Estimating mortality and disability in Peru before the COVID-19 pandemic: a systematic analysis from the Global Burden of the Disease Study 2019

Maria Jesus Rios-Blancas, Victoria Pando-Robles, Christian Razo, Cesar P. Carcamo, Walter Mendoza, Kevin Pacheco-Barrios, J. Jaime Miranda, Van Charles Lansingh, Takele Gezahegn Demie, Manika Saha, Osaretin Christabel Okonji, Arzu Yigit, Lucero Cahuana-Hurtado, Pamela R. Chacón-Uscamaita, Eduardo Bernabe, Carlos Culquichicon, Jesus Lorenzo Chirinos-Caceres, Rosario Cárdenas, Jacqueline Elizabeth Alcalde-Rabanal, Francisco J. BarreraBeatriz Paulina Ayala Quintanilla, Seyed Afshin Shorofi, Nuwan Darshana Wickramasinghe, Nuno Ferreira, Louay Almidani, Vivek Kumar Gupta, Hanie Karimi, Daniel Shewaye Alayu, Catherine P. Benziger, Takeshi Fukumoto, Ebrahim Mostafavi, Elrashdy Moustafa Mohamed Redwan, Mesfin Gebrehiwot, Khaled Khatab, Ai Koyanagi, Fiorella Krapp, Seung Lee, Maryam Noori, Ibrahim Qattea, Victor Daniel Rosenthal, Joseph W. Sakshaug, Birhanu Wagaye, Iman Zare, Doris V. Ortega-Altamirano, Efrén Murillo-Zamora, Dominique Vervoort, Diego Augusto Santos Silva, Abderrahim Oulhaj, Brenda Yuliana Herrera-Serna, Rahul Mehra, Mehrdad Amir-Behghadami, Nasrin Adib, Sandra Cortés, Anh Kim Dang, Binh Thanh Nguyen, Ali H. Mokdad, Simon I. Hay, Christopher J.L. Murray, Rafael Lozano, Patricia J. García*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Estimating and analyzing trends and patterns of health loss are essential to promote efficient resource allocation and improve Peru’s healthcare system performance. Methods: Using estimates from the Global Burden of Disease (GBD), Injuries, and Risk Factors Study (2019), we assessed mortality and disability in Peru from 1990 to 2019. We report demographic and epidemiologic trends in terms of population, life expectancy at birth (LE), mortality, incidence, prevalence, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) caused by the major diseases and risk factors in Peru. Finally, we compared Peru with 16 countries in the Latin American (LA) region. Results: The Peruvian population reached 33.9 million inhabitants (49.9% women) in 2019. From 1990 to 2019, LE at birth increased from 69.2 (95% uncertainty interval 67.8–70.3) to 80.3 (77.2–83.2) years. This increase was driven by the decline in under-5 mortality (−80.7%) and mortality from infectious diseases in older age groups (+60 years old). The number of DALYs in 1990 was 9.2 million (8.5–10.1) and reached 7.5 million (6.1–9.0) in 2019. The proportion of DALYs due to non-communicable diseases (NCDs) increased from 38.2% in 1990 to 67.9% in 2019. The all-ages and age-standardized DALYs rates and YLLs rates decreased, but YLDs rates remained constant. In 2019, the leading causes of DALYs were neonatal disorders, lower respiratory infections (LRIs), ischemic heart disease, road injuries, and low back pain. The leading risk factors associated with DALYs in 2019 were undernutrition, high body mass index, high fasting plasma glucose, and air pollution. Before the COVID-19 pandemic, Peru experienced one of the highest LRIs-DALYs rates in the LA region. Conclusion: In the last three decades, Peru experienced significant improvements in LE and child survival and an increase in the burden of NCDs and associated disability. The Peruvian healthcare system must be redesigned to respond to this epidemiological transition. The new design should aim to reduce premature deaths and maintain healthy longevity, focusing on effective coverage and treatment of NCDs and reducing and managing the related disability.

Original languageEnglish
Article number1189861
JournalFrontiers in Public Health
StatePublished - 2023


  • Peru
  • disability-adjusted life year (DALY)
  • global burden of disease
  • health metrics
  • mortality
  • risk factors


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