Global Burden of Disease

• 1991: World Bank launched Global Burden of Disease
• Most recent assessment: 2010 study
• 291 diseases and injuries
• 1160 sequelae
• 67 risk factors
• 187 countries

Internal consistency

• Year, Country, Age, Sex data combined to measure total deaths all causes
• Tallied with the records obtained from countries on all cause deaths
• This procedure was used for cause-specific mortality

Limitations of GBD

• The study itself is internally consistent
• Inconsistent data
• Complex models that are difficult to assess
• Several sources of uncertainty

How to compare burden of diseases

• For every condition:
• Consider age at death
• Life Expectancy of the person(s) affected
• Degree of disability

GBD 2010 measurement: comparison of deaths

• YLL = numbers_of_death * life_expectancy_at_death
• Life Expectancy calculated on the basis of a reference population
• Life Expectancy = 86 years
• Death at 1 year = 85 years lost
• Death at 25 years = 61 years lost

GBD measurement: comparison of disability

• Diverse disorders not amenable to comparison
• Disease –> Sequelae
• Use disability weights
• Disability weights derived from surveys

Disability Weights

• Surveys ask respondents to assess improvement in health for intervention
• Disability Weights are derived on that basis
• Range: 0-1
• 0: ideal health
• 1: equivalent to death

GBD measurement: YLD

• YLD = years lived with disability
• DALY = YLD + YLL
• Disability = Health loss

DALY estimates for US 2010

DALY as markers of change, Global DALYs between 1990 and 2010

Let’s explore GBD using GHDx

• Go to https://vizhub.healthdata.org/gbd-compare/