Table 5.
Joinpoint analysis for KC age-standardized DALYs in EU15 + countries and WHO regions for years 1990–2019 for both sexes.
| (A) | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Country/Region | Trend 1 | Trend 2 | Trend 3 | Trend 4 | ||||||||
| Years | EAPC (95% CI) | “P-value” | Years | EAPC (95% CI) | “P-value” | Years | EAPC (95% CI) | “P-value” | Years | EAPC (95% CI) | “P-value” | |
| Global | 1990–1994 | 1.8 (1.3–2.2) | < 0.001 | 1994–1998 | − 0.1 (− 0.9–0.6) | 0.736 | 1998–2005 | 1.2 (0.9–1.4) | < 0.001 | 2005–2019 | − 0.2 (− 0.2–0.1) | < 0.001 |
| Australia | 1990–1999 | 0.4 (0.2–0.6) | 0.001 | 1999–2003 | − 3 (− 4.1–1.9) | < 0.001 | 2003–2007 | 1.9 (0.8–3.1) | 0.002 | 2007–2019 | − 0.6 (− 0.7–0.4) | < 0.001 |
| Austria | 1990–1999 | − 3 (− 3.3–2.8) | < 0.001 | 1999–2014 | − 1.4 (-− 1.5–1.3) | < 0.001 | 2014–2019 | − 0.5 (− 1.1–0) | 0.07 | |||
| Belgium | 1990–1996 | − 1.6 (− 2.5–0.7) | 0.001 | 1996–2001 | 3.4 (1.7–5.2) | 0.001 | 2001–2019 | − 1.1 (− 1.3–0.9) | < 0.001 | |||
| Denmark | 1990–1996 | 8.4 (7.5–9.3) | < 0.001 | 1996–2009 | − 0.1 (− 0.4–0.2) | 0.352 | 2009–2019 | − 1.2 (− 1.6–0.9) | < 0.001 | |||
| Finland | 1990–1998 | 0.1 (− 0.2–0.4) | 0.555 | 1998–2001 | − 2.8 (− 5.3–0.4) | 0.027 | 2001–2006 | − 1.4 (− 2.2–0.6) | 0.002 | 2006–2019 | − 0.7 (− 0.9–0.6) | < 0.001 |
| France | 1990–1993 | 0 (− 0.9–0.9) | 0.927 | 1993–2007 | − 0.7 (− 0.8–0.6) | < 0.001 | 2007–2011 | 1.2 (0.3–2.2) | 0.01 | 2011–2019 | − 0.6 (− 0.8–0.4) | < 0.001 |
| Germany | 1990–1995 | 1.9 (1.5–2.3) | < 0.001 | 1995–2003 | − 1.2 (− 1.5–1) | < 0.001 | 2003–2006 | − 2.2 (− 3.8–0.6) | 0.009 | 2006–2019 | − 0.1 (− 0.2–0) | 0.031 |
| Greece | 1990–1992 | 3.9 (1.4–6.3) | 0.003 | 1992–1997 | 1.2 (0.5–2) | 0.002 | 1997–2019 | − 0.1 (− 0.1–0) | 0.047 | |||
| Ireland | 1990–1996 | 1 (0.3–1.6) | 0.007 | 1996–2000 | 3.8 (1.8–5.9) | 0.001 | 2000–2009 | 0.3 (− 0.1–0.8) | 0.124 | 2009–2019 | − 1.5 (− 1.8–1.1) | < 0.001 |
| Italy | 1990–2007 | − 0.3 (− 0.4–0.3) | < 0.001 | 2007–2013 | − 1.2 (− 1.6–0.7) | < 0.001 | 2013–2019 | − 0.4 (− 0.7–0.1) | 0.017 | |||
| Luxembourg | 1990–2004 | − 0.8 (− 0.9–0.7) | < 0.001 | 2004–2013 | − 1.8 (− 2.1–1.6) | < 0.001 | 2013–2016 | − 3 (− 5.2–0.8) | 0.011 | 2016–2019 | 0 (− 1.1–1.2) | 0.949 |
| Netherlands | 1990–2000 | 0.7 (0.3–1.2) | 0.003 | 2000–2003 | − 3.5 (− 8.8–2.2) | 0.207 | 2003–2007 | 3.4 (0.5–6.4) | 0.023 | 2007–2019 | − 0.9 (− 1.2–0.5) | < 0.001 |
| Norway | 1990–2013 | 0.4 (0.4–0.5) | < 0.001 | 2013–2017 | − 3.8 (− 5.3–2.3) | < 0.001 | 2017–2019 | 0.3 (− 2.8–3.4) | 0.858 | |||
| Portugal | 1990–1998 | 0.8 (0.3–1.4) | 0.004 | 1998–2001 | − 6.5 (− 11–1.7) | 0.011 | 2001–2007 | 3.2 (2–4.3) | < 0.001 | 2007–2019 | − 0.8 (− 1.1–0.6) | < 0.001 |
| Spain | 1990–1996 | 1.5 (1.2–1.8) | < 0.001 | 1996–2006 | − 0.1 (− 0.2–0.1) | 0.364 | 2006–2015 | 1.3 (1.1–1.4) | < 0.001 | 2015–2019 | − 0.4 (− 0.9–0.2) | 0.152 |
| Sweden | 1990–1998 | − 1.4 (− 1.7–1.1) | < 0.001 | 1998–2002 | − 2.9 (− 4.2–1.6) | < 0.001 | 2002–2009 | − 1.2 (− 1.7–0.8) | < 0.001 | 2009–2019 | − 0.4 (− 0.6–0.2) | 0.001 |
| United Kingdom | 1990–1996 | 1.1 (0.8–1.3) | < 0.001 | 1996–2007 | -0.2 (-0.4–0.1) | < 0.001 | 2007–2012 | -0.8 (-1.3–0.3) | 0.002 | 2012–2019 | 0.3 (0.1–0.5) | 0.01 |
| Canada | 1990–2001 | 0 (− 0.2–0.2) | 0.814 | 2001–2004 | 5.1 (2.2–8.2) | 0.002 | 2004–2008 | 1 (− 0.4–2.5) | 0.153 | 2008–2019 | − 0.5 (− 0.7–0.3) | < 0.001 |
| United States of America | 1990–1995 | 0.8 (0.4–1.3) | 0.001 | 1995–2013 | − 0.9 (− 0.9–0.8) | < 0.001 | 2013–2019 | 0.5 (0.1–0.8) | 0.01 | |||
| African Region | 1990–2006 | 1 (0.9–1) | < 0.001 | 2006–2009 | 0.1 (− 0.9–1.1) | 0.882 | 2009–2017 | 0.8 (0.7–1) | < 0.001 | 2017–2019 | − 0.1 (− 1.1–0.9) | 0.789 |
| Region of the Americas | 1990–1994 | 0.6 (0.2–1) | 0.006 | 1994–2015 | − 0.1 (− 0.1–0.1) | < 0.001 | 2015–2019 | 0.5 (0.1–0.9) | 0.018 | |||
| South-East Asia Region | 1990–1999 | 3.2 (2.9–3.5) | < 0.001 | 1999–2004 | − 0.3 (− 1.2–0.7) | 0.551 | 2004–2014 | 1 (0.7–1.2) | < 0.001 | 2014–2019 | 1.8 (1.2–2.5) | < 0.001 |
| European Region | 1990–1994 | 3.7 (2.9–4.4) | < 0.001 | 1994–1997 | − 1.1 (− 3.3–1.3) | 0.349 | 1997–2005 | 0.6 (0.2–0.9) | 0.001 | 2005–2019 | − 0.4 (− 0.5–0.3) | < 0.001 |
| Eastern Mediterranean Region | 1990–1996 | 1.6 (1.3–1.9) | < 0.001 | 1996–2000 | 2.9 (2.1–3.8) | < 0.001 | 2000–2019 | 1.9 (1.9–2) | < 0.001 | |||
| Western Pacific Region | 1990–1998 | 0.9 (0.5–1.2) | < 0.001 | 1998–2005 | 5.1 (4.6–5.7) | < 0.001 | 2005–2011 | 1.5 (0.8–2.2) | < 0.001 | 2011–2019 | − 0.5 (− 0.8–0.1) | 0.011 |
| (B) | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Country/Region | Trend 1 | Trend 2 | Trend 3 | Trend 4 | ||||||||
