In 2020, the considered 38 key diseases led to a loss of 1.1 million healthy life years due to a reduced quality of life as a result of living with a disability.
Mental and substance use disorders, musculoskeletal disorders, and neurological disorders were the leading causes of disease burden due to reduced quality of life in Belgium.
The total disease burden in 2020 due to reduced quality of life was similar among men and women.
The largest share of the disease burden due to reduced quality of life in 2020 was borne by youngsters and adults between 15 and 44 years old.
The total disease burden due to reduced quality of life was the highest in the Walloon Region, followed by the Brussels Capital Region, and the Flemish Region.
Among EU-14 countries, Belgium ranks 2nd worst in terms of disease burden due to reduced quality of life.
2.Years Lived with Disability
Belgium loses 1.1 million healthy life years in 2020
In 2020, the considered 38 key diseases led to a loss of 1,071,581 healthy life years (9,312 YLDs per 100,000) due to reduced quality of life (YLDs). Mental and substance use disorders, musculoskeletal disorders, and neurological disorders were the leading disease groups, accounting for more than 75% of the total disease burden due to reduced quality of life. The top 5 specific causes for YLDs were depression (17%), low back pain (13%), alcohol use disorders (11%), neck pain (8%) and Osteoarthritis (6%).
Men suffer a similar disease burden due to reduced quality of life compared to women. The age-adjusted YLDs equaled 9,361 per 100,000 men, and 9,262 per 100,000 women. In men, the three leading causes for YLDs were alcohol use (1,417 YLDs per 100,000), depression (1,326 YLDs per 100,000), and low back pain (1,118 YLDs per 100,000) whereas in women, the three leading specific causes were depression (1,789 YLDs per 100,000), low back pain (1,316 YLDs per 100,000), and neck pain (883 YLDs per 100,000).
In Belgium, the disease burden due to reduced quality of life is largely borne by the youngsters and adults. The majority (34%) of YLDs in the Belgian population are attributable to Belgians with an age between 15 and 44 years (50,033 YLDs per 100,000), followed by the group with an age between 45 and 64 years, where a total of 45,702 YLDs per 100,000, (34%) were lost in 2019. Among Belgians who are 65+ years, 10,4893 years were lost due to reduced quality of life per 100,000 (32%). The youngest group (< 15 years) accounted for 1% of the total amount of YLDs. The leading specific causes with the highest impact in terms of YLDs per 100,000 were asthma and epilepsy in children with an age < 5 year, epilepsy and asthma in children aged between 5 to 14 years, depression and alcohol use disorders in youngsters and adults with an age between 15 to 44 year, depression and low back pain in adults with an age between 45 and 64, and low back pain and depression in elderly with an age higher the 65.
The Walloon and Brussels Capital Regions have the highest burden
After correcting for differences in population size and age structure, the disease burden in terms of reduced quality of life is the highest in the Walloon Region (11,182 YLDs per 100,000), followed by the Brussels Capital Region (10,703 YLDs per 100,000), and the Flemish Region (8,073 YLDs per 100,000). The leading cause groups are identical among regions.
Looking at trends over time after correcting for the population size and age structure, the disease burden due to reduced quality of life of the leading diseases has remained stable over the years. The disease burden of mental and substance use disorders went from 3,885 YLDs per 100,000 in 2013 to 4,049 YLDs per 100,000 in 2020. The disease burden of musculoskeletal disorders went from 2,655 YLDs per 100,000 in 2013 to 2,715 YLDs per 100,000 in 2020.
In 2019, according to the Global Burden of Disease 2019 study [7] the estimated total YLDs in Belgium was above the EU-14 countries mean, ranking the country 2nd worst among the EU-14.
Age-adjusted YLD rate per 100,000, by country of residence (EU-14), 2019 Source: GBD 2019 study [7]
What are the most important diseases in Belgium? Which risk factors contribute most to the overall disease burden? How is the burden of disease evolving over time, and how does it compare with neighboring countries? To address these basic questions, Sciensano conducts a national burden of disease study, in which the population impact for 38 key diseases in Belgium is evaluated.
The burden of disease in terms of reduced quality of life as a result of living with a disability is quantified using the Years Lived with Disability (YLD) metric. The YLD is a measure of the non-fatal disease burden in a specific population. YLDs are calculated by multiplying the number of prevalent cases with the (severity-weighted) disability weight, which reflects the relative reduction in quality of life lost due to living with the disease.
We calculate disease burden estimates by age, sex and region, allowing for a very detailed assessment of the state of health. The complete set of estimates can be explored via https://burden.sciensano.be/shiny/daly.
