Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
Alize J Ferrari(University of Washington), Damian Santomauro(University of Washington), Amirali Aali(University of Washington), Yohannes Abate(University of Washington), Cristiana Abbafati(University of Washington), Hedayat Abbastabar(University of Washington), Samar Abd ElHafeez(University of Washington), Michael Abdelmasseh(University of Washington), Sherief Abd‐Elsalam(University of Washington), Arash Abdollahi(University of Washington), Auwal Abdullahi(University of Washington), Kedir Hussein Abegaz(University of Washington), Roberto Ariel Abeldaño Zúñiga(University of Washington), Richard Gyan Aboagye(University of Washington), Hassan Abolhassani(University of Washington), Lucas Guimarães Abreu(University of Washington), Hasan Abualruz(University of Washington), Eman Abu‐Gharbieh(University of Washington), Niveen ME Abu-Rmeileh(University of Washington), Ilana N. Ackerman(University of Washington), Isaac Yeboah Addo(University of Washington), Giovanni Addolorato(University of Washington), Akindele O. Adebiyi(University of Washington), Victor Abiola Adepoju(University of Washington), Habeeb Omoponle Adewuyi(University of Washington), Shadi Afyouni(University of Washington), Saira Afzal(University of Washington), Sina Afzal(University of Washington), Antonella Agodi(University of Washington), Aqeel Ahmad(University of Washington), Danish Ahmad(University of Washington), Firdos Ahmad(University of Washington), Shahzaib Ahmad(University of Washington), Ali Ahmed(University of Washington), Luai A. Ahmed(University of Washington), Muktar Beshir Ahmed(University of Washington), Marjan Ajami(University of Washington), Karolina Akinosoglou(University of Washington), Mohammed Ahmed Akkaif(University of Washington), Syed Mahfuz Al Hasan(University of Washington), Samer O Alalalmeh(University of Washington), Ziyad Al‐Aly(University of Washington), Mohammed ALBashtawy(University of Washington), Robert W Aldridge(University of Washington), Meseret Desalegn Alemu(University of Washington), Megbaru Alemu(University of Washington), Kefyalew Addis Alene(University of Washington), Adel Al‐Gheethi(University of Washington), Maryam Alharrasi(University of Washington), Robert Kaba Alhassan(University of Washington), Mohammed Usman Ali(University of Washington), Rafat Ali(University of Washington), Syed Shujait Ali(University of Washington), Sheikh Mohammad Alif(University of Washington), Syed Mohamed Aljunid(University of Washington), Sabah Al-Marwani(University of Washington), Joseph Uy Almazan(University of Washington), Mahmoud A. Alomari(University of Washington), Basem Al‐Omari(University of Washington), Zaid Altaany(University of Washington), Nelson Alvis‐Guzmán(University of Washington), Nelson J Alvis-Zakzuk(University of Washington), Hassan Alwafi(University of Washington), Mohammad Al‐Wardat(University of Washington), Yaser Mohammed Al‐Worafi(University of Washington), Safwat Aly(University of Washington), Karem H. Alzoubi(University of Washington), Azmeraw T. Amare(University of Washington), Prince M. Amegbor(University of Washington), Edward Kwabena Ameyaw(University of Washington), Tarek Tawfik Amin(University of Washington), Alireza Amindarolzarbi(University of Washington), Sohrab Amiri(University of Washington), Dickson A Amugsi(University of Washington), Robert Ancuceanu(University of Washington), Deanna Anderlini(University of Washington), David Anderson(University of Washington), Pedro