Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017

a systematic analysis for the Global Burden of Disease Study 2017

GBD 2017 Causes of Death Collaborators, Yohannes Kinfu

Research output: Contribution to journalArticle

211 Citations (Scopus)
2 Downloads (Pure)

Abstract

Background: Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods: The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries—Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings: At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5–74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6% (17·9–19·6), and injuries 8·0% (7·7–8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7% (21·5–23·9), representing an additional 7·61 million (7·20–8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9% (7·0–8·8). The number of deaths for CMNN causes decreased by 22·2% (20·0–24·0) and the death rate by 31·8% (30·1–33·3). Total deaths from injuries increased by 2·3% (0·5–4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7% (12·2–15·1) to 57·9 deaths (55·9–59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000–289 000) globally in 2007 to 352 000 (334 000–363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0% (88·8–148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4% (32·2–40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6% (31·2–36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990—neonatal disorders, lower respiratory infections, and diarrhoeal diseases—were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation: Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Funding: Bill & Melinda Gates Foundation.

Original languageEnglish
Pages (from-to)1736-1788
Number of pages53
JournalThe Lancet
Volume392
Issue number10159
DOIs
Publication statusPublished - 10 Nov 2018

Fingerprint

Cause of Death
Mortality
Respiratory Tract Infections
Wounds and Injuries
Substance-Related Disorders
Terrorism
Global Burden of Disease
Population Growth
Mothers
Uncertainty
Registries
Autopsy
Cardiovascular Diseases
Demography
Benchmarking
Neoplasms
Maternal Death
United Nations
Birth Rate
Russia

