Volume 392, Issue 10149, Pages 760-775 (September 2018) Burden of disease in Brazil, 1990–2016: a systematic subnational analysis for the Global Burden of Disease Study 2016  Fatima Marinho, Valéria Maria de Azeredo Passos, Deborah Carvalho Malta, Elizabeth Barboza França, Daisy M X Abreu, Valdelaine E M Araújo, Maria Teresa Bustamante-Teixeira, Paulo A M Camargos, Carolina Cândida da Cunha, Bruce Bartholow Duncan, Mariana Santos Felisbino-Mendes, Maximiliano Ribeiro Guerra, Mark D C Guimaraes, Paulo A Lotufo, Wagner Marcenes, Patricia Pereira Vasconcelos Oliveira, Marcel de Moares Pedroso, Antonio L Ribeiro, Maria Inês Schmidt, Renato Azeredo Teixeira, Ana Maria Nogales Vasconcelos, Mauricio L Barreto, Isabela M Bensenor, Luisa C C Brant, Rafael M Claro, Alexandre Costa Pereira, Ewerton Cousin, Maria Paula Curado, Kadine Priscila Bender dos Santos, André Faro, Cleusa P Ferri, João M Furtado, Julia Gall, Scott D Glenn, Alessandra Carvalho Goulart, Lenice Harumi Ishitani, Christian Kieling, Roberto Marini Ladeira, Isis Eloah Machado, Sheila Cristina Ouriques Martins, Francisco Rogerlândio Martins-Melo, Ana Paula Souto Melo, Molly K Miller-Petrie, Meghan D Mooney, Bruno P Nunes, Marcos Roberto Tovani Palone, Claudia C Pereira, Davide Rasella, Sarah E Ray, Leonardo Roever, Raphael de Freitas Saldanha, Itamar S Santos, Ione J C Schneider, Diego Augusto Santos Silva, Dayane Gabriele Alves Silveira, Adauto Martins Soares Filho, Tatiane Cristina Moraes Sousa, Celia L Szwarcwald, Jefferson Traebert, Gustavo Velasquez-Melendez, Yuan-Pang Wang, Rafael Lozano, Christopher J L Murray, Mohsen Naghavi Fatima Marinho, Valéria Maria de Azeredo Passos, Deborah Carvalho Malta, Elizabeth Barboza França, Daisy M X Abreu, Valdelaine E M Araújo, Maria Teresa Bustamante-Teixeira, Paulo A M Camargos, Carolina Cândida da Cunha, Bruce Bartholow Duncan, Mariana Santos Felisbino-Mendes, Maximiliano Ribeiro Guerra, Mark D C Guimaraes, Paulo A Lotufo, Wagner Marcenes, Patricia Pereira Vasconcelos Oliveira, Marcel de Moares Pedroso, Antonio L Ribeiro, Maria Inês Schmidt, Renato Azeredo Teixeira, Ana Maria Nogales Vasconcelos, Mauricio L Barreto, Isabela M Bensenor, Luisa C C Brant, Rafael M Claro, Alexandre Costa Pereira, Ewerton Cousin, Maria Paula Curado, Kadine Priscila Bender dos Santos, André Faro, Cleusa P Ferri, João M Furtado, Julia Gall, Scott D Glenn, Alessandra Carvalho Goulart, Lenice Harumi Ishitani, Christian Kieling, Roberto Marini Ladeira, Isis Eloah Machado, Sheila Cristina Ouriques Martins, Francisco Rogerlândio Martins-Melo, Ana Paula Souto Melo, Molly K Miller-Petrie, Meghan D Mooney, Bruno P Nunes, Marcos Roberto Tovani Palone, Claudia C Pereira, Davide Rasella, Sarah E Ray, Leonardo Roever, Raphael de Freitas Saldanha, Itamar S Santos, Ione J C Schneider, Diego Augusto Santos Silva, Dayane Gabriele Alves Silveira, Adauto Martins Soares Filho, Tatiane Cristina Moraes Sousa, Celia L Szwarcwald, Jefferson Traebert, Gustavo Velasquez-Melendez, Yuan-Pang Wang, Rafael Lozano, Christopher J L Murray, Mohsen Naghavi  The Lancet  Volume 392, Issue 10149, Pages 760-775 (September 2018) DOI: 10.1016/S0140-6736(18)31221-2 Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 1 Leading 25 GBD Level 3 causes of YLLs (A) and YLDs (B) for 1990 and 2016, Brazil, both sexes YLLs=years of life lost. YLDs=years lived with disability. The Lancet 2018 392, 760-775DOI: (10.1016/S0140-6736(18)31221-2) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 2 Leading causes of age-standardised YLLs in the states of Brazil, males and females, 1990 and 2016 YLLs=years of life lost. The Lancet 2018 392, 760-775DOI: (10.1016/S0140-6736(18)31221-2) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 3 Scatter of all-cause age-standardised disability-adjusted life-year rates and Socio-demographic Index in Brazil, its states, and the Federal District, both sexes, 1990–2016 Each point represents DALY rates in a single location-year by that location's SDI in the given year, coloured by location. SDI in locations has increased year on year, so points from earlier years are associated with lower SDI in most cases. The black line indicates expected values based on SDI. DALY=disability-adjusted life-year. The Lancet 2018 392, 760-775DOI: (10.1016/S0140-6736(18)31221-2) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 4 Total DALYs (A, in thousands), crude rates (B, per 100 000 people), and age-standardised rates (C, per 100 000 people), in Brazil, Maranhão, and São Paulo, both sexes, 1990–2016 DALYs=disability-adjusted life-years. The Lancet 2018 392, 760-775DOI: (10.1016/S0140-6736(18)31221-2) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 5 Percent contribution to DALYs by risk, all ages, Brazil, males (A), females (B) in 1990, and males (C), females (D) in 2016 DALYs=disability-adjusted life-years. The Lancet 2018 392, 760-775DOI: (10.1016/S0140-6736(18)31221-2) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions