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Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best... Full description

Journal Title: Lancet 2017, Vol.390 (10100), p.1084-1150
Main Author: Abate, Kalkidan Hassen
Other Authors: Adedoyin, Rufus Adesoji , Agrawal, Sutapa , Al Lami, Faris Hasan , Alabed, Samer , Aldridge, Robert William , Ali, Raghib , Aljunid, Syed M , Al-Raddadi, Rajaa , Amini, Erfan , Andrei, Catalina Liliana , Arora, Megha , Artaman, Al , Asayesh, Hamid , Assaye, Ashagre Molla , Awasthi, Ashish , Bärnighausen, Till , Benson, Jennifer , Biryukov, Stan , Brazinova, Alexandra , Chibalabala, Mirriam , Choi, Jee-Young Jasmine , Coresh, Josef , Dandona, Rakhi , Davey, Gail , Davitoiu, Dragos V , Dey, Subhojit , Diaz-Torné, Cesar , Duan, Leilei , El Bcheraoui, Charbel , Fereshtehnejad, Seyed-Mohammad , Fernandes, Jefferson G , Gankpé, Fortuné Gbètoho , Garcia-Basteiro, Alberto L , Gebrehiwot, Tsegaye Tewelde , Gibney, Katherine B , Goulart, Alessandra Carvalho , John, Oommen , Karimi, Seyed M , Kassaw, Nigussie Assefa , Kemp, Andrew Haddon , Khalil, Ibrahim A , Khosravi, Mohammad Hossein , Krohn, Kristopher J , Kuate Defo, Barthelemy , Lager, Anton Carl Jonas , Laxmaiah, Avula , Li, Yongmei , Lorkowski, Stefan , Macarayan, Erlyn RachelleKing , Magis-Rodriguez, Carlos , Malhotra, Rajesh , Mantovani, Lorenzo G , Mapoma, Chabila C , Maulik, Pallab K , Meretoja, Tuomo J , Mezgebe, Haftay Berhane , Misganaw, Awoke , Mohammad, Karzan Abdulmuhsin , Mohanty, Sanjay K , Moraga, Paula , Nanda, Lipika , Nisar, Muhammad Imran , O'Donnell, Martin J , Obermeyer, Carla Makhlouf , Panda-Jonas, Songhomitra , Parsaeian, Mahboubeh , Patton, George C , Petzold, Max , Pishgar, Farhad , Polinder, Suzanne , Poulton, Richie G , Qorbani, Mostafa , Rahman, Mahfuzar , Rajsic, Sasa , Ribeiro, Antonio L , Rokni, Mohammad Bagher , Ronfani, Luca , Rothenbacher, Dietrich , Ruhago, George Mugambage , Samy, Abdallah M , Santos, Itamar S , Santric Milicevic, Milena M , Seedat, Soraya , Sepanlou, Sadaf G , Servan-Mori, Edson E , Shibuya, Kenji , Silveira, Dayane Gabriele Alves , Stöckl, Heidi , Sunguya, Bruno F , Tadese, Fentaw , Terkawi, Abdullah Sulieman , Tesssema, Belay , Thompson, Alex H , Tortajada, Miguel , Venketasubramanian, Narayanaswamy , Vlassov, Vasiliy Victorovich , Wijeratne, Tissa , Yan, Lijing L , Zeeb, Hajo
Format: Electronic Article Electronic Article
Language: English
Subjects:
Age
HIV
Men
Sex
STD
Quelle: Alma/SFX Local Collection
Publisher: London: Elsevier Ltd
ID: ISSN: 0140-6736
Zum Text:
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title: Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016
format: Article
creator:
  • Abate, Kalkidan Hassen
  • Adedoyin, Rufus Adesoji
  • Agrawal, Sutapa
  • Al Lami, Faris Hasan
  • Alabed, Samer
  • Aldridge, Robert William
  • Ali, Raghib
  • Aljunid, Syed M
  • Al-Raddadi, Rajaa
  • Amini, Erfan
  • Andrei, Catalina Liliana
  • Arora, Megha
  • Artaman, Al
  • Asayesh, Hamid
  • Assaye, Ashagre Molla
  • Awasthi, Ashish
  • Bärnighausen, Till
  • Benson, Jennifer
  • Biryukov, Stan
  • Brazinova, Alexandra
  • Chibalabala, Mirriam
  • Choi, Jee-Young Jasmine
  • Coresh, Josef
  • Dandona, Rakhi
  • Davey, Gail
  • Davitoiu, Dragos V
  • Dey, Subhojit
  • Diaz-Torné, Cesar
  • Duan, Leilei
  • El Bcheraoui, Charbel
  • Fereshtehnejad, Seyed-Mohammad
  • Fernandes, Jefferson G
  • Gankpé, Fortuné Gbètoho
  • Garcia-Basteiro, Alberto L
  • Gebrehiwot, Tsegaye Tewelde
  • Gibney, Katherine B
  • Goulart, Alessandra Carvalho
  • John, Oommen
  • Karimi, Seyed M
  • Kassaw, Nigussie Assefa
  • Kemp, Andrew Haddon
  • Khalil, Ibrahim A
  • Khosravi, Mohammad Hossein
  • Krohn, Kristopher J
  • Kuate Defo, Barthelemy
  • Lager, Anton Carl Jonas
  • Laxmaiah, Avula
  • Li, Yongmei
  • Lorkowski, Stefan
  • Macarayan, Erlyn RachelleKing
  • Magis-Rodriguez, Carlos
  • Malhotra, Rajesh
  • Mantovani, Lorenzo G
  • Mapoma, Chabila C
  • Maulik, Pallab K
  • Meretoja, Tuomo J
  • Mezgebe, Haftay Berhane
  • Misganaw, Awoke
  • Mohammad, Karzan Abdulmuhsin
  • Mohanty, Sanjay K
  • Moraga, Paula
  • Nanda, Lipika
  • Nisar, Muhammad Imran
  • O'Donnell, Martin J
  • Obermeyer, Carla Makhlouf
  • Panda-Jonas, Songhomitra
  • Parsaeian, Mahboubeh
  • Patton, George C
  • Petzold, Max
  • Pishgar, Farhad
  • Polinder, Suzanne
  • Poulton, Richie G
  • Qorbani, Mostafa
  • Rahman, Mahfuzar
  • Rajsic, Sasa
  • Ribeiro, Antonio L
  • Rokni, Mohammad Bagher
  • Ronfani, Luca
  • Rothenbacher, Dietrich
  • Ruhago, George Mugambage
  • Samy, Abdallah M
  • Santos, Itamar S
  • Santric Milicevic, Milena M
  • Seedat, Soraya
  • Sepanlou, Sadaf G
  • Servan-Mori, Edson E
  • Shibuya, Kenji
  • Silveira, Dayane Gabriele Alves
  • Stöckl, Heidi
  • Sunguya, Bruno F
  • Tadese, Fentaw
  • Terkawi, Abdullah Sulieman
  • Tesssema, Belay
  • Thompson, Alex H
