Changes in health in England, with analysis by English regions and areas of deprivation, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Autor:	Ivy Shiue, Charis Gresser, S. M. Biryukov, Alison Tedstone, Harry Rutter, Matthew M Coates, Bernadette M. Hannigan, Martin McKee, Austin E Schumacher, Mohammad H. Forouzanfar, Henrik Møller, Rupert R A Bourne, Michele E. Murdoch, John N Newton, Carol Brayne, Julia A Critchley, Roderick J. Hay, Anthony D. Woolf, Theo Vos, Harry Hemingway, Derek F J Fay, Majid Ezzati, Adrian Davis, Charles D.A. Wolfe, Amanda J. Mason-Jones, Adam D M Briggs, Daniel C Casey, Nigel Bruce, Rajiv Chowdhury, Daniel Pope, Kyle J Foreman, Jürgen C Schmidt, Heidi J. Larson, Katharine J Looker, Daniel Dicker, Simon I. Hay, Thomas Fürst, Andrew Hughes, Jonathan Valabhji, Kazem Rahimi, Summer Lockett Ohno, Mohsen Naghavi, Traolach S. Brugha, Wagner Marcenes, Alina Rodriguez, Eduardo Bernabé, Kamaldeep Bhui, Hywel C Williams, Paul Elliott, Fiona E. Matthews, Ryan M Barber, Simon Capewell, Russell Ecob, David Gunnell, Michael Burch, Ibrahim Abubakar, Paul I. Dargan, H. Ross Anderson, Mark A. Green, Liam Smeeth, Jeffrey D. Stanaway, Maya S Fraser, Felix Greaves, Neil Pearce, Amitava Banerjee, Ronan A Lyons, R. Ali, Charles R. Newton, Mukesh Dherani, Peter Scarborough, Kevin A. Fenton, Cyrus Cooper, Christopher J L Murray, Frédéric B. Piel, Haidong Wang, Raimundas Lunevicius, Derrick A Bennett
Přispěvatelé:	Brayne, Carol [0000-0001-5307-663X], Chowdhury, Rajiv [0000-0003-4881-5690], Matthews, Fiona [0000-0002-1728-2388], Apollo - University of Cambridge Repository
Rok vydání:	2015
Předmět:	Gerontology Male Health Status Disease 030204 cardiovascular system & hematology 0302 clinical medicine Risk Factors Cause of Death Poverty Areas Prevalence Medicine Life Tables 030212 general & internal medicine media_common Aged 80 and over Medicine(all) DEMENTIA Mortality rate Incidence PRIMARY-CARE DEATH Public Health Global Health Social Medicine and Epidemiology 11 Medical And Health Sciences General Medicine ALZHEIMERS-DISEASE England Female Life Sciences & Biomedicine medicine.medical_specialty INTEGRATED APPROACH 187 COUNTRIES 03 medical and health sciences Medicine General & Internal Life Expectancy General & Internal Medicine media_common.cataloged_instance Humans European union Health policy Aged Science & Technology business.industry MORTALITY Public health Health Status Disparities Folkhälsovetenskap global hälsa socialmedicin och epidemiologi Years of potential life lost PRIMARY LIVER-CANCER Attributable risk Life expectancy L510 Health & Welfare business Demography
Zdroj:	Newton, J N, Briggs, A D M, Murray, C J L, Dicker, D, Foreman, K J, Wang, H, Naghavi, M, Forouzanfar, M H, Ohno, S L, Barber, R M, Vos, T, Stanaway, J D, Schmidt, J C, Hughes, A J, Fay, D F J, Ecob, R, Gresser, C, McKee, M, Rutter, H, Abubakar, I, Ali, R, Anderson, H R, Banerjee, A, Bennett, D A, Bernabé, E, Bhui, K S, Biryukov, S M, Bourne, R R, Brayne, C E G, Bruce, N G, Brugha, T S, Burch, M, Capewell, S, Casey, D, Chowdhury, R, Coates, M M, Cooper, C, Critchley, J A, Dargan, P I, Dherani, M K, Elliott, P, Ezzati, M, Fenton, K A, Fraser, M S, Fürst, T, Greaves, F, Green, M A, Gunnell, D J, Hannigan, B M, Hay, R J, Hay, S I, Hemingway, H, Larson, H J, Looker, K J, Lunevicius, R, Lyons, R A, Marcenes, W, Mason-Jones, A J, Matthews, F E, Moller, H, Murdoch, M E, Newton, C R, Pearce, N, Piel, F B, Pope, D, Rahimi, K, Rodriguez, A, Scarborough, P, Schumacher, A E, Shiue, I, Smeeth, L, Tedstone, A, Valabhji, J, Williams, H C, Wolfe, C D A, Woolf, A D & Davis, A C J 2015, ' Changes in health in England, with analysis by English regions and areas of deprivation, 1990-2013 : a systematic analysis for the Global Burden of Disease Study 2013 ', Lancet, vol. 386, no. 10010, pp. 2257–2274 . https://doi.org/10.1016/S0140-6736(15)00195-6 LANCET Lancet (London England)