Cite this

@article{eeb63cd2aeb24fc39acdf1d41b411971,
title = "Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017",
abstract = "Background: Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods: The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries—Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings: At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4{\%} (95{\%} uncertainty interval [UI] 72·5–74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6{\%} (17·9–19·6), and injuries 8·0{\%} (7·7–8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7{\%} (21·5–23·9), representing an additional 7·61 million (7·20–8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9{\%} (7·0–8·8). The number of deaths for CMNN causes decreased by 22·2{\%} (20·0–24·0) and the death rate by 31·8{\%} (30·1–33·3). Total deaths from injuries increased by 2·3{\%} (0·5–4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7{\%} (12·2–15·1) to 57·9 deaths (55·9–59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000–289 000) globally in 2007 to 352 000 (334 000–363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0{\%} (88·8–148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4{\%} (32·2–40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6{\%} (31·2–36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990—neonatal disorders, lower respiratory infections, and diarrhoeal diseases—were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation: Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Funding: Bill & Melinda Gates Foundation.",
keywords = "Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Cause of Death/trends, Child, Child, Preschool, Female, Global Burden of Disease/statistics & numerical data, Global Health/statistics & numerical data, Humans, Infant, Infant, Newborn, Life Expectancy, Male, Middle Aged, Sex Distribution, Socioeconomic Factors, Young Adult",
author = "{GBD 2017 Causes of Death Collaborators} and Roth, {Gregory A.} and Degu Abate and Abate, {Kalkidan Hassen} and Abay, {Solomon M.} and Cristiana Abbafati and Nooshin Abbasi and Hedayat Abbastabar and Foad Abd-Allah and Jemal Abdela and Ahmed Abdelalim and Ibrahim Abdollahpour and Abdulkader, {Rizwan Suliankatchi} and Abebe, {Haftom Temesgen} and Molla Abebe and Zegeye Abebe and Abejie, {Ayenew Negesse} and Abera, {Semaw F.} and Abil, {Olifan Zewdie} and Abraha, {Haftom Niguse} and Abrham, {Aklilu Roba} and Abu-Raddad, {Laith Jamal} and Accrombessi, {Manfred Mario Kokou} and Dilaram Acharya and Adamu, {Abdu A.} and Adebayo, {Oladimeji M.} and Adedoyin, {Rufus Adesoji} and Victor Adekanmbi and Adetokunboh, {Olatunji O.} and Adhena, {Beyene Meressa} and Adib, {Mina G.} and Amha Admasie and Ashkan Afshin and Gina Agarwal and Agesa, {Kareha M.} and Anurag Agrawal and Sutapa Agrawal and Alireza Ahmadi and Mehdi Ahmadi and Ahmed, {Muktar Beshir} and Sayem Ahmed and Aichour, {Amani Nidhal} and Ibtihel Aichour and Aichour, {Miloud Taki Eddine} and Akbari, {Mohammad Esmaeil} and Akinyemi, {Rufus Olusola} and Nadia Akseer and Ziyad Al-Aly and Ayman Al-Eyadhy and Al-Raddadi, {Rajaa M.} and Fares Alahdab and Khurshid Alam and Tahiya Alam and Animut Alebel and Alene, {Kefyalew Addis} and Mehran Alijanzadeh and Reza Alizadeh-Navaei and Aljunid, {Syed Mohamed} and Ala'a Alkerwi and Fran{\cc}ois Alla and Peter Allebeck and Jordi Alonso and Khalid Altirkawi and Nelson Alvis-Guzman and Amare, {Azmeraw T.} and Aminde, {Leopold N.} and Erfan Amini and Walid Ammar and Amoako, {Yaw Ampem} and Anber, {Nahla Hamed} and Andrei, {Catalina Liliana} and Sofia Androudi and Animut, {Megbaru Debalkie} and Mina Anjomshoa and Hossein Ansari and Ansha, {Mustafa Geleto} and Antonio, {Carl Abelardo T.} and Palwasha Anwari and Olatunde Aremu and Johan {\"A}rnl{\"o}v and Amit Arora and Monika Arora and Al Artaman and Aryal, {Krishna K.} and Hamid Asayesh and Asfaw, {Ephrem Tsegay} and Zerihun Ataro and Suleman Atique and Atre, {Sachin R.} and Marcel Ausloos and Avokpaho, {Euripide F.G.A.} and Ashish Awasthi and Quintanilla, {Beatriz Paulina Ayala} and Yohanes Ayele and Rakesh Ayer and Azzopardi, {Peter S.} and Arefeh Babazadeh and Umar Bacha and Hamid Badali and Alaa Badawi and Bali, {Ayele Geleto} and Ballesteros, {Katherine E.} and Maciej Banach and Kajori Banerjee and Bannick, {Marlena S.} and Banoub, {Joseph Adel Mattar} and Barboza, {Miguel A.} and Barker-Collo, {Suzanne Lyn} and B{\"a}rnighausen, {Till Winfried} and Simon Barquera and Barrero, {Lope H.} and Quique Bassat and Sanjay Basu and Baune, {Bernhard T.} and Baynes, {Habtamu Wondifraw} and Shahrzad Bazargan-Hejazi and Neeraj Bedi and Ettore Beghi and Masoud Behzadifar and Meysam Behzadifar and Yannick B{\'e}jot and Bekele, {Bayu Begashaw} and Belachew, {Abate Bekele} and Ezra Belay and Belay, {Yihalem Abebe} and Bell, {Michelle L.} and Bello, {Aminu K.} and Bennett, {Derrick A.} and Bensenor, {Isabela M.} and Berman, {Adam E.} and Eduardo Bernabe and Bernstein, {Robert S.} and Bertolacci, {Gregory J.} and Mircea Beuran and Tina Beyranvand and Ashish Bhalla and Suraj Bhattarai and Soumyadeeep Bhaumik and Bhutta, {Zulfiqar A.} and Belete Biadgo and Biehl, {Molly H.} and Ali Bijani and Boris Bikbov and Ver Bilano and Nigus Bililign and {Bin Sayeed}, {Muhammad Shahdaat} and Donal Bisanzio and Tuhin Biswas and Blacker, {Brigette F.} and Basara, {Berrak Bora} and Rohan Borschmann and Cristina Bosetti and Kayvan Bozorgmehr and Brady, {Oliver J.} and Brant, {Luisa C.} and Carol Brayne and Alexandra Brazinova and Breitborde, {Nicholas J.K.} and Hermann Brenner and Briant, {Paul Svitil} and Gabrielle Britton and Traolach Brugha and Reinhard Busse and Butt, {Zahid A.} and Callender, {Charlton S.K.H.} and Campos-Nonato, {Ismael R.} and {Campuzano Rincon}, {Julio Cesar} and Jorge Cano and Mate Car and Rosario C{\'a}rdenas and Giulia Carreras and Carrero, {Juan J.} and Austin Carter and F{\'e}lix Carvalho and Casta{\~n}eda-Orjuela, {Carlos A.} and {Castillo Rivas}, Jacqueline and Castle, {Chris D.} and Clara Castro and Franz Castro and Ferr{\'a}n Catal{\'a}-L{\'o}pez and Ester Cerin and Yazan Chaiah and Chang, {Jung Chen} and Charlson, {Fiona J.} and Pankaj Chaturvedi and Chiang, {Peggy Pei Chia} and Odgerel Chimed-Ochir and Chisumpa, {Vesper Hichilombwe} and Abdulaal Chitheer and Rajiv Chowdhury and Hanne Christensen and Christopher, {Devasahayam J.} and Chung, {Sheng Chia} and Cicuttini, {Flavia M.} and Ciobanu, {Liliana G.} and Massimo Cirillo and Cohen, {Aaron J.} and Cooper, {Leslie Trumbull} and Cortesi, {Paolo Angelo} and Monica Cortinovis and Ewerton Cousin and Cowie, {Benjamin C.} and Criqui, {Michael H.} and Cromwell, {Elizabeth A.} and Crowe, {Christopher Stephen} and Crump, {John A.} and Matthew Cunningham and Daba, {Alemneh Kabeta} and Dadi, {Abel Fekadu} and Lalit Dandona and Rakhi Dandona and Dang, {Anh Kim} and Dargan, {Paul I.} and Ahmad Daryani and Das, {Siddharth K.} and Gupta, {Rajat Das} and Neves, {Jos{\'e} Das} and Dasa, {Tamirat Tesfaye} and Dash, {Aditya Prasad} and Davis, {Adrian C.} and {Davis Weaver}, Nicole and Davitoiu, {Dragos Virgil} and Kairat Davletov and {De La Hoz}, {Fernando Pio} and {De Neve}, {Jan Walter} and Degefa, {Meaza Girma} and Louisa Degenhardt and Degfie, {Tizta T.} and Selina Deiparine and Demoz, {Gebre Teklemariam} and Demtsu, {Balem Betsu} and Edgar Denova-Guti{\'e}rrez and Kebede Deribe and Nikolaos Dervenis and {Des Jarlais}, {Don C.} and Dessie, {Getenet Ayalew} and Subhojit Dey and Dharmaratne, {Samath D.} and Daniel Dicker and Dinberu, {Mesfin Tadese} and Ding, {Eric L.} and Doyle, {Kerrie E.} and Nazrul Islam and Islam, {Sheikh Mohammed Shariful} and Yohannes Kinfu and McGrath, {John J.} and Nguyen, {Anh Quynh} and Nguyen, {Huong Thanh} and Minh Nguyen and Rahman, {Mohammad Hifz Ur} and Stokes, {Mark A.}",
year = "2018",
month = "11",
day = "10",
doi = "10.1016/S0140-6736(18)32203-7",
language = "English",
volume = "392",
pages = "1736--1788",
journal = "Lancet",
issn = "0140-6736",
publisher = "Elsevier Limited",
number = "10159",

