Abstract
BackgroundSince the Global Burden of Disease study (GBD) has become more comprehensive, data for hundreds of causes of disease burden, measured using Disability Adjusted Life Years (DALYs), have become increasingly available for almost every part of the world. However, undergoing any systematic comparative analysis of the trends can be challenging given the quantity of data that must be presented.MethodsWe use the GBD data to describe trends in cause-specific DALY rates for eight regions. We quantify the extent to which the importance of ‘major’ DALY causes changes relative to ‘minor’ DALY causes over time by decomposing changes in the Gini coefficient into ‘proportionality’ and ‘reranking’ indices.ResultsThe fall in regional DALY rates since 1990 has been accompanied by generally positive proportionality indices and reranking indices of negligible magnitude. However, the rate at which DALY rates have been falling has slowed and, at the same time, proportionality indices have tended towards zero. These findings are clearest where the focus is exclusively upon non-communicable diseases. Notably, large and positive proportionality indices are recorded for sub-Saharan Africa over the last decade.ConclusionThe positive proportionality indices show that disease burden has become less concentrated around the leading causes over time, and this trend has become less prominent as the DALY rate decline has slowed. The recent decline in disease burden in sub-Saharan Africa is disproportionally driven by improvements in DALY rates for HIV/AIDS, as well as for malaria, diarrheal diseases, and lower respiratory infections.
Highlights
By grouping causes of death as ‘communicable, maternal, neo-natal and nutritional diseases (CMNN)’, ‘noncommunicable diseases (NCDs)’, and ‘injuries’, Murray and Lopez [19] summarized findings on causes of death for eight regions of the world using data from the 1990 wave of the Global Burden of Disease study (GBD) study
Along with Disability Adjusted Life Year (DALY) rates, Gini coefficients have generally fallen over the period
In sharp contrast to this, the large positive proportionality index for the 2008 to 2017 period signals the steep falls in the HIV/AIDS DALY rate, as well as for malaria, diarrheal diseases, and lower respiratory infections
Summary
By grouping causes of death as ‘communicable, maternal, neo-natal and nutritional diseases (CMNN)’, ‘noncommunicable diseases (NCDs)’, and ‘injuries’, Murray and Lopez [19] summarized findings on causes of death for eight regions of the world using data from the 1990 wave of the GBD study. CMNN diseases, especially pneumonia, neo-natal conditions, and diarrheal diseases, are still important causes of death, in developing regions. These broad similarities mask a more complex picture of the varying relative importance of death causes. The importance of some global causes of ‘disease burden’, measured in the GBD using Disability Adjusted Life Years (DALYs), has changed substantially. Since the Global Burden of Disease study (GBD) has become more comprehensive, data for hundreds of causes of disease burden, measured using Disability Adjusted Life Years (DALYs), have become increasingly available for almost every part of the world. Undergoing any systematic comparative analysis of the trends can be challenging given the quantity of data that must be presented
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