The burden of disease is an important measure of the health status of a population. Mortality does not give a complete picture of the burden of disease borne by individuals in different populations. Therefore, 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 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) (WHO, 2024[1]).
There are wide disparities in the years of life lost due to premature death and years lived with a disability in the region, as measured by the rate of DALYs per 100 000 people (Figure 3.10). In 2021, the rate of disability-adjusted life years (DALYs) in upper-middle- and low- and middle‑income countries was nearly 50% higher than in high-income countries in the Asia Pacific region. Singapore had the lowest DALY rate at under 20 000 per 100 000 population across all ages, followed by Korea and Brunei Darussalam at under 25 000. In contrast, the burden of disease was highest in Fiji, Pakistan, India and Myanmar, with DALY rates exceeding 40 000 per 100 000 people across all ages in 2021. Low-income countries often face a high burden of disease due to limited access to healthcare, poor infrastructure, and high rates of poverty and malnutrition, which contribute to the spread of infectious diseases and inadequate management of non-communicable diseases.
Years lived with disability (YLDs) specifically measure the burden of living with disability or morbidity, without accounting for premature death. In 2021, high-income countries in the region had a YLD rate of 12 000 per 100 000 population across all ages, compared to 10 000 per 100 000 in upper-middle- and low- and middle‑income countries (Figure 3.11). Notably, Japan, Australia and New Zealand had a YLD rate of approximately 14 000 per 100 000 population. High-income countries tend to exhibit higher YLDs due to several factors, particularly an ageing population. Older populations are more susceptible to chronic diseases such as arthritis, dementia, and cardiovascular conditions, which contribute significantly to higher disability.
Non-communicable diseases (NCDs), such as cardiovascular diseases and cancers, are the most common causes of death in the Asia-Pacific, responsible for 23 million deaths in 2021. The burden of NCDs is driven by factors that includes rapid unplanned urbanisation, unhealthy lifestyles, and population ageing. The probability of death between the ages of 30 and 70 from NCDs – including cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases – was 20% for females and 30% for males in lower-middle- and low-income countries and territories in the Asia-Pacific in 2021(Figure 3.12). The burden of NCDs was particularly high in the Solomon Islands and Fiji, where males faced a probability of over 40% of dying from these diseases in 2021. In contrast, premature mortality due to NCDs poses a significantly lower burden in high-income countries in the Asia-Pacific, where the probability of death for both females and males was less than half that in lower-middle- and low-income countries at 7.5% and 12.5% respectively.
