Disease Burden and Health Planning
Introduction
The effect of a health issue on a given population is called the disease burden. This burden can be measured using multiple indicators like financial cost, morbidity, or mortality. These indicators allow us as researchers or public health practitioners to accurately compare different regions and areas. It can also help us predict the future needs of health care.
Epidemiological research makes use of a series of different measures of disease burden. The main two indicators, Disability-Adjusted Life-Years (DALYs) and Quality-Adjusted Life-Years (QALYs), are used to compare the burden of different diseases and take into account both death and morbidity in a single measure:
DALYs reveal the potential years of life lost (YLL) due to premature death and equivalent years of ‘healthy’ life lost by states of disability or poor health. One lost year of a healthy life can be thought of as a DALY.
QALYs are a measure of the life expectancy for loss of quality of that life caused by diseases and disabilities. Some interventions improve quality of life but do not prolong life. A QALY of 0 represents a year of complete functional impairment (death) while a year of perfect health gives a QALY of 1.
The Global Burden of Disease (GBD) is the most well-known assessment of disease burden. The first GBD study took place in 1990, here the concept of DALYs was devised and sought to quantify the health effects of more than 100 diseases and injuries for eight regions of the world. This provides estimates of morbidity and mortality by sex, age, and region. The GBD study is regularly updated, with estimates made every year. It provides age and sex stratified estimates of the burden of 333 leading causes of disability and death globally and for 195 regions and countries.
The WHO team provide guidance on the practicalities of measuring disease burden on a national and local scale; the GBD study results make an interesting read from a public health perspective. Estimates of the disease and injury burden caused by exposure to major risk factors are likely to be a much more useful guide to policies and priorities for prevention.
There are many reasons why it is important to measure disease burden:
- Planning for preventive action
- Assessing performance of healthcare systems
- Prioritising actions in health and the environment
- Identifying high-risk populations
- Planning for future needs and resources
- Setting priorities in health research
- Measures of Disease Burden
- Direct and Indirect Age Adjustment
- Life Expectancy, Disability-Adjusted and Quality-Adjusted Life Years
- Health care cost and implications on services
- Analysis and reporting techniques
- Data-informed decision making in public health practice and implementation
- Understand the cause of the most deaths and disability in a certain region
- Recognise the risk factors that drive disability and death
- Learn the main indicators in disease burden
- Realise the importance of health promotion and literacy to encourage good practices
- Assess the need to achieve positive changes in individual and community health by using health services and cost indicators
- Understand how long people live in a certain region and how it will change.
- Look at the fertility trend and how it affects the population now and, in the future.
- Recognise current and future health costs and the sources
- Look at the health indicators and trends in Saudi Arabia
- Propose changes and policies that can prevent some diseases on a local and global level
- Assess the focus and scope of initiatives to promote health by assessing the need to achieve positive changes in individual and community health
- Know, support, and engage in health-promoting and health literacy activities and programmes for implementing good practices to promote health at a population level and specific organization or institutional level
- Use evidence-based methods and strategies, social participation and intersectoral approaches as tools for promoting health and influencing public policies affecting health
- Evaluate the effectiveness of activities to promote health geared toward producing changes at the community and individual levels and in public or social policy to benefit health and quality of life
- When needed, generate, and/or promulgate factual information to counteract industry marketing in relation to nutrition, tobacco cessation, reducing alcohol consumption etc.
- Catalyse change (behavioural and/or cultural) in the organization, communities and/or individuals
- Advocate for healthy public policies and services that promote and protect the health and well-being of individuals and communities