 The adequacy of any socio-economic indicator has to be evaluated in the light of the purpose that it is meant to serve (Reiss 2008). If DALYs are supposed to measure the everyday concept “burden of disease”, we may criticize, for instance, that the indicator fails to take account of societal, cultural, climatic and other variations within which the disease or disability occurs. Being paraplegic, say, is less burdensome when it occurs in societies that spend more resources on making public buildings and transport wheelchair accessible, that display more tolerance towards the handicapped, or in flatter than in hillier regions. Arguably, therefore, DALYs measure ill-health rather than disease burden (Anand and Hanson 1997). Similarly, because ill-health is measured as a percentage, a disease occurring in a person who is already handicapped contributes less to the measure than the same disease occurring in an otherwise comparable but not handicapped person. If DALYs are used to make public health decisions, however, it might be better to prioritize those individuals who are least well off instead of those who are relatively better off (ibid.).