Prata Andrade(University of Washington), Cătălina Liliana Andrei(University of Washington), Hossein Ansari(University of Washington), Catherine M Antony(University of Washington), Saleha Anwar(University of Washington), Sumadi Lukman Anwar(University of Washington), Razique Anwer(University of Washington), P.E. Anyanwu(University of Washington), Juan Pablo Arab(University of Washington), Jalal Arabloo(University of Washington), Mosab Arafat(University of Washington), Daniel T Araki(University of Washington), Aleksandr Y. Aravkin(University of Washington), Mesay Arkew(University of Washington), Benedetta Armocida(University of Washington), Michael B. Arndt(University of Washington), Mahwish Arooj(University of Washington), Anton A Artamonov(University of Washington), Raphael Taiwo Aruleba(University of Washington), Ashokan Arumugam(University of Washington), Charlie Ashbaugh(University of Washington), Mubarek Yesse Ashemo(University of Washington), Muhammad Ashraf(University of Washington), Marvellous O Asika(University of Washington), Elaheh Askari(University of Washington), Thomas Astell‐Burt(University of Washington), Seyyed Shamsadin Athari(University of Washington), Prince Atorkey(University of Washington), Maha Atout(University of Washington), Alok Atreya(University of Washington), Avinash Aujayeb(University of Washington), Marcel Ausloos(University of Washington), Abolfazl Avan(University of Washington), Adedapo Wasiu Awotidebe(University of Washington), Kofi Awuviry‐Newton(University of Washington), Beatriz Paulina Ayala Quintanilla(University of Washington), José Luís Ayuso‐Mateos(University of Washington), Sina Azadnajafabad(University of Washington), Rui Azevedo(University of Washington), Abraham Samuel Babu(University of Washington), Muhammad Badar(University of Washington), Ashish Badiye(University of Washington), Soroush Baghdadi(University of Washington), Nasser Bagheri(University of Washington), Sulaiman Bah(University of Washington), Ruhai Bai(University of Washington), Jennifer L. Baker(University of Washington), Shankar M Bakkannavar(University of Washington), Abdulaziz Bako(University of Washington), Senthilkumar Balakrishnan(University of Washington), Kiran Bam(University of Washington), Palash Chandra Banik(University of Washington), Martina Barchitta(University of Washington), Mainak Bardhan(University of Washington), Erfan Bardideh(University of Washington), Suzanne Barker‐Collo(University of Washington), Hiba Jawdat Barqawi(University of Washington), Amadou Barrow(University of Washington), Sandra Barteit(University of Washington), Lingkan Barua(University of Washington), Somaye Bashiri Aliabadi(University of Washington), Afisu Basiru(University of Washington), Sanjay Basu(University of Washington), Saurav Basu(University of Washington), Prapthi Persis Bathini(University of Washington), Kavita Batra(University of Washington), Bernhard T. Baune(University of Washington), Nebiyou Simegnew Bayileyegn(University of Washington), Babak Behnam(University of Washington), Amir Hossein Behnoush(University of Washington), Maryam Beiranvand(University of Washington), Diana Fernanda Bejarano Ramírez(University of Washington), Michelle L. Bell(University of Washington), Olorunjuwon Omolaja Bello(University of Washington), Apostolos Beloukas(University of Washington), Isabela M. Benseñor(University of Washington), Zombor Berezvai(University of Washington), Eduardo Bernabé(University of Washington), Robert S. Bernstein(University