 So let's just imagine that you and some friends want to have a race or maybe how about you and your best friend? So you've got two people here Basically perfectly matched say every time you guys go running You always finish at the same time. You always run the same speed and you always tie Now let's imagine for the sake of this lesson that we then tie a big rock So here's our rock We tie that rock to your leg So there it is tied to your leg Now who do you think is going to win? Well in this case your friend is going to have a huge advantage getting to the starting line or to the finishing line Because you're going to be dragging this rock this big heavy rock. This rock is a burden Because it's holding you back. It's a nuisance and This rock kind of in a way for the sake of this lesson is going to represent disease Because in this lesson, we're going to be talking about the burden of disease We're talking about the global burden and the personal burden and the community burden and how disease holds people back This rock right here This is this is all a metaphor for something that could maybe be Malaria for example in lots of different places There's malaria as a disease that holds a lot of people back or maybe another one is tuberculosis, which I always call just TB You get that right here TB It could also be HIV which is also another common one that's holding a lot of people back around the world So how about we go take a look at what this really means? We're going to first start by taking a look at some definitions because definitions are kind of important because you know Need to know these things and we're going to start by just writing the global burden of disease and I think that this last word here really needs to be sort of taken apart actually didn't know this before I was The actual definition. I mean, I think everybody in their head kind of I has an idea of what disease mean means But I didn't really ever look up the definition because I kind of always thought well I guess I I know that but basically it means an abnormal condition affecting the body and In humans this leads this causes so it leads to I'm just going to make that with an arrow it leads to pain Dysfunction so things not working very well dysfunction stress So emotional stress physical stress social problems So maybe a disease causes you not to be able to get along with your friends And then in really bad cases when things are not going right at all It can result in death and that's and that's a bit very very bad thing obviously now these are caused by Diseases are caused by Often bacteria and so we'll talk a lot about bacteria in this course also caused by viruses Or they're caused by fun guy Then there's lots of other things that cause you to be sick in some way But a disease is generally caused by these three things now a disease is a little different than an illness an illness is actually Something they can't necessarily be proven so when someone is sick you can go in their body And you can look for signs of one of these things you look for bacteria or virus or fun guy and you can say oh Hey, this guy has an actually sorry fun guy is not spelled with an a I'm gonna be making this mistake all the time So fun. He's only spelled with any with an eye here. No way But when you go into someone's body when they are sick with a disease you can find evidence of one of these things Or maybe something else if they just have an illness It's actually something that someone feels but doesn't necessarily it's not necessarily always Provable or perceived. It's it's something that you can't necessarily look up It's something that someone feels Now obviously we've already talked about burden. It is some kind of hardship or maybe a nuisance of some kind So when we're talking about all these things we're talking about the ways that disease holds you back when we talk about the global disease burden, it's how disease Holds us back And I use us because we're all humans and no matter where you go in the world. There are sick people In some places there are more sick people than others But in general the global disease burden is one that we can talk about really for all humans everywhere. So So at some point the question comes up. How do you measure the burden and This is actually really a huge question if you think about it how it's it's so complicated How do you measure whether people are healthy or not and in a lot of ways? It's not really actually possible to do that You know you you're taking a look at people's lives and it's almost impossible to actually really quantify or qualify How someone is doing but people try to do that so in a lot of numbers You're going to see them counting The number of years of life So that's the ones that are quantity based and then you have the quality base Which are the ones that are trying to calculate out how healthy or how how well someone is doing Through some very complicated math that will very quickly breeze through and not really talk about in too much detail So let's take a look at the quality numbers. You're going to see these quite a lot The number one sort of number that you kind of come across a lot is called life expectancy Life expectancy is just sort of a measure of how long someone will live And it's often calculated from the day that you're born So if you're born in 1960 you have a different life expectancy then it's someone who's born in 1970 or in 1980 now there's another way of measuring someone's life a lot of time when it's already kind of over and that is the years of potential Life Lost and years of potential life lost basically is just asking how long were you supposed to live and how long did you actually live? So if you're supposed to live 80 years But you actually only lived 60 years then that means you lost these 20 years here that you were supposed to have and You'll see this abbreviated as Y PLL You'll also see life expectancy abbreviated as L E or L L E something sometimes there will be different things around it, but generally you'll see L E as sort of the abbreviation Now years of potential life loss and life expectancy are all just numbers of how long you're living But sort