The increasing significance of disease severity in a burden of disease framework

Grant M.A. Wyper*, Ricardo Assuncao, Eilidh Fletcher, Michelle Gourley, Ian Grant, Juanita A. Haagsma, Henk Hilderink, Jane Idavain, Tina Lesnik, Elena von der Lippe, Marek Majdan, Gerry Mccartney, Milena Santric-Milicevic, Elena Pallari, Sara Monteiro Pires, Dietrich Plass, Michael Porst, João V. Santos, Maria Teresa de Haro Moro, Diane L. StocktonBrecht Devleesschauwer

*Corresponding author for this work

Research output: Contribution to journalComment/debateResearchpeer-review

Abstract

Recent estimates have reiterated that non-fatal causes of disease, such as low back pain, headaches and depressive disorders, are amongst the leading causes of disability-adjusted life years (DALYs). For these causes, the contribution of years lived with disability (YLD) – put simply, ill-health – is what drives DALYs, not mortality. Being able to monitor trends in YLD closely is particularly relevant for countries that sit high on the socio-demographic spectrum of development, as it contributes more than half of all DALYs. There is a paucity of data on how the population-level occurrence of disease is distributed according to severity, and as such, the majority of global and national efforts in monitoring YLD lack the ability to differentiate changes in severity across time and location. This raises uncertainties in interpreting these findings without triangulation with other relevant data sources. Our commentary aims to bring this issue to the forefront for users of burden of disease estimates, as its impact is often easily overlooked as part of the fundamental process of generating DALY estimates. Moreover, the wider health harms of the COVID-19 pandemic have underlined the likelihood of latent and delayed demand in accessing vital health and care services that will ultimately lead to exacerbated disease severity and health outcomes. This places increased importance on attempts to be able to differentiate by both the occurrence and severity of disease.

Original languageEnglish
JournalScandinavian Journal of Public Health
Number of pages5
ISSN1403-4948
DOIs
Publication statusAccepted/In press - 2022

Keywords

  • Burden of disease
  • DALY
  • disability-adjusted life year
  • disease severity
  • European burden of disease network
  • Scottish burden of disease
  • severity distribution
  • years lived with disability
  • YLD

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