Years of potential life lost

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Years of potential life lost (YPLL) or potential years of life lost (PYLL) is an estimate of the average years a person would have lived if they had not died prematurely. [1] It is, therefore, a measure of premature mortality. As an alternative to death rates, it is a method that gives more weight to deaths that occur among younger people. An alternative is to consider the effects of both disability and premature death using disability adjusted life years.

Contents

Calculation

To calculate the years of potential life lost, the analyst has to set an upper reference age. The reference age should correspond roughly to the life expectancy of the population under study. In the developed world, this is commonly set at age 75, but it is essentially arbitrary. Thus, PYLL should be written with respect to the reference age used in the calculation: e.g., PYLL[75].

PYLL can be calculated using individual level data or using age grouped data. [2]

Briefly, for the individual method, each person's PYLL is calculated by subtracting the person's age at death from the reference age. If a person is older than the reference age when they die, that person's PYLL is set to zero (i.e., there are no "negative" PYLLs). In effect, only those who die before the reference age are included in the calculation. Some examples:

  1. Reference age = 75; Age at death = 60; PYLL[75] = 75 − 60 = 15
  2. Reference age = 75; Age at death = 6 months; PYLL[75] = 75 − 0.5 = 74.5
  3. Reference age = 75; Age at death = 80; PYLL[75] = 0 (age at death greater than reference age)

To calculate the PYLL for a particular population in a particular year, the analyst sums the individual PYLLs for all individuals in that population who died in that year. This can be done for all-cause mortality or for cause-specific mortality.

Significance

In the developed world, mortality counts and rates tend to emphasise the most common causes of death in older people because the risk of death increases with age. Because YPLL gives more weight to deaths among younger people, it is the favoured metric among those who wish to draw attention to those causes of death that are more common in younger people. Some researchers say that this measurement should be considered by governments when they decide how best to divide up scarce resources for research. [3]

For example, in most of the developed world, heart disease and cancer are the leading causes of death, as measured by the number (or rate) of deaths. For this reason, heart disease and cancer tend to get a lot of attention (and research funding). However, one might argue that everyone has to die of something eventually, and so public health efforts should be more explicitly directed at preventing premature death. When PYLL is used as an explicit measure of premature death, then injuries and infectious diseases, become more important. While the most common cause of death of young people aged 5 to 40 is injury and poisoning in the developed world, because relatively few young people die, the principal causes of lost years remain cardiovascular disease and cancer. [4]

By main cause of death in the United States of America

Person-years of potential life lost in the United States in 2006 [5]
Cause of premature deathPerson-years lost
Cancer8.6 million
Heart disease and strokes8.8 million
Accidents and other injuries5.9 million
All other causes13.6 million
Person-years of potential life lost in the United States in 2018
Cause of premature deathPerson-years lost
(Use/Accessibility/... of) firearms1.42 million [6] [7]
Motor vehicle crashes1.34 million [7]
All other causes

A study suggests the global "mean loss of life expectancy" (LLE) from all forms of direct violence was about 0.3 years, while air pollution accounted for about 2.9 years in 2015. [8]

By country

Here is a table of YPLL for all causes (ages 0–69, per 100,000) with the most recent available data from the OECD:

RankCountryFemale YPLLMale YPLLDate
1Flag of Latvia.svg  Latvia 4831132252015
2Flag of Mexico.svg  Mexico 6120114272016
3Flag of Lithuania.svg  Lithuania 4460123722017
4Flag of Hungary.svg  Hungary 458995472017
5Flag of Estonia.svg  Estonia 386396262016
6Flag of the United States.svg  United States 486282652016
7Flag of Poland.svg  Poland 372992902016
8Flag of Turkey.svg  Turkey 413172622016
9Flag of Chile.svg  Chile 366065092016
10Flag of the Czech Republic.svg  Czech Republic 308365552017
11Flag of Greece.svg  Greece 277657802016
12Flag of Slovenia.svg  Slovenia 263057232015
13Flag of the United Kingdom.svg  United Kingdom 329250962016
14Flag of France.svg  France 277556212015
15Flag of Germany.svg  Germany 297253122016
16Flag of Portugal.svg  Portugal 260757612016
17Flag of Canada (Pantone).svg  Canada 319750022015
18Flag of Belgium (civil).svg  Belgium 296351972016
19Flag of Finland.svg  Finland 255854512016
20Flag of Denmark.svg  Denmark 307547762015
21Flag of Austria.svg  Austria 260647362017
22Flag of Ireland.svg  Ireland 280045252015
23Flag of the Netherlands.svg  Netherlands 301940752016
24Flag of Australia (converted).svg  Australia 263444602016
25Flag of South Korea.svg  South Korea 220747092016
26Flag of Israel.svg  Israel 247341902016
27Flag of Spain.svg  Spain 219843912016
28Flag of Italy.svg  Italy 236441902015
29Flag of Sweden.svg  Sweden 250839752016
30Flag of Iceland.svg  Iceland 223541912017
31Flag of Norway.svg  Norway 247638952016
32Flag of Luxembourg.svg  Luxembourg 223139572016
33Flag of Japan.svg  Japan 214440152016
34Flag of Switzerland (Pantone).svg   Switzerland 236936142016

