Quantifying the burden of disease in Scotland in 2018: a Scottish Burden of Disease study

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Abstract

Abstract Background The Scottish Burden of Disease (SBoD) Study monitors the contribution of over 100 diseases and injuries to the population health in Scotland. Providing robust estimates of the burden is important as recent evidence has highlighted stalling life expectancy and worsening trends in self-assessed general health and understanding the burden of disease is the first step in identifying areas of prevention which could have the biggest impact on health. Our aim was to estimate disability-adjusted life years (DALYs) for 2018, for all causes of disease and injury. Methods The SBoD 2016 study estimated the burden for 132 causes of injury and disease using routine data and patient-level record linkage. For this update, years lived with disability were estimated using 2016 age-sex-deprivation specific rates, assuming no change in disease prevalence from 2016, but taking account of changes to the population structure. Years of life lost were calculated from 2018 observed deaths and the application of the Global Burden of Disease aspirational life table. Results In 2018 the leading causes of burden were ischaemic heart disease, Alzheimer's/other dementias, lung cancer, drug-use disorders and cerebrovascular disease, representing over a quarter (27%) of the total DALYs in Scotland. Of the 10 leading causes of disease burden, four are wholly attributable to ill-health, demonstrating the added-value of considering DALYs in conjunction with traditional measures of mortality and morbidity. Conclusions Ischaemic heart disease continues to be the leading cause of burden of disease in Scotland, however recent years show an increase in burden of social causes and diseases primarily affecting the ageing population. These changes in leading causes demonstrate the importance of continuing to monitor the burden of disease in Scotland, to provide robust evidence for planning of local and national services. Key messages The study demonstrates the added-value of considering the burden of disease, in conjunction with traditional measures of morbidity and mortality. Ischaemic heart disease continues to be the leading cause of burden of disease in Scotland.

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