of Washington), Paulo J. G. Bettencourt(University of Washington), Akshaya Srikanth Bhagavathula(University of Washington), Neeraj Bhala(University of Washington), Dinesh Bhandari(University of Washington), Ashish Bhargava(University of Washington), Sonu Bhaskar(University of Washington), Vivek Bhat(University of Washington), Gurjit Kaur Bhatti(University of Washington), Jasvinder Singh Bhatti(University of Washington), Manpreet S. Bhatti(University of Washington), Rajbir Bhatti(University of Washington), Zulfiqar A Bhutta(University of Washington), Boris Bikbov(University of Washington), Jessica Devin Bishai(University of Washington), Catherine Bisignano(University of Washington), Veera Raghavulu Bitra(University of Washington), Tone Bjørge(University of Washington), Virgínia Bodolica(University of Washington), Aadam Olalekan Bodunrin(University of Washington), Eyob Ketema Bogale(University of Washington), Milad Bonakdar Hashemi(University of Washington), Aimé Bonny(University of Washington), Berrak Bora Başara(University of Washington), Hamed Borhany(University of Washington), C. S. Boxe(University of Washington), Oliver J. Brady(University of Washington), Nicola Luigi Bragazzi(University of Washington), Dejana Braithwaite(University of Washington), Luísa Campos Caldeira Brant(University of Washington), Michael Bräuer(University of Washington), Susanne Breitner(University of Washington), Hermann Brenner(University of Washington), Julie Brown(University of Washington), Traolach Brugha(University of Washington), Norma B. Bulamu(University of Washington), Danilo Buonsenso(University of Washington), Katrin Burkart(University of Washington), Richard A. Burns(University of Washington), Reinhard Busse(University of Washington), Yasser Bustanji(University of Washington), Zahid A Butt(University of Washington), Justin Byun(University of Washington), Florentino Luciano Caetano dos Santos, Daniela Călina(University of Washington), Luis Alberto Cámera(University of Washington), Ismael Campos‐Nonato(University of Washington), Chao Cao(University of Washington), Angelo Capodici(University of Washington), Sinclair Carr(University of Washington), Giulia Carreras(University of Washington), Andrea Carugno(University of Washington), Márcia Carvalho(University of Washington), João Maurício Castaldelli-Maia(University of Washington), Carlos A Castañeda-Orjuela(University of Washington), Giulio Castelpietra(University of Washington), Alberico L. Catapano(University of Washington), Maria Sofia Cattaruzza(University of Washington), Arthur Caye(University of Washington), Luca Cegolon(University of Washington), Francieli Cembranel(University of Washington), Muthia Cenderadewi(University of Washington), Ester Cerin(University of Washington), Promit Ananyo Chakraborty(University of Washington), Jeffrey Shi Kai Chan(University of Washington), Raymond J. Chan(University of Washington), Rama Mohan Chandika(University of Washington), Eeshwar K Chandrasekar(University of Washington), Periklis Charalampous(University of Washington), Vijay Kumar Chattu(University of Washington), Victoria Chatzimavridou-Grigoriadou(University of Washington), Angela W Chen(University of Washington), An‐Tian Chen(University of Washington), Catherine S Chen(University of Washington), Haowei Chen(University of Washington), N Chen(University of Washington), Esther Cheng(University of Washington), Odgerel Chimed‐Ochir(University of Washington), Ritesh Chimoriya(University of Washington), Patrick