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1. Key messages

  • In 2018, the considered 37 key diseases led to a loss of 1.1 million health 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 sense organ disorders were the leading causes of disease burden due to reduced quality of life in Belgium.
  • The total disease burden due to reduced quality of life is similar among men and women.
  • The largest share of the disease burden due to reduced quality of life is borne by adults between 45 and 64 years old.
  • The total disease burden due to reduced quality of life is the highest in the Walloon Region, followed by the Brussels Capital Region, and the Flemish Region.
  • Among EU-14 countries, Belgium ranks worst in terms of disease burden due to reduced quality of life.

2. Background

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 37 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.

3. Belgium

In 2018, the considered 37 key diseases led to a loss 1,095,665 healthy life years (9,633 YLDs per 100,000) due to reduced quality of life (YLDs). Mental and substance use disorders, musculoskeletal disorders, and sense organ 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 (16.1%), low back pain (13.2%), alcohol use disorders (11.1%), neck pain (7.2%), and vision loss (7.1%).

Distribution of Years Lived with Disability by disease, Belgium, 2018
Source: Own calculations based on data from IMA, Intego, ERA, HIS, Belgian Cancer Registry and Statbel [1-6]

Men suffer a similar disease burden due to reduced quality of life compared to women. The age-adjusted YLDs equalled 9,620 per 100,000 men, and 9,630 per 100,000 women. In men, the three leading causes for YLDs were alcohol use (1,570 YLDs per 100,000), depression (1,315 YLDs per 100,000), and low back pain (1,156 YLDs per 100,000) whereas in women, the three leading specific causes were depression (1,782 YLDs per 100,000), low back pain (1,373 YLDs per 100,000), and neck pain (895 YLDs per 100,000).

Distribution of age-adjusted YLD rates by sex and disease group, Belgium, 2018
Source: Own calculations based on data from IMA, Intego, ERA, HIS, Belgian Cancer Registry and Statbel [1-6]

In Belgium, the disease burden due to reduced quality of life is largely borne by the adults. The majority (36%) of YLDs in the Belgian population are attributable to Belgians with an age between 45 and 64 years (12,728 YLDs per 100,000), followed by the group with an age between 15 and 44 years, where a total of 8,543 YLDs per 100,000 (33%) were lost in 2018. Among Belgians who are 65+ years, 15,547 years were lost due to reduced quality of life per 100,000 (30%). 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 chronic kidney disease in children with an age < 5 year, asthma and epilepsy in children aged between 5 to 15 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 osteoarthritis in elderly with an age higher the 65.

Distribution of YLD rates by age and disease group, Belgium, 2018
Source: Own calculations based on data from IMA, Intego, ERA, HIS, Belgian Cancer Registry and Statbel [1-6]

4. Regional differences

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 (11,239 YLDs per 100,000), followed by Brussels Capital region (9,987 YLDs per 100,000), and the Flemish Region (8,714 YLDs per100,000). The leading cause groups are identical among regions.

Ranking of disease groups by age-adjusted YLD rates, Belgium and regions, 2018
Source: Own calculations based on data from IMA, Intego, ERA, HIS, Belgian Cancer Registry and Statbel [1-6]

5. International comparison

In 2018, 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 worst among the EU-14.

Age-adjusted YLD rate per 100,000, by country of residence (EU-14), 2018
Source: GBD 2019 study [7]

6. Read more

Belgian Burden of Disease visualization tool
Belgian national burden of disease study. Guidelines for the calculation of DALYs in Belgium
Download Summary Table (.xlsx)231.31 KB

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.

References

  1. Intermualistic Agency (IMA). https://aim-ima.be/
  2. Intego, KU Leuven. https://intego.be/
  3. Renal Database, European Renal Association (ERA). https://www.era-online.org/en/registry/
  4. Health Interview Survey (HIS), Sciensano. https://www.sciensano.be/en/projects/health-interview-survey
  5. Belgian Cancer Registry (BCR). https://kankerregister.org/
  6. Statistics Belgium (Statbel). https://statbel.fgov.be/en
  7. 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.