Tratamiento óptimo de contaminantes y sistemáticos para la explotación presente y futura de datos del Fondo Cósmico de Microondas

Uno de los hitos más esperados en cosmología es la detección de las ondas gravitacionales primordiales, ya que constituirían una prueba irrefutable de la existencia de un periodo inflacionario. En principio, pueden medirse a través de la huella marcada en la señal del modo B del Fondo Cósmico de Microondas. Sin embargo, esta detección conlleva muchos retos desde el punto de vista experimental y de análisis de datos, ya que es relativamente débil en comparación con otras fuentes de modos B, como los contaminantes astrofísicos, los modos lensados de E a B, y los errores sistemáticos. Esta tesis es uno de los muchos esfuerzos en el campo del análisis de datos dedicados a la detección de esta señal de forma insesgada. Este trabajo es una tesis por compendio de artículos que incluye cuatro estudios realizados en el contexto de la separación de componentes aplicada a los datos de polarización del Fondo Cósmico de Microondas. Se presenta un nuevo método de separación de componentes (B-SeCRET) que se ha aplicado en varios contextos dentro de diferentes colaboraciones e iniciativas como: simulaciones para estudios predictivos de la futura misión del satélite LiteBIRD, simulaciones de iniciativas de experimentos en tierra como ELFS, y a los datos del instrumento QUIJOTE MFI, WMAP y Planck. Además se incluyen tres aplicaciones de esta metodología: 1) el estudio y optimización de los diseños experimentales, 2) la mitigación de los errores sistemáticos, y 3) la caracterización de contaminantes astrofísicos. En particular se probó: 1) la viabilidad de la detección de ondas gravitaciones con un telescopio terrestre operando el régimen de microondas de baja frecuencia (de 10 a 120 GHz), además de su alta complementariedad con otras misiones como LiteBIRD, 2) la posibilidad de calibrar los ángulos de polarización a partir de la señal multifrecuencia mediante dos métodos (uno basado en anular el cross espectro de potencias EB y otro parametrizando este sistemático en la parte de separación de componentes con B-SeCRET), ambas metodologías recuperan una estimación insesgada de la amplitud de las ondas gravitacionales primordiales, 3) la mejora en la caracterización de la emisión de sincrotrón cuando se añaden los datos del instrumento QUIJOTE-MFI junto con datos de WMAP y Planck, en particular se presenta el primer mapa detallado del índice espectral del sincrotrón en hemisferio norte el cual presenta variaciones espaciales más significativas que los obtenidos con solo datos de WMAP y Planck. En conclusión, esta tesis prueba que B-SeCRET es una metodología versátil para analizar los datos presentes y futuros relativos al estudio del fondo cósmico de microondas debido a su capacidad de tratar simultáneamente con contaminantes astrofísicos y errores sistemáticos.One of the most awaited milestones in cosmology is the detection of primordial gravitational waves, as they would constitute compelling evidence of the existence of an inflationary period. In principle, they can be measured through their imprint in the B-mode signal of the Cosmic Microwave Background. However, this detection carries many challenges from an experimental and data analysis point of view, as it is relatively weak compared to other sources of B-modes, such as astrophysical contaminants, E-to-B lens modes, and systematic errors. This thesis is one of many efforts in the field of data analysis devoted to the detection of this signal in an unbiased manner. This work is a compilation thesis that includes four studies performed in the context of component separation applied to Cosmic Microwave Background polarization data. A new component separation method (B-SeCRET) is presented. This method has been applied in several contexts within different collaborations and initiatives, such as simulations for predictive studies of the future LiteBIRD satellite mission, simulations of ground-based experiment initiatives such as ELFS, and QUIJOTE MFI, WMAP and Planck instrument data. In addition, three applications of this methodology are included: 1) the study and optimization of experimental designs, 2) the mitigation of systematic errors, and 3) the characterization of astrophysical contaminants. In particular, we tested: 1) the feasibility of gravitational wave detection with a ground-based telescope operating the low-frequency microwave regime (from 10 to 120 GHz), in addition to its high complementarity with other missions such as LiteBIRD, 2) the possibility of calibrating the polarization angles from the multi-frequency signal using two methods (one based on canceling the EB cross-spectrum and the other by parameterizing this systematic in the component separation part with B-SeCRET), both methodologies recover an unbiased estimate of the amplitude of the primordial gravitational waves, 3) the improvement in the characterization of the synchrotron emission when the QUIJOTE-MFI instrument data are added together with WMAP and Planck data, in particular, the first detailed map of the synchrotron spectral index in the northern hemisphere is presented, which presents more significant spatial variations than those obtained with only WMAP and Planck data. In conclusion, this thesis proves that B-SeCRET is a versatile methodology to analyze present and future data related to the study of the cosmic microwave background due to its ability to deal simultaneously with astrophysical contaminants and systematic errors