R Ching(University of Washington), William C. Cho(University of Washington), Sungchul Choi(University of Washington), Bryan Chong(University of Washington), Yuen Yu Chong(University of Washington), Sonali G Choudhari(University of Washington), Rajiv Chowdhury(University of Washington), Steffan Wittrup Christensen, Dinh‐Toi Chu(University of Washington), Isaac Sunday Chukwu, Eric Lim Teik Chung(University of Washington), Eunice Chung, Muhammad Chutiyami(University of Washington), Mareli Claassens, Rebecca M Cogen, Alyssa Columbus, João Conde(University of Washington), Paolo Angelo Cortesi, Ewerton Cousin, Michael H Criqui, Natália Martins, Omid Dadras, Siyu Dai, Xiaochen Dai, Zhaoli Dai, Maxwell Ayindenaba Dalaba, Giovanni Damiani(University of Washington), Jai K Das(University of Washington), Saswati Das(University of Washington), Mohsen Dashti, Claudio Alberto Dávila-Cervantes, Kairat Davletov, Diego De Leo, Aklilu Tamire Debele, Shayom Debopadhaya, Nicole DeCleene, Farah Deeba, Louisa Degenhardt, Cristian Del Bo’(University of Washington), Iván Delgado‐Enciso, Andreas K. Demetriades, Edgar Denova‐Gutiérrez, Nikolaos Dervenis, Hardik Dineshbhai Desai, Rupak Desai, Keshab Deuba, Kuldeep Dhama, Samath Dhamminda Dharmaratne, Sameer Dhingra, Diana Dias da Silva(University of Washington), Daniel Díaz(University of Washington), Luis Antonio Díaz, Michael J. Diaz, Adriana Dima, Delaney D Ding, M Ashworth Dirac, Thao Huynh Phuong(University of Washington), Camila Bruneli do Prado, Sushil Dohare, Regina-Mae Villanueva Dominguez, Wanyue Dong, Deepa Dongarwar, Mario D’Oria, E. Ray Dorsey, Leila Doshmangir, Robert Kokou Dowou, Tim Driscoll, Haneil Larson Dsouza, Viola Savy Dsouza, John Dube, Samuel Carvalho Dumith, Bruce Bartholow Duncan, André Rodrigues Durães, Senbagam Duraisamy, Oyewole Christopher Durojaiye, Paulina Agnieszka Dzianach, Arkadiusz Dziedzic, Ejemai Eboreime, Alireza Ebrahimi(University of Washington), Hisham Atan Edinur, David Edvardsson(University of Washington), Terje Andreas Eikemo, Ebrahim Eini, Michael Ekholuenetale(University of Washington), Temitope Cyrus Ekundayo, Iman El Sayed(University of Washington), Maha El Tantawi(University of Washington), Iffat Elbarazi, Noha Mousaad Elemam, Ghada Metwally Tawfik ElGohary, Muhammed Elhadi, Omar El Meligy, Gihan ELNahas, Mohammed Elshaer(University of Washington), Ibrahim Elsohaby, Luchuo Engelbert Bain, Ryenchindorj Erkhembayar, Babak Eshrati(University of Washington), Kara Estep, Natalia Fabin, Adeniyi Francis Fagbamigbe, Luca Falzone(University of Washington), Mohammad Fareed(University of Washington), Carla Sofia e Sá Farinha, MoezAlIslam E. Faris, André Faro(University of Washington), Pegah Farrokhi, Ali Fatehizadeh(University of Washington), Nelsensius Klau Fauk, Valery L. Feigin, Xiaoqi Feng, Seyed‐Mohammad Fereshtehnejad, Abdullah Feroze, Nuno Ferreira, Paulo H. Ferreira, Florian Fischer, Joanne Flavel, David Flood(University of Washington), Luísa Sório Flor(University of Washington), Nataliya A Foigt, Morẹ́nikẹ́ Oluwátóyìn Foláyan, Lisa M Force, Daniela Fortuna(University of Washington), Matteo Foschi, Richard C. Franklin, Alberto Freitas(University of Washington), Takeshi Fukumoto, João M. Furtado, Péter Gaál, Muktar A Gadanya, Abhay Gaidhane, Santosh Gaihre, Yaseen Galali, Mandukhai Ganbat, Aravind P. Gandhi, Balasankar Ganesan, Mohd Ashraf Ganie, Mohammad Arfat Ganiyani, William M. Gardner, Tilaye Gebru Gebi, Miglas Welay Gebregergis, Mesfin Gebrehiwot, Tesfay Brhane