The Economic Burden of Disease

Angela Y. Chang, Gretchen A. Stevens, Diego S. Cardoso, Bochen Cao, and Dean T. Jamison

Abstract

Background: As part of the World Bank’s Healthy Longevity Initiative, this paper introduces new analytical methods on defining and estimating the economic value of avoidable mortality.

Methods: We estimated the economic value of avoidable mortality by world regions, sex, and age, between 2000 and 2019, with projection to 2040 using two novel methods. First, we took the frontier approach to compute avoidable mortality by identifying the lowest observed or projected mortality rate and set it as the frontier for each age group and year. We defined avoidable mortality as the difference between current and the frontier mortality levels for each country, age, sex, and year. Second, the economic value of avoidable mortality in a given year is defined as the proportion of annual income one is willing to forgo to live that year at the frontier survival probabilities. We adopted the value per statistical life approach and used a logarithmic function to account for the effect of large risk changes and model the nonlinear trade-off relationship between income and risk reduction.

Findings: Avoidable mortality as percentage of total mortality was about 73.8% in 2019, with the lowest and highest percentages in the High-income region (46.3%) and sub-Saharan Africa (92.3%), respectively. Globally, more avoidable deaths occurred in older adults than children, adolescents or younger adults. The economic value of avoidable mortality globally in 2019 was 24.0% of annual income, with lowest and highest percentages in China (19.4%) and sub-Saharan Africa (33.1%), respectively. The economic value is approximately 30% higher for males than females, reflecting the higher avoidable mortality rates of males.

Interpretation: As governments worldwide engage in policy dialogues on how and how much to invest in improving population health, our work provides supportive evidence on the high economic value placed on improving health, even when considering resource constraints.