Estimating years of life lost due to premature mortality at regional level in France in 2017, using a probabilistic redistribution approach.

Publication date: Jul 03, 2025

Years of life lost (YLL) due to premature mortality is an important metric to assess the fatal impact of diseases. The main objectives of this study were to apply the four-step probabilistic method to redistribute ill-defined deaths (IDDs) and to quantify the premature mortality burden at regional level in France for 2017. We used the statistical database on medical causes of death derived from death certificate collection and coded by the Center for Epidemiology on Medical Causes of deaths (INSERM-CcE9piDc). First, we mapped the specific ICD-10 codes that define the underlying cause of death (CoD) to the Global Burden of Disease (GBD) cause list. Second, identified IDDs were redistributed to specific ICD-10 codes. A four-step probabilistic redistribution developed for the Belgium Burden of Disease (BeBOD) study was adopted to fit the French context: redistribution using predefined ICD codes, package redistribution using multiple causes of death data, internal redistribution, and redistribution to all causes. Finally, Standard Expected Years of Life Lost (SEYLL) and age-standardized SEYLL rates (ASYR) were calculated at regional level, using the GBD 2019 reference life table. In France, 36% of all deaths were IDDs in 2017. The majority was redistributed using predefined ICD codes (14%), followed by the package redistribution using multiple causes of death data (11%), all-cause redistribution (11%) and internal redistribution (

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