Measuring health in a vacuum: examining the disability weight of the DALY

Reidpath, Daniel D., Allotey, Pascale A., Kouame, Aka and Cummins, Robert A. 2003, Measuring health in a vacuum: examining the disability weight of the DALY, Health policy and planning, vol. 18, no. 4, pp. 351-356, doi: 10.1093/heapol/czg043.

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Title Measuring health in a vacuum: examining the disability weight of the DALY
Author(s) Reidpath, Daniel D.
Allotey, Pascale A.
Kouame, Aka
Cummins, Robert A.ORCID iD for Cummins, Robert A.
Journal name Health policy and planning
Volume number 18
Issue number 4
Start page 351
End page 356
Publisher Oxford University Press
Place of publication Oxford, England
Publication date 2003-12
ISSN 0268-1080
Keyword(s) disability adjusted life year
health outcomes
health status measurement
population health
Summary The Disability Adjusted Life Year (DALY) is a widely used summary measure of population health combining years of life lost due to mortality and years of healthy life lost due to disability. A feature of the DALY is that, in the assessment of morbidity, each health condition is associated with a disability weight. The disability weight lies on a scale between 0 (indicating the health condition is equivalent to full health) and 1 (indicating the health condition is equivalent to death). The disability weight associated with each health condition is currently fixed across all social, cultural and environmental contexts. Thus blindness in the United Kingdom has the same disability weight as blindness in Niger in spite of structural interventions in the UK that make the disability less severe than in Niger. Although the fixed disability weight is defended on grounds that it supports a strongly egalitarian flavour in the DALY, we argue that the lack of consideration of realistic contexts results in a measure that will underestimate the burden associated with morbidity in disadvantaged populations and overestimate the burden in advantaged populations. There is, consequently, a loss of information on possible non-clinical points of intervention. Disaggregated estimates of the burden of disease such as those in the World Health Report 2000 should be interpreted with caution.
Language eng
DOI 10.1093/heapol/czg043
Field of Research 170113 Social and Community Psychology
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2003, Oxford University Press
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Document type: Journal Article
Collection: School of Health and Social Development
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