  • Tortajada, Miguel
  • Venketasubramanian, Narayanaswamy
  • Vlassov, Vasiliy Victorovich
  • Wijeratne, Tissa
  • Yan, Lijing L
  • Zeeb, Hajo
subjects:
  • 11 Medical And Health Sciences
  • 3112 Neurosciences
  • 3121 Internal medicine
  • 3142 Public health care science
  • Acquired immune deficiency syndrome
  • Adolescent
  • Adult
  • Adults
  • Age
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Aging
  • Aging (natural)
  • AIDS
  • alcohol
  • Aldraðir
  • Aldurshópar
  • Alnæmi
  • Barnadauði
  • Best practice
  • Birth
  • Birth Rate
  • Burðarmálsdauði
  • Börn
  • Cause of Death
  • Charities
  • Child
  • Child mortality
  • Child, Preschool
  • Childbirth & labor
  • Children
  • Community medicine
  • Completeness
  • Death
  • Demographics
  • developing-countries
  • Disease
  • Dánarmein
  • Dánartíðni
  • Educational attainment
  • Educational Status
  • Empowerment
  • environmental
  • Epidemics
  • Epidemiology
  • Estimates
  • Faraldsfræði
  • Fatalities
  • Female
  • Fertility
  • Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
  • Frjósemi
  • Fæðingartíðni
  • Félagshagfræði
  • Gaussian process
  • GBD 2016 Mortality Collaborators
  • General & Internal Medicine
  • General Medicine
  • Global Burden of Disease
  • Global Health
  • Global Health Metrics
  • Halk Sağlığı
  • health
  • Health and Welfare
  • Health aspects
  • Health care science
  • Health risks
  • Health Sciences
  • Heilsufar
  • Helsefag
  • HIV
  • HIV Infections
  • Human health sciences
  • Human immunodeficiency virus
  • Humans
  • Hälsa och välfärd
  • Hälsovetenskap
  • Hälsovetenskaper
  • Income
  • Infant
  • Infant, Newborn
  • Infants
  • Infectious diseases
  • Journal Article
  • Karlar
  • Konur
  • Life Expectancy
  • Life span
  • Life tables
  • Lífslíkur
  • Male
  • Medical and Health Sciences
  • Medical disciplines
  • Medical research
  • Medicin och hälsovetenskap
  • Medicine
  • Medicine (all)
  • Medicine, Experimental
  • Medisinske Fag
  • Men
  • Menntun
  • Mental disorders
  • Mental health
  • metaanalysis
  • Middle Aged
  • Mortality
  • Mortality patterns
  • natural disaster
  • Natural disasters
  • Neonates
  • Neurologie
  • Neurology
  • Newborn
  • numerical data
  • occupational health
  • Older people
  • over
  • Personal health
  • Polls & surveys
  • Population
  • Populations
  • Preschool
  • Public Health, Global Health, Social Medicine and Epidemiology
  • Registration
  • Regression analysis
  • Risk factors
  • russian mortality
  • Samfunnsmedisin
  • Sciences de la santé humaine
  • Sex
  • Sexually transmitted diseases
  • Social medicine
  • Socioeconomic Factors
  • sosialmedisin
  • Statistical analysis
  • statistics
  • statistics & numerical data
  • Staðtölur
  • STD
  • Stillbirth
  • survival
  • Survival Rate
  • Tekjur
  • Terrorism
  • Terveystiede
  • Time series
  • Trends
  • Tölfræði
  • Ungbörn
  • Vital statistics
  • Women
  • World health
  • Young Adult
  • Þjóðir
ispartof: Lancet, 2017, Vol.390 (10100), p.1084-1150
description: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15–60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
  • 1474-547X
url: Link


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titleGlobal, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016
sourceAlma/SFX Local Collection
creatorAbate, Kalkidan Hassen ; Adedoyin, Rufus Adesoji ; Agrawal, Sutapa ; Al Lami, Faris Hasan ; Alabed, Samer ; Aldridge, Robert William ; Ali, Raghib ; Aljunid, Syed M ; Al-Raddadi, Rajaa ; Amini, Erfan ; Andrei, Catalina Liliana ; Arora, Megha ; Artaman, Al ; Asayesh, Hamid ; Assaye, Ashagre Molla ; Awasthi, Ashish ; Bärnighausen, Till ; Benson, Jennifer ; Biryukov, Stan ; Brazinova, Alexandra ; Chibalabala, Mirriam ; Choi, Jee-Young Jasmine ; Coresh, Josef ; Dandona, Rakhi ; Davey, Gail ; Davitoiu, Dragos V ; Dey, Subhojit ; Diaz-Torné, Cesar ; Duan, Leilei ; El Bcheraoui, Charbel ; Fereshtehnejad, Seyed-Mohammad ; Fernandes, Jefferson G ; Gankpé, Fortuné Gbètoho ; Garcia-Basteiro, Alberto L ; Gebrehiwot, Tsegaye Tewelde ; Gibney, Katherine B ; Goulart, Alessandra Carvalho ; John, Oommen ; Karimi, Seyed M ; Kassaw, Nigussie Assefa ; Kemp, Andrew Haddon ; Khalil, Ibrahim A ; Khosravi, Mohammad Hossein ; Krohn, Kristopher J ; Kuate Defo, Barthelemy ; Lager, Anton Carl Jonas ; Laxmaiah, Avula ; Li, Yongmei ; Lorkowski, Stefan ; Macarayan, Erlyn RachelleKing ; Magis-Rodriguez, Carlos ; Malhotra, Rajesh ; Mantovani, Lorenzo G ; Mapoma, Chabila C ; Maulik, Pallab K ; Meretoja, Tuomo J ; Mezgebe, Haftay Berhane ; Misganaw, Awoke ; Mohammad, Karzan Abdulmuhsin ; Mohanty, Sanjay K ; Moraga, Paula ; Nanda, Lipika ; Nisar, Muhammad Imran ; O'Donnell, Martin J ; Obermeyer, Carla Makhlouf ; Panda-Jonas, Songhomitra ; Parsaeian, Mahboubeh ; Patton, George C ; Petzold, Max ; Pishgar, Farhad ; Polinder, Suzanne ; Poulton, Richie G ; Qorbani, Mostafa ; Rahman, Mahfuzar ; Rajsic, Sasa ; Ribeiro, Antonio L ; Rokni, Mohammad Bagher ; Ronfani, Luca ; Rothenbacher, Dietrich ; Ruhago, George Mugambage ; Samy, Abdallah M ; Santos, Itamar S ; Santric Milicevic, Milena M ; Seedat, Soraya ; Sepanlou, Sadaf G ; Servan-Mori, Edson E ; Shibuya, Kenji ; Silveira, Dayane Gabriele Alves ; Stöckl, Heidi ; Sunguya, Bruno F ; Tadese, Fentaw ; Terkawi, Abdullah Sulieman ; Tesssema, Belay ; Thompson, Alex H ; Tortajada, Miguel ; Venketasubramanian, Narayanaswamy ; Vlassov, Vasiliy Victorovich ; Wijeratne, Tissa ; Yan, Lijing L ; Zeeb, Hajo