of right between this quantity and quality group. There's one called Hale which is Health adjusted There is a little dash there health adjusted life Expectancy and I'm not going to write out expectancy because you know that already Health adjusted life expectancy and this is just basically a number that is measuring how many healthy years Are you going to have in those in in your life? So say you're supposed to live 80 years, but only 50 of them are healthy Then you actually really have only kind of lived 50 years And that is an adjustment of that life expectancy So it's kind of this very similar. It's tied to this number But in a lot of ways it's also kind of tied to the next two concepts that we're going to see and I'm gonna write Them in green because they're a little bit different and you've got I always do this for some reason Kali And Dolly Now the difference between Kali and Dolly is there actually isn't too much of a difference in a lot of ways They're they're calculated in very similar ways, so they just kind of vary a little bit in their technique Kali is asking you as is basically the quality adjusted life years. So I'm just gonna write quality and Not really worry about the rest because you already know adjusted life years is pretty simple because you've already used it over here This one is called the D. The dally is called disability adjusted life years, so disability life adjusted years or adjusted life years is how much of your life are you spending? Are you not are you not going to have because you have been disabled? So In a sense, if you're really simple it down, how much life are you missing So you could with disability adjusted life years you could live to 80 But you're you could lose maybe 20 years to sickness in in principle So it's similar to your it's very similar to your health adjusted life expectancy But it's calculated in a different way and it's also a number that is sort of associated with It's used a lot for the economics of understanding health care. It's it's kind of a slightly more complicated Calculation the health adjusted life expectancy is a pretty simple number in sort of how it's built but dally and Kali come both with a very long set of Calculations they're actually calculated in a very interesting way. So They're actually calculated opposite of each other in Kali. For example health is a score of one for a year and death is a score of zero for a year and then any sort of sickness or illness or something in between Counts as sort of a number with a point So maybe if you have a year where you're about where you have a sickness for about a year that Puts puts you like 50% or so like kind of knocks you out about puts you at about 50% capacity it'll be a point five so half and Basically the same thing works for dolly except that it runs in the opposite direction because Kali is a positive Sort of count. It's asking. How many good years do you have? And this dolly is asking. How many years have you lost so when you talk about something? When you talk about a disease maybe taking away people's Living kind of like good living standard. It'll be usually framed in terms of dolly. It'll be usually said This many years were lost due to illness and usually not said the other way and so it's often kind of sort of more of a negative number Which is also a good thing. It's important to remain critical. I guess Here you can see I've prepared a little bit of a chart to kind of talk about some of the effects of being having a disease or the burdens of the effects of Disease so let's take a look at Kind of what I've done here So I've taken taken this and divided into the personal realm and the societal and I've created this really nifty Venn diagram here and you can see here that the societal level and the personal level sort of Mix here in the middle. There's a sort of Blending in the very middle of the diagram where they kind of overlap a little bit And they probably overlap more than I really have even shown here, but I've kind of simplified this whole thing So the effects of disease are first felt on the person and they've got their body feels bad Maybe your emotions don't feel so great. Maybe your mind is somehow affected by The disease that you have or just you feel bad because you have it This could all play out in your relationship. So you can with friends or people that you care about your family It could mean that you can't work Could really cut back on your ability to do things and lots of other stuff So I put etc. And that could be things like creativity for example or something like that So there's a billion effects that disease or has on on your body and the burdens of a disease Now over here on the societal level you being sick Maybe means that you can't be a part of your community or it hinders development because maybe you're a part of some sort of Progress that the state is undergoing or the community is undergoing And then you have the costs that your sickness costs to social services into the healthcare system So any kind of strain that are put on those things and then in the middle You have things that kind of are shared on both sides because when you're sick you can't necessarily go to school So it affects your education which affects the entire society's education if you're sick, you can't necessarily work So it affects productivity also on the societal level and when you're sick You can't always earn money because of that productivity and the work and all these things in your personal life Which then sort of falls into the societal level again So a country that has sick people is not as able to pull its economy out of the dumps Or maybe create some sort of productivity goals that they want or get everybody in school And the same thing is happening basically on the personal level because you know group health is just sort of the sum of The health of the people living in that society though. It's a little more complicated than that. So these are sort of the effects of Disease or the burden of disease sort of on the personal and societal level So that was our lesson about the burden of disease you can check out more videos like this one at alversity.org