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The European Journal of Public Health Advance Access published online on November 23, 2007
The European Journal of Public Health, doi:10.1093/eurpub/ckm109
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© The Author 2007. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Sensitivity analysis in summary measure of population health in France

Annabelle Lapostolle1, Agnès Lefranc2,3, Isabelle Gremy2 and Alfred Spira1

1Inserm U822/Service de Santé Publique, France
2Observatoire Régional de Santé Ile-de-France, 21-23 Rue Miollis, 75015 Paris, France
3Institut de Veille Sanitaire – DES, 12, Rue du Val d’Osne, 94415 Saint-Maurice cedex, France

Correspondence: Annabelle Lapostolle, Hôpital de Kremlin Bicêtre, 82 rue du Général Leclerc, 94276 Le Kremlin Bicêtre cedex, France, tel: +33 1 45 21 23 39, fax: +33 1 45 21 20 75, e-mail: lapostol{at}vjf.inserm.fr

Received December 4, 2006 , accepted October 25, 2007

Background: The aim of this study is to provide estimates of the French burden of disease, using the WHO Global Burden of Disease methodology and to perform sensitivity analysis on different set of mortality data. Methods: The burden of disease is measured by disability-adjusted life years (DALYs) that take into account both mortality and morbidity data. Results were obtained using French mortality data for the years 2000 and 2001 and morbidity data estimated by WHO for France. Sensitivity analyses were conducted using different mortality data sets and various life tables as mortality norms. Calculations were also performed with and without discounting and age-weighting. Results: In France, the annual burden of disease was about 12.4 million DALYs. Depending on the mortality data set and the choice of social values used for calculation, results could be quite different. The use of WHO estimates for mortality resulted in an underestimation of 2.6% of total DALYs with respect to French data. Changes of the mortality norm imply changes in the number of years of life lost (YLLs), whereas the use of discounting and age-weighting mainly modifies the ranking of diseases. Conclusion: DALYs constitute a summary measure of population health, which is a powerful tool for the grading of health problems, allowing to compare fatal and non-fatal diseases. Nevertheless, the validity of results obtained depends primarily on the validity of the input data. Collecting morbidity data (mainly incidence) at the national level is hence an important step in order to assess more accurately the specific burden of diseases in France.

Keywords: burden of disease, disabled person, France, mortality


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