}

TY - JOUR

T1 - Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017

T2 - a systematic analysis for the Global Burden of Disease Study 2017

AU - GBD 2017 Causes of Death Collaborators

AU - Roth, Gregory A.

AU - Abate, Degu

AU - Abate, Kalkidan Hassen

AU - Abay, Solomon M.

AU - Abbafati, Cristiana

AU - Abbasi, Nooshin

AU - Abbastabar, Hedayat

AU - Abd-Allah, Foad

AU - Abdela, Jemal

AU - Abdelalim, Ahmed

AU - Abdollahpour, Ibrahim

AU - Abdulkader, Rizwan Suliankatchi

AU - Abebe, Haftom Temesgen

AU - Abebe, Molla

AU - Abebe, Zegeye

AU - Abejie, Ayenew Negesse

AU - Abera, Semaw F.

AU - Abil, Olifan Zewdie

AU - Abraha, Haftom Niguse

AU - Abrham, Aklilu Roba

AU - Abu-Raddad, Laith Jamal

AU - Accrombessi, Manfred Mario Kokou

AU - Acharya, Dilaram

AU - Adamu, Abdu A.

AU - Adebayo, Oladimeji M.

AU - Adedoyin, Rufus Adesoji

AU - Adekanmbi, Victor

AU - Adetokunboh, Olatunji O.

AU - Adhena, Beyene Meressa

AU - Adib, Mina G.

AU - Admasie, Amha

AU - Afshin, Ashkan

AU - Agarwal, Gina

AU - Agesa, Kareha M.

