Estimating the burden of disease in an English region.

BACKGROUND Health Authorities seeking to make appropriate investments in health care require information about the nature of the burden of disease in their populations. The World Bank instrument called DALY-Disability Adjusted Life Year-has been used in the South and West Region to measure this burden. METHOD The burden of disease caused by a selection of diseases has been calculated using DALYs, which combine premature mortality and disability. An estimate of the total burden has been estimated by ICD chapter. RESULTS Premature mortality accounts for 52 per cent of the burden of disease and disability 48 per cent. Mental illness, for which its DALY value is largely derived from disability not premature mortality, contributes the third largest component of the total burden, after heart disease and cancer. DISCUSSION DALYs can be calculated using UK data, and, with an appreciation of the theoretical issues which surround the calculations, can be used to describe the burden of disease in a population. Although designed to assist investment decisions in developing countries, the DALY is likely to be valuable in established market economies.