The years of life lost to illness is not the only way the relative impact of diseases on national health should be viewed, suggests ConsultantLive editorial board member Steven A. King, MD.
A recent study looked at the overall health burden in terms of disability-adjusted life years, taking into account the effect of potentially fatal diseases by measuring years lost to premature mortality and the effect of more chronic disorders measured by years living with a disability.
• The leading years-lost-to-premature-mortality diseases: ischemic heart disease, lung cancer, stroke, and chronic obstructive pulmonary disease.
• The leading years-living-with-a-disability diseases: low back pain, major depressive disorder, other musculoskeletal disorders, neck pain, and anxiety disorders.
There is significant comorbidity between chronic pain and depressive and anxiety disorders. Pain can be a presenting symptom, and the experience of chronic pain can lead to their development.
These years-living-with-a-disability disease categories may represent different presentations of similar disease processes and may suggest addressing physical pain and psychological factors together, not as separate issues. Greater use of early psychological interventions in cases of low back pain and other types of pain that may become chronic might help reduce the disease burden.