title: Trends in disease burden in Germany: results, implications and limitations of the Global Burden of Disease study.
abstract: BACKGROUND
  The Global Burden of Disease (GBD) study is designed to give a comprehensive and standardized assessment of the health of populations around the world. It measures the burden of disease by considering years of life lost due to premature death as well as years lived with disability. The findings enable the identification of secular trends and disparities between countries and can serve as a basis for decision-making in health policy.
  
  
  METHODS
  In cooperation with the authors of the GBD study, we summarize the key methods used to assess the burden of disease in terms of disability-adjusted life years (DALYs). We present findings that specifically pertain to Germany, drawn from freely available data of the most recent round of analysis for the years 1990 and 2010.
  
  
  RESULTS
  According to the GBD study, life expectancy in Germany rose from 75.4 years in 1990 to 80.2 years in 2010. Ischemic heart disease and back pain caused the largest number of DALYs lost (2.5 million and 2.1 million, respectively). Over the period of the study, the absolute number of DALYs due to ischemic heart disease dropped by 33%, while the number of DALYs due to low back pain rose by 11%. Nutrition-related risks ranked first among all risk factors considered, accounting for 13.8% of total DALYs, followed by high blood pressure and high body-mass index, accounting for 10.9% each.
  
  
  CONCLUSIONS
  In Germany, important changes have been seen over time in the burden of disease attributable to different chronic diseases. Some of these changes reflect the successful interventions of the past, while others indicate a need for new action. The data from Germany that went into the GBD study must be systematically assessed and supplemented by further data relating to questions of specific relevance in this country.
authors.affiliation: Bielefeld University, Working Group 2, Department of Public Health Medicine, Bielefeld, Institute for Health Metrics and Evaluation, Seattle, USA, Bielefeld University, Working Group 7, Department of Environment and Health, Bielefeld, Department of Epidemiology and Health Monitoring of the Robert Koch Institute, Berlin, Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH, The Department of Prevention and Evaluation, Bremen.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Plass
authors.forename: Theo
authors.initials: T
authors.lastname: Vos
authors.forename: Claudia
authors.initials: C
authors.lastname: Hornberg
authors.forename: Christa
authors.initials: C
authors.lastname: Scheidt-Nave
authors.forename: Hajo
authors.initials: H
authors.lastname: Zeeb
authors.forename: Alexander
authors.initials: A
authors.lastname: Krämer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000401:mortality*; D017281:Cost of Illness; D004185:Disability Evaluation; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008017:Life Expectancy / Q000639:trends*; D008297:Male; D061213:Mortality, Premature / Q000639:trends*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012307:Risk Factors