Using Disability-Adjusted Life Years to Assess the Burden of Disease and Injury in Rhode Island
Using Disability-Adjusted Life Years to Assess the Burden of Disease and Injury in Rhode Island
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DOI：
10.1177/003335491212700309
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发表时间：
2012-05-01
影响因子：
3.3
通讯作者：
Hesser, Jana Earl
中科院分区：
文献类型：
--
作者：
Jiang, Yongwen;Hesser, Jana Earl
目标。残疾调整生命年（DALYs）衡量人群的疾病和损伤负担。我们检验了计算DALYs来评估罗德岛州（RI）疾病和损伤负担的可行性。我们使用世界卫生组织、哈佛大学和世界银行开发的方法计算2008年国际扶轮人口的伤残调整生命年。残疾调整生命年是一种综合衡量方法，将因过早死亡而丧失的生命年数与残疾生活年数相加。我们计算了90种RI主要健康状况的粗死亡率、YLLs、YLDs和DALYs，并按性别和年龄进行了分层。年产值和年产值是根据五年平均值计算的。我们将我们的结果与美国和加州洛杉矶县的估计结果进行了比较。伤残调整生命年的排名与基于死亡率的排名对国际扶轮的疾病和伤害负担产生了不同的看法。在为RI评估的90种主要健康状况中，死亡率和伤残调整生命年排名前10位的原因中有6种相同，但排名不同：缺血性心脏病、脑血管疾病、阿尔茨海默氏症和其他痴呆症、气管/支气管/肺癌、慢性阻塞性肺病和糖尿病。这六种情况占死亡人数的59%，但仅占残疾调整生命年的35%。DALYs的原因和等级顺序在男性和女性以及不同年龄组之间存在差异。在人口健康评估中纳入非致命性健康状况提供了与传统的基于死亡率的评估不同的情况。本研究证明了在州一级使用伤残调整生命年评估疾病和伤害负担的可行性和局限性。
Objectives. Disability-adjusted life years (DALYs) measure the burden of disease and injury in a population. We tested the feasibility of calculating DALYs to assess the burden of disease and injury in Rhode Island (RI).Methods. We computed DALYs for the 2008 RI population using methods developed by the World Health Organization, Harvard University, and the World Bank. DALYs are a composite measure that sum years of life lost (YLLs) due to premature mortality with years lived with disability (YLDs). We calculated crude mortality, YLLs, YLDs, and DALYs for 90 major health conditions for RI and stratified them by gender and age. Calculations for YLLs and YLDs were based on five-year averages. We compared our results with U.S. and Los Angeles County, California, estimates.Results. A DALYs ranking produces a different picture of RI's disease and injury burden than does mortality-based ranking. Of 90 major health conditions assessed for RI, six of the top 10 causes for mortality and DALYs were the same, but were ranked differently: ischemic heart disease, cerebrovascular disease, Alzheimer dementia and other dementias, trachea/bronchus/lung cancer, chronic obstructive pulmonary disease, and diabetes mellitus. These six conditions accounted for 59% of deaths but only 35% of DALYs. Causes and rank orders for DALYs differed between males and females and among age groups.Conclusions. Including nonfatal health conditions in an assessment of population health provides a different picture than traditional mortality-based assessments. This study demonstrates the feasibility and constraints of using DALYs to assess the burden of disease and injury at the state level.