Háskólinn í ReykjavíkReykjavik UniversityHay, Simon IAbajobir, Amanuel AlemuAbate, Kalkidan HassenAbbafati, CristianaAbbas, Kaja MAbd-Allah, FoadAbdulkader, Rizwan SuliankatchiAbdulle, Abdishakur MAbebo, Teshome AbukaAbera, Semaw FeredeAboyans, VictorAbu-Raddad, Laith JAckerman, Ilana NAdedeji, Isaac AAdetokunboh, OlatunjiAfshin, AshkanAggarwal, RakeshAgrawal, SutapaAgrawal, AnuragAhmed, Muktar BeshirAichour, Miloud Taki EddineAichour, Amani NidhalAichour, IbtihelAiyar, SnehaAkinyemiju, Tomi FAkseer, NadiaAl Lami, Faris HasanAlahdab, FaresAl-Aly, ZiyadAlam, KhurshidAlam, NooreAlam, TahiyaAlasfoor, DeenaAlene, Kefyalew AddisAli, RaghibAlizadeh-Navaei, RezaAlkaabi, Juma MAlkerwi, Ala'aAlla, FrançoisAllebeck, PeterAllen, ChristineAl-Maskari, FatmaAlMazroa, Mohammad AbdulAzizAl-Raddadi, RajaaAlsharif, UbaiAlsowaidi, ShirinaAlthouse, Benjamin MAltirkawi, Khalid AAlvis-Guzman, NelsonAmare, Azmeraw TAmini, ErfanAmmar, WalidAmoako, Yaw AmpemAnsha, Mustafa GeletoAntonio, Carl Abelardo TAnwari, PalwashaÄrnlöv, JohanArora, MeghaArtaman, AlAryal, Krishna KumarAsgedom, Solomon WAtey, Tesfay MehariAtnafu, Niguse TadeleAvila-Burgos, LeticiaAvokpaho, Euripide Frinel G ArthurAwasthi, AshishAwasthi, ShallyAzarpazhooh, Mahmoud RezaAzzopardi, PeterBabalola, Tesleem KayodeBacha, UmarBadawi, AlaaBalakrishnan, KalpanaBannick, Marlena SBarac, AleksandraBarker-Collo, Suzanne LBärnighausen, TillBarquera, SimonBarrero, Lope HBasu, SanjayBattista, RobertBattle, Katherine EBaune, Bernhard TBazargan-Hejazi, ShahrzadBeardsley, JustinBedi, NeerajBéjot, YannickBekele, Bayu BegashawBell, Michelle LBennett, Derrick ABennett, James RBensenor, Isabela MBenson, JenniferBerhane, AdugnawBerhe, Derbew FikaduBernabé, EduardoBetsu, Balem DemtsuBeuran, MirceaBeyene, Addisu ShunuBhansali, AnilBhatt, SamirBhutta, Zulfiqar ABiadgilign, SibhatuBicer, Burcu KucukBienhoff, KellyBikbov, BorisBirungi, CharlesBiryukov, StanBisanzio, DonalBizuayehu, Habtamu MellieBlyth, Fiona MBoneya, Dube JaraBose, DipanBou-Orm, Ibrahim RBourne, Rupert R ABrainin, MichaelBrayne, CarolBrazinova, AlexandraBreitborde, Nicholas J KBriant, Paul SBritton, GabrielleBrugha, Traolach SBuchbinder, RachelleBulto, Lemma Negesa BultoBumgarner, Blair RButt, Zahid ACahuana-Hurtado, LuceroCameron, EwanCampos-Nonato, Ismael RicardoCarabin, HélèneCárdenas, RosarioCarpenter, David OCarrero, Juan JesusCarter, AustinCarvalho, FelixCasey, DanielCastañeda-Orjuela, Carlos ACastle, Chris DCatalá-López, FerránChang, Jung-ChenCharlson, Fiona JChaturvedi, PankajChen, HongleiChibalabala, MirriamChibueze, Chioma EzinneChisumpa, Vesper HichilombweChitheer, Abdulaal AChowdhury, RajivChristopher, Devasahayam JesudasCiobanu, Liliana GCirillo, MassimoColombara, DannyCooper, Leslie TrumbullCooper, CyrusCortesi, Paolo AngeloCortinovis, MonicaCriqui, Michael HCromwell, Elizabeth ACross, MaritaCrump, John ADadi, Abel FekaduDalal, KoustuvDamasceno, AlbertinoDandona, LalitDandona, Rakhidas Neves, JoséDavitoiu, Dragos VDavletov, Kairatde Courten, 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JacobStrub, BryanSubart, MichelleSufiyan, Muawiyyah BabaleSunguya, Bruno FSur, Patrick JSwaminathan, SoumyaSykes, Bryan LSylte, DillonSzoeke, Cassandra E ITabarés-Seisdedos, RafaelTadakamadla, Santosh KumarTaffere, Getachew RedaeTakala, Jukka STandon, NikhilTanne, DavidTarekegn, Yihunie LTavakkoli, MohammadTaveira, NunoTaylor, Hugh RTegegne, Teketo KassawTehrani-Banihashemi, ArashTekelab, TesfalidetTerkawi, Abdullah SuliemanTesfaye, Dawit JemberTesssema, BelayThakur, JSThamsuwan, OrnwipaTheadom, Alice MTheis, Andrew