TY  - JOUR
PY  - 2015//
TI  - Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition
JO  - Lancet
A1  - Murray, Christopher J. L.
A1  - Barber, Ryan M.
A1  - Foreman, Kyle J.
A1  - Ozgoren, Ayse Abbasoglu
A1  - Abd-Allah, Foad
A1  - Abera, Semaw Ferede
A1  - Aboyans, Victor
A1  - Abraham, Jerry Puthenpurakal
A1  - Abubakar, Ibrahim
A1  - Abu-Raddad, Laith J.
A1  - Abu-Rmeileh, Niveen M. E.
A1  - Achoki, Tom
A1  - Ackerman, Ilana N.
A1  - Ademi, Zanfina
A1  - Adou, Arsène Kouablan
A1  - Adsuar, José C.
A1  - Afshin, Ashkan
A1  - Agardh, Emilie E.
A1  - Alam, Sayed Saidul
A1  - Alasfoor, Deena
A1  - Albittar, Mohammed I.
A1  - Alegretti, Miguel A.
A1  - Alemu, Zewdie A.
A1  - Alfonso-Cristancho, Rafael
A1  - Alhabib, Samia
A1  - Ali, Raghib
A1  - Alla, François
A1  - Allebeck, Peter
A1  - Almazroa, Mohammad A.
A1  - Alsharif, Ubai
A1  - Alvarez, Elena
A1  - Alvis-Guzmán, Nelson
A1  - Amare, Azmeraw T.
A1  - Ameh, Emmanuel A.
A1  - Amini, Heresh
A1  - Ammar, Walid
A1  - Anderson, H. Ross
A1  - Anderson, Benjamin O.
A1  - Antonio, Carl Abelardo T.
A1  - Anwari, Palwasha
A1  - Arnlöv, Johan
A1  - Arsenijevic, Valentina S. Arsic
A1  - Artaman, Al
A1  - Asghar, Rana J.
A1  - Assadi, Reza
A1  - Atkins, Lydia S.
A1  - Avila, Marco A.
A1  - Awuah, Baffour
A1  - Bachman, Victoria F.
A1  - Badawi, Alaa
A1  - Bahit, Maria C.
A1  - Balakrishnan, Kalpana
A1  - Banerjee, Amitava
A1  - Barker-Collo, Suzanne L.
A1  - Barquera, Simon
A1  - Barregård, Lars
A1  - Barrero, Lope H.
A1  - Basu, Arindam
A1  - Basu, Sanjay
A1  - Basulaiman, Mohammed O.
A1  - Beardsley, Justin
A1  - Bedi, Neeraj
A1  - Beghi, Ettore
A1  - Bekele, Tolesa
A1  - Bell, Michelle L.
A1  - Benjet, Corina
A1  - Bennett, Derrick A.
A1  - Benseñor, Isabela M.
A1  - Benzian, Habib
A1  - Bernabé, Eduardo
A1  - Bertozzi-Villa, Amelia
A1  - Beyene, Tariku J.
A1  - Bhala, Neeraj
A1  - Bhalla, Ashish
A1  - Bhutta, Zulfiqar A.
A1  - Bienhoff, Kelly
A1  - Bikbov, Boris
A1  - Biryukov, Stan
A1  - Blore, Jed D.
A1  - Blosser, Christopher D.
A1  - Blyth, Fiona M.
A1  - Bohensky, Megan A.
A1  - Bolliger, Ian W.
A1  - Basara, Berrak Bora
A1  - Bornstein, Natan M.
A1  - Bose, Dipan
A1  - Boufous, Soufiane
A1  - Bourne, Rupert R. A.
A1  - Boyers, Lindsay N.
A1  - Brainin, Michael
A1  - Brayne, Carol E.
A1  - Brazinova, Alexandra
A1  - Breitborde, Nicholas J. K.
A1  - Brenner, Hermann
A1  - Briggs, Adam D.
A1  - Brooks, Peter M.
A1  - Brown, Jonathan C.
