The Global Burden of Diseases, Injuries, and Risk Factors 2010 Study (GBD 2010 Study) began in the spring of 2007 and is the first major effort since the GBD 1990 Study to carry out a complete systematic assessment of the data on all diseases and injuries, producing comprehensive and comparable estimates of the burden of diseases, injuries, and risk factors for the years 1990, 2005, and 2010.
The GBD 2010 Study is significantly broader in scope than previous versions, including:
- More than 220 conditions and injuries
- More than 40 risk factors
- More than 230 sequelae (nonfatal health consequences)
- 800 collaborators worldwide
- Estimates for 21 regions
- Improved methods for the estimation of health state severity weights
The GBD 2010 Study brings together a community of experts and leaders in epidemiology and other areas of public health research from around the world to measure current levels and recent trends in all major diseases, injuries, and risk factors, and to produce new and comprehensive sets of estimates and easy-to-use tools for research and teaching. This ambitious effort is being conducted systematically and transparently; both its methods and results will be made available to the public.
The principle guiding the burden of disease approach is that the best estimates of incidence, prevalence, and mortality can be generated by carefully analyzing all available sources of information in a country or region and correcting for bias. The disability-adjusted life year (DALY), a time-based measure that combines years of life lost due to premature mortality and years of life lost due to time lived in health states less than ideal health, was developed to assess the burden of disease.
Collaborators
The GBD 2010 Study is led by IHME in conjuntion with four institutions:
- Harvard University
- Johns Hopkins University
- University of Queensland
- World Health Organization (WHO)
The study also includes the collaboration of 800 researchers around the world.
Key Activities
- Produce valid, unbiased, and comparable estimates of the incidence and prevalence of disease and injury cases or episodes and relevant disabling sequelae at the population level for the GBD regions.
Together with information on duration, distribution by severity, and corresponding health state severity weights, incidence and prevalence will be used to estimate the years lived with disability (YLD) by age and sex for all 21 regions of the world for 1990, 2005, and 2010.
- Produce all-cause mortality (numbers of all-cause deaths) by age, sex, region, and time period (1990, 2005, 2010) using multiple sources (e.g., civil registration systems, censuses, surveys) and demographic methods (e.g., death distribution techniques to estimate completeness of civil registration systems).
Researchers will also produce age-, sex-, and cause-specific mortality estimates for each GBD region that sum to all-cause mortality, utilizing all available sources and correcting for known issues of data quality.
- Revise the health state severity weight system, a highly debated component of past GBD studies that seeks to measure health state severity.
For all 220 causes, there are 230 resulting pathological conditions, or sequelae. A health state severity weight assigns each sequela a value representing a state between perfect health (0) and death (1). Health state severity weights provide the bridge between mortality and nonfatal outcomes in the burden of disease.
To obtain a broad cross-section of views spanning diverse cultural, environmental, and demographic circumstances, household surveys were conducted in Tanzania, Bangladesh, Indonesia, Peru, and the US. There is also an online survey available worldwide in English, Spanish, and Mandarin (
www.gbdsurvey.org). The survey asks individuals to imagine different health outcomes and compare them to each other in simple, comprehensible questions for all educational levels. For example: "Imagine two people – the first person is completely blind, and the second person suffers from constant intense back pain. Who is healthier overall?“ Answers are used to calculate a health state severity weight for each sequela.
History of the GBD Study
The original Global Burden of Disease study (GBD 1990) was commissioned by the World Bank in 1991 to provide a comprehensive assessment of the burden of 107 diseases and injuries and 10 selected risk factors for the world and eight major regions. The methods established by that study created a common metric to estimate the health loss associated with morbidity and mortality. The study represented a major step in quantifying global and regional effects of diseases, injuries, and risk factors on population health. It also stimulated numerous national studies of burden of disease. The results have been used by governments and non-governmental agencies to inform priorities for research, development, policies, and funding.
Impact
Improving the health and well-being of the world’s population is a moral imperative and essential for global stability and progress. The vast energies, technologies, and resources pouring into global health have given us the capacity to fight disease, remedy disability, and address deep inequalities in health between populations.
The new round of the Global Burden of Diseases, Injuries, and Risk Factors study will provide the tools and knowledge to inform efforts for making truly effective interventions possible. The GBD 2010 Study’s consistent and comprehensive regional estimates will help policymakers and nonresearch audiences interpret GBD concepts and utilize study results.
