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Korean Journal of Epidemiology 1997;19(2): 200-209.
Years of Life Lost(YLL) and Health Priority in Korea.
Joo Hon Sung
Department of Preventive Medicine, Seoul National UniversityCollege of Medicine, Korea.
BACKGROUND: A national burden of disease estimation enables priority setting in health policy, baseline and post hoc evaluation of public health service. But, lack of elementary statistics had kept it from having been fully appraised in Korea. Years of life lost(YLL) due to premature death of 1995 was estimated from National Death Certificate data. This study was launched as necessary step for assessing global burden of disease(GBD)which will include years lived with disability (YLD) and disabillity-adjusted life year(DALY).
National Death Certificate data in 1995 and 1991 were available with individual information. Diseases classification system suggested by GBD researchers were modified into 60 entities, reflecting death pattern in Korea. Some tropical, infectious, non-fatal conditions were combined and occupational injury category was newly defined. Potential years of life lost (PYLL) to 60-85 years by 5 years, death rate, standard expected years of life lost(SEYLL) were calculated according to new disease categories.
Cancer followed by traffic accident and Cardiovascular disease was the most important cause of PYLL and SEYLL by 24 categories classification, and traffic accident (TA) contributes by far the largest part of PYLL and SEYLL by 60 categories classification. SEYLL is thought to be a better single index for YLL, and 20 leading causes of SEYLL were calculated (by 60 categories). Such entities as self injury, leukemia, congenital anomaly, occupational injury among 20 leading causes showed discrepancy between relatively low death rate and larger YLLs.
TA, stomach, liver, lung cancers, cerebrovascular attacks, chronic liver diseases, cardiovascular diseases still shows high death rate and enormous YLLs. The importance of controling them cannot be over-emphasized. Diseases with larger YLLs and lower death rate should be reassessed and attentioned in view of public health promotion. This study could be a basis for health policy making and reference of further studies.


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