Quantifying the burden of disease due to premature mortality in Hong Kong using standard expected years of life lost

BMC Public Health

Alexander Kraemer²  Chit Ming Wong³  Poh Chin Lai¹  Heiko J Jahn²  Thuan Quoc Thach³  Patsy Yuen Kwan Chau³  Dietrich Plass² 

[1] Department of Geography, The University of Hong Kong, Hong Kong SAR, China;Department of Public Health Medicine, School of Public Health, Bielefeld University, Bielefeld, Germany;School of Public Health, The University of Hong Kong, Hong Kong SAR, China

关键词: SEYLL;    Standard expected years of life lost;    Hong Kong;    Burden of disease;   

Others  :  1161760
DOI  :  10.1186/1471-2458-13-863

 received in 2013-02-05, accepted in 2013-09-16,  发布年份 2013

【 摘 要 】

Background

To complement available information on mortality in a population Standard Expected Years of Life Lost (SEYLL), an indicator of premature mortality, is increasingly used to calculate the mortality-associated disease burden. SEYLL consider the age at death and therefore allow a more accurate view on mortality patterns as compared to routinely used measures (e.g. death counts). This study provides a comprehensive assessment of disease and injury SEYLL for Hong Kong in 2010.

Methods

To estimate the SEYLL, life-expectancy at birth was set according to the 2004 Global Burden of Disease study at 82.5 and 80 years for females and males, respectively. Cause of death data for 2010 were corrected for misclassification of cardiovascular and cancer causes. In addition to the baseline estimates, scenario analyses were performed using alternative assumptions on life-expectancy (Hong Kong standard life-expectancy), time-discounting and age-weighting. To estimate a trend of premature mortality a time-series analysis from 2001 to 2010 was conducted.

Results

In 2010 524,706.5 years were lost due to premature death in Hong Kong with 58.3% of the SEYLL attributable to male deaths. The three overall leading single causes of SEYLL were “trachea, bronchus and lung cancers”, “ischaemic heart disease” and “lower respiratory infections” together accounting for about 29% of the overall SEYLL. Further, self-inflicted injuries (5.6%; ranked 5) and liver cancer (4.9%; ranked 7) were identified as important causes not adequately captured by classical mortality measures. Scenario analyses highlighted that by using a 3% time-discount rate and non-uniform age-weights the SEYLL dropped by 51.6%. Using Hong Kong’s standard life-expectancy values resulted in an overall increase of SEYLL by 10.8% as compared to the baseline SEYLL. Time-series analysis indicates an overall increase of SEYLL by 6.4%. In particular, group I (communicable, maternal, perinatal and nutritional) conditions showed highest increases with SEYLL-rates per 100,000 in 2010 being 1.4 times higher than 2001.

Conclusions

The study stresses the mortality impact of diseases and injuries that occur in earlier stages of life and thus presents the SEYLL measure as a more sensitive indicator compared to classical mortality indicators. SEYLL provide useful additional information and supplement available death statistics.

【 授权许可】

   
2013 Plass et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

Figure 6.

