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

Calculation

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 they die, 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

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

By main cause of death in the United States of America

Cause of premature death Person-years lost
Cancer 8.6 million
Heart disease and strokes 8.8 million
Accidents and other injuries 5.9 million
All other causes 13.6 million
Person-years of potential life lost in the United States in 2018
Cause of premature death Person-years lost
(Use/Accessibility/... of) firearms 1.42 million[5][6]
Motor vehicle crashes 1.34 million[6]
All other causes

A study suggests the global "mean loss of life expectancy" (LLE) from all forms of direct violence was about 0.3 years, while air pollution accounted for about 2.9 years in 2015.[7]

By country

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]

Rank Country Female YPLL Male YPLL Date
1  Latvia 4831 13225 2015
2  Mexico 6120 11427 2016
3  Lithuania 4460 12372 2017
4  Hungary 4589 9547 2017
5  Estonia 3863 9626 2016
6  United States 4862 8265 2016
7  Poland 3729 9290 2016
8  Turkey 4131 7262 2016
9  Chile 3660 6509 2016
10  Czech Republic 3083 6555 2017
11  Greece 2776 5780 2016
12  Slovenia 2630 5723 2015
13  United Kingdom 3292 5096 2016
14  France 2775 5621 2015
15  Germany 2972 5312 2016
16  Portugal 2607 5761 2016
17  Canada 3197 5002 2015
18  Belgium 2963 5197 2016
19  Finland 2558 5451 2016
20  Denmark 3075 4776 2015
21  Austria 2606 4736 2017
22  Ireland 2800 4525 2015
23  Netherlands 3019 4075 2016
24  Australia 2634 4460 2016
25  South Korea 2207 4709 2016
26  Israel 2473 4190 2016
27  Spain 2198 4391 2016
28  Italy 2364 4190 2015
29  Sweden 2508 3975 2016
30  Iceland 2235 4191 2017
31  Norway 2476 3895 2016
32  Luxembourg 2231 3957 2016
33  Japan 2144 4015 2016
34   Switzerland 2369 3614 2016

Australia

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 [8]

When disability adjusted life years are considered, cancer (25.1/1,000), cardiovascular disease (23.8/1,000), mental health issues (17.6/1,000), neurological disorders (15.7/1,000), chronic respiratory disease (9.4/1,000) and diabetes (7.2/1,000) are the main causes of good years of expected life lost to disease or premature death.[9] The dramatic difference is in the greater number of years of disability caused mental illness and neurological issues and by diabetes.[citation needed]

See also

References

  1. ↑ Gardner JW; Sanborn JS (1976). "Years of potential life lost (YPLL)—what does it measure?". Comparative Biochemistry and Physiology. A, Comparative Physiology 53 (4): 323–6. doi:10.1016/s0300-9629(76)80148-x. PMID 3312. 
  2. ↑ Association of Public Health Epidemiologists in Ontario. "Calculating Potential Years of Life Lost (PYLL)". http://www.apheo.ca/index.php?pid=190. 
  3. ↑ "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. January 2005. doi:10.1038/sj.bjc.6602321. PMID 15655548. 
  4. ↑ "Archived copy". http://mhcs.health.nsw.gov.au/pubs/2008/pdf/chorep_summary_08.pdf. Page 54 Retrieved 17 January 2009.
  5. ↑ "Premature deaths from guns expose another toll of the firearms crisis" (in en). Georgia Public Broadcasting. https://www.gpb.org/news/2022/02/23/premature-deaths-guns-expose-another-toll-of-the-firearms-crisis. 
  6. ↑ 6.0 6.1 Klein, Joshua; Prabhakaran, Kartik; Latifi, Rifat; Rhee, Peter (1 February 2022). "Firearms: the leading cause of years of potential life lost" (in en). Trauma Surgery & Acute Care Open 7 (1): e000766. doi:10.1136/tsaco-2021-000766. ISSN 2397-5776. PMID 35141422. 
  7. ↑ Lelieveld, Jos; Pozzer, Andrea; Pöschl, Ulrich; Fnais, Mohammed; Haines, Andy; Münzel, Thomas (1 September 2020). "Loss of life expectancy from air pollution compared to other risk factors: a worldwide perspective". Cardiovascular Research 116 (11): 1910–1917. doi:10.1093/cvr/cvaa025. ISSN 0008-6363. PMID 32123898. 
  8. ↑ "Report of the NSW Chief Health Officer: Years of life lost due to premature mortality (YLL)". http://mhcs.health.nsw.gov.au/public-health/chorep02/bod/bod_YLLcateg.htm.  Retrieved=17 January 2009
  9. ↑ "Archived copy". http://mhcs.health.nsw.gov.au/pubs/2008/pdf/chorep_summary_08.pdf. Retrieved=17 January 2009 Page 53



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