The global burden of disease and injuries in 1990

This article presents the main findings of the study of the Global Burden o f Disease (GBD). The GBD assessed global health needs in 1990, and projecte d trends to the year 2020. Its approach to measuring health status differs from earlier ones because it takes into account not only the burden due to premature death but also that caused by non-fatal health outcomes. The GBD is expressed in a single indicator-the DALY (Disability Adjusted Life Year) -which sums the number of years lost due to premature death and the number of years lived with a disability. Findings from the GBD offered significant surprises, which challenge the traditional emphasis of public health polic y on infectious diseases. First, the study showed that the epidemiological transition was already well advanced in developing regions. Second, it show ed that the burden due to mental illness, such as depression, alcohol depen dence, and schizophrenia has been vastly underestimated by the traditional approach, which takes into account deaths but not disability. Third, it hig hlighted the important burden due to injuries, particularly among young adu lt males worldwide.