【 参考文献 】

• [1]Horton R: The global financial crisis: an acute threat to health. Lancet 2009, 373:355-356.
• [2]Marmot MG, Bell R: How will the financial crisis affect health? BMJ 2009, 338:858-860.
• [3]Chuang Y-C, Chuang K-Y, Chen Y-R, Shi B-W, Yang T-H: Welfare state regimes, infant mortality and life expectancy: integrating evidence from east Asia. JECH 2012, 66:e23.
• [4]Cheung KS, Yip PS: Trends in healthy life expectancy in Hong Kong SAR 1996–2008. Eur J Ageing 2010, 7:257-269.
• [5]Penner D, Pinheiro P, Krämer A: Measuring the burden of disease due to premature mortality using standard expected years of life lost (SEYLL) in North Rhine-Westphalia, a federal state of Germany, in 2005. JPH 2010, 18:319-325.
• [6]Marshall RJ: Standard expected years of life lost as a measure of mortality: norms and reference to New Zealand data. Aust N Z J Public Health 2004, 28:452-457.
• [7]Genova-Maleras R, Catala-Lopez F, de Larrea-Baz N, Alvarez-Martin E, Morant-Ginestar C: The burden of premature mortality in Spain using standard expected years of life lost: a population-based study. BMC Public Health 2011, 11:787. BioMed Central Full Text
• [8]Michaud C, McKenna M, Begg S, Tomijima N, Majmudar M, Bulzacchelli M, Ebrahim S, Ezzati M, Salomon J, Gaber Kreiser J, et al.: The burden of disease and injury in the United States 1996. Popul Health Metr 2006, 4:11. BioMed Central Full Text
• [9]Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL: Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 2006, 367:1747-1757.
• [10]Dodhia H, Phillips K: Measuring burden of disease in two inner London boroughs using disability adjusted life years. J Public Health 2008, 30(3):313-321. fdn015
• [11]Zhou SC, Cai L, Wang J, Cui SG, Chai Y, Liu B, Wan CH: Measuring the burden of disease using disability-adjusted life years in Shilin county of Yunnan province, China. Environ Health Prev Med 2011, 16:148-154.
• [12]WHO: The global burden of disease: 2004 update. Geneva: World Health Organization; 2008.
• [13]Field MJ, Gold MR: Summarizing population health directions for the development and application of population metrics. Washington: National Academy Press; 1998:85. [Summarizing population health directions for the development and application of population metrics]
• [14]Murray CJL, Lopez AD, World Health Organization, World Bank, Harvard School of Public Health: The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020: summary. Geneva: World Health Organization; 1996.
• [15]Murray CJL: Quantifying the burden of disease: the technical basis for disability-adjusted life years. Bull World Health Organ 1994, 72:429-445.
• [16]Boerma JT, Stansfield SK: Health statistics now: are we making the right investments? Lancet 2007, 369:779-786.
• [17]Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB: Years of life lost due to obesity. JAMA 2003, 289:187-193.
• [18]Mariotti S, D’Errigo P, Mastroeni S, Freeman K: Years of life lost due to premature mortality in Italy. Eur J Epidemiol 2003, 18:513-521.
• [19]Allard YE, Wilkins R, Berthelot JM: Premature mortality in health regions with high aboriginal populations. Health Rep 2004, 15:51-60.
• [20]Burnet NG, Jefferies SJ, Benson RJ, Hunt DP, Treasure FP: Years of life lost (YLL) from cancer is an important measure of population burden and should be considered when allocating research funds. Br J Cancer 2005, 92:241-245.
• [21]Vlajinac H, Marinkovic J, Kocev N, Sipetic S, Bjegovic V, Jankovic S, Stanisavljevic D, Markovic-Denic L, Maksimovic J: Years of life lost due to premature death in Serbia (excluding Kosovo and Metohia). Public Health 2008, 122:277-284.
• [22]Lopez AD: Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 2006, 367:1747.
• [23]Mathers CD, Vos T, Salomon J, Ezzati M: National burden of disease studies: a practical guide. Geneva: World Health Organization; 2001.
• [24]Hong Kong Census and Statistics Department: Hong Kong annual digest of statistics. 2011 edition. Hong Kong: ; 2011. [Hong Kong annual digest of statistics]
• [25]Anand S, Hanson K: DALYs: efficiency versus equity. World Dev 1998, 26:307-310.
• [26]Anand S, Hanson K: Disability-adjusted life years: a critical review. J Health Econ 1997, 16:685-702.
• [27]Arnesen T, Kapiriri L: Can the value choices in DALYs influence global priority-setting? Health Policy 2004, 70:137-149.
• [28]HK SAR Government Department: Hong Kong yearbook 2010. Hong Kong: the Goverment Logistics Department; 2010.
• [29]Hong Kong Census and Statistics Department: Hong Kong SAR: 2001–2010 known death microdata sets. Hong Kong; 2011. [Hong Kong SAR: 2001–2010 known death microdata sets, 21 december 2011 edition]
• [30]Lopez AD, Disease Control Priorities Project: Global burden of disease and risk factors. New York, NY, Washington, DC: Oxford University Press, World Bank; 2006.
• [31]Lozano R, Murray CJL, Lopez AD, Satoh T, World Health Organization: Miscoding and misclassification of ischaemic heart disease mortality. Geneva: World Health Organization; 2001.
• [32]Au JSK, Mang OWK, Foo W, Law SCK: Time trends of lung cancer incidence by histologic types and smoking prevalence in Hong Kong 1983–2000. Lung Cancer 2004, 45:143-152.
• [33]HK SAR Census and Statistics Department: Thematic houshold survey report No. 48. Hong Kong: Social Surveys Section Census and Statistics Department; 2011. [Thematic houshold survey report No. 48]
• [34]Smoking (public health) ordinance. http://www.legislation.gov.hk/blis_pdf.nsf/6799165D2FEE3FA94825755E0033E532/FC20BFF93D75ADCC482575EE00764F46/$FILE/CAP_371_e_b5.pdf webcite
• [35]Shah A: The relationship between suicide rates and age: an analysis of multinational data from the world health organization. Int Psychogeriatr 2007, 19:1141-1152.
• [36]Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, et al.: Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet 2012, 380:2197-2223.
• [37]OECD: Health at a glance 2011: OECD indicators. OECD Publishing; 2011. http://dx.doi.org/10.1787/health_glance-2011-en webcite
• [38]Werber D, Hille K, Frank C, Dehnert M, Altmann D, Muller-Nordhorn J, Koch J, Stark K: Years of potential life lost for six major enteric pathogens, Germany, 2004–2008. Epidemiol Infect 2012, 141:1-8.
• [39]Murray CJL, Mathers CD, Salomon JA, Lopez AD: Health gaps: an overview and critical appraisal. In Summary measures of population health - concepts, ethics, measurement and applications. Edited by Murray CJL, Salomon JA, Mathers CD, Lopez AD. Geneva: World Health Orgnaization; 2002:233-244.