| Years | EAPC (95% CI) | “P-value” | Years | EAPC (95% CI) | “P-value” | Years | EAPC (95% CI) | “P-value” | Years | EAPC (95% CI) | “P-value” | |
| Global | 1990–1994 | 0.4 (− 0.1–0.9) | 0.106 | 1994–1997 | − 1.1 (− 2.7–0.5) | 0.164 | 1997–2005 | − 0.1 (− 0.3–0.2) | 0.599 | 2005–2019 | − 0.7 (− 0.7–0.6) | < 0.001 |
| Australia | 1990–1993 | 2 (1.3–2.6) | < 0.001 | 1993–2011 | − 1.3 (− 1.4–1.3) | < 0.001 | 2011–2016 | − 2.4 (− 2.8–2) | < 0.001 | 2016–2019 | 0.9 (0.3–1.6) | 0.009 |
| Austria | 1990–1992 | − 0.4 (− 3.6–2.9) | 0.8 | 1992–2001 | − 2.7 (− 3–2.4) | < 0.001 | 2001–2017 | − 1.7 (− 1.9–1.6) | < 0.001 | 2017–2019 | 0.1 (− 3–3.4) | 0.925 |
| Belgium | 1990–1993 | 0.4 (− 3.3–4.3) | 0.817 | 1993–1996 | − 6 (− 12.9–1.4) | 0.105 | 1996–1999 | 6.5 (− 1.3–15) | 0.1 | 1999–2019 | − 1.3 (− 1.5–1.1) | < 0.001 |
| Denmark | 1990–1996 | 9.8 (8.9–10.8) | < 0.001 | 1996–1999 | 2.4 (− 2.9–7.9) | 0.361 | 1999–2014 | − 2.1 (− 2.3–1.8) | < 0.001 | 2014–2019 | − 0.5 (− 1.7–0.6) | 0.345 |
| Finland | 1990–2002 | 0.7 (0.5–0.9) | < 0.001 | 2002–2019 | − 0.8 (− 0.9–0.7) | < 0.001 | ||||||
| France | 1990–2000 | − 0.5 (− 0.6–0.4) | < 0.001 | 2000–2007 | − 2.4 (− 2.6–2.2) | < 0.001 | 2007–2011 | 0.9 (0.2–1.5) | 0.011 | 2011–2019 | 0.2 (0.1–0.3) | 0.006 |
| Germany | 1990–1997 | − 0.1 (− 0.3–0.1) | 0.192 | 1997–2005 | − 2.2 (− 2.3–2) | < 0.001 | 2005–2015 | − 0.8 (− 0.9–0.6) | < 0.001 | 2015–2019 | 0.2 (− 0.2–0.7) | 0.302 |
| Greece | 1990–1999 | 1.5 (1.2–1.7) | < 0.001 | 1999–2011 | − 1.7 (− 1.9–1.5) | < 0.001 | 2011–2019 | 0.6 (0.3–0.9) | 0.001 | |||
| Ireland | 1990–1994 | − 0.3 (− 1.2–0.6) | 0.473 | 1994–2006 | 1.8 (1.6–2) | < 0.001 | 2006–2010 | − 1.9 (− 3.3–0.5) | 0.01 | 2010–2019 | − 0.4 (− 0.6–0.1) | 0.005 |
| Italy | 1990–1994 | 0.1 (− 0.4–0.6) | 0.586 | 1994–2008 | − 0.9 (− 1–0.8) | < 0.001 | 2008–2015 | − 0.6 (− 0.8–0.3) | < 0.001 | 2015–2019 | 0.2 (− 0.3–0.7) | 0.397 |
| Luxembourg | 1990–2001 | − 0.6 (− 0.8–0.5) | < 0.001 | 2001–2004 | − 1.8 (− 4.1–0.6) | 0.134 | 2004–2019 | − 1.1 (− 1.2–1) | < 0.001 | |||
| Netherlands | 1990–2006 | 0.1 (-0.3–0.4) | 0.738 | 2006–2019 | − 1.1 (− 1.6–0.6) | < 0.001 | ||||||
| Norway | 1990–2001 | 1.2 (1–1.3) | < 0.001 | 2001–2012 | − 0.4 (− 0.6–0.3) | < 0.001 | 2012–2017 | − 2.9 (− 3.6–2.2) | < 0.001 | 2017–2019 | 0.9 (− 1.3–3.3) | 0.393 |