Australia

The report of the NSW Chief Medical Officer in 2002 indicates that cardiovascular disease (32.7% (of total Males Years of Life Lost due to premature mortality) and 36.6% of females YLL) and malignant neoplasms (27.5% of Males YLL and 31.2% of Females YLL) are the main causes of lost years [9]

When disability adjusted life years are considered, cancer (25.1/1,000), cardiovascular disease (23.8/1,000), mental health issues (17.6/1,000), neurological disorders (15.7/1,000), chronic respiratory disease (9.4/1,000) and diabetes (7.2/1,000) are the main causes of good years of expected life lost to disease or premature death. [10] The dramatic difference is in the greater number of years of disability caused mental illness and neurological issues and by diabetes.[ citation needed ]

See also

Related Research Articles

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References

  1. Gardner JW; Sanborn JS (1976). "Years of potential life lost (YPLL)—what does it measure?". Comparative Biochemistry and Physiology. A, Comparative Physiology. 53 (4): 323–6. doi:10.1016/s0300-9629(76)80148-x. PMID   3312.
  2. Association of Public Health Epidemiologists in Ontario. "Calculating Potential Years of Life Lost (PYLL)". Archived from the original on July 6, 2011. Retrieved 2008-05-13.
  3. Burnet NG, Jefferies SJ, Benson RJ, Hunt DP, Treasure FP (January 2005). "Years of life lost (YLL) from cancer is an important measure of population burden—and should be considered when allocating research funds". Br. J. Cancer. 92 (2): 241–5. doi:10.1038/sj.bjc.6602321. PMC   2361853 . PMID   15655548.
  4. "Archived copy" (PDF). Archived from the original (PDF) on 2009-01-21. Retrieved 2009-01-17.{{cite web}}: CS1 maint: archived copy as title (link)Page 54 Retrieved 17 January 2009.
  5. National Cancer Institute. "Person-Years of Life Lost". Cancer Trends Progress Report, 2009/2010 Update. Archived from the original on July 1, 2011.
  6. "Premature deaths from guns expose another toll of the firearms crisis". Georgia Public Broadcasting. Retrieved 16 March 2022.
  7. 1 2 Klein, Joshua; Prabhakaran, Kartik; Latifi, Rifat; Rhee, Peter (1 February 2022). "Firearms: the leading cause of years of potential life lost". Trauma Surgery & Acute Care Open. 7 (1): e000766. doi:10.1136/tsaco-2021-000766. ISSN   2397-5776. PMC   8819782 . PMID   35141422.
  8. Lelieveld, Jos; Pozzer, Andrea; Pöschl, Ulrich; Fnais, Mohammed; Haines, Andy; Münzel, Thomas (1 September 2020). "Loss of life expectancy from air pollution compared to other risk factors: a worldwide perspective". Cardiovascular Research. 116 (11): 1910–1917. doi:10.1093/cvr/cvaa025. ISSN   0008-6363. PMC   7449554 . PMID   32123898.
  9. "Report of the NSW Chief Health Officer: Years of life lost due to premature mortality (YLL)". Archived from the original on 13 June 2007. Retrieved 2009-01-17. Retrieved=17 January 2009
  10. "Archived copy" (PDF). Archived from the original (PDF) on 2009-01-21. Retrieved 2009-01-17.{{cite web}}: CS1 maint: archived copy as title (link)Retrieved=17 January 2009 Page 53