J Korean Med Sci.  2016 Nov;31(Suppl 2):S158-S167. 10.3346/jkms.2016.31.S2.S158.

The Non-Communicable Disease Burden in Korea: Findings from the 2012 Korean Burden of Disease Study

• Yoon J
• Seo H
• Oh IH
• Yoon SJ

• KMID: 2360666
• DOI: http://doi.org/10.3346/jkms.2016.31.S2.S158

Abstract

In recognition of Korea's rising burden of non-communicable diseases (NCDs), we investigated the nation's NCD status and extracted detailed information from the 2012 Korean Burden of Disease study. Consistent with that study, we used disability-adjusted life year (DALY) as a metric. Using national data sources and disability weights specific to the Korean population, we analyzed 116 disaggregated NCDs from the study's four-level disease and injury hierarchy for both sexes and nine age groups. Per 100,000 population, 21,019 DALYs were lost to 116 NCDs. Of those, 13.97% were due to premature death (death prior to the standard life expectancy for a subject's age) and 86.03% to non-fatal health outcomes. Based on traditional statistics, the main causes of health loss were mortality of neoplasms; cardiovascular and circulatory diseases; diabetes, urogenital, blood, and endocrine diseases; and chronic respiratory diseases. When combined with analyses of premature death and non-fatal outcomes, however, a substantially different view emerged: the main causes of health loss were diabetes mellitus, low back pain, chronic obstructive pulmonary disease, ischemic heart disease, ischemic stroke, cirrhosis of the liver, osteoarthritis, asthma, gastritis and duodenitis, and periodontal disease (in that order), collectively causing 49.20% of DALYs. Thus, burden of disease data using DALYs rather than traditional statistics brings a new perspective to characterization of the population's health that provides practical information useful for developing and targeting national NCD control programs to better meet national needs.

Keyword

Disability-adjusted Life Years; DALY; Burden of Disease; Non-communicable Diseases; Korea

MeSH Terms

Asthma
Diabetes Mellitus
Duodenitis
Endocrine System Diseases
Fibrosis
Gastritis
Humans
Information Storage and Retrieval
Korea*
Life Expectancy
Liver
Low Back Pain
Mortality
Mortality, Premature
Myocardial Ischemia
Osteoarthritis
Periodontal Diseases
Pulmonary Disease, Chronic Obstructive
Stroke
Weights and Measures

Figure

• 

  Fig. 1 Proportion (A) and number of deaths (B), and number of incidences (C) in non-communicable diseases (NCDs) for 9 broad cause groups by sex and age group, 2012.

• 

  Fig. 2 Proportions of disability-adjusted life years (DALYs) (A) with the YLL and YLD as a proportion of total DALYs (B) according to broad 9 cause groups in 2012. YLL, years of life lost due to premature mortality; YLD, years lived with a disability.

• 

  Fig. 3 Top 10 causes of disability-adjusted life years (DALYs) with the YLL and YLD shares in males by age-group. X-axis: age group, Y-axis: DALYs per 100,000 males. The maximum value of the Y-axis was tailored to the distribution. YLL, years of life lost due to premature mortality; YLD, years lived with a disability.

• 

  Fig. 4 Top 10 causes of disability-adjusted life years (DALYs) with the YLL and YLD shares in females by age-group. X-axis: age group, Y-axis: DALYs per 100,000 females. The maximum value of the Y-axis was tailored to the distribution. YLL, years of life lost due to premature mortality; YLD, years lived with a disability.

• 

  Fig. 5 Comparison of the proportional distribution of death and years of life lost (YLL) by leading cause of death, 2012. Cirrhosis, cirrhosis of the liver; liver, liver cancer; IHD, ischemic heart disease; TBL, trachea, bronchus and lung cancers; stomach, stomach cancer; colon & rectum, colon and rectum cancers; DM, diabetes mellitus; COPD, chronic obstructive pulmonary disease; breast, breast cancer.

Reference

1. Korea Centers for Disease Control and Prevention. Factbook: Non-communicable Diseases 2015. Cheongju: Korea Centers for Disease Control and Prevention;2015.

2. Statistics Korea. Trends in life expectancy and healthy life expectancy [Internet]. accessed on 3 January 2015. Available at http://www.index.go.kr/potal/main/EachDtlPageDetail.do?idx_cd=2758.

3. Ko SJ, Jung YH. Health-adjusted life expectancy in Korea. Issue Focus. 2014; 247:1–8.

4. Murray CJ, Salomon JA, Mathers CD, Lopez AD. Summary Measures of Population Health: Concepts, Ethics, Measurement and Applications. Geneva: World Health Organization;2002.

5. Van der Maas PJ. Applications of summary measures of population health. In : Murray CJ, Salomon JA, Mathers CD, Lopez AD, editors. Summary Measures of Population Health: Concepts, Ethics, Measurement and Applications. Geneva: World Health Organization;2002. p. 53–60.

6. Pinheiro P, Plaß D, Krämer A. The burden of disease approach for measuring population health. In : Krämer A, Khan MH, Kraas F, editors. Health in Megacities and Urban Areas. Heidelberg: Springer;2011. p. 21–38.

7. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Measuring the global burden of disease and risk factors, 1990??001. In : Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ, editors. Global Burden of Diseases and Risk Factors. . Washington, D.C.: The World Bank;2006. p. 1–14.

8. Murray CJ, Lopez AD. The Global Burden of Disease: a Comprehensive Assessment of Mortality and Disability from Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. Boston, MA: Harvard University Press;1996.