A1  - Brugha, Traolach S.
A1  - Buchbinder, Rachelle
A1  - Buckle, Geoffrey C.
A1  - Budke, Christine M.
A1  - Bulchis, Anne
A1  - Bulloch, Andrew G.
A1  - Campos-Nonato, Ismael R.
A1  - Carabin, Hélène
A1  - Carapetis, Jonathan R.
A1  - Cárdenas, Rosario
A1  - Carpenter, David O.
A1  - Caso, Valeria
A1  - Castañeda-Orjuela, Carlos A.
A1  - Castro, Ruben E.
A1  - Catala-Lopez, Ferran
A1  - Cavalleri, Fiorella
A1  - Cavlin, Alanur
A1  - Chadha, Vineet K.
A1  - Chang, Jung-Chen
A1  - Charlson, Fiona J.
A1  - Chen, Honglei
A1  - Chen, Wanqing
A1  - Chiang, Peggy P.
A1  - Chimed-Ochir, Odgerel
A1  - Chowdhury, Rajiv
A1  - Christensen, Hanne
A1  - Christophi, Costas A.
A1  - Cirillo, Massimo
A1  - Coates, Matthew M.
A1  - Coffeng, Luc E.
A1  - Coggeshall, Megan S.
A1  - Colistro, Valentina
A1  - Colquhoun, Samantha M.
A1  - Cooke, Graham S.
A1  - Cooper, Cyrus
A1  - Cooper, Leslie T.
A1  - Coppola, Luis M.
A1  - Cortinovis, Monica
A1  - Criqui, Michael H.
A1  - Crump, John A.
A1  - Cuevas-Nasu, Lucia
A1  - Danawi, Hadi
A1  - Dandona, Lalit
A1  - Dandona, Rakhi
A1  - Dansereau, Emily
A1  - Dargan, Paul I.
A1  - Davey, Gail
A1  - Davis, Adrian
A1  - Davitoiu, Dragos V.
A1  - Dayama, Anand
A1  - De Leo, Diego
A1  - Degenhardt, Louisa
A1  - Del Pozo-Cruz, Borja
A1  - Dellavalle, Robert P.
A1  - Deribe, Kebede
A1  - Derrett, Sarah
A1  - Jarlais, Don C. Des
A1  - Dessalegn, Muluken
A1  - Dharmaratne, Samath D.
A1  - Dherani, Mukesh K.
A1  - Diaz-Torne, Cesar
A1  - Dicker, Daniel
A1  - Ding, Eric L.
A1  - Dokova, Klara
A1  - Dorsey, E. Ray
A1  - Driscoll, Tim R.
A1  - Duan, Leilei
A1  - Duber, Herbert C.
A1  - Ebel, Beth E.
A1  - Edmond, Karen M.
A1  - Elshrek, Yousef M.
A1  - Endres, Matthias
A1  - Ermakov, Sergey P.
A1  - Erskine, Holly E.
A1  - Eshrati, Babak
A1  - Esteghamati, Alireza
A1  - Estep, Kara
A1  - Faraon, Emerito Jose A.
A1  - Farzadfar, Farshad
A1  - Fay, Derek F.
A1  - Feigin, Valery L.
A1  - Felson, David T.
A1  - Fereshtehnejad, Seyed-Mohammad
A1  - Fernandes, Jefferson G.
A1  - Ferrari, Alize J.
A1  - Fitzmaurice, Christina
A1  - Flaxman, Abraham D.
A1  - Fleming, Thomas D.
A1  - Foigt, Nataliya
A1  - Forouzanfar, Mohammad H.
A1  - Fowkes, F. Gerry R.
A1  - Paleo, Urbano Fra
A1  - Franklin, Richard Charles
A1  - Fürst, Thomas
A1  - Gabbe, Belinda
A1  - Gaffikin, Lynne
A1  - Gankpé, Fortuné G.
A1  - Geleijnse, Johanna M.
A1  - Gessner, Bradford D.