Estudio sistemático del color de coloides de nanopartículas metálicas

ABSTRACT: Metallic nanoparticles under electromagnetic radiation illumination experience physical phenomena known as localized plasmon resonances whose most significant consequence is a great enhancement of the electric field in the vicinity of the nanoparticles. These phenomena are responsible for stunning colorimetric properties of certain metallic nanoparticles colloids. However, the relationship between the colloids properties and their color is neither simple nor direct. In this work we review how color coordinates can be evaluated from colloids properties. There are three aspects involved in color coordinates calculations: i. localized plasmon resonances, ii. radiative transfer models, and iii. color science. Here, we have studied each one of them independently, and applied them in combination to study colloids’ color dependences on nanoparticles size, shape, optical properties, and the embedding medium. Additionally, we have developed a multilayer four-flux based Monte Carlo to study light transfer. This Monte Carlo, unlike analytical methods, allows the study of transient states, and light transfer across heterogeneous media. The color review conducted in this work has, among others, potential applications in industries where coloring techniques are applied, e.g., glass industry.RESUMEN: Cuando nanoparticulas metálicas son iluminadas con radiación electromagnética sufren fenómenos físicos conocidos como resonancias plasmónicas localizadas cuya principal consecuencia es un aumento significativo del campo eléctrico en las inmediaciones de las nanopartículas. Estas resonancias son responsables de las sorprendentes propiedades colorimétricas de algunos coloides de nanopartículas metálicas. Sin embargo, la relación entre las propiedades de los coloides y su color no es simple ni directa. En este trabajo, se ha revisado como obtener coordenadas de color a partir de las propiedades de los coloides. Hay tres aspectos involucrados en estos cálculos: i. Resonancias plasmónicas localizadas, ii. Modelos de transferencia de radiación, y iii. La ciencia del color. En este trabajo se ha estudiado cada uno de estos aspectos de forma independiente, y se han aplicado en conjunto en el estudio de la dependencia del color de los coloides en función de las propiedades ópticas, tamaño y forma de las nanopartículas, y del medio embebedor. También, se ha desarrollado un Monte Carlo multicapa basado en el “four-flux model” para estudiar el transporte de luz. Este Monte Carlo, al contrario que modelos analíticos, permite estudiar estados transitorios además de medios heterogéneos. El análisis del color realizado en este trabajo tiene, entre otras, una potencial aplicaci ón en industrias que utilicen técnicas de coloreado, por ejemplo en la industria del vidrio.Máster en Física, Instrumentación y Medio Ambient

QUIJOTE scientific results - IV. A northern sky survey in intensity and polarization at 10-20-GHz with the multifrequency instrument

