Measuring the burden of disease: healthy life-years.
OBJECTIVE
This paper presents the background and rationale for a composite indicator, healthy life-year (HeaLY), that incorporates mortality and morbidity into a single number. HeaLY is compared with the disability-adjusted life-year (DALY) indicator, to demonstrate the relative simplicity and ease of use of the former.


METHODS
Data collected by the Ghana Health Assessment team from census records, death certificates, medical records, and special studies were used to create a spreadsheet. HeaLYs lost as a result of premature mortality and disability from 56 conditions were estimated.


RESULTS
Two thirds of HeaLYs lost in Ghana were from maternal and communicable diseases and were largely preventable. The age weighting in DALYs leads to a higher value placed on deaths at younger ages than in HeaLYs. This spreadsheet can be used as a template for assessing changes in health status attributable to interventions.


CONCLUSIONS
HeaLY can aid in setting health priorities and identifying disadvantaged groups. The disaggregated approach of the HeaLY spreadsheet tool is simpler for decision makers and useful for country application.
Hyder
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AA
Department of International Health, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Rotllant
G
G
Morrow
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RH
D017281:Cost of Illness; D006233:Persons with Disabilities; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D008017:Life Expectancy; D019057:Quality-Adjusted Life Years