| Portugal | 1990–1998 | − 0.8 (− 1.1–0.5) | < 0.001 | 1998–2001 | − 5.7 (− 8.5–2.8) | 0.001 | 2001–2019 | − 0.3 (− 0.4–0.2) | < 0.001 | |||
| Spain | 1990–2008 | 0.2 (0.2–0.3) | < 0.001 | 2008–2014 | − 0.7 (− 1.2–0.3) | 0.004 | 2014–2019 | 0.7 (0.3–1.2) | 0.003 | |||
| Sweden | 1990–1998 | − 1.5 (− 1.7–1.3) | < 0.001 | 1998–2002 | − 3.2 (− 4.1–2.2) | < 0.001 | 2002–2009 | − 2 (− 2.3–1.6) | < 0.001 | 2009–2019 | − 1 (− 1.2–0.9) | < 0.001 |
| United Kingdom | 1990–1997 | 0.8 (0.7–1) | < 0.001 | 1997–2008 | 0 (− 0.1–0.1) | 0.759 | 2008–2014 | − 0.7 (− 0.9–0.5) | < 0.001 | 2014–2019 | 0 (− 0.3–0.2) | 0.813 |
| Canada | 1990–1998 | − 0.2 (− 0.7–0.3) | 0.357 | 1998–2006 | 3.3 (2.7–3.9) | < 0.001 | 2006–2014 | − 2.4 (− 3–1.8) | < 0.001 | 2014–2019 | − 0.3 (− 1.3–0.7) | 0.517 |
| United States of America | 1990–1995 | 0.5 (0.2–0.7) | 0.001 | 1995–2003 | − 1 (− 1.2–0.9) | < 0.001 | 2003–2014 | − 1.4 (− 1.5–1.4) | < 0.001 | 2014–2019 | − 0.1 (− 0.3–0.2) | 0.464 |
| African Region | 1990–2004 | 0.3 (0.3–0.4) | < 0.001 | 2004–2009 | 1 (0.6–1.5) | < 0.001 | 2009–2014 | 1.8 (1.4–2.3) | < 0.001 | 2014–2019 | 0.8 (0.4–1.1) | < 0.001 |
| Region of the Americas | 1990–1995 | − 0.8 (− 1–0.7) | < 0.001 | 1995–1999 | − 3.2 (− 3.6–2.8) | < 0.001 | 1999–2014 | − 0.6 (− 0.7–0.6) | < 0.001 | 2014–2019 | − 0.1 (− 0.3–0.1) | 0.351 |
| South-East Asia Region | 1990–1999 | 1.7 (1.5–1.9) | < 0.001 | 1999–2004 | − 0.7 (− 1.3–0) | 0.049 | 2004–2012 | 0.2 (− 0.1–0.5) | 0.184 | 2012–2019 | 1.4 (1.1–1.7) | < 0.001 |
| European Region | 1990–1994 | 1.8 (1.3–2.4) | < 0.001 | 1994–2005 | 0.2 (0–0.3) | 0.011 | 2005–2017 | − 0.7 (− 0.8–0.6) | < 0.001 | 2017–2019 | 0.5 (− 1.3–2.2) | 0.578 |
| Eastern Mediterranean Region | 1990–1994 | 1.2 (0.8–1.6) | < 0.001 | 1994–2002 | 0.6 (0.4–0.7) | < 0.001 | 2002–2016 | 1.4 (1.4–1.5) | < 0.001 | 2016–2019 | 0.5 (− 0.1–1.1) | 0.081 |
| Western Pacific Region | 1990–1997 | − 0.7 (− 1.1–0.4) | 0.001 | 1997–2005 | 2.7 (2.3–3.1) | < 0.001 | 2005–2016 | − 1.1 (− 1.3–0.9) | < 0.001 | 2016–2019 | 0.4 (− 1–1.8) | 0.572 |
EAPC indicates estimated annual percentage change, with 95% confidence intervals in brackets.
*Significantly different from 0 (P < 0.05). AAPC (Average annual percentage change) indicates summary measure of the trend over 1990–2019.