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Med Clin (Barc). 2018 Sep 14;151(5):171-190. doi: 10.1016/j.medcli.2018.05.011. Epub 2018 Jul 20.

The burden of disease in Spain: Results from the Global Burden of Disease 2016.

[Article in English, Spanish]

Author information

1
Instituto de Investigación Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, España; SEPAR, Barcelona, España. Electronic address: jbsoriano2@gmail.com.
2
Instituto de Salud Global de Barcelona, Barcelona, España; IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España; Universitat Pompeu Fabra (UPF), Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, España.
3
IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España; Universitat Pompeu Fabra (UPF), Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España.
4
Institut Germans Trias i Pujol, Badalona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, España; Universitat Autònoma de Barcelona, Barcelona, España.
5
Institut Català d'Oncologia (ICO)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España.
6
Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, Países Bajos; Instituto de Salud Global de Barcelona, Barcelona, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España.
7
Center for Research in Occupational Health, Universitat Pompeu Fabra (UPF), Barcelona, España; Universitat Pompeu Fabra (UPF), Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España.
8
Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, Estados Unidos.
9
Instituto de Salud Global de Barcelona, Barcelona, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España.
10
Hospital Universitario Doctor Peset, Valencia, España; Universitat de Valencia, Valencia, España; University Cardenal Herrera CEU, Valencia, España.
11
Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España.
12
IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, España.
13
Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España; Biomedical Research Networking Center in Epidemiology & Public (CIBERESP), Barcelona, España.
14
Hospital Universitario Doctor Peset, Valencia, España; Departamento de Pediatría, Obstetricia y Ginecología, Universidad de Valencia, Valencia, España.
15
Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, España; Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, Estados Unidos.
16
Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, España; Facultat de Medicina, Universitat de Barcelona, Barcelona, España; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, España.

Abstract

BACKGROUND AND OBJECTIVES:

The global burden of disease (GBD) project measures the health of populations worldwide on an annual basis, and results are available by country. We used the estimates of the GBD to summarise the state of health in Spain in 2016 and report trends in mortality and morbidity from 1990 to 2016.

MATERIAL AND METHODS:

GBD 2016 estimated disease burden due to 333 diseases and injuries, and 84 risk factors. The GBD list of causes is hierarchical and includes 3 top level categories, namely: 1) communicable, maternal, neonatal, and nutritional diseases; 2) non-communicable diseases (NCDs), and 3) injuries. Mortality and disability-adjusted life-years (DALYs), risk factors, and progress towards the sustainable development goals (SDGs) are presented based on the GBD 2016 data in Spain.

RESULTS:

There were 418,516 deaths in Spain in 2016, from a total population of 46.5 million, and 80.5% of them occurred in those aged 70 years and older. Overall, NCDs were the main cause of death: 388,617 (95% uncertainty interval 374,959-402,486), corresponding to 92.8% of all deaths. They were followed by 3.6% due to injuries with 15,052 (13,902-17,107) deaths, and 3.5% communicable diseases with 14,847 (13,208-16,482) deaths. The 5 leading specific causes of death were ischaemic heart disease (IHD, 14.6% of all deaths), Alzheimer disease and other dementias (13.6%), stroke (7.1%), chronic obstructive pulmonary disease (6.9%), and lung cancer (5.0%). Remarkable increases in mortality from 1990 to 2016 were observed in other cancers, lower respiratory infections, chronic kidney disease, and other cardiovascular disease, among others. On the contrary, road injuries moved down from 8th to 32nd position, and diabetes from 6th to 10th. Low back and neck pain became the number one cause of DALYs in Spain in 2016, just surpassing IHD, while Alzheimer disease moved from 9th to 3rd position. The greatest changes in DALYs were observed for road injuries dropping from 4th to 16th position, and congenital disorders from 17th to 35th; conversely, oral disorders rose from 25th to 17th. Overall, smoking is by far the most relevant risk factor in Spain, followed by high blood pressure, high body mass index, alcohol use, and high fasting plasma glucose. Finally, Spain scored 74.3 of 100 points in the SDG index classification in 2016, and the main national drivers of detrimental health in SDGs were alcohol consumption, smoking and child obesity. An increase to 80.3 points is projected in 2030.

CONCLUSION:

Low back and neck pain was the most important contributor of disability in Spain in 2016. There has seen a remarkable increase in the burden due to Alzheimer disease and other dementias. Tobacco remains the most important health issue to address in Spain.

KEYWORDS:

(GBD); Años de vida ajustados por discapacidad; Años de vida perdidos; Años vividos con discapacidad; Carga global de las enfermedades; Disability-adjusted life years; España; Global burden of disease; Mortalidad; Mortality; Spain; Years lived with disability; Years of life lost

PMID:
30037695
DOI:
10.1016/j.medcli.2018.05.011
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