MThomas, Katie EThomas, NihalThompson, RobertThrift, Amanda GTobe-Gai, RuoyanTobollik, MyriamTonelli, MarcelloTopor-Madry, RomanTortajada, MiguelTouvier, MathildeTraebert, JeffersonTran, Bach XuanTroeger, ChristopherTruelsen, ThomasTsoi, DerrickTuzcu, Emin MuratTymeson, HayleyTyrovolas, StefanosUkwaja, Kingsley NnannaUndurraga, Eduardo AUneke, Chigozie JesseUpdike, RachelUthman, Olalekan AUzochukwu, Benjamin S Chudivan Boven, Job F MVarughese, SantoshVasankari, TommiVeerman, Lennert JVenkatesh, SVenketasubramanian, NarayanaswamyVidavalur, RameshVijayakumar, LakshmiViolante, Francesco SVishnu, AbhishekVladimirov, Sergey KVlassov, Vasiliy VictorovichVollset, Stein EmilVos, TheoWadilo, FisehaWakayo, TolassaWallin, Mitchell TWang, Yuan-PangWeichenthal, ScottWeiderpass, ElisabeteWeintraub, Robert GWeiss, Daniel JWerdecker, AndreaWesterman, RonnyWhiteford, Harvey AWijeratne, TissaWilliams, Hywel CWiysonge, Charles SheyWoldeyes, Belete GetahunWolfe, Charles D AWoodbrook, RachelWoolf, Anthony DWorkicho, AbdulhalikXavier, DenisXu, GelinYadgir, SimonYaghoubi, MohsenYakob, BereketYan, Lijing LYano, YuichiroYe, PengpengYihdego, Mahari GideyYimam, Hassen HamidYip, PaulYonemoto, NaohiroYoon, Seok-JunYotebieng, MarcelYounis, Mustafa ZYu, ChuanhuaZaidi, ZoubidaZaki, Maysaa El SayedZegeye, Elias AsfawZenebe, Zerihun MenlkalewZhang, XueyingZheng, YingfengZhou, MaigengZipkin, BenZodpey, SanjayZoeckler, LeoZuhlke, Liesl JoannaMurray, Christopher J L2020-02-172020-02-172017-09-16Hay, S. I., Abajobir, A. A., Abate, K. H., Abbafati, C., Abbas, K. M., Abd-Allah, F., Abdulle, A. M., Abebo, T. A., Abera, S. F., Aboyans, V., Abu-Raddad, L. J., Ackerman, I. N., Adedeji, I. A., Adetokunboh, O., Afshin, A., Aggarwal, R., Agrawal, S., Agrawal, A., Kiadaliri, A. A., … Murray, C. J. L. (2017). Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet, 390(10100), 1260–1344. https://doi.org/10.1016/S0140-6736(17)32130-X0140-67361474-547X (eISSN)https://hdl.handle.net/20.500.11815/1539Correction in: LANCET Volume: 390 Issue: 10106 Pages: E38-E38 Published: OCT 28 2017Background Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. Findings The highest globally observed HALE at birth for both women and men was in Singapore, at 75.2 years (95% uncertainty interval 71.9-78.6) for females and 72.0 years (68.8-75.1) for males. The lowest for females was in the Central African Republic (45.6 years [42.0-49.5]) and for males was in Lesotho (41.5 years [39.0-44.0]). From 1990 to 2016, global HALE increased by an average of 6.24 years (5.97-6.48) for both sexes combined. Global HALE increased by 6.04 years (5.74-6.27) for males and 6.49 years (6.08-6.77) for females, whereas HALE at age 65 years increased by 1.78 years (1.61-1.93) for males and 1.96 years (1.69-2.13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2.3% [-5.9 to 0.9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16.1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. Interpretation At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support.1260-1344eninfo:eu-repo/semantics/openAccessWorld health/statisticsHealth policyEpidemiologySocial ecologyPeople with disabilitiesMenWomenAdultsOlder peopleDiseasesWounds and injuriesQuality of lifeLife expectancyMortalityHeilsufarTölfræðiLýðheilsaHeilbrigðisstefnaFaraldsfræðiFélagshagfræðiÞjóðirFatlaðirKonurKarlarFullorðnirAldraðirSjúkdómarÁverkarLífsgæðiLífslíkurDánarmeinSálfræðiPsychologyGlobal Burden of DiseaseGlobal, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016info:eu-repo/semantics/article10.1016/S0140-6736(17)32130-X