creatorcontribAbate, Kalkidan Hassen ; Adedoyin, Rufus Adesoji ; Agrawal, Sutapa ; Al Lami, Faris Hasan ; Alabed, Samer ; Aldridge, Robert William ; Ali, Raghib ; Aljunid, Syed M ; Al-Raddadi, Rajaa ; Amini, Erfan ; Andrei, Catalina Liliana ; Arora, Megha ; Artaman, Al ; Asayesh, Hamid ; Assaye, Ashagre Molla ; Awasthi, Ashish ; Bärnighausen, Till ; Benson, Jennifer ; Biryukov, Stan ; Brazinova, Alexandra ; Chibalabala, Mirriam ; Choi, Jee-Young Jasmine ; Coresh, Josef ; Dandona, Rakhi ; Davey, Gail ; Davitoiu, Dragos V ; Dey, Subhojit ; Diaz-Torné, Cesar ; Duan, Leilei ; El Bcheraoui, Charbel ; Fereshtehnejad, Seyed-Mohammad ; Fernandes, Jefferson G ; Gankpé, Fortuné Gbètoho ; Garcia-Basteiro, Alberto L ; Gebrehiwot, Tsegaye Tewelde ; Gibney, Katherine B ; Goulart, Alessandra Carvalho ; John, Oommen ; Karimi, Seyed M ; Kassaw, Nigussie Assefa ; Kemp, Andrew Haddon ; Khalil, Ibrahim A ; Khosravi, Mohammad Hossein ; Krohn, Kristopher J ; Kuate Defo, Barthelemy ; Lager, Anton Carl Jonas ; Laxmaiah, Avula ; Li, Yongmei ; Lorkowski, Stefan ; Macarayan, Erlyn RachelleKing ; Magis-Rodriguez, Carlos ; Malhotra, Rajesh ; Mantovani, Lorenzo G ; Mapoma, Chabila C ; Maulik, Pallab K ; Meretoja, Tuomo J ; Mezgebe, Haftay Berhane ; Misganaw, Awoke ; Mohammad, Karzan Abdulmuhsin ; Mohanty, Sanjay K ; Moraga, Paula ; Nanda, Lipika ; Nisar, Muhammad Imran ; O'Donnell, Martin J ; Obermeyer, Carla Makhlouf ; Panda-Jonas, Songhomitra ; Parsaeian, Mahboubeh ; Patton, George C ; Petzold, Max ; Pishgar, Farhad ; Polinder, Suzanne ; Poulton, Richie G ; Qorbani, Mostafa ; Rahman, Mahfuzar ; Rajsic, Sasa ; Ribeiro, Antonio L ; Rokni, Mohammad Bagher ; Ronfani, Luca ; Rothenbacher, Dietrich ; Ruhago, George Mugambage ; Samy, Abdallah M ; Santos, Itamar S ; Santric Milicevic, Milena M ; Seedat, Soraya ; Sepanlou, Sadaf G ; Servan-Mori, Edson E ; Shibuya, Kenji ; Silveira, Dayane Gabriele Alves ; Stöckl, Heidi ; Sunguya, Bruno F ; Tadese, Fentaw ; Terkawi, Abdullah Sulieman ; Tesssema, Belay ; Thompson, Alex H ; Tortajada, Miguel ; Venketasubramanian, Narayanaswamy ; Vlassov, Vasiliy Victorovich ; Wijeratne, Tissa ; Yan, Lijing L ; Zeeb, Hajo ; GBD 2016 Mortality Collaborators ; Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa ; Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri ; Göteborgs universitet ; Gothenburg University ; Institute of Medicine, School of Public Health and Community Medicine ; Sahlgrenska Academy ; Sahlgrenska akademin ; Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
descriptionDetailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15–60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5–24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates—a measure of relative inequality—increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7–87·2), and for men in Singapore, at 81·3 years (78·8–83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, and the gap between male and female life expectancy increased with progression to higher levels of SDI. Some countries with exceptional health performance in 1990 in terms of the difference in observed to expected life expectancy at birth had slower progress on the same measure in 2016. Globally, mortality rates have decreased across all age groups over the past five decades, with the largest improvements occurring among children younger than 5 years. However, at the national level, considerable heterogeneity remains in terms of both level and rate of changes in age-specific mortality; increases in mortality for certain age groups occurred in some locations. We found evidence that the absolute gap between countries in age-specific death rates has declined, although the relative gap for some age-sex groups increased. Countries that now lead in terms of having higher observed life expectancy than that expected on the basis of development alone, or locations that have either increased this advantage or rapidly decreased the deficit from expected levels, could provide insight into the means to accelerate progress in nations where progress has stalled. Bill & Melinda Gates Foundation, and the National Institute on Aging and the National Institute of Mental Health of the National Institutes of Health.
