Global Disease Rankings (Deaths, DALYs, Disability) — 2021 Snapshot and What It Means 세계 질병 순위(사망·DALY·장애부담) — 2021 스냅샷과 의미 > CommonSense

Global Disease Rankings (Deaths, DALYs, Disability) — 2021 Snapshot and What It Means
세계 질병 순위(사망·DALY·장애부담) — 2021 스냅샷과 의미

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## English

### What “global disease ranking” actually means

A single “world disease ranking” does not exist, because “top” depends on the metric:

* **Deaths**: what kills the most people (mortality).
* **DALYs (Disability-Adjusted Life Years)**: the *total* health loss from early death **plus** living with illness/disability (burden). One DALY ≈ one year of healthy life lost.
* **YLDs (Years Lived with Disability)**: the biggest sources of *non-fatal* suffering/impairment (morbidity).

Below are **global, both sexes, all ages, year 2021** rankings using **WHO Global Health Estimates (GHE 2021)** datasets released with updated methods (not strictly comparable to older WHO releases).
*(Values are rounded; “million” = 1,000,000.)*

---

### A) Top 10 causes of death worldwide (2021, WHO GHE)

1. Ischaemic heart disease — **9.03 million** deaths • **13.22%**
2. COVID-19 — **8.72 million** • **12.77%**
3. Stroke — **6.97 million** • **10.21%**
4. Chronic obstructive pulmonary disease (COPD) — **3.52 million** • **5.15%**
5. Lower respiratory infections — **2.45 million** • **3.59%**
6. Trachea/bronchus/lung cancers — **1.86 million** • **2.72%**
7. Alzheimer disease & other dementias — **1.84 million** • **2.69%**
8. Diabetes mellitus — **1.62 million** • **2.37%**
9. Kidney diseases — **1.40 million** • **2.05%**
10. Tuberculosis — **1.39 million** • **2.04%**

**How to interpret this list**

* It is dominated by **noncommunicable diseases** (cardiovascular, cancer, dementia, diabetes, kidney disease), with major contributions from **respiratory causes** and a persistent infectious killer (**TB**).
* **Income level changes the ranking sharply**: low-income settings have a much larger share of communicable causes in their top 10 than high-income settings.

**High-leverage drivers behind the top-10 deaths**

* **Blood pressure + atherosclerosis** → heart disease, stroke, kidney disease (often interconnected).
* **Tobacco and air pollution** → COPD, lung cancer, cardiovascular risk.
* **Ageing** → dementia and many chronic conditions rise even if age-standardized rates improve.
* **System capacity** (vaccination, primary care, emergency care, oxygen, antibiotics, TB programs) strongly shifts respiratory and infectious outcomes.

---

### B) Top 10 causes of DALYs worldwide (2021, WHO GHE)

1. COVID-19 — **243.1 million** DALYs • **8.07%**
2. Ischaemic heart disease — **193.9 million** • **6.43%**
3. Stroke — **160.2 million** • **5.32%**
4. Lower respiratory infections — **105.6 million** • **3.51%**
5. Preterm birth complications — **100.5 million** • **3.33%**
6. Back and neck pain — **90.9 million** • **3.02%**
7. Diabetes mellitus — **80.5 million** • **2.67%**
8. COPD — **78.1 million** • **2.59%**
9. Diarrhoeal diseases — **69.7 million** • **2.31%**
10. Road injury — **67.9 million** • **2.25%** ([PubMed][1])

**Why DALYs look different from deaths**

* DALYs pull **non-fatal but high-prevalence conditions** (e.g., back/neck pain) into the top ranks.
* They also highlight **early-life losses** (preterm complications) and **injuries** (road injury) because they remove many potential years of healthy life.

A separate major global study (GBD 2021) likewise reports **COVID-19 as the leading cause of DALYs globally in 2021**, with heart disease and stroke immediately behind. ([PubMed][1])

---

### C) Top 10 causes of YLDs worldwide (2021, WHO GHE)

1. Back and neck pain — **90.8 million** YLDs • **10.00%**
2. Depressive disorders — **56.7 million** • **6.24%**
3. Other hearing loss — **44.2 million** • **4.87%**
4. Migraine — **43.6 million** • **4.80%**
5. Anxiety disorders — **42.8 million** • **4.71%**
6. Diabetes mellitus — **41.1 million** • **4.53%**
7. Skin diseases — **39.3 million** • **4.32%**
8. Iron-deficiency anaemia — **32.4 million** • **3.57%**
9. Gynecological diseases — **26.8 million** • **2.96%**
10. Falls — **24.0 million** • **2.64%**

**Key point:** the biggest disability burdens are often *not* the biggest killers. If a strategy targets only mortality, it can miss a large share of day-to-day suffering and productivity loss.