ISSN:	0140-6736 1474-547X
DOI:	10.1016/s0140-6736(15)00195-6
Popis:	Background In the Global Burden of Disease Study 2013 (GBD 2013), knowledge about health and its determinants has been integrated into a comparable framework to inform health policy. Outputs of this analysis are relevant to current policy questions in England and elsewhere, particularly on health inequalities. We use GBD 2013 data on mortality and causes of death, and disease and injury incidence and prevalence to analyse the burden of disease and injury in England as a whole, in English regions, and within each English region by deprivation quintile. We also assess disease and injury burden in England attributable to potentially preventable risk factors. England and the English regions are compared with the remaining constituent countries of the UK and with comparable countries in the European Union (EU) and beyond. Methods We extracted data from the GBD 2013 to compare mortality, causes of death, years of life lost (YLLs), years lived with a disability (YLDs), and disability-adjusted life-years (DALYs) in England, the UK, and 18 other countries (the first 15 EU members [apart from the UK] and Australia, Canada, Norway, and the USA [EU15+]). We extended elements of the analysis to English regions, and subregional areas defined by deprivation quintile (deprivation areas). We used data split by the nine English regions (corresponding to the European boundaries of the Nomenclature for Territorial Statistics level 1 [NUTS 1] regions), and by quintile groups within each English region according to deprivation, thereby making 45 regional deprivation areas. Deprivation quintiles were defined by area of residence ranked at national level by Index of Multiple Deprivation score, 2010. Burden due to various risk factors is described for England using new GBD methodology to estimate independent and overlapping attributable risk for five tiers of behavioural, metabolic, and environmental risk factors. We present results for 306 causes and 2337 sequelae, and 79 risks or risk clusters. Findings Between 1990 and 2013, life expectancy from birth in England increased by 5·4 years (95% uncertainty interval 5·0-5·8) from 75·9 years (75·9-76·0) to 81·3 years (80·9-81·7); gains were greater for men than for women. Rates of age-standardised YLLs reduced by 41·1% (38·3-43·6), whereas DALYs were reduced by 23·8% (20·9-27·1), and YLDs by 1·4% (0·1-2·8). For these measures, England ranked better than the UK and the EU15+ means. Between 1990 and 2013, the range in life expectancy among 45 regional deprivation areas remained 8·2 years for men and decreased from 7·2 years in 1990 to 6·9 years in 2013 for women. In 2013, the leading cause of YLLs was ischaemic heart disease, and the leading cause of DALYs was low back and neck pain. Known risk factors accounted for 39·6% (37·7-41·7) of DALYs; leading behavioural risk factors were suboptimal diet (10·8% [9·1-12·7]) and tobacco (10·7% [9·4-12·0]). Interpretation Health in England is improving although substantial opportunities exist for further reductions in the burden of preventable disease. The gap in mortality rates between men and women has reduced, but marked health inequalities between the least deprived and most deprived areas remain. Declines in mortality have not been matched by similar declines in morbidity, resulting in people living longer with diseases. Health policies must therefore address the causes of ill health as well as those of premature mortality. Systematic action locally and nationally is needed to reduce risk exposures, support healthy behaviours, alleviate the severity of chronic disabling disorders, and mitigate the effects of socioeconomic deprivation. Funding Bill & Melinda Gates Foundation and Public Health England. © 2015 Newton et al. Open Access article distributed under the terms of CC BY. 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