The burden of disease and injury in the United States 1996

• Type of Material: Article
• Authors: Catherine M. Michaud, Harvard University; Matthew McKenna, Emory University; Stephen Begg, University of Queensland; Niels Tomijima, Columbia University in the City of New York; Meghna Majmudar, UC Berkeley Haas School of Business; Maria T Bulzacchelli, Johns Hopkins Bloomberg School of Public Health; Shahul Ebrahim, Centers for Disease Control and Prevention; Majid Ezzati, Harvard University; Joshua A Salomon, Harvard University; Jessica Gaber Kreiser, University of Queensland; Mollie Hogan, Harvard University; Christopher J.L Murray
• Language: English
• Date: 2006-10-18
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © 2006 Michaud et al; licensee BioMed Central Ltd.
• License: Creative Commons Attribution 2.0 Generic
• Final Published Version (URL): http://dx.doi.org/10.1186/1478-7954-4-11
• Title of Journal or Parent Work: Population Health Metrics
• ISSN: 1478-7954
• Volume: 4
• Start Page: 11
• End Page: 11
• Grant/Funding Information: This study was funded by an Association of Schools of Public Health; ASPH/Centers for Disease Control and Prevention (CDC)/Agency for Toxic Substances and Disease Registry (ATSDR) Cooperative Agreement.
• Research Categories: Health Sciences, General; Health Sciences, Public Health

Abstract

Background: Burden of disease studies have been implemented in many countries using the Disability-Adjusted Life Year (DALY) to assess major health problems. Important objectives of the study were to quantify intra-country differentials in health outcomes and to place the United States situation in the international context. Methods: We applied methods developed for the Global Burden of Disease (GBD) to data specific to the United States to compute Disability-Adjusted Life Years. Estimates are provided by age and gender for the general population of the United States and for each of the four official race groups: White; Black; American Indian or Alaskan Native; and Asian or Pacific Islander. Several adjustments of GBD methods were made: the inclusion of race; a revised list of causes; and a revised algorithm to allocate cardiovascular disease garbage codes to ischaemic heart disease. We compared the results of this analysis to international estimates published by the World Health Organization for developed and developing regions of the world. Results: In the mid-1990s the leading sources of premature death and disability in the United States, as measured by DALYs, were: cardiovascular conditions, breast and lung cancers, depression, osteoarthritis, diabetes mellitus, and alcohol use and abuse. In addition, motor vehicle-related injuries and the HIV epidemic exacted a substantial toll on the health status of the US population, particularly among racial minorities. The major sources of death and disability in these latter populations were more similar to patterns of burden in developing rather than developed countries. Conclusion: Estimating DALYs specifically for the United States provides a comprehensive assessment of health problems for this country compared to what is available using mortality data alone.