---

### What is likely to happen next (directional outlook)

These are evidence-based *drivers* and plausible *directions*, not guarantees:

* **Diabetes and dementia**: strong upward pressure from ageing, obesity, and longer survival with chronic disease; WHO notes diabetes and Alzheimer’s burden has risen substantially over time.
* **Kidney disease**: tends to rise with diabetes, hypertension, ageing, and limited early detection.
* **Mental health and pain conditions**: remain dominant in YLDs; they are structurally persistent because they are common, recurrent, and under-treated. ([PubMed][1])
* **Infectious volatility**: pandemic risk remains; “ranking spikes” can reappear quickly even when chronic diseases dominate baseline burden. ([PubMed][1])
* **Climate and conflict pressures**: can amplify respiratory disease, diarrhoeal disease, malnutrition, and injury burdens through heat, displacement, and health-system disruption (magnitude varies by region).

---

### Practical “use” of rankings (policy, planning, individual-level framing)

* **Separate “death prevention” from “disability reduction.”** You need both to improve healthy life expectancy. ([PubMed][1])
* **Aim interventions at upstream risk factors** (hypertension control, tobacco, air quality, diet/physical activity, vaccination, road safety, maternal/newborn care). These shift multiple top-ranked outcomes simultaneously.
* **Segment by country income and age**: what is “top 10” globally can be very different locally.

---

## 한국어

### “세계 질병 순위”는 무엇을 기준으로 매길까?

“1위 질병”은 하나로 고정되지 않습니다. 기준이 달라지면 순위가 크게 바뀝니다.

* **사망(Deaths)**: 가장 많은 사람을 사망하게 하는 원인
* **DALY(장애보정생존년)**: 조기 사망 손실(YLL) + 질병·장애로 잃는 건강년(YLD)의 합(=건강 손실 총량). **DALY 1 = 건강 1년 손실**
* **YLD(장애로 산 삶의 해)**: “죽지는 않지만 오래·많이 고통/제한을 주는” 원인

아래는 **WHO Global Health Estimates(GHE 2021)** 기준으로 **2021년/전세계/남녀 합/전 연령** 순위입니다. (반올림, “million” 단위)

---

### A) 전세계 사망 원인 Top 10 (2021)

1. **허혈성 심장질환** — 9.03 million • 13.22%
2. **코로나19(COVID-19)** — 8.72 million • 12.77%
3. **뇌졸중** — 6.97 million • 10.21%
4. **만성 폐쇄성 폐질환(COPD)** — 3.52 million • 5.15%
5. **하기도 감염** — 2.45 million • 3.59%
6. **기관·기관지·폐암** — 1.86 million • 2.72%
7. **알츠하이머병 및 기타 치매** — 1.84 million • 2.69%
8. **당뇨병** — 1.62 million • 2.37%
9. **신장 질환** — 1.40 million • 2.05%
10. **결핵** — 1.39 million • 2.04%

**핵심 해석**

* 전세계적으로는 **비감염성 만성질환(NCD)** 비중이 매우 큽니다(심뇌혈관·암·치매·당뇨·신장).
* 다만 **저소득 국가**에서는 상위 10위가 감염성 질환 중심으로 바뀌는 경향이 강합니다.

---

### B) 전세계 DALY(건강 손실) Top 10 (2021)

1. **코로나19(COVID-19)** — 243.1 million DALYs • 8.07%
2. **허혈성 심장질환** — 193.9 million • 6.43%
3. **뇌졸중** — 160.2 million • 5.32%
4. **하기도 감염** — 105.6 million • 3.51%
5. **조산 합병증** — 100.5 million • 3.33%
6. **요통·경부통(등/목 통증)** — 90.9 million • 3.02%
7. **당뇨병** — 80.5 million • 2.67%
8. **만성 폐쇄성 폐질환(COPD)** — 78.1 million • 2.59%
9. **설사성 질환** — 69.7 million • 2.31%
10. **도로 교통 손상(교통사고)** — 67.9 million • 2.25% ([PubMed][1])

**DALY에서 순위가 달라지는 이유**

* DALY는 “사망”뿐 아니라 “장애·고통·기능 제한”을 합치기 때문에, **요통 같은 비치명적이지만 매우 흔한 질환**이 상위로 올라옵니다.
* **신생아/산과(조산)**, **손상(교통사고)**처럼 “한 번 발생하면 잃는 건강년이 큰” 원인도 부각됩니다.