9. Mathers CD, Vos T, Lopez A, Salomon J, Ezzati M. National Burden of Disease Studies: a Practical Guide. Geneva: World Health Organization;2001.

10. Yoon J, Oh IH, Seo H, Kim EJ, Gong YH, Ock M, Lim D, Lee WK, Lee YR, Kim D, et al. Disability-adjusted Life Years for 313 Diseases and Injuries: the 2012 Korean Burden of Disease Study. J Korean Med Sci. 2016; 31:Suppl 2. S146–S157.

11. Lim D, Lee WK, Park H. Disability-adjusted Life Years (DALYs) for Mental and Substance Use Disorders in the Korean Burden of Disease Study 2012. J Korean Med Sci. 2016; 31:Suppl 2. S191–S199.

12. World Health Organization. Metrics: disability-adjusted life year (DALY) [Internet]. accessed on 30 November 2015. Available at http://www.who.int/healthinfo/global_burden_disease/metrics_daly/en/.

13. Korean Statistical Information Service. Life table [Internet]. accessed on 17 November 2015. Available at http://kosis.kr/statisticsList/statisticsList_01List.jsp?vwcd=MT_ZTITLE&parentId=A#SubCont.

14. Lee YR, Kim YA, Park SY, Oh CM, Kim YE, Oh IH. Application of a Modified Garbage Code Algorithm to Estimate Cause-Specific Mortality and Years of Life Lost in Korea. J Korean Med Sci. 2016; 31:Suppl 2. S121–S128.

15. Barendregt JJ, Van Oortmarssen GJ, Vos T, Murray CJ. A generic model for the assessment of disease epidemiology: the computational basis of DisMod II. Popul Health Metr. 2003; 1:4.

16. Ock M, Lee JY, Oh IH, Park H, Yoon SJ, Jo MW. Disability Weights Measurement for 228 Causes of Disease in the Korean Burden of Disease Study 2012. J Korean Med Sci. 2016; 31:Suppl 2. S129–S138.

17. Alwan A. Global Status Report: on Noncommunicable Diseases 2010. Geneva: World Health Organization;2011.

18. Mathers C, Boerma T, Fat DM. The Global Burden of Disease: 2004 Update. Geneva: World Health Organization;2008.

19. Murray CJ, Lopez AD. Measuring the global burden of disease. N Engl J Med. 2013; 369:448–457.

20. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Ezzati M, Shibuya K, Salomon JA, Abdalla S, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012; 380:2197–2223.

21. Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, Williams G, Smith E, Vos T, Barendregt J, et al. The global burden of low back pain: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014; 73:968–974.

22. Hoy DG, Smith E, Cross M, Sanchez-Riera L, Buchbinder R, Blyth FM, Brooks P, Woolf AD, Osborne RH, Fransen M, et al. The global burden of musculoskeletal conditions for 2010: an overview of methods. Ann Rheum Dis. 2014; 73:982–989.

23. March L, Smith EU, Hoy DG, Cross MJ, Sanchez-Riera L, Blyth F, Buchbinder R, Vos T, Woolf AD. Burden of disability due to musculoskeletal (MSK) disorders. Best Pract Res Clin Rheumatol. 2014; 28:353–366.

24. Vos T, Barber RM, Bell B, Bertozzi-Villa A, Biryukov S, Bolliger I, Charlson F, Davis A, Degenhardt L, Dicker D. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2015; 386:743–800.

25. Hoy D, Geere JA, Davatchi F, Meggitt B, Barrero LH. A time for action: opportunities for preventing the growing burden and disability from musculoskeletal conditions in low- and middle-income countries. Best Pract Res Clin Rheumatol. 2014; 28:377–393.

26. Yoon SJ, Bae SC, Lee SI, Chang H, Jo HS, Sung JH, Park JH, Lee JY, Shin Y. Measuring the burden of disease in Korea. J Korean Med Sci. 2007; 22:518–523.

27. Kim EJ, Yoon SJ, Jo MW, Kim HJ. Measuring the burden of chronic diseases in Korea in 2007. Public Health. 2013; 127:806–813.

28. Korean Diabetes Association; National Heatlh Insurance Service (KR). Korean Diabetes Fact Sheet: 2015. Seoul: Korean Diabetes Association;2015.

29. Kwon HS, Kim WH, Lee DY, Park SI. Current status and need for a Korean diabetes prevention study. Public Health Wkly Rep. 1995; 8:746–753.

30. World Health Organization. Noncommunicable Diseases Progress Monitor 2015. Geneva: World Health Organization;2015.

31. World Health Organization. Preventing Chronic Diseases: a Vital Investment. Geneva: World Health Organization;2005.

32. Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P, Baugh V, Bekedam H, Billo N, Casswell S, et al. Priority actions for the non-communicable disease crisis. Lancet. 2011; 377:1438–1447.

33. Alleyne G, Binagwaho A, Haines A, Jahan S, Nugent R, Rojhani A, Stuckler D; Lancet NCD Action Group. Embedding non-communicable diseases in the post-2015 development agenda. Lancet. 2013; 381:566–574.

34. Bonita R, Magnusson R, Bovet P, Zhao D, Malta DC, Geneau R, Suh I, Thankappan KR, McKee M, Hospedales J, et al. Country actions to meet UN commitments on non-communicable diseases: a stepwise approach. Lancet. 2013; 381:575–584.

35. World Health Organization. Global Action Plan: for the Prevention and Control of Noncommunicable Diseases 2013-2020. Geneva: World Health Organization;2013.

36. Ezzati M, Riboli E. Can noncommunicable diseases be prevented? Lessons from studies of populations and individuals. Science. 2012; 337:1482–1487.