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Changes in life expectancy and disease burden in Norway, 1990–2019: an analysis of the Global Burden of Disease Study 2019
The Lancet Public Health ( IF 50.0 ) Pub Date : 2022-06-29 , DOI: 10.1016/s2468-2667(22)00092-5
Benjamin Clarsen 1 , Magne Nylenna 2 , Søren Toksvig Klitkou 3 , Stein Emil Vollset 4 , Carl Michael Baravelli 3 , Anette Kocbach Bølling 5 , Gunn Marit Aasvang 5 , Gerhard Sulo 3 , Mohsen Naghavi 4 , Maja Pasovic 6 , Muhammad Asaduzzaman 7 , Tone Bjørge 8 , Anne Elise Eggen 9 , Terje Andreas Eikemo 10 , Christian Lycke Ellingsen 11 , Øystein Ariansen Haaland 12 , Alemayehu Hailu 12 , Shoaib Hassan 13 , Simon I Hay 4 , Petur B Juliusson 14 , Adnan Kisa 15 , Sezer Kisa 16 , Johan Månsson 6 , Teferi Mekonnen 17 , Christopher J L Murray 4 , Ole F Norheim 18 , Trygve Ottersen 19 , Dominic Sagoe 20 , Kam Sripada 10 , Andrea Sylvia Winkler 21 , Ann Kristin Skrindo Knudsen 3
Affiliation  

Background

Geographical differences in health outcomes are reported in many countries. Norway has led an active policy aiming for regional balance since the 1970s. Using data from the Global Burden of Disease Study (GBD) 2019, we examined regional differences in development and current state of health across Norwegian counties.

Methods

Data for life expectancy, healthy life expectancy (HALE), years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) in Norway and its 11 counties from 1990 to 2019 were extracted from GBD 2019. County-specific contributors to changes in life expectancy were compared. Inequality in disease burden was examined by use of the Gini coefficient.

Findings

Life expectancy and HALE improved in all Norwegian counties from 1990 to 2019. Improvements in life expectancy and HALE were greatest in the two counties with the lowest values in 1990: Oslo, in which life expectancy and HALE increased from 71·9 years (95% uncertainty interval 71·4–72·4) and 63·0 years (60·5–65·4) in 1990 to 81·3 years (80·0–82·7) and 70·6 years (67·4–73·6) in 2019, respectively; and Troms og Finnmark, in which life expectancy and HALE increased from 71·9 years (71·5–72·4) and 63·5 years (60·9–65·6) in 1990 to 80·3 years (79·4–81·2) and 70·0 years (66·8–72·2) in 2019, respectively. Increased life expectancy was mainly due to reductions in cardiovascular disease, neoplasms, and respiratory infections. No significant differences between the national YLD or DALY rates and the corresponding age-standardised rates were reported in any of the counties in 2019; however, Troms og Finnmark had a higher age-standardised YLL rate than the national rate (8394 per 100 000 [95% UI 7801–8944] vs 7536 per 100 000 [7391–7691]). Low inequality between counties was shown for life expectancy, HALE, all level-1 causes of DALYs, and exposure to level-1 risk factors.

Interpretation

Over the past 30 years, Norway has reduced inequality in disease burden between counties. However, inequalities still exist at a within-county level and along other sociodemographic gradients. Because of insufficient Norwegian primary data, there remains substantial uncertainty associated with regional estimates for non-fatal disease burden and exposure to risk factors.

Funding

Bill & Melinda Gates Foundation, Research Council of Norway, and Norwegian Institute of Public Health.



中文翻译:

1990-2019 年挪威预期寿命和疾病负担的变化:对 2019 年全球疾病负担研究的分析

背景

许多国家报告了健康结果的地理差异。自 1970 年代以来,挪威一直引领着旨在实现地区平衡的积极政策。我们使用 2019 年全球疾病负担研究 (GBD) 的数据,检查了挪威各县在发展和当前健康状况方面的区域差异。

方法

提取了 1990 年至 2019 年挪威及其 11 个县的预期寿命、健康预期寿命 (HALE)、失去生命年数 (YLLs)、残疾生活年数 (YLDs) 和残疾调整生命年 (DALYs) 的数据来自 GBD 2019。比较了特定县对预期寿命变化的贡献。通过使用基尼系数检查疾病负担的不平等。

发现

从 1990 年到 2019 年,挪威所有县的预期寿命和 HALE 都有所改善。在 1990 年值最低的两个县,预期寿命和 HALE 的改善最大:奥斯陆,其中预期寿命和 HALE 从 71·9 年(95%不确定性区间 1990 年 71·4–72·4) 和 63·0 年 (60·5–65·4) 到 81·3 年 (80·0–82·7) 和 70·6 年 (67·4– 2019年分别为73·6);和 Troms og Finnmark,其中预期寿命和 HALE 从 1990 年的 71·9 年 (71·5–72·4) 和 63·5 年 (60·9–65·6) 增加到 80·3 年 (79· 2019 年分别为 4–81·2) 和 70·0 年 (66·8–72·2)。预期寿命增加主要是由于心血管疾病、肿瘤和呼吸道感染的减少。2019 年任何县的全国 YLD 或 DALY 率与相应的年龄标准化率之间没有显着差异;然而,Troms og Finnmark 的年龄标准化 YLL 比率高于全国比率(每 100 000 人中有 8394 [95% UI 7801–8944]而每 100 000 人中有 7536 人 [7391–7691])在预期寿命、HALE、所有 1 级 DALY 原因以及暴露于 1 级风险因素方面,县之间的不平等程度较低。

解释

在过去 30 年中,挪威减少了县之间疾病负担的不平等。然而,在县内和其他社会人口梯度上仍然存在不平等。由于挪威的原始数据不足,对非致命疾病负担和风险因素暴露的区域估计仍然存在很大的不确定性。

资金

比尔和梅琳达盖茨基金会、挪威研究委员会和挪威公共卫生研究所。

更新日期:2022-06-30
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