---

### C) 전세계 YLD(장애 부담) Top 10 (2021)

1. **요통·경부통** — 90.8 million YLDs • 10.00%
2. **우울 장애** — 56.7 million • 6.24%
3. **기타 청력 손실** — 44.2 million • 4.87%
4. **편두통** — 43.6 million • 4.80%
5. **불안 장애** — 42.8 million • 4.71%
6. **당뇨병** — 41.1 million • 4.53%
7. **피부 질환** — 39.3 million • 4.32%
8. **철결핍성 빈혈** — 32.4 million • 3.57%
9. **부인과 질환** — 26.8 million • 2.96%
10. **낙상** — 24.0 million • 2.64%

---

### 앞으로(방향성 전망)

* **당뇨·치매·만성 신장질환**: 고령화·비만·만성질환 생존 증가로 상향 압력이 큼. WHO도 당뇨·알츠하이머 부담 증가를 강조합니다.
* **정신건강·통증 질환**: YLD 상위권을 장기간 점유(유병률 높고 재발/만성화). ([PubMed][1])
* **감염병**: 평시에는 NCD가 우세하지만, 팬데믹은 단기간에 순위를 뒤집을 수 있음. ([PubMed][1])

---

## 日本語

### 「世界の疾病ランキング」は指標で変わる

* **死亡（Deaths）**：最も多く命を奪う原因
* **DALY**：早死による損失（YLL）＋障害を抱えて生きる年数（YLD）の合計。**DALY 1＝健康な1年の損失**
* **YLD**：非致死的だが生活機能を長く損なう原因

以下は **WHO GHE 2021** による **2021年・世界・男女計・全年齢**（四捨五入、million単位）。

### A) 死因 Top 10（2021）

1. **虚血性心疾患** — 9.03 million • 13.22%
2. **COVID-19** — 8.72 million • 12.77%
3. **脳卒中** — 6.97 million • 10.21%
4. **慢性閉塞性肺疾患（COPD）** — 3.52 million • 5.15%
5. **下気道感染症** — 2.45 million • 3.59%
6. **気管・気管支・肺がん** — 1.86 million • 2.72%
7. **アルツハイマー病およびその他の認知症** — 1.84 million • 2.69%
8. **糖尿病** — 1.62 million • 2.37%
9. **腎疾患** — 1.40 million • 2.05%
10. **結核** — 1.39 million • 2.04%

### B) DALY Top 10（2021）

1. **COVID-19** — 243.1 million DALYs • 8.07%
2. **虚血性心疾患** — 193.9 million • 6.43%
3. **脳卒中** — 160.2 million • 5.32%
4. **下気道感染症** — 105.6 million • 3.51%
5. **早産合併症** — 100.5 million • 3.33%
6. **腰背部・頸部痛** — 90.9 million • 3.02%
7. **糖尿病** — 80.5 million • 2.67%
8. **COPD** — 78.1 million • 2.59%
9. **下痢性疾患** — 69.7 million • 2.31%
10. **道路交通傷害** — 67.9 million • 2.25% ([PubMed][1])

### C) YLD Top 10（2021）

1. **腰背部・頸部痛** — 90.8 million YLDs • 10.00%
2. **うつ病性障害** — 56.7 million • 6.24%
3. **その他の難聴** — 44.2 million • 4.87%
4. **片頭痛** — 43.6 million • 4.80%
5. **不安障害** — 42.8 million • 4.71%
6. **糖尿病** — 41.1 million • 4.53%
7. **皮膚疾患** — 39.3 million • 4.32%
8. **鉄欠乏性貧血** — 32.4 million • 3.57%
9. **婦人科疾患** — 26.8 million • 2.96%
10. **転倒** — 24.0 million • 2.64%

---

## Español

### La “clasificación mundial de enfermedades” depende del indicador

* **Muertes**: lo que más mata.
* **DALYs**: pérdida total de salud (muerte prematura + vivir con discapacidad). **1 DALY ≈ 1 año de vida sana perdido.**
* **YLDs**: principales causas de discapacidad no mortal.

Datos: **OMS (GHE 2021), año 2021, mundial, ambos sexos, todas las edades** (redondeado, en “million”).

