Diseases, Injuries, and Risk Factors in Child and Adolescent Health, 1990 to 2017

Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study

Robert C. Reiner, Helen Elizabeth Olsen, Chad Ikeda, Michelle Echko, Katherine E. Ballesteros, Helena Manguerra, Ira Martopullo, Anoushka I. Millear, Chloe Shields, Alison Smith, Bryan Strub, Molla Abebe, Zegeye Abebe, Beyene Meressa Adhena, Tara Ballav Adhikari, Mohammed Akibu, Rajaa Al-Raddadi, Nelson Alvis-Guzman, Carl Abelardo T. Antonio, Olatunde Aremu & 100 others Solomon Weldegebreal Asgedom, Netsanet Abera Asseffa, Leticia Avila-Burgos, Aleksandra Barac, Till Bärnighausen, Quique Bassat, Isabela M. Bensenor, Zulfiqar Bhutta, Ali Bijani, Nigus Bililign, Lucero Cahuana-Hurtado, Deborah Carvalho Malta, Jung Chen Chang, Fiona Charlson, Samath Dhamminda Dharmaratne, David Teye Doku, Dumessa Edessa, Ziad El-Khatib, Holly E. Erskine, Alize J. Ferrari, Nancy Fullman, Rahul Gupta, Hamid Yimam Hassen, Simon I Hay, Olayinka Stephen Ilesanmi, Kathryn H. Jacobsen, Amaha Kahsay, Amir Kasaeian, Tesfaye Dessale Kassa, Seifu Kebede, Yousef Saleh Khader, Ejaz Ahmad Khan, Mohammed Nuruzzaman Khan, Young-Ho Khang, Jagdish Khubchandani, Yohannes KINFU, Sonali Kochhar, Yoshihiro Kokubo, Ai Koyanagi, Barthelemy Kuate Defo, Dharmesh Kumar Lal, Fekede Asefa Kumsa, Heidi J Larson, Janni Leung, Abdullah A Mamun, Suresh Mehata, Mulugeta Melku, Walter Mendoza, Haftay Berhane Mezgebe, Ted Miller, Nurilign Abebe Moges, Shafiu Mohammed, Ali H Mokdad, Lorenzo Monasta, Subas Neupane, Huong Lan Thi Nguyen, Dina Nur Anggraini Ningrum, Yirga Legesse Nirayo, Vuong Minh Nong, Felix Akpojene Ogbo, Andrew Toyin Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, George C Patton, David M Pereira, Farshad Pourmalek, Mostafa Qorbani, Anwar Rafay, Rajesh Kumar Rai, Usha Ram, Chhabi Lal Ranabhat, Andre M. N. Renzaho, Mohammad Sadegh Rezai, Luca Ronfani, Gregory A. Roth, Saeid Safiri, Benn Sartorius, James G. Scott, Katya Anne Shackelford, Karen Sliwa, Chandrashekhar Sreeramareddy, Mu'awiyyah Bable Sufiyan, Abdullah Sulieman Terkawi, Roman Topor-Madry, Bach Xuan Tran, Kingsley Nnanna Ukwaja, Olalekan A Uthman, Stein Emil Vollset, Kidu Gidey Weldegwergs, Andrea Werdecker, Harvey A. Whiteford, Tissa Wijeratne, Naohiro Yonemoto, Marcel Yotebieng, Liesl J. Zuhlke, Hmwe Hmwe Kyu, Mohsen Naghavi, Theo Vos, Christopher J L Murray, Nicholas J Kassebaum

Research output: Contribution to journalArticle

11 Citations (Scopus)
11 Downloads (Pure)

Abstract

Importance: Understanding causes and correlates of health loss among children and adolescents can identify areas of success, stagnation, and emerging threats and thereby facilitate effective improvement strategies. Objective: To estimate mortality and morbidity in children and adolescents from 1990 to 2017 by age and sex in 195 countries and territories. Design, Setting, and Participants: This study examined levels, trends, and spatiotemporal patterns of cause-specific mortality and nonfatal health outcomes using standardized approaches to data processing and statistical analysis. It also describes epidemiologic transitions by evaluating historical associations between disease indicators and the Socio-Demographic Index (SDI), a composite indicator of income, educational attainment, and fertility. Data collected from 1990 to 2017 on children and adolescents from birth through 19 years of age in 195 countries and territories were assessed. Data analysis occurred from January 2018 to August 2018. Exposures: Being under the age of 20 years between 1990 and 2017. Main Outcomes and Measures: Death and disability. All-cause and cause-specific deaths, disability-adjusted life years, years of life lost, and years of life lived with disability. Results: Child and adolescent deaths decreased 51.7% from 13.77 million (95% uncertainty interval [UI], 13.60-13.93 million) in 1990 to 6.64 million (95% UI, 6.44-6.87 million) in 2017, but in 2017, but aggregate disability increased 4.7% to a total of 145 million (95% UI, 107-190 million) years lived with disability globally. Progress was uneven, and inequity increased, with low-SDI and low-middle-SDI locations experiencing 82.2% (95% UI, 81.6%-82.9%) of deaths, up from 70.9% (95% UI, 70.4%-71.4%) in 1990. The leading disaggregated causes of disability-adjusted life years in 2017 in the low-SDI quintile were neonatal disorders, lower respiratory infections, diarrhea, malaria, and congenital birth defects, whereas neonatal disorders, congenital birth defects, headache, dermatitis, and anxiety were highest-ranked in the high-SDI quintile. Conclusions and Relevance: Mortality reductions over this 27-year period mean that children are more likely than ever to reach their 20th birthdays. The concomitant expansion of nonfatal health loss and epidemiological transition in children and adolescents, especially in low-SDI and middle-SDI countries, has the potential to increase already overburdened health systems, will affect the human capital potential of societies, and may influence the trajectory of socioeconomic development. Continued monitoring of child and adolescent health loss is crucial to sustain the progress of the past 27 years..

Original languageEnglish
Pages (from-to)1-17
Number of pages17
JournalJAMA Pediatrics
Volume173
Issue number6
DOIs
Publication statusPublished - 2019

    Fingerprint

Cite this