjamiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAKarolina AkinosoglouInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMohammed Ahmed AkkaifInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USASyed Mahfuz Al HasanInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USASamer O AlalalmehInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAZiyad Al‐AlyInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMohammed ALBashtawyInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USARobert W AldridgeInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMeseret Desalegn AlemuInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMegbaru AlemuInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAKefyalew Addis AleneInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAAdel Al‐GheethiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMaryam AlharrasiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USARobert Kaba AlhassanInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMohammed Usman AliInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USARafat AliInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USASyed Shujait AliInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USASheikh Mohammad AlifInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USASyed Mohamed AljunidInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USASabah Al-MarwaniInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAJoseph Uy AlmazanInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMahmoud A. AlomariInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USABasem Al‐OmariInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAZaid AltaanyInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USANelson Alvis‐GuzmánInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USANelson J Alvis-ZakzukInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAHassan AlwafiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMohammad Al‐WardatInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAYaser Mohammed Al‐WorafiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USASafwat AlyInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAKarem H. AlzoubiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAAzmeraw T. AmareInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAPrince M. AmegborInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAEdward Kwabena AmeyawInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USATarek Tawfik AminInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAAlireza AmindarolzarbiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USASohrab AmiriInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USADickson A AmugsiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USARobert AncuceanuInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USADeanna AnderliniInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USADavid AndersonInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAPedro Prata AndradeInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USACătălina Liliana AndreiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAHossein AnsariInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USACatherine M AntonyInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USASaleha AnwarInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USASumadi Lukman AnwarInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USARazique AnwerInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAP.E. AnyanwuInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAJuan Pablo ArabInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAJalal ArablooInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMosab ArafatInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USADaniel T ArakiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAAleksandr Y. AravkinInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMesay ArkewInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USABenedetta ArmocidaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMichael B. ArndtInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMahwish AroojInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAAnton A ArtamonovInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USARaphael Taiwo ArulebaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAAshokan ArumugamInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USACharlie AshbaughInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMubarek Yesse AshemoInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USAMuhammad AshrafInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USA

2024en

ABI

Annotatsiya

BACKGROUND: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. METHODS: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. FINDINGS: Global DALYs increased from 2·63 billion (95% UI 2·44-2·85) in 2010 to 2·88 billion (2·64-3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7-17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8-6·3) in 2020 and 7·2% (4·7-10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0-234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7-198·3]), neonatal disorders (186·3 million [162·3-214·9]), and stroke (160·4 million [148·0-171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3-51·7) and for diarrhoeal diseases decreased by 47·0% (39·9-52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54-1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5-9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0-19·8]), depressive disorders (16·4% [11·9-21·3]), and diabetes (14·0% [10·0-17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7-27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6-63·6) in 2010 to 62·2 years (59·4-64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6-2·9) between 2019 and 2021. INTERPRETATION: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. FUNDING: Bill & Melinda Gates Foundation.

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DOI: 10.1016/s0140-6736(24)00757-8

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