Measuring the burden of disease: healthy life-years

• Published in: American journal of public health (1971) Vol. 88; no. 2; pp. 196 - 202
• Main Authors: Hyder, A A, Rotllant, G, Morrow, R H
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Public Health Assoc 01-02-1998; American Public Health Association
• Subjects: Age; Biological and medical sciences; Cost of Illness; Disability; Disabled Persons; Disease; Epidemiology; General aspects; Ghana; Ghana - epidemiology; Health care; Health indicators; Health risk assessment; Humans; Inclusion; Infections; Intervention; Life Expectancy; Malaria; Medical sciences; Methodology; Morbidity; Mortality; Population; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality-Adjusted Life Years; Tropical diseases; Ghana; Performance evaluation; Human; Disability; Disease; Methodology; Health; Mortality; Epidemiology; Indicator; Morbidity; Public health; Comparative Studies; Evaluation; Africa; Ghana; Evaluation Methodology; Financial Activities; Health Status Indexes; Research Methodology; English Speaking Africa; Diseases; Studies; Western Africa; Economic Factors; Resource Allocation; Developing Countries; Africa South Of The Sahara
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.88.2.196

This paper presents the background and rationale for a composite indicator, healthy life-year (HeaLY), that incorporates mortality and morbidity into a single number. HeaLY is compared with the disability-adjusted life-year (DALY) indicator, to demonstrate the relative simplicity and ease of use of the former.
Data collected by the Ghana Health Assessment team from census records, death certificates, medical records, and special studies were used to create a spreadsheet. HeaLYs lost as a result of premature mortality and disability from 56 conditions were estimated.
Two thirds of HeaLYs lost in Ghana were from maternal and communicable diseases and were largely preventable. The age weighting in DALYs leads to a higher value placed on deaths at younger ages than in HeaLYs. This spreadsheet can be used as a template for assessing changes in health status attributable to interventions.
HeaLY can aid in setting health priorities and identifying disadvantaged groups. The disaggregated approach of the HeaLY spreadsheet tool is simpler for decision makers and useful for country application.