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

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 clu
Export Date: 21 December 2015 CODEN: LANCA Correspondence Address: Newton, J.N.; Public Health England, Wellington HouseUnited Kingdom; email: john.newton@phe.gov.uk References: Murray C.J.L., Richards M.A., Newton J.N., UK health performance: Findings of the Global Burden of Disease Study 2010 (2013) Lancet, 381, pp. 997-1020; Greer S.L., Devolution and divergence in UK health policies (2008) BMJ, 337, p. a2616; England N.H.S., (2014) Five Year Forward View, , http://www.england.nhs.uk/ourwork/futurenhs/, (accessed Aug 24, 2015); Naghavi M., Wang H., Lozano R., Global, regional and national levels of age-specific mortality and 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013 (2015) Lancet, 385, pp. 117-171; Global, regional, and national incidence, prevalence, and years lived with disabilities for 301 acute and chronic diseases and injuries for 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013 (2015) Lancet, 386, pp. 743-800; Global, regional, and national comparative risk assessment of 76 behavioural, environmental, occupational, and metabolic risks or clusters of risks in 188 countries 1990-2013: A systematic analysis for the Global Burden of Disease study 2013 (2015) Lancet, , http://dx.doi.org/10.1016/S0140-6736(15)00128-2, published online Sept 11; Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: Quantifying the epidemiological transition (2015) Lancet, , http://dx.doi.org/10.1016/S0140-6736(15)61340-X, published online Aug 27; Vos T., Flaxman A.D., Naghavi M., Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010 (2012) Lancet, 380, pp. 2163-2196; Murray C.J.L., Ezzati M., Flaxman A.D., GBD 2010: Design, definitions, and metrics (2012) Lancet, 380, p