identifier
0ISSN: 0140-6736
1ISSN: 1474-547X
2EISSN: 1474-547X
3DOI: 10.1016/S0140-6736(17)31833-0
4PMID: 28919115
languageeng
publisherLondon: Elsevier Ltd
subject11 Medical And Health Sciences ; 3112 Neurosciences ; 3121 Internal medicine ; 3142 Public health care science ; Acquired immune deficiency syndrome ; Adolescent ; Adult ; Adults ; Age ; Age Distribution ; Aged ; Aged, 80 and over ; Aging ; Aging (natural) ; AIDS ; alcohol ; Aldraðir ; Aldurshópar ; Alnæmi ; Barnadauði ; Best practice ; Birth ; Birth Rate ; Burðarmálsdauði ; Börn ; Cause of Death ; Charities ; Child ; Child mortality ; Child, Preschool ; Childbirth & labor ; Children ; Community medicine ; Completeness ; Death ; Demographics ; developing-countries ; Disease ; Dánarmein ; Dánartíðni ; Educational attainment ; Educational Status ; Empowerment ; environmental ; Epidemics ; Epidemiology ; Estimates ; Faraldsfræði ; Fatalities ; Female ; Fertility ; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ; Frjósemi ; Fæðingartíðni ; Félagshagfræði ; Gaussian process ; GBD 2016 Mortality Collaborators ; General & Internal Medicine ; General Medicine ; Global Burden of Disease ; Global Health ; Global Health Metrics ; Halk Sağlığı ; health ; Health and Welfare ; Health aspects ; Health care science ; Health risks ; Health Sciences ; Heilsufar ; Helsefag ; HIV ; HIV Infections ; Human health sciences ; Human immunodeficiency virus ; Humans ; Hälsa och välfärd ; Hälsovetenskap ; Hälsovetenskaper ; Income ; Infant ; Infant, Newborn ; Infants ; Infectious diseases ; Journal Article ; Karlar ; Konur ; Life Expectancy ; Life span ; Life tables ; Lífslíkur ; Male ; Medical and Health Sciences ; Medical disciplines ; Medical research ; Medicin och hälsovetenskap ; Medicine ; Medicine (all) ; Medicine, Experimental ; Medisinske Fag ; Men ; Menntun ; Mental disorders ; Mental health ; metaanalysis ; Middle Aged ; Mortality ; Mortality patterns ; natural disaster ; Natural disasters ; Neonates ; Neurologie ; Neurology ; Newborn ; numerical data ; occupational health ; Older people ; over ; Personal health ; Polls & surveys ; Population ; Populations ; Preschool ; Public Health, Global Health, Social Medicine and Epidemiology ; Registration ; Regression analysis ; Risk factors ; russian mortality ; Samfunnsmedisin ; Sciences de la santé humaine ; Sex ; Sexually transmitted diseases ; Social medicine ; Socioeconomic Factors ; sosialmedisin ; Statistical analysis ; statistics ; statistics & numerical data ; Staðtölur ; STD ; Stillbirth ; survival ; Survival Rate ; Tekjur ; Terrorism ; Terveystiede ; Time series ; Trends ; Tölfræði ; Ungbörn ; Vital statistics ; Women ; World health ; Young Adult ; Þjóðir
ispartofLancet, 2017, Vol.390 (10100), p.1084-1150
rights
02017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
1COPYRIGHT 2017 Elsevier B.V.
2Copyright Elsevier Limited Sep 16, 2017
32017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license 2017
lds50peer_reviewed
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creatorcontrib
0Abate, Kalkidan Hassen
1Adedoyin, Rufus Adesoji
2Agrawal, Sutapa
3Al Lami, Faris Hasan
4Alabed, Samer
5Aldridge, Robert William
6Ali, Raghib
7Aljunid, Syed M
8Al-Raddadi, Rajaa
9Amini, Erfan
10Andrei, Catalina Liliana
11Arora, Megha
12Artaman, Al
13Asayesh, Hamid
14Assaye, Ashagre Molla
15Awasthi, Ashish
16Bärnighausen, Till
17Benson, Jennifer
18Biryukov, Stan
19Brazinova, Alexandra
20Chibalabala, Mirriam
21Choi, Jee-Young Jasmine
22Coresh, Josef
23Dandona, Rakhi
24Davey, Gail
25Davitoiu, Dragos V
26Dey, Subhojit
27Diaz-Torné, Cesar
28Duan, Leilei
29El Bcheraoui, Charbel
30Fereshtehnejad, Seyed-Mohammad
31Fernandes, Jefferson G
32Gankpé, Fortuné Gbètoho
33Garcia-Basteiro, Alberto L
34Gebrehiwot, Tsegaye Tewelde
35Gibney, Katherine B
36Goulart, Alessandra Carvalho
37John, Oommen
38Karimi, Seyed M
39Kassaw, Nigussie Assefa
40Kemp, Andrew Haddon
41Khalil, Ibrahim A
42Khosravi, Mohammad Hossein
43Krohn, Kristopher J
44Kuate Defo, Barthelemy
45Lager, Anton Carl Jonas
46Laxmaiah, Avula
47Li, Yongmei
48Lorkowski, Stefan
49Macarayan, Erlyn RachelleKing
50Magis-Rodriguez, Carlos
51Malhotra, Rajesh
52Mantovani, Lorenzo G
53Mapoma, Chabila C
54Maulik, Pallab K
55Meretoja, Tuomo J
56Mezgebe, Haftay Berhane
57Misganaw, Awoke
58Mohammad, Karzan Abdulmuhsin
59Mohanty, Sanjay K
60Moraga, Paula
61Nanda, Lipika
62Nisar, Muhammad Imran
63O'Donnell, Martin J
64Obermeyer, Carla Makhlouf
65Panda-Jonas, Songhomitra
66Parsaeian, Mahboubeh
67Patton, George C
68Petzold, Max
69Pishgar, Farhad
70Polinder, Suzanne
71Poulton, Richie G
72Qorbani, Mostafa
73Rahman, Mahfuzar
74Rajsic, Sasa
75Ribeiro, Antonio L
76Rokni, Mohammad Bagher
77Ronfani, Luca
78Rothenbacher, Dietrich
79Ruhago, George Mugambage
80Samy, Abdallah M
81Santos, Itamar S
82Santric Milicevic, Milena M
83Seedat, Soraya
84Sepanlou, Sadaf G
85Servan-Mori, Edson E
86Shibuya, Kenji
