GBD PROFILE: JAPAN

1 GLOBAL burden OF DISEASES, INJURIES, AND RISK FACTORS STUDY 2010 The Global burden of Disease Study 2010 (GBD 2010) is a collaborative project of nearly 500 researchers in 50 countries led by theInstitute for Health Metrics and Evaluation (IHME) at the University of Washington. It is the largest systematic scientific effort in history toquantify levels and trends of health loss due to diseases, injuries, and risk factors. GBD serves as a global public good to informevidence-based policymaking and health systems OVERVIEWlIn terms of the number of years of life lost (YLLs) due topremature death in JAPAN , cerebrovascular disease, ischemicheart disease, and lower respiratory infections were the highestranking causes in the 25 most important causes of burden , as measured bydisability-adjusted life years (DALYs)

2 , road injury showed thelargest decrease, falling by 42% from 1990 to leading risk factor in JAPAN is dietary MORTALITY RATElThis chart shows the decline in mortality rate at every age higher points on the chart indicate that declines in mortalityrates were faster in those age groups between 1990 and greatest reductions in all-cause mortality rate wereexperienced by males aged 5-9 years (55%). Males aged 30-34years saw the smallest decrease in mortality rate (11%).Percent decline in age-specific mortality rate by sex from 1990-2010 in JapanCAUSES OF PREMATURE DEATHY ears of life lost (YLLs) quantify premature mortality by weighting younger deaths more than older chart shows thechange in the top 25causes of YLLs due topremature mortalityfrom 1990 to lines indicate acause has moved up inrank or stayed thesame.

3 Broken linesindicate a cause hasmoved down in causes are colorcoded by blue fornon-communicablediseases, green forinjuries, and red forcommunicable,maternal, neonatal, andnutritional causes PROFILE: | GBD | page 1015304560 Percent decline in age specific mortality rate 1 45 910 1415 1920 2425 2930 3435 3940 4445 4950 5455 5960 6465 6970 7475 7980+Age groupMalesFemales# YLLs in thousands(% of total)Rank and disorder 1990 Rank and disorder 2010# YLLs in thousands(% of total)% change132 ( )24 Asthma49 Asthma174 ( )21 Breast cancer299 ( )12 COPD143 ( )23 Cardiomyopathy26 Cardiomyopathy236 ( )15 Chronic kidney disease461 ( )11 Cirrhosis506 ( )9 Colorectal cancer266 ( )13 Congenital anomalies160 ( )22 Diabetes27 Diabetes127 ( )25 Drowning180 ( )

4 19 Esophageal cancer191 ( )17 Gallbladder cancer178 ( )20 Hypertensive heart disease1,193 ( )2 Ischemic heart disease185 ( )18 Leukemia673 ( )7 Liver cancer837 ( )4 Lower respiratory infections722 ( )6 Lung cancer481 ( )10 Other cardio & circulatory264 ( )14 Pancreatic cancer186 ( )16 Rheumatic heart disease34 Rheumatic heart disease577 ( )8 Road injury830 ( )5 Self-harm1,185 ( )3 Stomach cancer1,778 ( )1 Stroke140 ( )23 Aortic aneurysm9735 Aortic aneurysm254 ( )14 Breast cancer46295 ( )12 COPD-1321 ( )11 Chronic kidney disease36432 ( )9 Cirrhosis-8705 ( )7 Colorectal cancer39140 ( )22 Congenital anomalies-49130 ( )25 Drowning6226 ( )17 Esophageal cancer26138 ( )24 Falls3527 Falls252 ( )15 Gallbladder cancer30180 ( )20 Hypertensive heart disease-3185 ( )19 Interstitial lung diseases12434 Interstitial lung diseases1,521 ( )2 Ischemic heart disease28188 ( )18 Leukemia2621 ( )8 Liver cancer-131,177 ( )3 Lower respiratory infections411,033 ( )4 Lung cancer45154 ( )21 Non-Hodgkin lymphoma3326 Non-Hodgkin lymphoma243 ( )16 Other cardio & circulatory-50404 ( )10 Pancreatic cancer54265 ( )13 Road injury-58986 ( )

5 5 Self-harm31907 ( )6 Stomach cancer-251,800 ( )1 Stroke-1 Ranks for top 25 causes of YLLs 1990-2010, JapanCCCommuni cabl e, maternal , neonatal , and nutri ti onalCCNon-communi cabl eCCInj uri es0500,0001,000,0001,500,0002,000,000 YLDs0 6 days7 27 days28 364 days1 4 years5 9 years10 14 years15 19 years20 24 years25 29 years30 34 years35 39 years40 44 years45 49 years50 54 years55 59 years60 64 years65 69 years70 74 years75 79 years80+ yearsWar & disasterIntentional injuriesUnintentional injuriesTransport injuriesOther non communicableMusculoskeletal disordersDiabetes/urogen/blood/endoMenta l & behavioral disordersNeurological disordersDigestive diseasesCirrhosisChronic respiratory diseasesCardio & circulatory diseasesCancerOther communicableNutritional deficienciesNeonatal disordersMaternal