Gebremariam, Teferi Gebru Gebremeskel, Yibeltal Yismaw Gela(University of Washington), Simona Roxana Georgescu, Abera Getachew Obsa, Peter W. Gething, Molla Getie, Keyghobad Ghadiri, Fataneh Ghadirian, Khalid Y. Ghailan, Alireza Ghajar(University of Washington), Mohammad‐Reza Ghasemi, Ghazal Ghasempour Dabaghi, Afsaneh Ghasemzadeh, Ramy Mohamed Ghazy, Ali Gholamrezanezhad(University of Washington), Mahsa Ghorbani, Elena Ghotbi, Ruth Margaret Gibson, Tiffany K. Gill, Themba G. Ginindza, Alem Girmay(University of Washington), James Glasbey, László Göbölös, Myron Anthony Godinho, Salime Goharinezhad, Mohamad Goldust, Mahaveer Golechha, Pouya Goleij, Philimon Gona, Giuseppe Gorini, Alessandra C. Goulart, Ayman Grada, Michal Grivna, Shi‐Yang Guan, Giovanni Guarducci(University of Washington), Mohammed Ibrahim Mohialdeen Gubari, Mesay Dechasa Gudeta, Avirup Guha, Stefano Guicciardi, Snigdha Gulati, David Gulisashvili(University of Washington), Damitha Asanga Gunawardane, Cui Guo, Anish Gupta, Bhawna Gupta, Ishita Gupta, Mohak Gupta, Rajeev Gupta, Veer Bala Gupta, Vijai Kumar Gupta, Vivek Gupta, Reyna Alma Gutiérrez, Farrokh Habibzadeh, Parham Habibzadeh, Rasool Haddadi, Najah R Hadi(University of Washington), Nils Haep, Nima Hafezi‐Nejad, Abdul Hafiz(University of Washington), Hailey Hagins, Esam Halboub, Aram Halimi, Sebastian Haller, Rabih Halwani, Erin B Hamilton, Graeme J. Hankey, Md. Abdul Hannan, Md. Nuruzzaman Haque, Harapan Harapan, Josep María Haro, Jan Hartvigsen(University of Washington), Ahmed I Hasaballah, Ikramul Hasan(University of Washington), Mohammad Hasanian(University of Washington), Md Saquib Hasnain, Amr Hassan(University of Washington), Johannes Haubold, Rasmus Havmoeller, Simon I Hay(University of Washington), Khezar Hayat, Jeffrey J. Hébert, Omar E Hegazi, Golnaz Heidari, Bartosz Helfer, Mehdi Hemmati, Delia Hendrie, Claire A Henson, Kamal Hezam, Yuta Hiraike, Nguyen Quoc Hoan, Ramesh Holla, Julia Hon(University of Washington), Md Mahbub Hossain, Hassan Hosseinzadeh(University of Washington), Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Johnathan M Hsu, Junjie Huang, Fernando Neves Hugo, Kiavash Hushmandi, Javid Hussain, Nawfal R Hussein(University of Washington), Chantal Huynh, Hong-Han Huynh, Bing‐Fang Hwang, Vincent C Iannucci, Audrey L Ihler, Adalia I Ikiroma, Kevin S Ikuta, Olayinka Stephen Ilesanmi, Irena Ilić, Milena Ilić, Mohammad Tarique Imam, Mustapha Immurana, Lalu Muhammad Irham, Md. Rabiul Islam, Sheikh Mohammed Shariful Islam, Farhad Islami, Faisal Ismail, Nahlah Elkudssiah Ismail, Gaetano Isola, Masao Iwagami, Chidozie C D Iwu, Mahalaxmi Iyer, Jalil Jaafari, Kathryn H. Jacobsen, Farhad Jadidi‐Niaragh, Morteza Jafarinia, Khushleen Jaggi, Kasra Jahankhani, Nader Jahanmehr, Haitham Jahrami, Akhil Jain, Nityanand Jain, Ammar Abdulrahman Jairoun, Abhishek Jaiswal, Mihajlo Jakovljević, Abubakar Ibrahim Jatau, Sabzali Javadov, Tahereh Javaheri, Sathish Kumar Jayapal, Shubha Jayaram, Sun Ha Jee, Jayakumar Jeganathan, Angeline Jeyakumar, Anil Kumar Jha, Heng Bo Jiang(University of Washington), Yinzi Jin, Jost B. Jonas, Tamás Joó, Abel Joseph(University of Washington), Nitin Joseph(University of Washington), Charity Ehimwenma Joshua, Jacek Jerzy Jozwiak, Mikk Jürisson, K Vaishali(University of Washington), Billingsley Kaambwa, Ali Kabir(University of Washington), Zubair Kabir, Vidya Kadashetti, Rizwan Kalani, Leila R Kalankesh, Feroze Kaliyadan, Sanjay Kalra(University of Washington), Kaloyan Kamenov, Naser