Definitions
YLD
The Years Lived with Disability or YLDs in short is a measure of the non-fatal disease burden in a specific population. YLDs are calculated by multiplying the number of prevalent cases with the (severity-weighted) disability weight, which reflects the relative reduction in quality of life lost due to living with the disease.
EU-14
The EU-14 corresponds to all countries that belonged to the European Union between 1995 and 2004: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, and Sweden. We compare the Belgian health status to that of the EU-14 because these countries have similar socioeconomic conditions. Note: The United Kingdom is not included since they have left the EU.
Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 (GBD 2019) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2020. Available from http://ghdx.healthdata.org/gbd-results-tool.
In 2020, the considered 38 key diseases led to a loss of 1.4 million healthy life years due to premature mortality.
In 2020, cancer, infectious diseases and cardiovascular diseases were the leading causes of disease burden due to premature mortality in Belgium.
The total disease burden due to premature mortality in 2020 was higher among men compared to women.
The largest share of the disease burden due to premature mortality was borne by the elderly.
The total disease burden due to premature mortality was the highest in the Walloon Region, followed by the Brussels Capital Region, and the Flemish Region.
Among EU-14 countries, Belgium ranks third worst in terms of disease burden due to premature mortality.
2.Years of Life Lost
More than 1.4 million life years lost in 2020
In 2020, the considered 38 key diseases led to a loss of 1,437,747 healthy life years (12,494 YLLs per 100,000) due to premature mortality. Cancer, infectious diseases and cardiovascular diseases were the leading disease groups, accounting for more than 60% of the total disease burden due to mortality. The top 5 specific causes for YLLs were COVID-19 (19%), lung cancer (10%), Ischemic heart disease (9%), cerebrovascular disease (7%), Alzheimer’s disease and other dementias (6%).
Distribution of the Years of Life Lost by disease, Belgium, 2020 Source: Own calculations based on data from Statbel [1]
Men suffer a higher disease burden due to premature mortality compared to women. The age-adjusted YLLs equaled 15,996 per 100,000 among men, and 9,553 per 100,000 among women. In men, the three leading causes for YLLs were COVID-19 (3,101 YLLs per 100,000), ischemic heart disease (1,760 YLLs per 100,000), lung cancer (1,748 YLLs per 100,000), whereas, in women, the leading three causes were COVID-19 (1,850 YLLs per 100,000), lung cancer (846 YLLs per 100,000) Alzheimer’s disease and other dementias (821 YLLs per 100,000).
Distribution of age-adjusted YLL rate by sex and disease group, Belgium, 2020 Source: Own calculations based on data from Statbel [1]
In Belgium, the disease burden due to premature mortality is largely borne by the elderly. The majority (68%) of YLLs in the Belgian population are attributable to the group of 65+ years (49,8860 YLLs per 100,000). In the group with an age between 45 and 64 years, Belgians suffered from 44,727 YLLs per 100,000 (24%), followed by a total of 14,854 YLLs per 100,000 in the group aged between 15 and 44 years (8%). The youngest group (< 15 years) accounted for less than 1% of the total amount of YLLs. The leading specific causes with the highest impact in terms of YLLs per 100,000 were lower respiratory infections and epilepsy in children with an age < 5 years, brain and nervous system cancer, and cerebrovascular disease in children with an age between 5 and 14 years, self-harm and road injuries in youngsters and adults with an age between 15 and 44 years, lung cancer and COVID-19 in adults with an age between 45 and 64, and COVID-19 and Alzheimer’s disease and other dementias in elderly with an age higher than 65.
Distribution of YLL rates by age and disease group, Belgium, 2020 Source: Own calculations based on data from Statbel [1]
The highest burden is in the Walloon Region
After correcting for differences in population size and age structure, the disease burden in terms of premature mortality was the highest in the Walloon Region (15,042 YLLs per 100,000), followed by the Brussels Capital Region (14,310 YLLs per 100,000), and the Flemish Region (10,943 YLLs per 100,000). The leading causes were similar across regions except for the Brussels Region, where infectious disease is the most important group.
Ranking of disease groups by age-adjusted YLL rates, Belgium and regions, 2020 Source: Own calculations based on data from Statbel [1]
Infectious diseases on the rise in 2020
Looking at trends over time after correcting for the population size and age structure, the disease burden of cancer due to premature mortality has decreased for the top disorders. The disease burden of cancer has decreased from 4,202 YLLs per 100,000 individuals in 2013 to 3,474 YLLs per 100,000 individuals in 2020. A similar trend is observed for cardiovascular disorders, for which the disease burden has decreased from 2,774 DALYs per 100,000 individuals to 1,985 DALYs per 100,000 individuals in 2020. Nevertheless, the number of infectious diseases has increased, rising from 681 DALYs per 100,000 individuals to 2,934 DALYs per 100,000 individuals. This sharp increase is mainly due to COVID-19.