A1  - Gething, Peter
A1  - Gibney, Katherine B.
A1  - Giroud, Maurice
A1  - Giussani, Giorgia
A1  - Dantes, Hector Gomez
A1  - Gona, Philimon
A1  - Gonzalez-Medina, Diego
A1  - Gosselin, Richard A.
A1  - Gotay, Carolyn C.
A1  - Goto, Atsushi
A1  - Gouda, Hebe N.
A1  - Graetz, Nicholas
A1  - Gugnani, Harish C.
A1  - Gupta, Rahul
A1  - Gupta, Rajeev
A1  - Gutiérrez, Reyna A.
A1  - Haagsma, Juanita
A1  - Hafezi-Nejad, Nima
A1  - Hagan, Holly
A1  - Halasa, Yara A.
A1  - Hamadeh, Randah R.
A1  - Hamavid, Hannah
A1  - Hammami, Mouhanad
A1  - Hancock, Jamie
A1  - Hankey, Graeme J.
A1  - Hansen, Gillian M.
A1  - Hao, Yuantao
A1  - Harb, Hilda L.
A1  - Haro, Josep Maria
A1  - Havmoeller, Rasmus
A1  - Hay, Simon I.
A1  - Hay, Roderick J.
A1  - Heredia-Pi, Ileana B.
A1  - Heuton, Kyle R.
A1  - Heydarpour, Pouria
A1  - Higashi, Hideki
A1  - Hijar, Martha
A1  - Hoek, Hans W.
A1  - Hoffman, Howard J.
A1  - Hosgood, H. Dean
A1  - Hossain, Mazeda
A1  - Hotez, Peter J.
A1  - Hoy, Damian G.
A1  - Hsairi, Mohamed
A1  - Hu, Guoqing
A1  - Huang, Cheng
A1  - Huang, John J.
A1  - Husseini, Abdullatif
A1  - Huynh, Chantal
A1  - Iannarone, Marissa L.
A1  - Iburg, Kim M.
A1  - Innos, Kaire
A1  - Inoue, Manami
A1  - Islami, Farhad
A1  - Jacobsen, Kathryn H.
A1  - Jarvis, Deborah L.
A1  - Jassal, Simerjot K.
A1  - Jee, Sun Ha
A1  - Jeemon, Panniyammakal
A1  - Jensen, Paul N.
A1  - Jha, Vivekanand
A1  - Jiang, Guohong
A1  - Jiang, Ying
A1  - Jonas, Jost B.
A1  - Juel, Knud
A1  - Kan, Haidong
A1  - Karch, André
A1  - Karema, Corine K.
A1  - Karimkhani, Chante
A1  - Karthikeyan, Ganesan
A1  - Kassebaum, Nicholas J.
A1  - Kaul, Anil
A1  - Kawakami, Norito
A1  - Kazanjan, Konstantin
A1  - Kemp, Andrew H.
A1  - Kengne, Andre P.
A1  - Keren, Andre
A1  - Khader, Yousef S.
A1  - Khalifa, Shams Eldin A.
A1  - Khan, Ejaz A.
A1  - Khan, Gulfaraz
A1  - Khang, Young-Ho
A1  - Kieling, Christian
A1  - Kim, Daniel
A1  - Kim, Sungroul
A1  - Kim, Yunjin
A1  - Kinfu, Yohannes
A1  - Kinge, Jonas M.
A1  - Kivipelto, Miia
A1  - Knibbs, Luke D.
A1  - Knudsen, Ann Kristin
A1  - Kokubo, Yoshihiro
A1  - Kosen, Soewarta
A1  - Krishnaswami, Sanjay
A1  - Defo, Barthelemy Kuate
A1  - Biçer, Burcu Küçük
A1  - Kuipers, Ernst J.
A1  - Kulkarni, Chanda
A1  - Kulkarni, Veena S.
A1  - Kumar, G. Anil
A1  - Kyu, Hmwe H.
