Dutch DALYS: The Dutch National Burden of Disease study

Abstract

Abstract The Netherlands National Institute for Public health and the Environment published for more than 25 years their National Burden of Disease estimates (Dutch DALYs). This is done as part of their Public health Status and Foresight study which is commissioned by the Ministry of Health. In these 25 years, the translation of knowledge resulting from the Burden of Disease study has been progressed over the years. The knowledge translation has both pull and push elements. Various stakeholders are consulted for example to select health conditions and relevant risk factors, to better interpret input data and to compare results with other burden of disease results. As push elements, website, concise reporting and visualization techniques such as infographics are being used. Burden of disease results are being used in several Dutch policy documents. Policy goals to reduce avoidable disease burden is based on the results of the Dutch DALY studies. In addition, the allocation of disease burden to underlying risk factors receives substantial attention from policy maker to prioritize policies on prevention. It is also used by other organizations to advocate specific issues, such as cardiovascular diseases. However, policy makers still have difficulties interpreting a complex metric as the Disability-Adjusted Life Year (DALY). In the Netherlands, the uptake by policy makers of burden of disease results has increased strongly over the years and forms by now an essential aspect of public health reporting. However, improving understanding of the DALY concept, for example by using complementary metrics such as the healthy life expectancy, could stimulate its use further. Also, the allocation to risk factors is used frequently. Policy makers indicated that a better link of risk factors to policy interventions, is a valuable next step.