Kamyari, Thanigaivelan Kanagasabai, Himal Kandel, Arun Kanmanthareddy, Kehinde Kazeem Kanmodi, Rami S. Kantar, Ibraheem M. Karaye, Asima Karim, Salah Eddin Karimi, Yeganeh Karimi, Hengameh Kasraei, Molly B Kassel, Joonas H. Kauppila, Norito Kawakami, Gbenga A Kayode, Foad Kazemi, Sina Kazemian(University of Washington), Leila Keikavoosi-Arani, Cathleen Keller, John H. Kempen, Jessica A. Kerr(University of Washington), Kamyab Keshtkar, Emmanuelle Kesse‐Guyot, Mohammad Keykhaei(University of Washington), Himanshu Khajuria, Amirmohammad Khalaji, Asaad Khalid, Nauman Khalid, Alireza Khalilian(University of Washington), Faham Khamesipour, Asaduzzaman Khan, Ikramullah Khan, Maseer Khan, Moien AB Khan, Shaghayegh Khanmohammadi, Khaled Khatab, Fatemeh Khatami, Moawiah Khatatbeh, Amir M Khater, Hamid Reza Khayat Kashani, Feriha Fatima Khidri, Elaheh Khodadoust(University of Washington), Moein Khormali, Zahra Khorrami, Zemene Demelash Kifle, Min Seo Kim, Ruth W Kimokoti, Adnan Kısa, Sezer Kısa, Ann Kristin Knudsen, Jonathan Kocarnik, Sonali Kochhar(University of Washington), Hyun Yong Koh, Ali‐Asghar Kolahi, Farzad Kompani, Gerbrand Koren, Oleksii Korzh, Soewarta Kosen, Sindhura Lakshmi Koulmane Laxminarayana, Kewal Krishan, Varun Krishna(University of Washington), Vijay Krishnamoorthy(University of Washington), Barthélémy Kuate Defo, Md Abdul Kuddus, Mohammed Kuddus(University of Washington), Ilari Kuitunen, Vishnutheertha Kulkarni, Manasi Kumar(University of Washington), Nithin Kumar(University of Washington), Rakesh Kumar(University of Washington), Om Kurmi, Dian Kusuma(University of Washington), Hmwe Hmwe Kyu, Carlo La Vecchia(University of Washington), Ben Lacey(University of Washington), Muhammad Awwal Ladan, Lucie Laflamme, Alessandra Lafranconi, Chandrakant Lahariya, Daphne Teck Ching Lai(University of Washington), Dharmesh Kumar Lal(University of Washington), Ratilal Lalloo, Tea Lallukka, Judit Lám(University of Washington), Qing Lan(University of Washington), Tuo Lan(University of Washington), Iván Landires, Francesco Lanfranchi, Berthold Langguth, Ariane Laplante-Lévesque, Bagher Larijani(University of Washington), Anders Larsson(University of Washington), Savita Lasrado, Paolo Lauriola, Huu‐Hoai Le(University of Washington), Long Khanh‐Dao Le(University of Washington), Nhi Huu Hanh Le(University of Washington), Trang Diep Thanh Le(University of Washington), Janet L Leasher, Caterina Ledda, Munjae Lee, Paul H. Lee, Sang-woong Lee, Seung Won Lee, Wei‐Chen Lee(University of Washington), Yo Han Lee(University of Washington), Kate E LeGrand, Jacopo Lenzi, Elvynna Leong, Janni Leung, Ming‐Chieh Li(University of Washington), Wei Li(University of Washington), Xiaopan Li(University of Washington), Li Y(University of Washington), Yongze Li(University of Washington), Lee‐Ling Lim(University of Washington), Stephen S Lim(University of Washington), Megan Lindstrom, Shai Linn(University of Washington), Gang Liu, Run-Ben Liu, Shiwei Liu, Wei Liu(University of Washington), Xiaofeng Liu, Xuefeng Liu, Erand Llanaj, Chun‐Han Lo(University of Washington), Rubén López‐Bueno, Arianna Maever Loreche, László Lorenzovici, Rafael Lozano, Jailos Lubinda, Giancarlo Lucchetti, Raimundas Lunevičius, Jay B. Lusk(University of Washington), Hengliang Lv(University of Washington), Zheng Feei(University of Washington), Nikolaos Machairas, Áurea Madureira-Carvalho, Javier A. Magaña‐Gómez, Azzam A. Maghazachi, Preeti Maharjan, Phetole Walter Mahasha, Mina Maheri, Soleiman