title: Quantifying the burden of disease due to premature mortality in Hong Kong using standard expected years of life lost.
abstract: BACKGROUND
  To complement available information on mortality in a population Standard Expected Years of Life Lost (SEYLL), an indicator of premature mortality, is increasingly used to calculate the mortality-associated disease burden. SEYLL consider the age at death and therefore allow a more accurate view on mortality patterns as compared to routinely used measures (e.g. death counts). This study provides a comprehensive assessment of disease and injury SEYLL for Hong Kong in 2010.
  
  
  METHODS
  To estimate the SEYLL, life-expectancy at birth was set according to the 2004 Global Burden of Disease study at 82.5 and 80 years for females and males, respectively. Cause of death data for 2010 were corrected for misclassification of cardiovascular and cancer causes. In addition to the baseline estimates, scenario analyses were performed using alternative assumptions on life-expectancy (Hong Kong standard life-expectancy), time-discounting and age-weighting. To estimate a trend of premature mortality a time-series analysis from 2001 to 2010 was conducted.
  
  
  RESULTS
  In 2010 524,706.5 years were lost due to premature death in Hong Kong with 58.3% of the SEYLL attributable to male deaths. The three overall leading single causes of SEYLL were "trachea, bronchus and lung cancers", "ischaemic heart disease" and "lower respiratory infections" together accounting for about 29% of the overall SEYLL. Further, self-inflicted injuries (5.6%; ranked 5) and liver cancer (4.9%; ranked 7) were identified as important causes not adequately captured by classical mortality measures. Scenario analyses highlighted that by using a 3% time-discount rate and non-uniform age-weights the SEYLL dropped by 51.6%. Using Hong Kong's standard life-expectancy values resulted in an overall increase of SEYLL by 10.8% as compared to the baseline SEYLL. Time-series analysis indicates an overall increase of SEYLL by 6.4%. In particular, group I (communicable, maternal, perinatal and nutritional) conditions showed highest increases with SEYLL-rates per 100,000 in 2010 being 1.4 times higher than 2001.
  
  
  CONCLUSIONS
  The study stresses the mortality impact of diseases and injuries that occur in earlier stages of life and thus presents the SEYLL measure as a more sensitive indicator compared to classical mortality indicators. SEYLL provide useful additional information and supplement available death statistics.
authors.affiliation: Department of Public Health Medicine, School of Public Health, Bielefeld University, Bielefeld, Germany. dietrich.plass@uni-bielefeld.de.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Plass
authors.forename: Patsy Yuen Kwan
authors.initials: PY
authors.lastname: Chau
authors.forename: Thuan Quoc
authors.initials: TQ
authors.lastname: Thach
authors.forename: Heiko J
authors.initials: HJ
authors.lastname: Jahn
authors.forename: Poh Chin
authors.initials: PC
authors.lastname: Lai
authors.forename: Chit Ming
authors.initials: CM
authors.lastname: Wong
authors.forename: Alexander
authors.initials: A
authors.lastname: Kraemer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D061213:Mortality, Premature; D012737:Sex Factors
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