6 DisordersNTD & malariaDiarrhea/LRI/other infectiousHIV/AIDS & tuberculosisLOW BACK PAINSTROKEISCHEMIC HEART DISEASELOWER RESPIRATORY INFECTIONSOTHER MUSCULOSKELETALLUNG CANCERSELF-HARMSTOMACH CANCERNECK PAINFALLSCOLORECTAL CANCERMAJOR DEPRESSIVE DISORDEROSTEOARTHRITISDIABETESLIVER CANCERALZHEIMER'S DISEASECHRONIC KIDNEY DISEASECOPDROAD INJURYCIRRHOSISPANCREATIC CANCEROTHER HEARING LOSSANXIETY DISORDERSSCHIZOPHRENIAASTHMA1 2 3 4 5 6 789 10 111213 141516 17 1819 2021 22 23 2425-200-150-100-50050100150200 | GBD | page 2 Percent change 1990-2010 YEARS LIVED WITH DISABILITY (YLDs)Years lived with disability (YLDs) are estimated by weighting the prevalence of different conditions based on severity.

7 The top five leadingcauses of YLDs in JAPAN are low back pain, other musculoskeletal disorders, neck pain, major depressive disorder, and size of the coloredportion in each barrepresents the number ofYLDs attributable to eachcause. The height of each barshows which age groups hadthe most YLDs in 2010. Thecauses are aggregated. Forexample, musculoskeletaldisorders include low backpain and neck YLDs by cause and age 2010 DISABILITY-ADJUSTED LIFE YEARS (DALYs)Disability-adjusted life years (DALYs) quantify both premature mortality (YLLs) and disability (YLDs) within a population.

8 In JAPAN , the topthree causes of DALYs in 2010 were low back pain, cerebrovascular disease, and ischemic heart disease. The only cause to appear in the10 leading causes of DALYs in 2010 and not 1990 was top 25 causes of DALY sare ranked from left to rightin order of the number ofDALYs they contributed in2010. Bars going up show thepercent by which DALYs haveincreased since 1990. Barsgoing down show the percentby which DALYs havedecreased. Globally,non-communicable diseasesand injuries are generally onthe rise, while communicable,maternal, neonatal, andnutritional causes of DALY sare generally on the causes of DALYs and percent change 1990 to 2010 for | GBD | page 3 101234567891011121314% DALYs attributable to risk factorsChildhood sexual abuseIntimate partner violenceLow bone mineral densityIron deficiencyDrug useOccupational risksHigh total cholesterolAmbient PM pollutionAlcohol useHigh fasting plasma glucoseHigh body mass indexPhysical inactivitySmokingHigh blood pressureDietary risksWar & disasterIntentional injuriesUnintentional injuriesTransport injuriesOther non communicableMusculoskeletal

9 DisordersDiabetes/urogen/blood/endoMenta l & behavioral disordersNeurological disordersDigestive diseasesCirrhosisChronic respiratory diseasesCardio & circulatory diseasesCancerOther communicableNutritional deficienciesNeonatal disordersMaternal disordersNTD & malariaDiarrhea/LRI/other infectiousHIV/AIDS & tuberculosisAge-standardized death rates, YLL rates, YLD rates, and life expectancy at birth and health-adjusted life expectancy at birth for 1990 and 2010, both sexes combinedCountryAge-standardized death rate(per 100,000)Age-standardized YLL rate(per 100,000)Age-standardized YLD rate(per 100,000)

10 Life expectancy at birthHealth-adjusted lifeexpectancy at birth19902010199020101990201019902010199 02010 Rate Rank Rate Rank Rate Rank Rate Rank Rate Rank Rate Rank LE Rank LE Rank HALE Rank HALE RankAustria62284186 13,732 9 8,401 5 11,052 6 11,381 11 11,196 27,2962 11,378 12 11,250 14,383 11 9,592 12 11,209 10 11,456 13 12 13,458 89,381 11 11,119 8 10,933 11 United Kingdom63894559 13,452 78,949 9 11,453 13 11,435 10 Germany644104337 14,032 10 8,512 6 11,165 9 11,015 10 10698 Finland655114378 14,467 12 9,050 10 11,092 7 11,248 9,658 1 6,827 1 9,406 1 9,094 1 1 1 France54934085 12,717 68,666 7 11,358 11 11,194 16,396 13 10,440 13 10,592 39, 12,202 47,485 3 11,038 4 10,907 Bahamas9491554115 29,297 15 18,258 15 13,220 14 12,79114 12,630 57,6944 10.