Factors associated with changes in DALYs in five Asian health systems, 2000-2019

Rapid population aging in Asia has significantly increased the disease burden. However, there is limited research on the drivers of such changes in disability-adjusted life years (DALYs).

To examine the factors contributing to changes in DALYs in China, Japan, Singapore, South Korea, and Taiwan in 2000 and 2019.

We conducted cross-sectional analysis using data from the Global Burden of Disease Study 2021. Changes in DALYs between 2010 and 2019 were decomposed into four factors: population size, age-sex structure, disease cases per person, and DALYs per disease case.

From 2000 to 2019, total DALYs increased across all locations. While DALYs from injuries, communicable, maternal and neonatal conditions and nutritional deficiencies decreased, DALYs from non-communicable diseases increased. Decomposition analysis identified population aging (changes in age-sex structure) as the primary driver of increases in total DALYs, contributing an average of 33.6%. Population growth accounted for 15.3% on average. However, these increases were partially offset by decreases in DALYs per disease case, which fell by an average of -29.4%. Contributions from disease cases per person were relatively modest, averaging -3.4%. Notably, the decline in DALYs per disease case was more pronounced for non-communicable diseases, despite an overall increase in disease cases per person.

The increase in DALYs across these Asian societies was primarily driven by population aging and growth. However, DALYs per disease case decreased, suggesting improvements in disease management. Given the growing burden of non-communicable diseases in these societies, maintaining a focus on effective interventions remains crucial.