In 2019, according to the Global Burden of Disease 2019 study [2] the estimated YLLs in Belgium was above the EU-14 countries mean, ranking the country third worst among the EU-14.
Age-adjusted Years of Life Lost rate per 100,000 by country of residence (EU-14), 2019 Source: GBD 2019 study [2]
What are the most important diseases in Belgium? Which risk factors contribute most to the overall disease burden? How is the burden of disease evolving over time, and how does it compare with neighboring countries? To address these basic questions, Sciensano conducts a national burden of disease study, in which the population impact for 38 key diseases in Belgium is evaluated.
The burden of disease due to premature mortality is quantified using the Years of Life Lost (YLL) metric. YLLs are calculated by multiplying the number of deaths with the residual life expectancy at the age of death, thereby reflecting the number of years an individual has lost due to premature death.
We calculate disease burden estimates by age, sex and region, allowing for a very detailed assessment of the state of health. The complete set of estimates can be explored via https://burden.sciensano.be/shiny/daly.
Definitions
YLL
The Years of Life Lost or YLLs in short is a measure of the fatal disease burden in a specific population. YLLs are calculated by multiplying the number of deaths with the residual life expectancy at the age of death, thereby reflecting the number of years an individual has lost due to premature death.
EU-14
The EU-14 corresponds to all countries that belonged to the European Union between 1995 and 2004: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, and Sweden. We compare the Belgian health status to that of the EU-14 because these countries have similar socioeconomic conditions. Note: The United Kingdom is not included since they have left the EU.
Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 (GBD 2019) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2020. Available from http://ghdx.healthdata.org/gbd-results-tool.
Please cite this page as: Sciensano. Burden of disease: Years of Life Lost, Health Status Report, 18 Sep 2023, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/burden-of-disease/years-of-life-lost
The Belgian national burden of disease study quantifies the health impact of 38 key diseases in terms of Disability-Adjusted Life Years (healthy life years lost due to morbidity and mortality).
In 2020, the considered diseases led to a loss of 2.5 million healthy life years.
In 2020, mental and substance use disorders, cancers, and infectious diseases were the leading causes of disease burden in Belgium.
The disease burden in 2020 was almost equally attributable to premature mortality (57%) as to losses in quality of life (43%).
The total disease burden in 2020 was higher among men compared to women.
The largest share of the disease burden was borne by the elderly (65+).
The total disease burden was the highest in the Walloon Region, followed by the Brussels Capital Region, and Flemish Region.
Among EU-14 countries, Belgium ranks 2nd worst in terms of total disease burden.
2.Disability-Adjusted Life Years
More than 2.5 millions healthy life years lost in Belgium in 2020
In 2020, the considered 38 key diseases led to a loss of 2,509,328 healthy life years (21,807 DALYs per 100,000). Mental and substance use disorders, cancers, and infectious diseases were the leading disease groups, accounting for 50% of the total disease burden. The top 5 specific causes for DALYs were COVID-19 (11%), depression (7%), lung cancer (6%), ischemic heart disease (6%) and low back pain (6%).
Overall, DALYs could be attributed almost equally to premature mortality (57%) and to reduced quality of life (43%). Across disorders, there was a wide variety in the contribution of the mortality and morbidity impact: some disorders had almost entirely a morbidity impact (e.g., sense organ disorders), while others had almost entirely a mortality impact (e.g., injuries).
Men suffer a higher disease burden compared to women. Among men, the age-adjusted DALYs equaled 25,357 per 100,000 in 2020, of which 61% could be attributed to premature mortality, and 39% to reduced quality of life. Among women, the age-adjusted DALYs equaled 18,815 per 100,000 in 2020, of which 53% could be attributed to premature mortality, and 47% to reduced quality of life. In both sexes, the leading disease for DALYs was COVID-19 (men: 3,134 DALYs per 100,000; women : 1,884 DALYs per 100,000).