We present QUIJOTE intensity and polarization maps in four frequency bands centred around 11, 13, 17, and 19-GHz, and covering approximately 29?000?deg2, including most of the northern sky region. These maps result from 9000?h of observations taken between May 2013 and June 2018 with the first QUIJOTE multifrequency instrument (MFI), and have angular resolutions of around 1°, and sensitivities in polarization within the range 35?40?µK per 1° beam, being a factor ?2?4 worse in intensity. We discuss the data processing pipeline employed, and the basic characteristics of the maps in terms of real space statistics and angular power spectra. A number of validation tests have been applied to characterize the accuracy of the calibration and the residual level of systematic effects, finding a conservative overall calibration uncertainty of 5 per?cent. We also discuss flux densities for four bright celestial sources (Tau A, Cas A, Cyg A, and 3C274), which are often used as calibrators at microwave frequencies. The polarization signal in our maps is dominated by synchrotron emission. The distribution of spectral index values between the 11?GHz and WMAP 23?GHz map peaks at [Beta] = -3.09 with a standard deviation of 0.14. The measured BB/EE ratio at scales of [L lower case+ = 80 is 0.26 ± 0.07 for a Galactic cut |b| > 10°. We find a positive TE correlation for 11?GHz at large angular scales ([L lower case+ [less than or equivalent to] 50), while the EB and TB signals are consistent with zero in the multipole range 30 [less than or equivalent to] [L lower case+ [less than or equivalent to] 150. The maps discussed in this paper are publicly available.We thank the staff of the Teide Observatory for invaluable assistance in the commissioning and operation of QUIJOTE. The QUIJOTE experiment is being developed by the Instituto de Astrofisica de Canarias (IAC), the Instituto de Fisica de Cantabria (IFCA), and the Universities of Cantabria, Manchester and Cambridge. Partial finan- cial support was provided by the Spanish Ministry of Science and Innovation under the projects AYA2007-68058-C03-01, AYA2007- 68058-C03-02, AYA2010-21766-C03-01, AYA2010-21766-C03-02, AYA2014-60438-P, ESP2015-70646-C2-1-R, AYA2017-84185-P, ESP2017-83921-C2-1-R, AYA2017-90675-REDC (co-funded with EU FEDER funds), PGC2018-101814-B-I00, PID2019-110610RB- C21, PID2020-120514GB-I00, IACA13-3E-2336, IACA15-BE- 3707, EQC2018-004918-P, the Severo Ochoa Programs SEV-2015- 0548 and CEX2019-000920-S, the Maria de Maeztu Program MDM- 2017-0765, and by the Consolider-Ingenio project CSD2010-00064 (EPI: Exploring the Physics of Inflation). We acknowledge support from the ACIISI, Consejeria de Economia, Conocimiento y Empleo del Gobierno de Canarias and the European Regional Development Fund (ERDF) under grant with reference ProID2020010108. This project has received funding from the European Union’s Horizon 2020 - Research and Innovation Framework Programme under grant agreement number 687312 (RADIOFOREGROUNDS). This research made use of computing time available on the high-performance computing systems at the IAC. We thankfully acknowledge the technical expertise and assistance provided by the Spanish Supercomputing Network (Red Espa ˜ nola de Supercom- putaci ´on), as well as the computer resources used: the Deimos/Di v a Supercomputer, located at the IAC. This research used resources of the National Energy Research Scientific Computing Center, which is supported by the Office of Science of the U.S. Department of Energy under Contract No. DE-AC02-05CH11231. The PWV data used in the tests presented in Section 4 comes from the Iza ˜ na Atmospheric Observatory (IZO), and have been made available to us by the Iza ˜ na Atmospheric Research Center (AEMET). SEH and CD acknowledge support from the STFC Consolidated Grant (ST/P000649/1). FP acknowledges support from the Spanish State Research Agency (AEI) under grant number PID2019-105552RB- C43. DT acknowledges the support from the Chinese Academy of Sciences (CAS) President’s International Fellowship Initiative (PIFI) with Grant N. 2020PM0042. Some of the presented results are based on observations obtained with Planck ( http:// www.esa.int/ Planck), an ESA science mission with instruments and contributions directly funded by ESA Member States, NASA, and Canada. We acknowl- edge the use of the Le gac y Archiv e for Microwav e Background Data Analysis (LAMBDA). Support for LAMBDA is provided by the NASA Office of Space Science. Some of the results in this paper have been derived using the HEALPIX (G ´orski et al. 2005 ) and HEALPY (Zonca et al. 2019 ) packages. We also use Numpy (Harris et al. 2020 ), Matplotlib (Hunter 2007 ), and the SKLEARN module (Pedregosa et al. 2011 )

QUIJOTE scientific results - VIII. Diffuse polarized foregrounds from component separation with QUIJOTE-MFI

