Years of Life Lost

1. Key messages

  • In 2018, the considered 37 key diseases led to a loss of 1.2 million healthy life years due to premature mortality.
  • Cancer, cardiovascular diseases, and neurological disorder were the leading causes of disease burden due to premature mortality in Belgium.
  • The total disease burden due to premature mortality is higher among men compared to women.
  • The largest share of the disease burden due to premature mortality is borne by elderly.
  • The total disease burden due to premature mortality is the highest in the Walloon Region, followed by the Brussels Capital Region, and the Flemish Region.
  • Among EU-14 countries, Belgium ranks 4th worst in terms of disease burden due to premature mortality.

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 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.

3. Belgium

In 2018, the considered 37 key diseases led to a loss of 1,219,836 healthy life years (10,697 YLLs per 100,000) due to premature mortality. Cancer, cardiovascular diseases, and neurological disorder were the leading disease groups, accounting for more than 65% of the total disease burden due to mortality. The top 5 specific causes for YLLs were lung cancer (12.2%), Ischemic heart disease (12.1%), Alzheimer’s disease and other dementias (8.0%), cerebrovascular disease (8.0%), and chronic obstructive pulmonary disease (7.1%).

Distribution of the Years of Life Lost by disease, Belgium, 2018
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 13,580 per 100,000 among men, and 8,228 per 100,000 among women. In men, the three leading causes for YLLs were ischemic heart disease (1,905 YLLs per 100,000), lung cancer (1,884 YLLs per 100,000), and self-harm (1,065 YLLs per 100,000) whereas in women, the leading three causes were Alzheimer’s disease and other dementias (868 YLLs per 100,000), breast cancer (865 YLLs per 100,000), and lung cancer (829 YLLs per 100,000).

Distribution of age-adjusted YLL rate by sex and disease group, Belgium, 2018
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 (64%) of YLLs in the Belgian population are attributable to the group of 65+ years (104,871 YLLs per 100,000). In the group with an age between 45 and 64 years, Belgians suffered from 10,521 YLLs per 100,000 (27%), followed by a total of 2,412 YLLs per 100,000 in the group aged between 15 and 44 years (9%). 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 year, brain and nervous system cancer and road injuries 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 year, lung cancer and ischemic heart disease in adults with an age between 45 and 64, and Alzheimer’s disease and other dementias and ischemic heart disease in elderly with an age higher than 65.

Distribution of YLL rates by age and disease group, Belgium, 2018
Source: Own calculations based on data from Statbel [1]

4. Regional differences

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 (12,379 YLLs per 100,000), followed by the Brussels Capital Region (10,627 YLLs per 100,000), and the Flemish Region (9,780 YLLs per100,000). The leading causes were similar across regions.

Ranking of disease groups by age-adjusted YLL rates, Belgium and regions, 2018
Source: Own calculations based on data from Statbel [1]

5. International comparison

In 2018, 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 4th worst among the EU-14.

Age-adjusted Years of Life Lost rate per 100,000 by country of residence (EU-14), 2018
Source: GBD 2019 study [2]

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

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.

References

  1. Statistics Belgium (Statbel). https://statbel.fgov.be/en
  2. 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.