### A) Top 10 por muertes (2021)

1. **Cardiopatía isquémica** — 9.03 million • 13.22%
2. **COVID-19** — 8.72 million • 12.77%
3. **Accidente cerebrovascular (ACV)** — 6.97 million • 10.21%
4. **EPOC** — 3.52 million • 5.15%
5. **Infecciones respiratorias inferiores** — 2.45 million • 3.59%
6. **Cáncer de tráquea, bronquios y pulmón** — 1.86 million • 2.72%
7. **Alzheimer y otras demencias** — 1.84 million • 2.69%
8. **Diabetes mellitus** — 1.62 million • 2.37%
9. **Enfermedades renales** — 1.40 million • 2.05%
10. **Tuberculosis** — 1.39 million • 2.04%

### B) Top 10 por DALYs (2021)

1. **COVID-19** — 243.1 million DALYs • 8.07%
2. **Cardiopatía isquémica** — 193.9 million • 6.43%
3. **ACV** — 160.2 million • 5.32%
4. **Infecciones respiratorias inferiores** — 105.6 million • 3.51%
5. **Complicaciones del parto prematuro** — 100.5 million • 3.33%
6. **Dolor de espalda y cuello** — 90.9 million • 3.02%
7. **Diabetes mellitus** — 80.5 million • 2.67%
8. **EPOC** — 78.1 million • 2.59%
9. **Enfermedades diarreicas** — 69.7 million • 2.31%
10. **Lesiones por accidentes de tráfico** — 67.9 million • 2.25% ([PubMed][1])

### C) Top 10 por YLDs (2021)

1. **Dolor de espalda y cuello** — 90.8 million YLDs • 10.00%
2. **Trastornos depresivos** — 56.7 million • 6.24%
3. **Otras pérdidas auditivas** — 44.2 million • 4.87%
4. **Migraña** — 43.6 million • 4.80%
5. **Trastornos de ansiedad** — 42.8 million • 4.71%
6. **Diabetes mellitus** — 41.1 million • 4.53%
7. **Enfermedades de la piel** — 39.3 million • 4.32%
8. **Anemia por deficiencia de hierro** — 32.4 million • 3.57%
9. **Enfermedades ginecológicas** — 26.8 million • 2.96%
10. **Caídas** — 24.0 million • 2.64%

---

## Français

### Le “classement mondial des maladies” dépend de la mesure

* **Décès** : ce qui tue le plus.
* **DALYs** : perte totale de santé (décès prématuré + handicap). **1 DALY ≈ 1 année de vie en bonne santé perdue.**
* **YLDs** : principales causes de handicap non mortel.

Base : **OMS (GHE 2021), 2021, mondial, deux sexes, tous âges** (arrondi, en “million”).

### A) Top 10 des causes de décès (2021)

1. **Cardiopathie ischémique** — 9.03 million • 13.22%
2. **COVID-19** — 8.72 million • 12.77%
3. **Accident vasculaire cérébral (AVC)** — 6.97 million • 10.21%
4. **BPCO** — 3.52 million • 5.15%
5. **Infections des voies respiratoires inférieures** — 2.45 million • 3.59%
6. **Cancers de la trachée, des bronches et du poumon** — 1.86 million • 2.72%
7. **Maladie d’Alzheimer et autres démences** — 1.84 million • 2.69%
8. **Diabète sucré** — 1.62 million • 2.37%
9. **Maladies rénales** — 1.40 million • 2.05%
10. **Tuberculose** — 1.39 million • 2.04%

### B) Top 10 des DALYs (2021)

1. **COVID-19** — 243.1 million DALYs • 8.07%
2. **Cardiopathie ischémique** — 193.9 million • 6.43%
3. **AVC** — 160.2 million • 5.32%
4. **Infections des voies respiratoires inférieures** — 105.6 million • 3.51%
5. **Complications de la prématurité** — 100.5 million • 3.33%
6. **Douleurs du dos et du cou** — 90.9 million • 3.02%
7. **Diabète sucré** — 80.5 million • 2.67%
8. **BPCO** — 78.1 million • 2.59%
9. **Maladies diarrhéiques** — 69.7 million • 2.31%
10. **Traumatismes routiers** — 67.9 million • 2.25% ([PubMed][1])

### C) Top 10 des YLDs (2021)

1. **Douleurs du dos et du cou** — 90.8 million YLDs • 10.00%
2. **Troubles dépressifs** — 56.7 million • 6.24%
3. **Autres pertes auditives** — 44.2 million • 4.87%
4. **Migraine** — 43.6 million • 4.80%
5. **Troubles anxieux** — 42.8 million • 4.71%
6. **Diabète sucré** — 41.1 million • 4.53%
7. **Maladies de la peau** — 39.3 million • 4.32%
8. **Anémie ferriprive** — 32.4 million • 3.57%
9. **Maladies gynécologiques** — 26.8 million • 2.96%
10. **Chutes** — 24.0 million • 2.64%

[1]: https://pubmed.ncbi.nlm.nih.gov/38642570/ "Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021 - PubMed"