87Silveira, Dayane Gabriele Alves
88Stöckl, Heidi
89Sunguya, Bruno F
90Tadese, Fentaw
91Terkawi, Abdullah Sulieman
92Tesssema, Belay
93Thompson, Alex H
94Tortajada, Miguel
95Venketasubramanian, Narayanaswamy
96Vlassov, Vasiliy Victorovich
97Wijeratne, Tissa
98Yan, Lijing L
99Zeeb, Hajo
100GBD 2016 Mortality Collaborators
101Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
102Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri
103Göteborgs universitet
104Gothenburg University
105Institute of Medicine, School of Public Health and Community Medicine
106Sahlgrenska Academy
107Sahlgrenska akademin
108Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
title
0Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016
1Lancet
descriptionDetailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15–60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5–24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates—a measure of relative inequality—increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7–87·2), and for men in Singapore, at 81·3 years (78·8–83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, and the gap between male and female life expectancy increased with progression to higher levels of SDI. Some countries with exceptional health performance in 1990 in terms of the difference in observed to expected life expectancy at birth had slower progress on the same measure in 2016. Globally, mortality rates have decreased across all age groups over the past five decades, with the largest improvements occurring among children younger than 5 years. However, at the national level, considerable heterogeneity remains in terms of both level and rate of changes in age-specific mortality; increases in mortality for certain age groups occurred in some locations. We found evidence that the absolute gap between countries in age-specific death rates has declined, although the relative gap for some age-sex groups increased. Countries that now lead in terms of having higher observed life expectancy than that expected on the basis of development alone, or locations that have either increased this advantage or rapidly decreased the deficit from expected levels, could provide insight into the means to accelerate progress in nations where progress has stalled. Bill & Melinda Gates Foundation, and the National Institute on Aging and the National Institute of Mental Health of the National Institutes of Health.
subject
011 Medical And Health Sciences
13112 Neurosciences
23121 Internal medicine
33142 Public health care science
4Acquired immune deficiency syndrome
5Adolescent
6Adult
7Adults
8Age
9Age Distribution
10Aged
11Aged, 80 and over
12Aging
13Aging (natural)
14AIDS
15alcohol
16Aldraðir
17Aldurshópar
18Alnæmi
19Barnadauði
20Best practice
21Birth
22Birth Rate
23Burðarmálsdauði
24Börn
25Cause of Death
26Charities
27Child
28Child mortality
29Child, Preschool
30Childbirth & labor
31Children
32Community medicine
33Completeness
34Death
35Demographics
36developing-countries
37Disease
38Dánarmein
39Dánartíðni
40Educational attainment
41Educational Status
42Empowerment
43environmental
44Epidemics
45Epidemiology
46Estimates
47Faraldsfræði
48Fatalities
49Female
50Fertility
51Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
52Frjósemi
53Fæðingartíðni
54Félagshagfræði
55Gaussian process
56GBD 2016 Mortality Collaborators
57General & Internal Medicine
58General Medicine
59Global Burden of Disease
60Global Health
61Global Health Metrics
62Halk Sağlığı
63health
64Health and Welfare
65Health aspects
66Health care science
67Health risks
68Health Sciences
69Heilsufar
70Helsefag
71HIV
72HIV Infections
73Human health sciences
74Human immunodeficiency virus
75Humans
76Hälsa och välfärd
77Hälsovetenskap
78Hälsovetenskaper
79Income
80Infant
81Infant, Newborn
82Infants
83Infectious diseases
84Journal Article
85Karlar
86Konur
87Life Expectancy
88Life span
89Life tables
90Lífslíkur
91Male
92Medical and Health Sciences
93Medical disciplines
94Medical research
95Medicin och hälsovetenskap
96Medicine
97Medicine (all)
98Medicine, Experimental
99Medisinske Fag
100Men
101Menntun
102Mental disorders
103Mental health
104metaanalysis
105Middle Aged
106Mortality
107Mortality patterns
108natural disaster
109Natural disasters
110Neonates
111Neurologie
112Neurology
113Newborn
114numerical data
115occupational health
116Older people
117over
118Personal health
119Polls & surveys
120Population
121Populations
122Preschool
123Public Health, Global Health, Social Medicine and Epidemiology
124Registration
125Regression analysis
126Risk factors
127russian mortality
128Samfunnsmedisin
129Sciences de la santé humaine
130Sex
131Sexually transmitted diseases
132Social medicine
133Socioeconomic Factors
134sosialmedisin
135Statistical analysis
136statistics
137statistics & numerical data
138Staðtölur
139STD
140Stillbirth
141survival
142Survival Rate
143Tekjur
144Terrorism
145Terveystiede
