Disability-adjusted Life Years for 313 Diseases and Injuries: the 2012 Korean Burden of Disease Study

Abstract

This study is part of a 5-year research project on the national burden of diseases, injuries, and risk factors in Korea. Using disability-adjusted life years (DALYs), a metric introduced by the 1990 Global Burden of Disease (GBD) project, we performed a comprehensive and detailed assessment of the magnitude and distribution of both fatal and non-fatal health problems in the Korean population. The concept and general approach were consistent with the original GBD study, with some methodological modifications to make the study more suitable for Korea. We computed DALYs for 313 causes in both sexes and nine age groups using the entire population's medical records and newly generated Korean disability weights. In 2012, the dominant disease burden was non-communicable diseases, which accounted for 85.21% of total DALYs, while injuries accounted for 7.77% and communicable, maternal, neonatal, and nutritional disorders for 7.02%. Of the total DALYs, 88.67% were from years lived with disability and 11.32% were from years of life lost due to premature mortality. Diabetes mellitus was the leading cause of DALYs, followed by low back pain, chronic obstructive pulmonary disease, ischemic heart disease, ischemic stroke, cirrhosis of the liver, falls, osteoarthritis, motorized vehicle with three or more wheels, and self-harm. The results reported here identify key health challenges and opportunities for future health interventions and policy changes, and provide information that will help assess the major public health issues in Korea, a nation faced with one of the world's most rapidly ageing populations.

Keywords: Burden of Disease; Disability-Adjusted Life Year (DALY); Health Policy; Korea; Population Health.

Fig. 1

DALY shares by broad cause groups (A) and YLL & YLD composition of total DALYs by sex and broad cause groups (B), 2012. DALYs, disability-adjusted life years; YLLs, years of life lost due to premature mortality; YLDs, years lived with disability; NCD, non-communicable diseases; CMMN, communicable, maternal, neonatal, and nutritional disorders; INJ, injuries.

Fig. 2

Total disability-adjusted life years (DALYs), by sex and age group, 2012. DALYs per 100,000 population.

Fig. 3

Ten leading broad cause groups of YLLs, YLDs and DALYs, 2012. YLLs*, YLDs*, and DALYs^* per 100,000 population. Sums may not add up to exact total due to rounding. 18 residual categories were excluded in calculation of percentages of YLLs, YLDs, and DALYs. YLLs, years of life lost due to premature mortality; YLDs, years lived with a disability; DALYs, disability-adjusted life years.

Fig. 4

Relationship between the rank of causes of disability-adjusted life years (DALYs) with and without age weighting and discounting, 2012. Rank 1 is the largest cause.

Fig. 5

Top 30 specific causes of disability-adjusted life years (DALYs) by sex with fraction of years of life lost (YLLs) and years lived with disability (YLDs), 2012. DALYs per 100,000 population. Cirrhosis-, cirrhosis of the liver; IHD, ischemic heart disease; COPD, chronic obstructive pulmonary disease; motorized v. 3+, motorized vehicle with three or more wheels; BPH, benign prostatic hyperplasia; c, cancer(s); hemorrhagic-, hemorrhagic and other non-ischemic stroke; gastroesophageal-, gastroesophageal reflux disease; major depressive-, major depressive disorder; hypertensive HD, hypertensive heart disease; gastritis-, gastritis and duodenitis; refraction-, refraction and accommodation disorders; mechanical forces, mechanical forces (other); motorized v. 2+, motorized vehicle with two wheels; Alzheimer's-, Alzheimer's disease and other dementias; tubulointerstitial-, tubulointerstitial nephritis; pyelonephritis, and urinary tract infections, phobic anxiety-, phobic anxiety disorders, et al.