Mahjoub, Mansour Adam Mahmoud(University of Washington), Elham Mahmoudi, Azeem Majeed, Konstantinos C. Makris, Elaheh Malakan Rad(University of Washington), Kashish Malhotra, Ahmad Azam Malik, Iram Malik, Déborah Carvalho Malta, Yosef Manla, Ali Mansour(University of Washington), Pejman Mansouri, Mohammad Alì Mansournia(University of Washington), Ana Maria Mantilla Herrera, LG Mantovani, Emmanuel Kwaku Manu, Hamid Reza Marateb, Parham Mardi, Gabriel Martínez, Ramón Martínez, Daniela Martini(University of Washington), Francisco Rogerlândio Martins‐Melo, Miquel Martorell, Wolfgang Marx, Sharmeen Maryam(University of Washington), Roy Rillera Marzo, Yasith Mathangasinghe, Stephanie Mathieson, Alexander G. Mathioudakis, Jishanth Mattumpuram, Andrea Maugeri(University of Washington), Mahsa Mayeli, Mohsen Mazidi, Antonio Mazzotti, John J. McGrath, Martin McKee(University of Washington), Anna Laura W McKowen, Michael A McPhail(University of Washington), Kamran Mehrabani-Zeinabad, Entezar Mehrabi Nasab, Tesfahun Mekene Meto, Walter Mendoza, Ritesh G. Menezes, George A. Mensah, Alexios‐Fotios A. Mentis, Sultan Ayoub Meo, Haftu Asmerom, Atte Meretoja, Tuomo J Meretoja, Abera Mersha, Tomislav Meštrović, Kukulege Chamila Dinushi Mettananda, Sachith Mettananda, Irmina Maria Michałek, Paul Miller, Ted R. Miller, Edward J Mills, Le Huu Nhat Minh, Antonio Mirijello, Erkin М Мirrakhimov, Mizan Kiros Mirutse, Mohammad Mirza‐Aghazadeh‐Attari(University of Washington), Maryam Mirzaei(University of Washington), Roya Mirzaei, Awoke Misganaw, Ajay Kumar Mishra, Philip B. Mitchell, Chaitanya Mittal, Babak Moazen(University of Washington), Madeline E Moberg, Jama Mohamed(University of Washington), Mouhand Mohamed(University of Washington), Nouh Saad Mohamed(University of Washington), Esmaeil Mohammadi, Soheil Mohammadi, Hussen Mohammed(University of Washington), Salahuddin Mohammed(University of Washington), Shafiu Mohammed(University of Washington), Robin M Mohr, Ali H. Mokdad, Sabrina Molinaro, Sara Momtazmanesh(University of Washington), Lorenzo Monasta, Stefania Mondello, AmirAli Moodi Ghalibaf(University of Washington), Maryam Moradi(University of Washington), Yousef Moradi, Maziar Moradi‐Lakeh, Paula Moraga, Lídia Morawska, Rafael Silveira Moreira, Negar Morovatdar, Shane D. Morrison, Jakub Morze, Abbas Mosapour(University of Washington), Jonathan F Mosser, Elías Mossialos, Rohith Motappa, Vincent Mougin, Simin Mouodi, Matías Mrejen, Ahmed Msherghi(University of Washington), Sumaira Mubarik, Ulrich Müeller, Francesk Mulita, Kavita Munjal(University of Washington), Efrén Murillo‐Zamora, Murlimanju Bv, Ghulam Mustafa, Sathish Muthu, Muhammad Muzaffar(University of Washington), Woojae Myung, Ahamarshan Jayaraman Nagarajan, Pirouz Naghavi, Ganesh R. Naik, Firzan Nainu, Sanjeev Nair, Hastyar Hama Rashid Najmuldeen, Vinay Nangia, Atta Abbas Naqvi, Aparna Ichalangod Narayana, Shumaila Nargus, Gustavo G. Nascimento, Abdulqadir J. Nashwan, Ali Nasrollahizadeh(University of Washington), Amir Nasrollahizadeh(University of Washington), Zuhair S. Natto, Biswa Prakash Nayak, Vinod C Nayak, Sabina O. Nduaguba, Hadush Negash, Ionuţ Negoi, Ruxandra Irina Negoi, Seyed Aria Nejadghaderi, Olivia D Nesbit, Henok Biresaw Netsere, Marie Ng(University of Washington), Georges Nguefack‐Tsague, Josephine W Ngunjiri, Dang Nguyen, Hien Quang Nguyen, Robina Khan Niazi, Τaxiarchis Κonstantinos Νikolouzakis, Ali Nikoobar(University of Washington), Fatemeh Nikoomanesh, Amin Reza Nikpoor, Chukwudi