146Time series
147Trends
148Tölfræði
149Ungbörn
150Vital statistics
151Women
152World health
153Young Adult
154Þjóðir
issn
00140-6736
11474-547X
21474-547X
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creator
0Abate, Kalkidan Hassen
1Adedoyin, Rufus Adesoji
2Agrawal, Sutapa
3Al Lami, Faris Hasan
4Alabed, Samer
5Aldridge, Robert William
6Ali, Raghib
7Aljunid, Syed M
8Al-Raddadi, Rajaa
9Amini, Erfan
10Andrei, Catalina Liliana
11Arora, Megha
12Artaman, Al
13Asayesh, Hamid
14Assaye, Ashagre Molla
15Awasthi, Ashish
16Bärnighausen, Till
17Benson, Jennifer
18Biryukov, Stan
19Brazinova, Alexandra
20Chibalabala, Mirriam
21Choi, Jee-Young Jasmine
22Coresh, Josef
23Dandona, Rakhi
24Davey, Gail
25Davitoiu, Dragos V
26Dey, Subhojit
27Diaz-Torné, Cesar
28Duan, Leilei
29El Bcheraoui, Charbel
30Fereshtehnejad, Seyed-Mohammad
31Fernandes, Jefferson G
32Gankpé, Fortuné Gbètoho
33Garcia-Basteiro, Alberto L
34Gebrehiwot, Tsegaye Tewelde
35Gibney, Katherine B
36Goulart, Alessandra Carvalho
37John, Oommen
38Karimi, Seyed M
39Kassaw, Nigussie Assefa
40Kemp, Andrew Haddon
41Khalil, Ibrahim A
42Khosravi, Mohammad Hossein
43Krohn, Kristopher J
44Kuate Defo, Barthelemy
45Lager, Anton Carl Jonas
46Laxmaiah, Avula
47Li, Yongmei
48Lorkowski, Stefan
49Macarayan, Erlyn RachelleKing
50Magis-Rodriguez, Carlos
51Malhotra, Rajesh
52Mantovani, Lorenzo G
53Mapoma, Chabila C
54Maulik, Pallab K
55Meretoja, Tuomo J
56Mezgebe, Haftay Berhane
57Misganaw, Awoke
58Mohammad, Karzan Abdulmuhsin
59Mohanty, Sanjay K
60Moraga, Paula
61Nanda, Lipika
62Nisar, Muhammad Imran
63O'Donnell, Martin J
64Obermeyer, Carla Makhlouf
65Panda-Jonas, Songhomitra
66Parsaeian, Mahboubeh
67Patton, George C
68Petzold, Max
69Pishgar, Farhad
70Polinder, Suzanne
71Poulton, Richie G
72Qorbani, Mostafa
73Rahman, Mahfuzar
74Rajsic, Sasa
75Ribeiro, Antonio L
76Rokni, Mohammad Bagher
77Ronfani, Luca
78Rothenbacher, Dietrich
79Ruhago, George Mugambage
80Samy, Abdallah M
81Santos, Itamar S
82Santric Milicevic, Milena M
83Seedat, Soraya
84Sepanlou, Sadaf G
85Servan-Mori, Edson E
86Shibuya, Kenji
87Silveira, Dayane Gabriele Alves
88Stöckl, Heidi
89Sunguya, Bruno F
90Tadese, Fentaw
91Terkawi, Abdullah Sulieman
92Tesssema, Belay
93Thompson, Alex H
94Tortajada, Miguel
95Venketasubramanian, Narayanaswamy
96Vlassov, Vasiliy Victorovich
97Wijeratne, Tissa
98Yan, Lijing L
99Zeeb, Hajo
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creationdate20170916
titleGlobal, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016
authorAbate, Kalkidan Hassen ; Adedoyin, Rufus Adesoji ; Agrawal, Sutapa ; Al Lami, Faris Hasan ; Alabed, Samer ; Aldridge, Robert William ; Ali, Raghib ; Aljunid, Syed M ; Al-Raddadi, Rajaa ; Amini, Erfan ; Andrei, Catalina Liliana ; Arora, Megha ; Artaman, Al ; Asayesh, Hamid ; Assaye, Ashagre Molla ; Awasthi, Ashish ; Bärnighausen, Till ; Benson, Jennifer ; Biryukov, Stan ; Brazinova, Alexandra ; Chibalabala, Mirriam ; Choi, Jee-Young Jasmine ; Coresh, Josef ; Dandona, Rakhi ; Davey, Gail ; Davitoiu, Dragos V ; Dey, Subhojit ; Diaz-Torné, Cesar ; Duan, Leilei ; El Bcheraoui, Charbel ; Fereshtehnejad, Seyed-Mohammad ; Fernandes, Jefferson G ; Gankpé, Fortuné Gbètoho ; Garcia-Basteiro, Alberto L ; Gebrehiwot, Tsegaye Tewelde ; Gibney, Katherine B ; Goulart, Alessandra Carvalho ; John, Oommen ; Karimi, Seyed M ; Kassaw, Nigussie Assefa ; Kemp, Andrew Haddon ; Khalil, Ibrahim A ; Khosravi, Mohammad Hossein ; Krohn, Kristopher J ; Kuate Defo, Barthelemy ; Lager, Anton Carl Jonas ; Laxmaiah, Avula ; Li, Yongmei ; Lorkowski, Stefan ; Macarayan, Erlyn RachelleKing ; Magis-Rodriguez, Carlos ; Malhotra, Rajesh ; Mantovani, Lorenzo G ; Mapoma, Chabila C ; Maulik, Pallab K ; Meretoja, Tuomo J ; Mezgebe, Haftay Berhane ; Misganaw, Awoke ; Mohammad, Karzan Abdulmuhsin ; Mohanty, Sanjay K ; Moraga, Paula ; Nanda, Lipika ; Nisar, Muhammad Imran ; O'Donnell, Martin J ; Obermeyer, Carla Makhlouf ; Panda-Jonas, Songhomitra ; Parsaeian, Mahboubeh ; Patton, George C ; Petzold, Max ; Pishgar, Farhad ; Polinder, Suzanne ; Poulton, Richie G ; Qorbani, Mostafa ; Rahman, Mahfuzar ; Rajsic, Sasa ; Ribeiro, Antonio L ; Rokni, Mohammad Bagher ; Ronfani, Luca ; Rothenbacher, Dietrich ; Ruhago, George Mugambage ; Samy, Abdallah M ; Santos, Itamar S ; Santric Milicevic, Milena M ; Seedat, Soraya ; Sepanlou, Sadaf G ; Servan-Mori, Edson E ; Shibuya, Kenji ; Silveira, Dayane Gabriele Alves ; Stöckl, Heidi ; Sunguya, Bruno F ; Tadese, Fentaw ; Terkawi, Abdullah Sulieman ; Tesssema, Belay ; Thompson, Alex H ; Tortajada, Miguel ; Venketasubramanian, Narayanaswamy ; Vlassov, Vasiliy Victorovich ; Wijeratne, Tissa ; Yan, Lijing L ; Zeeb, Hajo
facets
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languageeng
creationdate2017
topic
011 Medical And Health Sciences
13112 Neurosciences
23121 Internal medicine
33142 Public health care science
4Acquired immune deficiency syndrome
5Adolescent
6Adult
7Adults
8Age
