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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 he or she had not died prematurely.[1] It is, therefore, a measure of premature mortality. As a method, it is an alternative to death rates that gives more weight to deaths that occur among younger people. Another alternative is to consider the effects of both disability and premature death using disability adjusted life years.

Calculation Edit

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 he or she dies, 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 Edit

In the developed world, mortality counts and rates tend to emphasize the most common causes of death in older people, because the risk of death increases with age. Because PYLL gives more weight to deaths among younger individuals, 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]

Person-years of potential life lost in the United States in 2006[5]
Cause of premature death Person-years lost
Cancer 8,628,000 person-years
Heart disease and strokes 8,760,000 person-years
Accidents and other injuries 5,873,000 person-years
All other causes 13,649,000 person-years

By countryEdit

Here is a table of YPLL for all causes (ages 0-69, per 100,000) with the most recent available data from the OECD:[1][2]

Rank Country Female YPLL Male YPLL Date
1 Template:Country data Mexico 5027 8528 2006
2 Template:Country data Hungary 4032 9235 2005
3 Template:Country data United States 3633 6291 2005
4 Template:Country data Slovakia 334377322005
5 Template:Country data Poland 321179622006
6 Template:Country data Portugal 285860242003
7 Template:Country data Belgium 284854711999
8 Template:Country data New Zealand 274745402005
9 Template:Country flag2 256442202007
10 Template:Country data Canada 255441682004
11 Template:Country data Denmark 249343112006
12 Template:Country data Czech Republic 243054862007
13 Template:Country data Luxembourg 237840802005
14 Template:Country data Australia 228939462004
15 Template:Country data Ireland 228940082007
16 Template:Country data Netherlands 226632592007
17 Template:Country data Finland 225550942007
18 Template:Country data France 225246652006
19 Template:Country data South Korea 222745682006
20 Template:Country data Germany 221240442006
21 Template:Country data Norway 211837102006
22 Template:Country data Switzerland 210034882006
23 Template:Country flag2 206841432007
24 Template:Country data Greece 201745622007
25 Template:Country data Sweden 201131912006
26 Template:Country data Spain 200043992005
27 Template:Country data Italy 188736052006
28 Template:Country data Japan 183133972007
29 Template:Country data Iceland 174431182007


AustraliaEdit

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 [6]

When disability adjusted life years are considered, [[ mental health issues (17.6/1,000), neurological disorders (15.7/1,000), are amongst the main causes of good years of expected life lost to disease or premature death. [7] The dramatic difference is in the greater number of years of disability caused mental illness and neurological issues.

ReferencesEdit

  1. Gardner JW, Sanborn JS. Years of potential life lost (YPLL)--what does it measure?. URL accessed on 2006-12-14.
  2. Association of Public Health Epidemiologists in Ontario Calculating Potential Years of Life Lost (PYLL). URL accessed on 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.
  4. http://mhcs.health.nsw.gov.au/pubs/2008/pdf/chorep_summary_08.pdf Page 54 Retrieved 17 January 2009.
  5. National Cancer Institute. Person-Years of Life Lost. Cancer Trends Progress Report, 2009/2010 Update.
  6. http://mhcs.health.nsw.gov.au/public-health/chorep02/bod/bod_YLLcateg.htm Retrieved=17 January 2009
  7. http://mhcs.health.nsw.gov.au/pubs/2008/pdf/chorep_summary_08.pdf Retrieved=17 January 2009 Page 53
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