We derive linearly polarized astrophysical component maps in the Northern Sky from the QUIJOTE-MFI data at 11 and 13?GHz in combination with the Wilkinson Microwave Anisotropy Probe K and Ka bands (23 and 33?GHz) and all Planck polarized channels (30-353-GHz), using the parametric component separation method B-SeCRET. The addition of QUIJOTE-MFI data significantly improves the parameter estimation of the low-frequency foregrounds, especially the estimation of the synchrotron spectral index, [beta]s. We present the first detailed ?s map of the Northern Celestial Hemisphere at a smoothing scale of 2°. We find statistically significant spatial variability across the sky. We obtain an average value of ?3.08 and a dispersion of 0.13, considering only pixels with reliable goodness of fit. The power-law model of the synchrotron emission provides a good fit to the data outside the Galactic plane but fails to track the complexity within this region. Moreover, when we assume a synchrotron model with uniform curvature, cs, we find a value of cs = ?0.0797 ± 0.0012. However, there is insufficient statistical significance to determine which model is favoured, either the power law or the power law with uniform curvature. Furthermore, we estimate the thermal dust spectral parameters in polarization. Our cosmic microwave background, synchrotron, and thermal dust maps are highly correlated with the corresponding products of the PR4 Planck release, although some large-scale differences are observed in the synchrotron emission. Finally, we find that the ?s estimation in the high signal-to-noise synchrotron emission areas is prior-independent, while, outside these regions, the prior governs the [beta]s estimation.We thank the staff of the Teide Observatory for invaluable assistance in the commissioning and operation of QUIJOTE. The QUIJOTE experiment is being developed by the Instituto de Astrofisica de Canarias (IAC), the Instituto de Fisica de Cantabria (IFCA), and the Universities of Cantabria, Manchester, and Cambridge. Partial financial support was provided by the Spanish Ministry of Science and Innovation under the projects AYA2007-68058-C03-01, AYA2007- 68058-C03-02, AYA2010-21766-C03-01, AYA2010-21766-C03-02, AYA2014-60438-P, ESP2015-70646-C2-1-R, AYA2017-84185-P, ESP2017-83921-C2-1-R, AYA2017-90675-REDC (co-funded with EU FEDER funds), PGC2018-101814-B-I00, PID2019-110610RBC21, PID2020-120514GB-I00, IACA13-3E-2336, IACA15-BE3707, EQC2018-004918-P, the Severo Ochoa Programs SEV-2015- 0548 and CEX2019-000920-S, the Maria de Maeztu Program MDM2017-0765, and by the Consolider-Ingenio project CSD2010-00064 (EPI: Exploring the Physics of Inflation). We acknowledge support from the ACIISI, Consejeria de Economia, Conocimiento y Empleo del Gobierno de Canarias, and the European Regional Development Fund (ERDF) under grant with reference ProID2020010108. This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement number 687312 (RADIOFOREGROUNDS). EdlH acknowledges financial support from the Concepcion´ Arenal Programme of the Universidad de Cantabria. DT acknowledges the support from the Chinese Academy of Sciences (CAS) President’s International Fellowship Initiative (PIFI) with grant no. 2020PM0042. FP acknowledges support from the Spanish State Research Agency (AEI) under grant number PID2019-105552RB-C43. The authors acknowledge the computer resources, technical expertise, and assistance provided by the Spanish Supercomputing Network (RES) node at Universidad de Cantabria. Some of the presented results are based on observations obtained with Planck (http://www.esa.int/Planck), an ESA science mission with instruments and contributions directly funded by ESA Member States, NASA, and Canada. We acknowledge the use of the Legacy Archive for Microwave Background Data Analysis (LAMBDA) and the Planck Legacy Archive (PLA). Support for LAMBDA is provided by the NASA Office of Space Science. Some of the results in this paper have been derived using the HEALPIX package (Gorski ´ et al. 2005), and the HEALPY (Zonca et al. 2019), NUMPY (Harris et al. 2020), EMCEE (ForemanMackey et al. 2013), and MATPLOTLIB (Hunter 2007) PYTHON packages