9Age Distribution
10Aged
11Aged, 80 and over
12Aging
13Aging (natural)
14AIDS
15alcohol
16Aldraðir
17Aldurshópar
18Alnæmi
19Barnadauði
20Best practice
21Birth
22Birth Rate
23Burðarmálsdauði
24Börn
25Cause of Death
26Charities
27Child
28Child mortality
29Child, Preschool
30Childbirth & labor
31Children
32Community medicine
33Completeness
34Death
35Demographics
36developing-countries
37Disease
38Dánarmein
39Dánartíðni
40Educational attainment
41Educational Status
42Empowerment
43environmental
44Epidemics
45Epidemiology
46Estimates
47Faraldsfræði
48Fatalities
49Female
50Fertility
51Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
52Frjósemi
53Fæðingartíðni
54Félagshagfræði
55Gaussian process
56GBD 2016 Mortality Collaborators
57General & Internal Medicine
58General Medicine
59Global Burden of Disease
60Global Health
61Global Health Metrics
62Halk Sağlığı
63health
64Health and Welfare
65Health aspects
66Health care science
67Health risks
68Health Sciences
69Heilsufar
70Helsefag
71HIV
72HIV Infections
73Human health sciences
74Human immunodeficiency virus
75Humans
76Hälsa och välfärd
77Hälsovetenskap
78Hälsovetenskaper
79Income
80Infant
81Infant, Newborn
82Infants
83Infectious diseases
84Journal Article
85Karlar
86Konur
87Life Expectancy
88Life span
89Life tables
90Lífslíkur
91Male
92Medical and Health Sciences
93Medical disciplines
94Medical research
95Medicin och hälsovetenskap
96Medicine
97Medicine (all)
98Medicine, Experimental
99Medisinske Fag
100Men
101Menntun
102Mental disorders
103Mental health
104metaanalysis
105Middle Aged
106Mortality
107Mortality patterns
108natural disaster
109Natural disasters
110Neonates
111Neurologie
112Neurology
113Newborn
114numerical data
115occupational health
116Older people
117over
118Personal health
119Polls & surveys
120Population
121Populations
122Preschool
123Public Health, Global Health, Social Medicine and Epidemiology
124Registration
125Regression analysis
126Risk factors
127russian mortality
128Samfunnsmedisin
129Sciences de la santé humaine
130Sex
131Sexually transmitted diseases
132Social medicine
133Socioeconomic Factors
134sosialmedisin
135Statistical analysis
136statistics
137statistics & numerical data
138Staðtölur
139STD
140Stillbirth
141survival
142Survival Rate
143Tekjur
144Terrorism
145Terveystiede
146Time series
147Trends
148Tölfræði
149Ungbörn
150Vital statistics
151Women
152World health
153Young Adult
154Þjóðir
toplevel
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0Abate, Kalkidan Hassen
1Adedoyin, Rufus Adesoji
2Agrawal, Sutapa
3Al Lami, Faris Hasan
4Alabed, Samer
5Aldridge, Robert William
6Ali, Raghib
7Aljunid, Syed M
8Al-Raddadi, Rajaa
9Amini, Erfan
10Andrei, Catalina Liliana
11Arora, Megha
12Artaman, Al
13Asayesh, Hamid
14Assaye, Ashagre Molla
15Awasthi, Ashish
16Bärnighausen, Till
17Benson, Jennifer
18Biryukov, Stan
19Brazinova, Alexandra
20Chibalabala, Mirriam
21Choi, Jee-Young Jasmine
22Coresh, Josef
23Dandona, Rakhi
24Davey, Gail
25Davitoiu, Dragos V
26Dey, Subhojit
27Diaz-Torné, Cesar
28Duan, Leilei
29El Bcheraoui, Charbel
30Fereshtehnejad, Seyed-Mohammad
31Fernandes, Jefferson G
32Gankpé, Fortuné Gbètoho
33Garcia-Basteiro, Alberto L
34Gebrehiwot, Tsegaye Tewelde
35Gibney, Katherine B
36Goulart, Alessandra Carvalho
37John, Oommen
38Karimi, Seyed M
39Kassaw, Nigussie Assefa
40Kemp, Andrew Haddon
41Khalil, Ibrahim A
42Khosravi, Mohammad Hossein
43Krohn, Kristopher J
44Kuate Defo, Barthelemy
45Lager, Anton Carl Jonas
46Laxmaiah, Avula
47Li, Yongmei
48Lorkowski, Stefan
49Macarayan, Erlyn RachelleKing
50Magis-Rodriguez, Carlos
51Malhotra, Rajesh
52Mantovani, Lorenzo G
53Mapoma, Chabila C
54Maulik, Pallab K
55Meretoja, Tuomo J
56Mezgebe, Haftay Berhane
57Misganaw, Awoke
58Mohammad, Karzan Abdulmuhsin
59Mohanty, Sanjay K
60Moraga, Paula
61Nanda, Lipika
62Nisar, Muhammad Imran
63O'Donnell, Martin J
64Obermeyer, Carla Makhlouf
65Panda-Jonas, Songhomitra
66Parsaeian, Mahboubeh
67Patton, George C
68Petzold, Max
69Pishgar, Farhad
70Polinder, Suzanne
71Poulton, Richie G
72Qorbani, Mostafa
73Rahman, Mahfuzar
74Rajsic, Sasa
75Ribeiro, Antonio L
76Rokni, Mohammad Bagher
77Ronfani, Luca
78Rothenbacher, Dietrich
79Ruhago, George Mugambage
80Samy, Abdallah M
81Santos, Itamar S
82Santric Milicevic, Milena M
83Seedat, Soraya
84Sepanlou, Sadaf G
85Servan-Mori, Edson E
86Shibuya, Kenji
87Silveira, Dayane Gabriele Alves
88Stöckl, Heidi
89Sunguya, Bruno F
90Tadese, Fentaw
91Terkawi, Abdullah Sulieman
92Tesssema, Belay
93Thompson, Alex H
94Tortajada, Miguel
95Venketasubramanian, Narayanaswamy
96Vlassov, Vasiliy Victorovich
97Wijeratne, Tissa
98Yan, Lijing L
99Zeeb, Hajo
100GBD 2016 Mortality Collaborators
101Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
102Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri
103Göteborgs universitet
104Gothenburg University
105Institute of Medicine, School of Public Health and Community Medicine
106Sahlgrenska Academy
