Burden of disease

Age — 2013: the age at last birthday in full years; 2015: the age by July 1st 2015 in full years; 2017: the age at the beginning of the visits; 2019-2023: the age by July 1st in full years.

Average annual population — half the sum number of the population at the beginning and the end of the year. This index is used to calculate rates.

County (in the DALY methodology) — the settlement in which a person resides according to the Population Register. Counties are classified on the basis of Classification of Estonian administrative units and settlements (EHAK). Until 2017, data by the counties is distributed by the administrative division that existed before administrative reform (October 2017).

DALY — Disability Adjusted Life Years are calculated as the sum of the Years of Life Lost (YLL) due to premature mortality in the population and the Years Lost due to Disability (YLD) for people living with the health condition or its consequences.

Disease groups of DALY (according to the ICD-10) — causes of morbidity or causes of death according to the ICD-10.

ICD-10 — International Statistical Classification of Diseases and Related Health Problems 10th Revision.

YLD — Years of Lived with Disability due to the health conditions or its consequences.

YLL — Years of Life Lost in the population due to premature mortality.

The methodology of Disability Adjusted Life Years (DALY) is based on the calculations of Global Burden of Diseases developed by the World Health Organization and adjusted to conditions of Estonia (see T. Lai, J. Habicht and R.-A. Kiivet 2009' article "Measuring burden of disease in Estonia to support public health policy"). Documents about the GBD methodology are available here.

The overall burden of disease is assessed using the disability-adjusted life year (DALY), a time-based measure that combines years of life lost due to premature mortality (YLLs) and years of life lost due to time lived in states of less than full health, or years of healthy life lost due to disability (YLDs). One DALY represents the loss of the equivalent of one year of full health.

The YLLs for a cause are calculated as the number of cause-specific deaths multiplied by a standard life expectancy of the age at which death occurs. To estimate YLD for a specific cause in a period, the number of cases in that period is multiplied by the average duration of the disease and a weight factor that reflects the severity of the disease on a scale from 0 (perfect health) to 1 (dead).

The source for mortality data of Estonian residents is Estonian Causes of Death Registry and data on morbidity come from the medical care invoice database of Estonian Health Insurance Fund. DALY, YLD and YLL are presented in absolute numbers (years) as well as in rates per 1000 population.

Causes of DALY are released in selected groups of diseases according to the methodology of GBD and the ICD-10. Burden of disease calculations are published every two years.

Classification of Estonian administrative units and settlements (EHAK)
Classification is used to provide regional statistics. Until 2017, data by the counties is distributed by the administrative division that existed before administrative reform (October 2017). EHAK is available on the website of Statistics Estonia under the heading List of Classifications.

International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)
ICD-10 is used for coding diagnoses in morbidity and causes of death. The classification system is available on the webpage of the here.

Karelson, K. (2016). Disability-adjusted life years of population in counties. Eesti piirkondlik areng. 2016. Regional Development in Estonia. Tallinn: Statistics Estonia, 117-127. .pdf

University of Washington Institute for Health Metrics and Evaluation interactive tool for global burden of disease data

OECD calculated and published Years of Life Lost statistics by countries, sex and causes of death in OECD database.

Maria Lepnurm

Department of Health Statistics

National Institute for Health Development

E-mail: Maria.Lepnurm[at]tai.ee

Updated: 19.06.2024