UK health performance: findings of the Global Burden of Disease Study 2010

Murray, Christopher J. L., Richards, Michael A., Newton, John N., Fenton, Kevin A., Anderson, H. Ross, Atkinson, Charles, Bennett, Derrick, Bernab, Eduardo, Blencowe, Hannah, Bourne, Rupert, Braithwaite, Tasanee, Brayne, Carol, Bruce, Nigel G., Brugha, Traolach S., Burney, Peter, Dherani, Mukesh, Dolk, Helen, Edmond, Karen, Ezzati, Majid, Flaxman, Abraham D., Fleming, Tom D., Freedman, Greg, Gunnell, David, Hay, Roderick J., Hutchings, Sally J., Ohno, Summer Lockett, Lozano, Rafael, Lyons, Ronan A., Marcenes, Wagner, Naghavi, Mohsen, Newton, Charles R., Pearce, Neil, Pope, Dan, Rushton, Lesley, Salomon, Joshua A., Shibuya, Kenji, Vos, Theo, Wang, Haidong, Williams, Hywel C., Woolf, Anthony D., Lopez, Alan D. and Davis, Adrian (2013) UK health performance: findings of the Global Burden of Disease Study 2010. Lancet, 381 9871: 997-1020. doi:10.1016/S0140-6736(13)60355-4


Author Murray, Christopher J. L.
Richards, Michael A.
Newton, John N.
Fenton, Kevin A.
Anderson, H. Ross
Atkinson, Charles
Bennett, Derrick
Bernab, Eduardo
Blencowe, Hannah
Bourne, Rupert
Braithwaite, Tasanee
Brayne, Carol
Bruce, Nigel G.
Brugha, Traolach S.
Burney, Peter
Dherani, Mukesh
Dolk, Helen
Edmond, Karen
Ezzati, Majid
Flaxman, Abraham D.
Fleming, Tom D.
Freedman, Greg
Gunnell, David
Hay, Roderick J.
Hutchings, Sally J.
Ohno, Summer Lockett
Lozano, Rafael
Lyons, Ronan A.
Marcenes, Wagner
Naghavi, Mohsen
Newton, Charles R.
Pearce, Neil
Pope, Dan
Rushton, Lesley
Salomon, Joshua A.
Shibuya, Kenji
Vos, Theo
Wang, Haidong
Williams, Hywel C.
Woolf, Anthony D.
Lopez, Alan D.
Davis, Adrian
Title UK health performance: findings of the Global Burden of Disease Study 2010
Journal name Lancet   Check publisher's open access policy
ISSN 0140-6736
1474-547X
Publication date 2013-03
Year available 2013
Sub-type Article (original research)
DOI 10.1016/S0140-6736(13)60355-4
Volume 381
Issue 9871
Start page 997
End page 1020
Total pages 24
Place of publication London, United Kingdom
Publisher The Lancet Publishing Group
Collection year 2014
Language eng
Formatted abstract
Background The UK has had universal free health care and public health programmes for more than six decades. Several policy initiatives and structural reforms of the health system have been undertaken. Health expenditure has increased substantially since 1990, albeit from relatively low levels compared with other countries. We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) to examine the patterns of health loss in the UK, the leading preventable risks that explain some of these patterns, and how UK outcomes compare with a set of comparable countries in the European Union and elsewhere in 1990 and 2010.

Methods We used results of GBD 2010 for 1990 and 2010 for the UK and 18 other comparator nations (the original 15 members of the European Union, Australia, Canada, Norway, and the USA; henceforth EU15+). We present analyses of trends and relative performance for mortality, causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE). We present results for 259 diseases and injuries and for 67 risk factors or clusters of risk factors relevant to the UK. We assessed the UK's rank for age-standardised YLLs and DALYs for their leading causes compared with EU15+ in 1990 and 2010. We estimated 95% uncertainty intervals (UIs) for all measures.

Findings
For both mortality and disability, overall health has improved substantially in absolute terms in the UK from 1990 to 2010. Life expectancy in the UK increased by 4•2 years (95% UI 4•2-4•3) from 1990 to 2010. However, the UK performed significantly worse than the EU15+ for age-standardised death rates, age-standardised YLL rates, and life expectancy in 1990, and its relative position had worsened by 2010. Although in most age groups, there have been reductions in age-specific mortality, for men aged 30-34 years, mortality rates have hardly changed (reduction of 3•7%, 95% UI 2•7-4•9). In terms of premature mortality, worsening ranks are most notable for men and women aged 20-54 years. For all age groups, the contributions of Alzheimer's disease (increase of 137%, 16-277), cirrhosis (65%, -15 to 107), and drug use disorders (577%, 71-942) to premature mortality rose from 1990 to 2010. In 2010, compared with EU15+, the UK had significantly lower rates of age-standardised YLLs for road injury, diabetes, liver cancer, and chronic kidney disease, but significantly greater rates for ischaemic heart disease, chronic obstructive pulmonary disease, lower respiratory infections, breast cancer, other cardiovascular and circulatory disorders, oesophageal cancer, preterm birth complications, congenital anomalies, and aortic aneurysm. Because YLDs per person by age and sex have not changed substantially from 1990 to 2010 but age-specific mortality has been falling, the importance of chronic disability is rising. The major causes of YLDs in 2010 were mental and behavioural disorders (including substance abuse; 21•5% [95 UI 17•2-26•3] of YLDs), and musculoskeletal disorders (30•5% [25•5-35•7]). The leading risk factor in the UK was tobacco (11•8% [10•5-13•3] of DALYs), followed by increased blood pressure (9•0 % [7•5-10•5]), and high body-mass index (8•6% [7•4-9•8]). Diet and physical inactivity accounted for 14•3% (95% UI 12•8-15•9) of UK DALYs in 2010.

Interpretation The performance of the UK in terms of premature mortality is persistently and significantly below the mean of EU15+ and requires additional concerted action. Further progress in premature mortality from several major causes, such as cardiovascular diseases and cancers, will probably require improved public health, prevention, early intervention, and treatment activities. The growing burden of disability, particularly from mental disorders, substance use, musculoskeletal disorders, and falls deserves an integrated and strategic response.

Funding
Bill &Melinda Gates Foundation.
Keyword Coronary Heart Disease
Social Care Bill
Systematic Analysis
Hypertension Management
Smoking Cessation
Mortality rates
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Public Health Publications
 
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