In short
What are the most important diseases in Belgium? Which risk factors contribute most to the overall disease burden? How is the burden of disease evolving over time, and how does it compare with neighbouring countries? In a context of increasing budgetary constraints, a precise answer to these basic questions is more than ever necessary to inform policy-making. However, although various data sources routinely generate partial information related to health in Belgium, coherent and comparable estimates of the burden of diseases, injuries and risk factors in Belgium are lacking.
To address this gap, Sciensano is conducting a national burden of disease study. In addition to generating internally consistent estimates of death rate (mortality) or how unhealthy we are (morbidity) by age, sex and region, the burden of disease will also be quantified using Disability-Adjusted Life Years (DALYs). The use of DALY allows to estimate the years of life lost from premature death and years of life lived with disabilities. It therefore permits a truly comparative ranking of the burden of various diseases, injuries and risk factors.
Project description
The main goal of public health policy is to protect and promote population health. Therefore, understanding which diseases pose the greatest threat to health and wellbeing is crucial. The relative importance of diseases in a population is often referred to as the “burden of disease”.
With ageing populations and the growing importance of non-fatal diseases, current evidence-based public health policy requires a global measure of population health, combining morbidity and mortality and taking account of health-related quality of life. Summary measures of population health such as the Disability-Adjusted Life Year (DALY) have therefore become key metrics for quantifying burden of disease. DALYs quantify the health gap from a life lived in perfect health as the number of potentially healthy life years lost due to illness and/or premature death.
Estimates on the burden of disease in Belgium are available from sporadic international and national efforts. However, if disease burden were to support health policy in Belgium, a more systematic approach is required, generating comparable estimates rooted in recent, local data.
Given the need for disease burden estimates to guide decision-making processes within the health sector and the limitations of the currently available burden estimates, Sciensano has taken the lead in launching a Belgian National Burden of Disease Study (BeBOD) which aims to establish a coherent framework for routinely quantifying the burden of disease in Belgium using the DALY metric. The project will ensure ownership and sustainability, embedment within the local context, methodological flexibility and comparability, and capacity building.
BeBOD relies on routine data sources to estimate the true disease burden and quantify related uncertainties. The different BeBOD activities are implemented in a stepwise way and gradually scaled-up. Dedicated technical reports document the methods, data and results for each of the specific steps.
Results
The BeBOD study generates a large number of disease burden estimates by cause, age, sex, region, and year. To explore these detailed estimates, a series of interactive visualisation tools have been developed. These tools allow creating graphs of the relative contribution of different causes, trends over time, comparisons across regions, patterns by age, and much more. The following tools are available:
Estimates of mortality and years of life lost for 131 causes of death
Estimates of the non-fatal burden of 57 cancer sites
Estimates of the burden of 38 key diseases
Estimates of attributable mortality and years of life lost due to tobacco use