107Sahlgrenska akademin
108Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
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jtitleLancet
delivery
delcategoryRemote Search Resource
fulltextfulltext
addata
au
0Abate, Kalkidan Hassen
1Adedoyin, Rufus Adesoji
2Agrawal, Sutapa
3Al Lami, Faris Hasan
4Alabed, Samer
5Aldridge, Robert William
6Ali, Raghib
7Aljunid, Syed M
8Al-Raddadi, Rajaa
9Amini, Erfan
10Andrei, Catalina Liliana
11Arora, Megha
12Artaman, Al
13Asayesh, Hamid
14Assaye, Ashagre Molla
15Awasthi, Ashish
16Bärnighausen, Till
17Benson, Jennifer
18Biryukov, Stan
19Brazinova, Alexandra
20Chibalabala, Mirriam
21Choi, Jee-Young Jasmine
22Coresh, Josef
23Dandona, Rakhi
24Davey, Gail
25Davitoiu, Dragos V
26Dey, Subhojit
27Diaz-Torné, Cesar
28Duan, Leilei
29El Bcheraoui, Charbel
30Fereshtehnejad, Seyed-Mohammad
31Fernandes, Jefferson G
32Gankpé, Fortuné Gbètoho
33Garcia-Basteiro, Alberto L
34Gebrehiwot, Tsegaye Tewelde
35Gibney, Katherine B
36Goulart, Alessandra Carvalho
37John, Oommen
38Karimi, Seyed M
39Kassaw, Nigussie Assefa
40Kemp, Andrew Haddon
41Khalil, Ibrahim A
42Khosravi, Mohammad Hossein
43Krohn, Kristopher J
44Kuate Defo, Barthelemy
45Lager, Anton Carl Jonas
46Laxmaiah, Avula
47Li, Yongmei
48Lorkowski, Stefan
49Macarayan, Erlyn RachelleKing
50Magis-Rodriguez, Carlos
51Malhotra, Rajesh
52Mantovani, Lorenzo G
53Mapoma, Chabila C
54Maulik, Pallab K
55Meretoja, Tuomo J
56Mezgebe, Haftay Berhane
57Misganaw, Awoke
58Mohammad, Karzan Abdulmuhsin
59Mohanty, Sanjay K
60Moraga, Paula
61Nanda, Lipika
62Nisar, Muhammad Imran
63O'Donnell, Martin J
64Obermeyer, Carla Makhlouf
65Panda-Jonas, Songhomitra
66Parsaeian, Mahboubeh
67Patton, George C
68Petzold, Max
69Pishgar, Farhad
70Polinder, Suzanne
71Poulton, Richie G
72Qorbani, Mostafa
73Rahman, Mahfuzar
74Rajsic, Sasa
75Ribeiro, Antonio L
76Rokni, Mohammad Bagher
77Ronfani, Luca
78Rothenbacher, Dietrich
79Ruhago, George Mugambage
80Samy, Abdallah M
81Santos, Itamar S
82Santric Milicevic, Milena M
83Seedat, Soraya
84Sepanlou, Sadaf G
85Servan-Mori, Edson E
86Shibuya, Kenji
87Silveira, Dayane Gabriele Alves
88Stöckl, Heidi
89Sunguya, Bruno F
90Tadese, Fentaw
91Terkawi, Abdullah Sulieman
92Tesssema, Belay
93Thompson, Alex H
94Tortajada, Miguel
95Venketasubramanian, Narayanaswamy
96Vlassov, Vasiliy Victorovich
97Wijeratne, Tissa
98Yan, Lijing L
99Zeeb, Hajo
aucorp
0GBD 2016 Mortality Collaborators
1Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
2Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri
3Göteborgs universitet
4Gothenburg University
5Institute of Medicine, School of Public Health and Community Medicine
6Sahlgrenska Academy
7Sahlgrenska akademin
8Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
formatjournal
genrearticle
ristypeJOUR
atitleGlobal, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016
jtitleLancet
date2017-09-16
risdate2017
volume390
issue10100
spage1084
epage1150
pages1084-1150
issn
00140-6736
11474-547X
eissn1474-547X
notes
0scopus-id:2-s2.0-85031719180
1https://api.elsevier.com/content/article/PII:S0140673617318330?httpAccept=text/xml
2Collaborators listed at the end of the paper
abstractDetailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15–60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5–24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates—a measure of relative inequality—increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7–87·2), and for men in Singapore, at 81·3 years (78·8–83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, and the gap between male and female life expectancy increased with progression to higher levels of SDI. Some countries with exceptional health performance in 1990 in terms of the difference in observed to expected life expectancy at birth had slower progress on the same measure in 2016. Globally, mortality rates have decreased across all age groups over the past five decades, with the largest improvements occurring among children younger than 5 years. However, at the national level, considerable heterogeneity remains in terms of both level and rate of changes in age-specific mortality; increases in mortality for certain age groups occurred in some locations. We found evidence that the absolute gap between countries in age-specific death rates has declined, although the relative gap for some age-sex groups increased. Countries that now lead in terms of having higher observed life expectancy than that expected on the basis of development alone, or locations that have either increased this advantage or rapidly decreased the deficit from expected levels, could provide insight into the means to accelerate progress in nations where progress has stalled. Bill & Melinda Gates Foundation, and the National Institute on Aging and the National Institute of Mental Health of the National Institutes of Health.
copLondon
pubElsevier Ltd
pmid28919115
doi10.1016/S0140-6736(17)31833-0
oafree_for_read