A1  - Lai, Taavi
A1  - Lalloo, Ratilal
A1  - Lallukka, Tea
A1  - Lam, Hilton
A1  - Lan, Qing
A1  - Lansingh, Van C.
A1  - Larsson, Anders
A1  - Lawrynowicz, Alicia E. B.
A1  - Leasher, Janet L.
A1  - Leigh, James
A1  - Leung, Ricky
A1  - Levitz, Carly E.
A1  - Li, Bin
A1  - Li, Yichong
A1  - Li, Yongmei
A1  - Lim, Stephen S.
A1  - Lind, Maggie
A1  - Lipshultz, Steven E.
A1  - Liu, Shiwei
A1  - Liu, Yang
A1  - Lloyd, Belinda K.
A1  - Lofgren, Katherine T.
A1  - Logroscino, Giancarlo
A1  - Looker, Katharine J.
A1  - Lortet-Tieulent, Joannie
A1  - Lotufo, Paulo A.
A1  - Lozano, Rafael
A1  - Lucas, Robyn M.
A1  - Lunevicius, Raimundas
A1  - Lyons, Ronan A.
A1  - Ma, Stefan
A1  - Macintyre, Michael F.
A1  - Mackay, Mark T.
A1  - Majdan, Marek
A1  - Malekzadeh, Reza
A1  - Marcenes, Wagner
A1  - Margolis, David J.
A1  - Margono, Christopher
A1  - Marzan, Melvin B.
A1  - Masci, Joseph R.
A1  - Mashal, Mohammad T.
A1  - Matzopoulos, Richard
A1  - Mayosi, Bongani M.
A1  - Mazorodze, Tasara T.
A1  - Mcgill, Neil W.
A1  - McGrath, John J.
A1  - McKee, Michael
A1  - Mclain, Abigail
A1  - Meaney, Peter A.
A1  - Medina, Catalina
A1  - Mehndiratta, Man Mohan
A1  - Mekonnen, Wubegzier
A1  - Melaku, Yohannes A.
A1  - Meltzer, Michele
A1  - Memish, Ziad A.
A1  - Mensah, George A.
A1  - Meretoja, Atte
A1  - Mhimbira, Francis A.
A1  - Micha, Renata
A1  - Miller, Ted R.
A1  - Mills, Edward J.
A1  - Mitchell, Philip B.
A1  - Mock, Charles N.
A1  - Ibrahim, Norlinah Mohamed
A1  - Mohammad, Karzan A.
A1  - Mokdad, Ali H.
A1  - Mola, Glen L. D.
A1  - Monasta, Lorenzo
A1  - Hernandez, Julio C. Montañez
A1  - Montico, Marcella
A1  - Montine, Thomas J.
A1  - Mooney, Meghan D.
A1  - Moore, Ami R.
A1  - Moradi-Lakeh, Maziar
A1  - Moran, Andrew E.
A1  - Mori, Rintaro
A1  - Moschandreas, Joanna
A1  - Moturi, Wilkister N.
A1  - Moyer, Madeline L.
A1  - Mozaffarian, Dariush
A1  - Msemburi, William T.
A1  - Mueller, Ulrich O.
A1  - Mukaigawara, Mitsuru
A1  - Mullany, Erin C.
A1  - Murdoch, Michele E.
A1  - Murray, Joseph
A1  - Murthy, Kinnari S.
A1  - Naghavi, Mohsen
A1  - Naheed, Aliya
A1  - Naidoo, Kovin S.
A1  - Naldi, Luigi
A1  - Nand, Devina
A1  - Nangia, Vinay
A1  - Narayan, K. M. Venkat
A1  - Nejjari, Chakib
A1  - Neupane, Sudan P.
A1  - Newton, Charles R.
A1  - Ng, Marie
A1  - Ngalesoni, Frida N.
A1  - Nguyen, Grant
A1  - Nisar, Muhammad I.
A1  - Nolte, Sandra
A1  - Norheim, Ole F.
A1  - Norman, Rosana E.
