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. 2024 Feb 29:39:100848.
doi: 10.1016/j.lanepe.2024.100848. eCollection 2024 Apr.

The health state of France before COVID-19 pandemic between 1990 and 2019: an analysis of the Global Burden of Disease study 2019

Florence Francis-Oliviero  1   2   3 , Panayotis Constantinou  4 , Romana Haneef  5 ; French GBD Collaborators; Michaël Schwarzinger  2   6 , Anne Gallay  5 , Antoine Rachas  4 , François Alla  2   3   6
Collaborators, Affiliations

The health state of France before COVID-19 pandemic between 1990 and 2019: an analysis of the Global Burden of Disease study 2019

Florence Francis-Oliviero et al. Lancet Reg Health Eur. .

Abstract

Background: France faces nowadays some major challenges regarding its health care system including medically underserved areas, social health inequalities, and hospital pressures. Various indicators and sources of data allow us to describe the health status of a population and, consequently, to assess the impact of these challenges. We assessed the burden of diseases before COVID-19 in France in 2019 and its evolution from 1990 to 2019, and compared it with Western European countries.

Methods: We used specific Global Burden of Diseases (GBD) metrics: socio-demographic index (SDI), life expectancy (LE), healthy life expectancy (HALE), years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) with their 95% uncertainty interval (95% UI). We compared French age-standardized metrics to those for other Western European Countries for both sexes and also between 1990 and 2019. We also described the specific causes of these different metrics.

Findings: We observed for life expectancy at birth in France a trend to an improvement over time from 77.2 (95% UI: 77.2-77.3) years in 1990 to 82.9 (82.7-83.1) in 2019, which represented the seventh highest life expectancy among 23 Western European countries. HALE at birth in France increased from 67.0 (64.0-69.7) to 71.5 (68.1-74.5), which represented the fourth highest HALE among 23 Western European countries. In France, the total number of DALY per 100.000 population tended to decrease from 25,192 (22,374-28,351) in 1990 to 18,782 (16,408-21,920) in 2019. As compared to other European countries, the burden due to cardiovascular diseases was lower. Neoplasms and cardio-vascular diseases were the two leading causes of YLLs. Mental and musculoskeletal disorders were the two leading causes of YLDs.

Interpretation: Overall, these results highlight a clear trend of improvement in the health status in France with certain differences between western European countries. The health policy makers need to devise interventional strategies to reduce the burden of diseases and injuries, with specific attention to causes such as cancers, cardiovascular diseases, mental health and musculoskeletal disorders.

Funding: Bill & Melinda Gates Foundation.

Keywords: France; Western Europe; “Global Burden of disease” evolution.

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Conflict of interest statement

M Béjot reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from BMS, Pfizer, Medtronic, Amgen, NovoNordisk, and Servier and support for attending meetings and/or travel from Medtronic, all payments made to them, and an unpaid leadership or fiduciary role for the French Neurovascular Society, all outside the submitted work. M Pigeolet reports grants or contracts from Belgian Kids’ Fund for Pediatric Research, outside the submitted work. M Raad is the founder and an employee of Smartbiotic and reports consulting fees from Fondation Mérieux, all outside the submitted work. D-J Zeitoun reports consulting fees from Boehringer Ingelheim and IQVIA and stock or stock options from Allurion, all outside the submitted work.

Figures

Fig. 1
Fig. 1
A: 20 leading Level-3 causes of YLLs in France, with percent change, both sexes 1990–2019. B: 20 leading Level-3 causes of YLLs in Western Europe, with percent change, both sexes 1990–2019.
Fig. 2
Fig. 2
A: 20 leading Level-3 causes of YLDs in France, with percent change, both sexes 1990–2019. B: 20 leading Level-3 causes of YLDs in Western Europe, with percent change, both sexes 1990–2019.
Fig. 3
Fig. 3
A: 20 leading Level-3 causes of DALYs in France, with percent change, both sexes 1990–2019. B: 20 leading Level-3 causes of DALYs in Western Europe, with percent change, both sexes 1990–2019.
See this image and copyright information in PMC

References

    1. Vos T., Lim S.S., Abbafati C., et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396:1204–1222. - PMC - PubMed
    1. Nay O., Béjean S., Benamouzig D., Bergeron H., Castel P., Ventelou B. Achieving universal health coverage in France: policy reforms and the challenge of inequalities. Lancet. 2016;387:2236–2249. - PubMed
    1. Atlani-Duault L., Dozon J.-P., Wilson A., Delfraissy J.-F., Moatti J.-P. State humanitarian verticalism versus universal health coverage: a century of French international health assistance revisited. Lancet. 2016;387:2250–2262. - PubMed
    1. OECD . Organisation for Economic Co-operation and Development; Paris: 2020. Health at a glance: Europe 2020: state of health in the EU cycle.https://www.oecd-ilibrary.org/social-issues-migration-health/health-at-a...
    1. Chevreul K., Berg Brigham K., Durand-Zaleski I., Hernandez-Quevedo C. France: health system review. Health Syst Transit. 2015;17:1–218. xvii. - PubMed