The state of health in Belgium, 1990-2017 : A benchmarking analysis based on the Global Burden of Disease 2017 study

Background: Despite higher health expenditures and multiple reforms, the health status in Belgium shows alarming mental health results and high prevalence of non-communicable diseases. Belgium introduced many reforms and programs to address the needs of an aging population. It is important to explore if these health expenditures lead to the projected health results, and, thereafter, propose reforms to improve them. The Global Burden of disease study offers a comprehensive framework to understand health trends and provide quality evidence to guide policy. The objective of this research is to assess the health trends in Belgium between 1990 and 2017, and compare them to the neighboring EU-15 countries based on the Global Burden of Disease 2017 study. Methods: We conducted a literature review and collected our data from the Global Burden of Disease (GBD) 2017 via the GBD results tools (GBD results tool, 2019), GBD visualizations tool (GBD Compare, 2019) and the lancet Global Burden of Disease 2017. We benchmarked the results from Belgium with the EU-15 countries and compared the results. Results: Between 1990 and 2017, age-standardized YLLs decreased in Belgium from 14541 YLLs per 100,000 to 8,404 YLLs per 100,000. Despite this decrease, Belgium ranking dropped compared to other EU-15 countries. Age-standardized YLLs were caused by ischemic heart disease and lung cancer in men and women. Overall YLDs in Belgium did not significantly increase between 1990 and 2017. The main contributors to YLDs observed in men in Belgium were low back pain, headache disorders and diabetes mellitus while main YLDs causes in women were caused by low back pain, headache disorders and depressive disorders. Between 1990 and 2017, age-standardized DALYs significantly decreased from 25,402 DALYs per 100,000 to 19,465 DALYs per 100,000. In 2017, Belgium performed better in terms of ischemic heart disease in men and women compared to other EU-15 countries; however Belgium had worse outcomes in terms of DALYs associated with lung cancer, and self-harm in men and low back pain, and headache disorders in women compared to other EU-15 countries. Conclusion: Health status in Belgium improved between 1990 and 2017. Despite the positive outcome, results show that Belgium did not perform better than the other EU-15 countries and improvement slowed down over the years compared to other neighboring countries. Non-communicable diseases remain the main source of health burden in Belgium and they are the main contributors since 1990. Many causes of disease and risk factors can be avoided through appropriate policy; priorities could target smoking, alcohol consumption, nutritional habits and road injuries.