The new multi-frequency instrument (MFI2) for the QUIJOTE facility in Tenerife

The QUIJOTE (Q-U-I joint Tenerife) experiment combines the operation of two radio-telescopes and three instruments working in the microwave bands 10?20 GHz, 26-36 GHz and 35-47 GHz at the Teide Observatory, Tenerife, and has already been presented in previous SPIE meetings (Hoyland, R. J. et al, 2012; Rubiño-Martín et al., 2012). The Cosmology group at the IAC have designed a new upgrade to the MFI instrument in the band 10-20 GHz. The aim of the QUIJOTE telescopes is to characterise the polarised emission of the cosmic microwave background (CMB), as well as galactic and extra-galactic sources, at medium and large angular scales. This MFI2 will continue the survey at even higher sensitivity levels. The MFI2 project led by the Instituto de Astrofísica de Canarias (IAC) consists of five polarimeters, three of them operating in the sub-band 10?15 GHz, and two in the sub-band 15-20 GHz. The MFI2 instrument is expected to be a full two-three times more sensitive than the former MFI. The microwave complex correlator design has been replaced by a simple correlator design with a digital back-end based on the latest Xilinx FPGAs (ZCU111). During the first half of 2019 the manufacture of the new cryostat was completed and since then the opto-mechanical components have been designed and manufactured. It is expected that the cryogenic front-end will be completed by the end of 2022 along with the FPGA acquisition and observing system. This digital system has been employed to be more robust against stray ground-based and satellite interference, having a frequency resolution of 1 MHz.The MFI2 instrument is being developed by the Instituto de Astrofisica de Canarias (IAC), with an instrumental participation from the Universidad Politecnica de Cartagena (UPCT). Partial financial support is provided by the Spanish Ministry of Science and Innovation (MICINN), under the projects AYA2017-84185-P, IACA15-BE-3707, EQC2018-004918-P and the FEDER Agreement INSIDE-OOCC (ICTS-2019-03-IAC-12). We also acknowledge financial support of the Severo Ochoa Programs SEV-2015-0548 and CEX2019-000920-S

Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted life-years (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severity of ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-specific mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Socio-demographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9-6·7), from 57·0 years (54·6-59·1) in 1990 to 63·3 years (60·5-65·7) in 2017. The increase varied from 3·8 years (3·4-4·1) in high SDI countries to 10·5 years (9·8-11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4-1·7) in Saint Vincent and the Grenadines (62·4 years [59·9-64·7] in 1990 to 63·5 years [60·9-65·8] in 2017) to 23·7 years (21·9-25·6) in Eritrea (30·7 years [28·9-32·2] in 1990 to 54·4 years [51·5-57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6-2·3) in Algeria to 11·9 years (10·9-12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4-78·7]) and males (72·6 years [69·8-75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7-50·2] for females and 42·8 years [40·1-45·6] for males). Globally, in 2017, the five leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8-43·5) for communicable diseases and by 49·8% (47·9-51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8-43·0), although age-standardised DALY rates decreased by 18·1% (16·0-20·2)

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

The Global Burden of Diseases, Injuries and Risk Factors 2017 includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. METHODS: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting

Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted life-years (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severity of ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years.; We used data for age-specific mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Socio-demographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9-6·7), from 57·0 years (54·6-59·1) in 1990 to 63·3 years (60·5-65·7) in 2017. The increase varied from 3·8 years (3·4-4·1) in high SDI countries to 10·5 years (9·8-11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4-1·7) in Saint Vincent and the Grenadines (62·4 years [59·9-64·7] in 1990 to 63·5 years [60·9-65·8] in 2017) to 23·7 years (21·9-25·6) in Eritrea (30·7 years [28·9-32·2] in 1990 to 54·4 years [51·5-57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6-2·3) in Algeria to 11·9 years (10·9-12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4-78·7]) and males (72·6 years [69·8-75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7-50·2] for females and 42·8 years [40·1-45·6] for males). Globally, in 2017, the five leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8-43·5) for communicable diseases and by 49·8% (47·9-51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8-43·0), although age-standardised DALY rates decreased by 18·1% (16·0-20·2). With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low SDI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk-outcome associations. METHODS: We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017