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@article{Steel:2018:10.1016/S0140-6736(18)32207-4,
author = {Steel, N and Ford, JA and Newton, JN and Davis, ACJ and Vos, T and Naghavi, M and Glenn, S and Hughes, A and Dalton, AM and Stockton, D and Humphreys, C and Dallat, M and Schmidt, J and Flowers, J and Fox, S and Abubakar, I and Aldridge, RW and Baker, A and Brayne, C and Brugha, T and Capewell, S and Car, J and Cooper, C and Ezzati, M and Fitzpatrick, J and Greaves, F and Hay, R and Hay, S and Kee, F and Larson, HJ and Lyons, RA and Majeed, A and McKee, M and Rawaf, S and Rutter, H and Saxena, S and Sheikh, A and Smeeth, L and Viner, RM and Vollset, SE and Williams, HC and Wolfe, C and Woolf, A and Murray, CJL},
doi = {10.1016/S0140-6736(18)32207-4},
journal = {The Lancet},
pages = {1647--1661},
title = {Changes in health in the countries of the UK and 150 English Local Authority areas 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016},
url = {http://dx.doi.org/10.1016/S0140-6736(18)32207-4},
volume = {392},
year = {2018}
}

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TY  - JOUR
AB  - BackgroundPrevious studies have reported national and regional Global Burden of Disease (GBD) estimates for the UK. Because of substantial variation in health within the UK, action to improve it requires comparable estimates of disease burden and risks at country and local levels. The slowdown in the rate of improvement in life expectancy requires further investigation. We use GBD 2016 data on mortality, causes of death, and disability to analyse the burden of disease in the countries of the UK and within local authorities in England by deprivation quintile.MethodsWe extracted data from the GBD 2016 to estimate years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and attributable risks from 1990 to 2016 for England, Scotland, Wales, Northern Ireland, the UK, and 150 English Upper-Tier Local Authorities. We estimated the burden of disease by cause of death, condition, year, and sex. We analysed the association between burden of disease and socioeconomic deprivation using the Index of Multiple Deprivation. We present results for all 264 GBD causes of death combined and the leading 20 specific causes, and all 84 GBD risks or risk clusters combined and 17 specific risks or risk clusters.FindingsThe leading causes of age-adjusted YLLs in all UK countries in 2016 were ischaemic heart disease, lung cancers, cerebrovascular disease, and chronic obstructive pulmonary disease. Age-standardised rates of YLLs for all causes varied by two times between local areas in England according to levels of socioeconomic deprivation (from 14274 per 100000 population [95% uncertainty interval 12791–15875] in Blackpool to 6888 [6145–7739] in Wokingham). Some Upper-Tier Local Authorities, particularly those in London, did better than expected for their level of deprivation. Allowing for differences in age structure, more deprived Upper-Tier Local Authorities had higher attributable YLLs for most major risk factors in the GBD.
AU  - Steel,N
AU  - Ford,JA
AU  - Newton,JN
AU  - Davis,ACJ
AU  - Vos,T
AU  - Naghavi,M
AU  - Glenn,S
AU  - Hughes,A
AU  - Dalton,AM
AU  - Stockton,D
AU  - Humphreys,C
AU  - Dallat,M
AU  - Schmidt,J
AU  - Flowers,J
AU  - Fox,S
AU  - Abubakar,I
AU  - Aldridge,RW
AU  - Baker,A
AU  - Brayne,C
AU  - Brugha,T
AU  - Capewell,S
AU  - Car,J
AU  - Cooper,C
AU  - Ezzati,M
AU  - Fitzpatrick,J
AU  - Greaves,F
AU  - Hay,R
AU  - Hay,S
AU  - Kee,F
AU  - Larson,HJ
AU  - Lyons,RA
AU  - Majeed,A
AU  - McKee,M
AU  - Rawaf,S
AU  - Rutter,H
AU  - Saxena,S
AU  - Sheikh,A
AU  - Smeeth,L
AU  - Viner,RM
AU  - Vollset,SE
AU  - Williams,HC
AU  - Wolfe,C
AU  - Woolf,A
AU  - Murray,CJL
DO  - 10.1016/S0140-6736(18)32207-4
EP  - 1661
PY  - 2018///
SN  - 0140-6736
SP  - 1647
TI  - Changes in health in the countries of the UK and 150 English Local Authority areas 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
T2  - The Lancet
UR  - http://dx.doi.org/10.1016/S0140-6736(18)32207-4
UR  - http://hdl.handle.net/10044/1/64093
VL  - 392
ER  -

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