A Nnaji, Lawrence Achilles Nnyanzi, Efaq Ali Noman, Shuhei Nomura, Bo Norrving(University of Washington), Chisom Adaobi Nri-Ezedi, George Ntaios, Mpiko Ntsekhe, Dieta Nurrika, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Nzoputam, Bogdan Oancea, Ismail Ayoade Odetokun, Martin O’Donnell, Ayodipupo Sikiru Oguntade, James Odhiambo Oguta, Hassan Okati‐Aliabad(University of Washington), Sylvester Reuben Okeke, Akinkunmi Paul Okekunle, Osaretin Christabel Okonji, Andrew T Olagunju, Omotola O Olasupo, Matthew Idowu Olatubi, Gláucia Maria Moraes de Oliveira, Isaac Iyinoluwa Olufadewa, Bolajoko O. Olusanya, Jacob Olusegun Olusanya, Hany A. Omar(University of Washington), Goran Latif Omer, Abidemi Omonisi, Sandersan Onie, Obinna Onwujekwe, Michał Ordak, Verner N. Orish, Doris V Ortega-Altamirano, Alberto Ortíz(University of Washington), Edgar Ortíz‐Brizuela, Wael M S Osman, Samuel M Ostroff, Uchechukwu Levi Osuagwu, Adrian Oţoiu, Nikita Otstavnov, Stanislav S Otstavnov, Amel Ouyahia, Guoqing Ouyang, Mayowa Owolabi, Mahesh Padukudru P A(University of Washington), Alicia Padrón‐Monedero, Jagadish Rao Padubidri, Tamás Palicz, Claudia Palladino, Feng Pan(University of Washington), Seithikurippu R. Pandi‐Perumal, Helena Ullyartha Pangaribuan, Georgios D. Panos, Leonidas D Panos, Anca Pantea Stoian, Shahina Pardhan, Romil R Parikh, Ava Pashaei(University of Washington), Maja Pasovic, Roberto Passera(University of Washington), Jay Patel(University of Washington), Sangram Kishor Patel, Shankargouda Patil, Dimitrios Patoulias, Venkata Suresh Patthipati, Shrikant Pawar, Hamidreza Pazoki–Toroudi, Spencer A Pease, Amy E. Peden, Paolo Pedersini, Minjin Peng, Umberto Pensato, Veincent Christian Filipino Pepito, Emmanuel Peprah, Prince Peprah(University of Washington), João Perdigão(University of Washington), Maria Odete Pereira, Arokiasamy Perianayagam, Norberto Perico, Konrad Pesudovs, Fanny Emily Petermann-Rocha, William A. Petri(University of Washington), Hoang Tran Pham, Anil K. Philip(University of Washington), Michael Phillips, Manon Pigeolet, David M. 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Cited by 4,272Open Access
Abstract
BACKGROUND: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. METHODS: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. FINDINGS: Global DALYs increased from 2·63 billion (95% UI 2·44-2·85) in 2010 to 2·88 billion (2·64-3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7-17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8-6·3) in 2020 and 7·2% (4·7-10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0-234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7-198·3]), neonatal disorders (186·3 million [162·3-214·9]), and stroke (160·4 million [148·0-171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3-51·7) and for diarrhoeal diseases decreased by 47·0% (39·9-52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54-1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5-9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0-19·8]), depressive disorders (16·4% [11·9-21·3]), and diabetes (14·0% [10·0-17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7-27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6-63·6) in 2010 to 62·2 years (59·4-64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6-2·9) between 2019 and 2021. INTERPRETATION: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. FUNDING: Bill & Melinda Gates Foundation.
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