A1  - Norrving, Bo
A1  - Nyakarahuka, Luke
A1  - Oh, In-Hwan
A1  - Ohkubo, Takayoshi
A1  - Ohno, Summer L.
A1  - Olusanya, Bolajoko O.
A1  - Opio, John Nelson
A1  - Ortblad, Katrina
A1  - Ortiz, Alberto
A1  - Pain, Amanda W.
A1  - Pandian, Jeyaraj D.
A1  - Panelo, Carlo Irwin A.
A1  - Papachristou, Christina
A1  - Park, Eun-Kee
A1  - Park, Jae-Hyun
A1  - Patten, Scott B.
A1  - Patton, George C.
A1  - Paul, Vinod K.
A1  - Pavlin, Boris I.
A1  - Pearce, Neil
A1  - Pereira, David M.
A1  - Perez-Padilla, Rogelio
A1  - Perez-Ruiz, Fernando
A1  - Perico, Norberto
A1  - Pervaiz, Aslam
A1  - Pesudovs, Konrad
A1  - Peterson, Carrie B.
A1  - Petzold, Max
A1  - Phillips, Michael R.
A1  - Phillips, Bryan K.
A1  - Phillips, David E.
A1  - Piel, Frédéric B.
A1  - Plass, Dietrich
A1  - Poenaru, Dan
A1  - Polinder, Suzanne
A1  - Pope, Daniel
A1  - Popova, Svetlana
A1  - Poulton, Richie G.
A1  - Pourmalek, Farshad
A1  - Prabhakaran, Dorairaj
A1  - Prasad, Noela M.
A1  - Pullan, Rachel L.
A1  - Qato, Dima M.
A1  - Quistberg, Duane Alexander
A1  - Rafay, Anwar
A1  - Rahimi, Kazem
A1  - Rahman, Sajjad U.
A1  - Raju, Murugesan
A1  - Rana, Saleem M.
A1  - Razavi, Homie
A1  - Reddy, K. Srinath
A1  - Refaat, Amany
A1  - Remuzzi, Giuseppe
A1  - Resnikoff, Serge
A1  - Ribeiro, Antonio L.
A1  - Richardson, Lee
A1  - Richardus, Jan Hendrik
A1  - Roberts, D. Allen
A1  - Rojas-Rueda, David
A1  - Ronfani, Luca
A1  - Roth, Gregory A.
A1  - Rothenbacher, Dietrich
A1  - Rothstein, David H.
A1  - Rowley, Jane T.
A1  - Roy, Nobhojit
A1  - Ruhago, George M.
A1  - Saeedi, Mohammad Y.
A1  - Saha, Sukanta
A1  - Sahraian, Mohammad Ali
A1  - Sampson, Uchechukwu K. A.
A1  - Sanabria, Juan R.
A1  - Sandar, Logan
A1  - Santos, Itamar S.
A1  - Satpathy, Maheswar
A1  - Sawhney, Monika
A1  - Scarborough, Peter
A1  - Schneider, Ione J.
A1  - Schöttker, Ben
A1  - Schumacher, Austin E.
A1  - Schwebel, David C.
A1  - Scott, James G.
A1  - Seedat, Soraya
A1  - Sepanlou, Sadaf G.
A1  - Serina, Peter T.
A1  - Servan-Mori, Edson E.
A1  - Shackelford, Katya A.
A1  - Shaheen, Amira
A1  - Shahraz, Saeid
A1  - Levy, Teresa Shamah
A1  - Shangguan, Siyi
A1  - She, Jun
A1  - Sheikhbahaei, Sara
A1  - Shi, Peilin
A1  - Shibuya, Kenji
A1  - Shinohara, Yukito
A1  - Shiri, Rahman
A1  - Shishani, Kawkab
A1  - Shiue, Ivy
A1  - Shrime, Mark G.
A1  - Sigfúsdóttir, Inga D.
A1  - Silberberg, Donald H.
A1  - Simard, Edgar P.