The disease burden in Belgium is largely borne by the elderly. The majority (53%) of DALYs in the Belgian population are attributed to the group of 65+ years (603,753 DALYs per 100,000). Among the group aged between 45 and 64 years, the Belgians suffered a total of 90,430 DALYs per 100,000 (28%), followed by a total of 64,886 DALYs per 100,000 among the group aged between 15 and 44 years (19%). The youngest group (< 15 years) accounted for less than 1% of the total DALYs. The leading disease groups with the highest impact in terms of DALYs per 100,000 were chronic respiratory diseases in children aged 5 years or less, neurological disorders in children aged between 5 to 14 years, mental and substance use disorders in youngsters and adults with an age between 15 to 64 years and infectious diseases in the elderly.
After correcting for differences in population size and age structure, the disease burden is the highest in the Walloon Region (26,224 DALYs per 100,000), followed by the Brussels Capital Region (25,013 DALYs per 100,000), and the Flemish Region (19,016 DALYs per 100,000). In general, the leading disease groups do not differ across regions with mental and substance disorders being the group with the highest impact in all regions except the Flemish Region, where cancer is the leading disease group. Cancer is the second largest disease group in the Walloon Region, mental and substance disorders are the second most important group in the Flemish Region, and infectious diseases are in second place in the Brussels-Capital Region. The third largest group in the Walloon Region is infectious diseases, while in Brussels this is cancer, and in the Flemish Region these are musculoskeletal disorders.
The burden of disease decreases over time but COVID-19 has increased the burden of infectious diseases
Looking at trends over time after correcting for the population size and age structure, the disease burden of cancer has decreased from 4,507 DALYs per 100,000 individuals in 2013 to 3,770 DALYs per 100,000 individuals in 2020. A similar trend is observed for cardiovascular disorders, for which the disease burden has decreased from 3,026 DALYs per 100,000 individuals in 2013 to 2,225 DALYs per 100,000 individuals in 2020. In contrast, the disease burden of mental and substance use disorder has increased from 4,095 DALYs per 100,000 in 2013 to 4,260 DALYs per 100,000 in 2020. The disease burden of musculoskeletal disorders was 2,664 DALYs per 100,000 in 2013 and 2,724 DALYs per 100,000 in 2020, remaining stable over time. However, infectious diseases have increased between 2019 and 2020. They have risen from 681 DALYs per 100,000 individuals in 2019 to 2,967 DALYs per 100,000 individuals in 2020. This is mainly due to the appearance of Covid-19.
In 2019, according to the Global Burden of Disease 2019 study [7], the estimated total DALYs in Belgium was above the EU-14 countries mean, ranking the country 2nd worst among the EU-14 countries after Greece.
Age-adjusted DALY rate per 100,000 by country of residence (EU-14), 2019 Source: GBD 2019 study [7]
What are the most important diseases in Belgium? Which risk factors contribute most to the overall disease burden? How is the burden of disease evolving over time, and how does it compare with neighboring countries? To address these basic questions, Sciensano conducts a national burden of disease study, in which the population impact for 38 key diseases in Belgium is evaluated.
The burden of disease is quantified using the Disability-Adjusted Life Year (DALY) metric. The use of DALYs allows to combine the years of healthy life lost due to reduced quality of life (Years Lived with Disability, YLD) and due to premature death (Years of Life Lost, YLL). It therefore permits a truly comparative ranking of the burden of various diseases, injuries and risk factors.
We calculate disease burden estimates by age, sex and region, allowing for a very detailed assessment of the state of health. The complete set of estimates can be explored via https://burden.sciensano.be/shiny/daly.
Definitions
DALY
The Disability-Adjusted Life Year or DALY in short is a population-level measure of the disease or disability burden in a specific population. DALYs are calculated by combining measures of life expectancy as well as the adjusted quality of life during a burdensome disease or disability for a population. More specifically the DALY reflects the sum of years of life lost (YLL) due to premature mortality and years of life lost due to disability (YLD) for a specific disease or condition.
YLD
The Years Lived with Disability or YLDs in short is a measure of the non-fatal disease burden in a specific population. YLDs are calculated by multiplying the number of prevalent cases with the (severity-weighted) disability weight, which reflects the relative reduction in quality of life lost due to living with the disease.
YLL
The Years of Life Lost or YLLs in short is a measure of the fatal disease burden in a specific population. YLLs are calculated by multiplying the number of deaths with the residual life expectancy at the age of death, thereby reflecting the number of years an individual has lost due to premature death.
EU-14
The EU-14 corresponds to all countries that belonged to the European Union between 1995 and 2004: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, and Sweden. We compare the Belgian health status to that of the EU-14 because these countries have similar socioeconomic conditions.Note: The United Kingdom is not included since they have left the EU.
Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 (GBD 2019) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2020. Available from http://ghdx.healthdata.org/gbd-results-tool.