Burden of non-communicable diseases among adolescents and young adults aged 10-24 years in the South-East Asia and Western Pacific regions, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Huan Wang; Yi Song; Jun Ma; Sheng Ma; Lijuan Shen; Yangmu Huang; Pugazhenthan Thangaraju; Zarrin Basharat; Yifei Hu; Yuan Lin; Amy E Peden; Susan M Sawyer; Hao Zhang; Zhiyong Zou

doi:10.1016/S2352-4642(23)00148-7

Burden of non-communicable diseases among adolescents and young adults aged 10-24 years in the South-East Asia and Western Pacific regions, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Lancet Child Adolesc Health. 2023 Sep;7(9):621-635. doi: 10.1016/S2352-4642(23)00148-7. Epub 2023 Jul 28.

Authors

Huan Wang¹, Yi Song¹, Jun Ma¹, Sheng Ma¹, Lijuan Shen¹, Yangmu Huang², Pugazhenthan Thangaraju³, Zarrin Basharat⁴, Yifei Hu⁵, Yuan Lin⁶, Amy E Peden⁷, Susan M Sawyer⁸, Hao Zhang⁹, Zhiyong Zou¹⁰

Affiliations

¹ Institute of Child and Adolescent Health and National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.
² School of Public Health, Peking University, Beijing, China.
³ All India Institute of Medical Sciences, Tatibandh, Raipur, India.
⁴ Jamil-ur-Rahman Center for Genome Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan.
⁵ Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China.
⁶ Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
⁷ School of Population Health, University of New South Wales, Sydney, NSW, Australia; College of Public Health, Medical, and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.
⁸ Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.
⁹ Heart Center and Shanghai Institute of Pediatric Congenital Heart Disease, Shanghai Children's Medical Center, National Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹⁰ Institute of Child and Adolescent Health and National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China. Electronic address: harveyzou2002@bjmu.edu.cn.

PMID: 37524095
DOI: 10.1016/S2352-4642(23)00148-7

Abstract

Background: Although non-communicable diseases (NCDs) remain the leading causes of mortality and disability worldwide, little comprehensive or recent evidence of the burden of NCDs among adolescents and young adults in the South-East Asia and Western Pacific regions is available. We aimed to report population shifts in people aged 10-24 years and their NCD burden from 1990 to 2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.

Methods: We retrieved data from GBD 2019 for people aged 10-24 years in the South-East Asia and Western Pacific regions from 1990 to 2019. We presented population shifts and analysed deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) for NCDs. We also quantified the associations of deaths and DALYs with the Socio-demographic Index (SDI) and Universal Health Coverage (UHC) effective coverage index using Spearman correlation and linear regression analyses. Percentages are reported to 1 decimal place and rates are reported to 2 decimal places.

Findings: In 2019, there were 559·2 million young people aged 10-24 years in the South-East Asia region and 335·0 million in the Western Pacific region; India and China remained the countries with greatest number of this age group. In 1990-2019, India had an absolute increase of 139·4 million adolescents, while China had a decrease of 134·3 million. In 2019, NCDs accounted for 27·3% (95% uncertainty interval 25·1 to 29·2) and 34·6% (33·5 to 36·1) of total deaths, and 49·8% (45·3 to 54·4) and 65·1% (60·6 to 69·3) of total DALYs in the South-East Asia and the Western Pacific regions, respectively. Neoplasms, cardiovascular diseases, and mental disorders were the leading causes of NCD burden in 42 countries. Kiribati had the highest rates of deaths (62·82 [50·77 to 76·11] per 100 000 population), YLLs (4364·73 [3545·04 to 5275·63] per 100 000 population), and DALYs (9368·73 [7713·65 to 11340·99] per 100 000 population) for NCDs, whereas Australia (6976·51 [5044·46 to 9190·01] per 100 000 population) and New Zealand (6716·81 [4827·25 to 8827·69] per 100 000 population) had the largest rates of YLDs due to NCDs. From 1990 to 2019 across both regions, the rate of death due to NCDs declined by over a third (-32·8% [-41·1 to -22·9] in the South-East Asia region and -40·0% [-48·6 to -30·4] in the Western Pacific region), and DALYs decreased by about 12% (-12·0% [-16·8 to -7·7] in the South-East Asia region and -12·8% [-17·7 to -8·7] in the Western Pacific region), whereas the proportion of NCD burden relative to all-cause burden increased (45·7% [32·9 to 61·7] for deaths and 41·2% [35·2 to 48·8] for DALYs in the South-East Asia region; 11·8% [7·1 to 21·5] for deaths and 18·2% [14·6 to 22·0] for DALYs in the Western Pacific region). The rate of deaths and DALYs due to NCDs decreased monotonically alongside increases in SDI (r_s=-0·57 [95% CI -0·81 to -0·32] for deaths and r_s=-0·30 [-0·61 to 0·03] for DALYs). The rate of deaths (r_s=-0·89 [95% CI -0·97 to -0·80]) and DALYs (r_s=-0·67 [-0·93 to -0·41]) due to NCDs also decreased alongside increases in the UHC effective coverage index.

Interpretation: Specific preventive and health service measures are needed for adolescents and young adults in countries with different levels of socioeconomic development to reduce the burden from NCDs.

Funding: National Natural Science Foundation of China.

Translation: For the Chinese translation of the abstract see Supplementary Materials section.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Asia, Eastern
Disabled Persons*
Global Burden of Disease
Global Health
Humans
Noncommunicable Diseases* / epidemiology
Young Adult