A1  - Sindi, Shireen
A1  - Singh, Abhishek
A1  - Singh, Jasvinder A.
A1  - Singh, Lavanya
A1  - Skirbekk, Vegard
A1  - Slepak, Erica Leigh
A1  - Sliwa, Karen
A1  - Soneji, Samir
A1  - Søreide, Kjetil
A1  - Soshnikov, Sergey
A1  - Sposato, Luciano A.
A1  - Sreeramareddy, Chandrashekhar T.
A1  - Stanaway, Jeffrey D.
A1  - Stathopoulou, Vasiliki
A1  - Stein, Dan J.
A1  - Stein, Murray B.
A1  - Steiner, Caitlyn
A1  - Steiner, Timothy J.
A1  - Stevens, Antony
A1  - Stewart, Andrea
A1  - Stovner, Lars J.
A1  - Stroumpoulis, Konstantinos
A1  - Sunguya, Bruno F.
A1  - Swaminathan, Soumya
A1  - Swaroop, Mamta
A1  - Sykes, Bryan L.
A1  - Tabb, Karen M.
A1  - Takahashi, Ken
A1  - Tandon, Nikhil
A1  - Tanne, David
A1  - Tanner, Marcel
A1  - Tavakkoli, Mohammad
A1  - Taylor, Hugh R.
A1  - Ao, Braden J. Te
A1  - Tediosi, Fabrizio
A1  - Temesgen, Awoke M.
A1  - Templin, Tara
A1  - ten Have, Margreet
A1  - Tenkorang, Eric Y.
A1  - Terkawi, Abdullah S.
A1  - Thomson, Blake
A1  - Thorne-Lyman, Andrew L.
A1  - Thrift, Amanda G.
A1  - Thurston, George D.
A1  - Tillmann, Taavi
A1  - Tonelli, Marcello
A1  - Topouzis, Fotis
A1  - Toyoshima, Hideaki
A1  - Traebert, Jefferson
A1  - Tran, Bach X.
A1  - Trillini, Matias
A1  - Truelsen, Thomas
A1  - Tsilimbaris, Miltiadis
A1  - Tuzcu, Emin M.
A1  - Uchendu, Uche S.
A1  - Ukwaja, Kingsley N.
A1  - Undurraga, Eduardo A.
A1  - Uzun, Selen B.
A1  - Van Brakel, Wim H.
A1  - Van De Vijver, Steven
A1  - van Gool, Coen H.
A1  - van Os, Jim
A1  - Vasankari, Tommi J.
A1  - Venketasubramanian, N.
A1  - Violante, Francesco S.
A1  - Vlassov, Vasiliy V.
A1  - Vollset, Stein Emil
A1  - Wagner, Gregory R.
A1  - Wagner, Joseph
A1  - Waller, Stephen G.
A1  - Wan, Xia
A1  - Wang, Haidong
A1  - Wang, Jianli
A1  - Wang, Linhong
A1  - Warouw, Tati S.
A1  - Weichenthal, Scott
A1  - Weiderpass, Elisabete
A1  - Weintraub, Robert G.
A1  - Wenzhi, Wang
A1  - Werdecker, Andrea
A1  - Westerman, Ronny
A1  - Whiteford, Harvey A.
A1  - Wilkinson, James D.
A1  - Williams, Thomas N.
A1  - Wolfe, Charles D.
A1  - Wolock, Timothy M.
A1  - Woolf, Anthony D.
A1  - Wulf, Sarah
A1  - Wurtz, Brittany
A1  - Xu, Gelin
A1  - Yan, Lijing L.
A1  - Yano, Yuichiro
A1  - Ye, Pengpeng
A1  - Yentür, Gökalp K.
A1  - Yip, Paul
A1  - Yonemoto, Naohiro
A1  - Yoon, Seok-Jun
A1  - Younis, Mustafa Z.
A1  - Yu, Chuanhua
A1  - Zaki, Maysaa E.
