Abstract
BackgroundTo complement available information on mortality in a population Standard Expected Years of Life Lost (SEYLL), an indicator of premature mortality, is increasingly used to calculate the mortality-associated disease burden. SEYLL consider the age at death and therefore allow a more accurate view on mortality patterns as compared to routinely used measures (e.g. death counts). This study provides a comprehensive assessment of disease and injury SEYLL for Hong Kong in 2010.MethodsTo estimate the SEYLL, life-expectancy at birth was set according to the 2004 Global Burden of Disease study at 82.5 and 80 years for females and males, respectively. Cause of death data for 2010 were corrected for misclassification of cardiovascular and cancer causes. In addition to the baseline estimates, scenario analyses were performed using alternative assumptions on life-expectancy (Hong Kong standard life-expectancy), time-discounting and age-weighting. To estimate a trend of premature mortality a time-series analysis from 2001 to 2010 was conducted.ResultsIn 2010 524,706.5 years were lost due to premature death in Hong Kong with 58.3% of the SEYLL attributable to male deaths. The three overall leading single causes of SEYLL were “trachea, bronchus and lung cancers”, “ischaemic heart disease” and “lower respiratory infections” together accounting for about 29% of the overall SEYLL. Further, self-inflicted injuries (5.6%; ranked 5) and liver cancer (4.9%; ranked 7) were identified as important causes not adequately captured by classical mortality measures. Scenario analyses highlighted that by using a 3% time-discount rate and non-uniform age-weights the SEYLL dropped by 51.6%. Using Hong Kong’s standard life-expectancy values resulted in an overall increase of SEYLL by 10.8% as compared to the baseline SEYLL. Time-series analysis indicates an overall increase of SEYLL by 6.4%. In particular, group I (communicable, maternal, perinatal and nutritional) conditions showed highest increases with SEYLL-rates per 100,000 in 2010 being 1.4 times higher than 2001.ConclusionsThe study stresses the mortality impact of diseases and injuries that occur in earlier stages of life and thus presents the SEYLL measure as a more sensitive indicator compared to classical mortality indicators. SEYLL provide useful additional information and supplement available death statistics.
Highlights
To complement available information on mortality in a population Standard Expected Years of Life Lost (SEYLL), an indicator of premature mortality, is increasingly used to calculate the mortality-associated disease burden
Standard expected years of life lost Methods provided by the Global Burden of Disease (GBD) framework were adopted for the Hong Kong setting and SEYLL were quantified by cause, sex and 19 age-groups for the year 2010 [22]
SEYLL by main broad cause groups During 2010, an overall number of 41,887 deaths were registered in Hong Kong, resulting in 524,706.5 years lost due to premature death, with 41.7% and 58.3% of the SEYLL attributable to female and male deaths, respectively
Summary
To complement available information on mortality in a population Standard Expected Years of Life Lost (SEYLL), an indicator of premature mortality, is increasingly used to calculate the mortality-associated disease burden. Health indicators using lost time as an outcome are increasingly used in public health at global, national and local levels [8,9,10,11,12] Many of these measures combine complementary epidemiologic information and present the health of a population as a single numerical indicator. The DALY combines the impact of mortality and morbidity and uses time as the unit to measure health losses in populations [15] It is presented as the sum of years lived with disability (YLD, morbidity component) and years of life lost due to premature death (YLL, mortality component). SEYLL can supplement the traditional set of mortality indicators and enhance the monitoring of disease patterns in populations
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