Financial Burdens and Disability-Adjusted Life Years in Los Angeles County

  • G. F. Kominski
  • P. A. Simon
  • A. Y. Ho
  • J. E. Fielding
Reference work entry


This chapter assesses the burden of disease and injury in the Los Angeles County population using disability-adjusted life years (DALYs), a composite measure of premature mortality and disability that equates to years of healthy life lost. DALYs were calculated for 105 health conditions, and aggregated groups of conditions, in the Los Angeles County population in 2005. Years of life lost (YLLs) were calculated using 2005 county mortality statistics and published life tables. Years lived with disability (YLDs) were derived from age- and gender-specific disease incidence and disability data published in the Global Burden of Disease Study. DALYs produce a substantially different ranking of disease and injury burden than did mortality rates alone. The leading five causes of DALYs among males in the county are ischemic heart disease, alcohol dependence, homicide/other violence, diabetes, and depression. Among females, the leading five causes are Alzheimer’s disease/other dementias, ischemic heart disease, alcohol dependence, diabetes, and depression. Differences in disease burden are also observed by race/ethnicity. The  age-adjusted rates of DALYs for all health conditions combined was highest in African-Americans, followed by whites, Latinos, and Asians/Pacific Islanders. DALYs are a useful tool for assessing population health and burden of disease at the local level, and produce results that are notably difference from those based on mortality rates. The combined economic impact of the top 15 causes of DALYs produced an estimated $28.92 billion loss to the Los Angeles economy in 2005.


Chronic Obstructive Pulmonary Disease Alcohol Dependence Premature Mortality Disability Weight County Population 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:


chronic obstructive pulmonary disease


disability adjusted life years


emerging market economies


global burden of disease


International Classification of Diseases, 9th Edition


International Classification of Diseases, 10th Edition


National Institutes of Health


years lived with disability


years of life lost


  1. Abdalla SI, Malik EM, Ali KM. (2007). Malar J. 6: 97.PubMedCrossRefGoogle Scholar
  2. Anand S, Hanson K. (1997). J Health Econ. 16: 685–702.PubMedCrossRefGoogle Scholar
  3. Arnesen T, Nord E. (1999). British Med J. 319: 1423–1425.Google Scholar
  4. California Department of Health Services. (2005). Data Statistical Master File 2005. Modified by Los Angeles County Department of Health Services, Office of Health Assessment and Epidemiology, Data Collection and Analysis Unit.Google Scholar
  5. Evans RG, Stoddart GL. (1990). Soc Sci Med. 31: 1347–1363.PubMedCrossRefGoogle Scholar
  6. Gan Q, Smith KR, Hammond SK, Hu TW. (2007). Tob Control. 16: 417–422.PubMedCrossRefGoogle Scholar
  7. Gold MR, Siegel JE, Russell LB, Weinstein MC (eds.). (1996). Cost-Effectiveness in Medicine and Health. Oxford University Press, New York, NY.Google Scholar
  8. Gross CP, Anderson GF, Powe NR. (1999). N Engl J Med. 340: 1881–1887.PubMedCrossRefGoogle Scholar
  9. Gwatkin DR, Guillot M, Heuveline P. (1999). Lancet. 354: 586–589.PubMedCrossRefGoogle Scholar
  10. James KC, Foster SD. (1999). Lancet. 354: 87–88.PubMedCrossRefGoogle Scholar
  11. Kominski GF, Simon PA, Ho A, Luck J, Lim YW, Fielding JE. (2002). Pubic Health Rep. 117: 185–191.Google Scholar
  12. Kyser J, Sidhu ND, Martinez EJ, Hynek CF. (2008). 2008–2009 Economic Forecast and Industry Outlook for California and Southern California. Los Angeles County Economic Development Corporation, Los Angeles, CA.Google Scholar
  13. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL (eds.). (2006). Global Burden of Disease and Risk Factors. Oxford University Press, New York.Google Scholar
  14. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. (2004). J Am Med Assoc. 291: 1238–1245.CrossRefGoogle Scholar
  15. Murray CJL, Lopez AD (eds.). (1996). The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. Harvard University Press, Cambridge, MA.Google Scholar
  16. Murray CJL, Acharya AK. (1997). J Health Econ. 16: 703–730.PubMedCrossRefGoogle Scholar
  17. Murray CJL, Lopez AD. (1997). Bull World Health Organ. 75: 377–381.PubMedGoogle Scholar
  18. Sayers BM, Fliedner TM. (1997). Bull World Health Organ. 75: 383–384.PubMedGoogle Scholar
  19. Sinha A, Levine O, Knoll MD, Muhib F, Lieu TA. (2007). Lancet. 369: 389–396.PubMedCrossRefGoogle Scholar
  20. Usten TB, Rehm J, Chatteriji S, Saxena S, Trotter R, Room R, Bickenbach J. (1999). Lancet. 354: 111–115.CrossRefGoogle Scholar
  21. World Bank. (1993). World Development Report 1993: Investing in Health. Oxford University Press, New York.Google Scholar

Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • G. F. Kominski
  • P. A. Simon
  • A. Y. Ho
  • J. E. Fielding

There are no affiliations available

Personalised recommendations