The Burden of Disease in Germany at the National and Regional Level-Results in Terms of Disability–Adjusted Life Years (DALY) from the BURDEN 2020 Study
Measures such as disability-adjusted life years (DALY) are becoming increasingly important for the standardized assessment of the burden of disease due to death and disability.
The BURDEN 2020 pilot project was designed as an independent burden-of disease study for Germany, which was based on nationwide data, but which also yielded regional estimates.
DALY is defined as the sum of years of life lost due to death (YLL) and years lived with disability (YLD).
- YLL is the difference between the age at death due to disease and the remaining life expectancy at this age.
- YLD quantifies the number of years individuals have spent with health impairments.
Data are derived mainly from causes of death statistics, population health surveys, and claims data from health insurers.
In 2017, there were approximately 12 million DALY in Germany, or 14,584 DALY per 100,000 inhabitants.
Conditions which caused the greatest number of DALY were coronary heart disease (2321 DALY), low back pain (1735 DALY), and lung cancer (1197 DALY).
Headache and dementia accounted for a greater disease burden in women than in men, while lung cancer and alcohol use disorders accounted for a greater disease burden in men than in women.
Pain disorders and alcohol use disorders were the leading causes of DALY among young adults of both sexes. The disease burden rose with age for some diseases, including cardiovascular diseases, dementia, and diabetes mellitus. For some diseases and conditions, the disease burden varied by geographical region.
The results indicate a need for age- and sex-specific prevention and for differing interventions according to geographic region. Burden of disease studies yield comprehensive population health surveillance data and are a useful aid to decision-making in health policy.
Focus on health burden due to alcohol in Germany
- Alcohol-related disorders cause more than 3 times the disease burden in men than in women.
- In relative terms, the burden of disease increases overall and for both sexes over the course of age, with the ranking and thus the importance of the selected causes of the burden of disease varying by age.
- Headache disorders, low back pain, road traffic accidents, alcohol-related and anxiety disorders top the DALY ranking in younger adulthood.
- An age-related decline in DALY rates can be observed in lung cancer, alcohol-related disorders and headache disorders.