The Belgian national burden of disease study (BeBOD): from methodological foundations to impact

Abstract The Belgian National Burden of Disease Study (BeBOD) was initiated in 2016 by Sciensano, the Belgian institute for health. Initial methodological efforts focused on calculating Years of Life Lost (YLL) for all causes of death-leveraging a redistribution approach for multiple cause-of-death data-and Years Lived with Disability (YLD) for all cancers and a growing set of non-communicable diseases. In 2022, BeBOD published its first comprehensive results for the reference year 2018. Subsequent annual iterations expanded the study's scope and temporal coverage, with time series estimates available from 2013 onwards. The 2020 update introduced COVID-19 into the disease burden estimates, reflecting its significant health impact. To enhance the utility and relevance of the estimates, BeBOD has undergone several methodological extensions. The 2024 release included economic impact assessments for diseases and risk factors, the first national estimates for major risk factors such as tobacco and alcohol, and projections of non-fatal disease burden through 2040. Ongoing work is addressing social inequalities in health, drawing on the Belgian Index of Multiple Deprivation, and laying the groundwork for a comprehensive health impact assessment (HIA) framework. Knowledge translation (KT) is a central pillar of the BeBOD initiative. Results are made available via interactive dashboards and the Zenodo repository. Key findings are also synthesized in the Belgian Health Status Report. A proactive communication strategy-including press releases and social media engagement-ensures wide dissemination. Crucially, BeBOD results are increasingly embedded in policy frameworks, supporting national health objectives and informing discussions on unmet health needs. Looking ahead, BeBOD will continue to innovate in both methodology and impact to remain relevant for the next generation of public health challenges. Sustained international collaboration will be key to achieving this goal.