A1  - Zhao, Yong
A1  - Zheng, Yingfeng
A1  - Zonies, David
A1  - Zou, Xiaonong
A1  - Salomon, Joshua A.
A1  - Lopez, Alan D.
A1  - Vos, Theo
SP  - 2145
EP  - 2191
VL  - 386
IS  - 10009
N2  - BACKGROUND: The Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age-sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development. <br><br>METHODS: We used the published GBD 2013 data for age-specific mortality, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) to calculate DALYs and HALE for 1990, 1995, 2000, 2005, 2010, and 2013 for 188 countries. We calculated HALE using the Sullivan method; 95% uncertainty intervals (UIs) represent uncertainty in age-specific death rates and YLDs per person for each country, age, sex, and year. We estimated DALYs for 306 causes for each country as the sum of YLLs and YLDs; 95% UIs represent uncertainty in YLL and YLD rates. We quantified patterns of the epidemiological transition with a composite indicator of sociodemographic status, which we constructed from income per person, average years of schooling after age 15 years, and the total fertility rate and mean age of the population. We applied hierarchical regression to DALY rates by cause across countries to decompose variance related to the sociodemographic status variable, country, and time. <br><br>FINDINGS: Worldwide, from 1990 to 2013, life expectancy at birth rose by 6·2 years (95% UI 5·6-6·6), from 65·3 years (65·0-65·6) in 1990 to 71·5 years (71·0-71·9) in 2013, HALE at birth rose by 5·4 years (4·9-5·8), from 56·9 years (54·5-59·1) to 62·3 years (59·7-64·8), total DALYs fell by 3·6% (0·3-7·4), and age-standardised DALY rates per 100 000 people fell by 26·7% (24·6-29·1). For communicable, maternal, neonatal, and nutritional disorders, global DALY numbers, crude rates, and age-standardised rates have all declined between 1990 and 2013, whereas for non-communicable diseases, global DALYs have been increasing, DALY rates have remained nearly constant, and age-standardised DALY rates declined during the same period. From 2005 to 2013, the number of DALYs increased for most specific non-communicable diseases, including cardiovascular diseases and neoplasms, in addition to dengue, food-borne trematodes, and leishmaniasis; DALYs decreased for nearly all other causes. By 2013, the five leading causes of DALYs were ischaemic heart disease, lower respiratory infections, cerebrovascular disease, low back and neck pain, and road injuries. Sociodemographic status explained more than 50% of the variance between countries and over time for diarrhoea, lower respiratory infections, and other common infectious diseases; maternal disorders; neonatal disorders; nutritional deficiencies; other communicable, maternal, neonatal, and nutritional diseases; musculoskeletal disorders; and other non-communicable diseases. However, sociodemographic status explained less than 10% of the variance in DALY rates for cardiovascular diseases; chronic respiratory diseases; cirrhosis; diabetes, urogenital, blood, and endocrine diseases; unintentional injuries; and self-harm and interpersonal violence. Predictably, increased sociodemographic status was associated with a shift in burden from YLLs to YLDs, driven by declines in YLLs and increases in YLDs from musculoskeletal disorders, neurological disorders, and mental and substance use disorders. In most country-specific estimates, the increase in life expectancy was greater than that in HALE. Leading causes of DALYs are highly variable across countries. <br><br>INTERPRETATION: Global health is improving. Population growth and ageing have driven up numbers of DALYs, but crude rates have remained relatively constant, showing that progress in health does not mean fewer demands on health systems. The notion of an epidemiological transition-in which increasing sociodemographic status brings structured change in disease burden-is useful, but there is tremendous variation in burden of disease that is not associated with sociodemographic status. This further underscores the need for country-specific assessments of DALYs and HALE to appropriately inform health policy decisions and attendant actions. FUNDING: Bill & Melinda Gates Foundation.<p />  <p>Language: en</p>
LA  - en
SN  - 0140-6736
UR  - http://dx.doi.org/10.1016/S0140-6736(15)61340-X
ID  - ref1
ER  -