AU - Agrawal, Anurag

AU - Agrawal, Sutapa

AU - Ahmadi, Alireza

AU - Ahmadi, Mehdi

AU - Ahmed, Muktar Beshir

AU - Ahmed, Sayem

AU - Aichour, Amani Nidhal

AU - Aichour, Ibtihel

AU - Aichour, Miloud Taki Eddine

AU - Akbari, Mohammad Esmaeil

AU - Akinyemi, Rufus Olusola

AU - Akseer, Nadia

AU - Al-Aly, Ziyad

AU - Al-Eyadhy, Ayman

AU - Al-Raddadi, Rajaa M.

AU - Alahdab, Fares

AU - Alam, Khurshid

AU - Alam, Tahiya

AU - Alebel, Animut

AU - Alene, Kefyalew Addis

AU - Alijanzadeh, Mehran

AU - Alizadeh-Navaei, Reza

AU - Aljunid, Syed Mohamed

AU - Alkerwi, Ala'a

AU - Alla, François

AU - Allebeck, Peter

AU - Alonso, Jordi

AU - Altirkawi, Khalid

AU - Alvis-Guzman, Nelson

AU - Amare, Azmeraw T.

AU - Aminde, Leopold N.

AU - Amini, Erfan

AU - Ammar, Walid

AU - Amoako, Yaw Ampem

AU - Anber, Nahla Hamed

AU - Andrei, Catalina Liliana

AU - Androudi, Sofia

AU - Animut, Megbaru Debalkie

AU - Anjomshoa, Mina

AU - Ansari, Hossein

AU - Ansha, Mustafa Geleto

AU - Antonio, Carl Abelardo T.

AU - Anwari, Palwasha

AU - Aremu, Olatunde

AU - Ärnlöv, Johan

AU - Arora, Amit

AU - Arora, Monika

AU - Artaman, Al

AU - Aryal, Krishna K.

AU - Asayesh, Hamid

AU - Asfaw, Ephrem Tsegay

AU - Ataro, Zerihun

AU - Atique, Suleman

AU - Atre, Sachin R.

AU - Ausloos, Marcel

AU - Avokpaho, Euripide F.G.A.

AU - Awasthi, Ashish

AU - Quintanilla, Beatriz Paulina Ayala

AU - Ayele, Yohanes

AU - Ayer, Rakesh

AU - Azzopardi, Peter S.

AU - Babazadeh, Arefeh

AU - Bacha, Umar

AU - Badali, Hamid

AU - Badawi, Alaa

AU - Bali, Ayele Geleto

AU - Ballesteros, Katherine E.

AU - Banach, Maciej

AU - Banerjee, Kajori

AU - Bannick, Marlena S.

AU - Banoub, Joseph Adel Mattar

AU - Barboza, Miguel A.

AU - Barker-Collo, Suzanne Lyn

AU - Bärnighausen, Till Winfried

AU - Barquera, Simon

AU - Barrero, Lope H.

AU - Bassat, Quique

AU - Basu, Sanjay

AU - Baune, Bernhard T.

AU - Baynes, Habtamu Wondifraw

AU - Bazargan-Hejazi, Shahrzad

AU - Bedi, Neeraj

AU - Beghi, Ettore

AU - Behzadifar, Masoud

AU - Behzadifar, Meysam

AU - Béjot, Yannick

AU - Bekele, Bayu Begashaw

AU - Belachew, Abate Bekele

AU - Belay, Ezra

AU - Belay, Yihalem Abebe

AU - Bell, Michelle L.

AU - Bello, Aminu K.

AU - Bennett, Derrick A.

AU - Bensenor, Isabela M.

AU - Berman, Adam E.

AU - Bernabe, Eduardo

AU - Bernstein, Robert S.

AU - Bertolacci, Gregory J.

AU - Beuran, Mircea

AU - Beyranvand, Tina

AU - Bhalla, Ashish

AU - Bhattarai, Suraj

AU - Bhaumik, Soumyadeeep

AU - Bhutta, Zulfiqar A.

AU - Biadgo, Belete

AU - Biehl, Molly H.

AU - Bijani, Ali

AU - Bikbov, Boris

AU - Bilano, Ver

AU - Bililign, Nigus

AU - Bin Sayeed, Muhammad Shahdaat

AU - Bisanzio, Donal

AU - Biswas, Tuhin

AU - Blacker, Brigette F.

AU - Basara, Berrak Bora

AU - Borschmann, Rohan

AU - Bosetti, Cristina

AU - Bozorgmehr, Kayvan

AU - Brady, Oliver J.

AU - Brant, Luisa C.

AU - Brayne, Carol

AU - Brazinova, Alexandra

AU - Breitborde, Nicholas J.K.

AU - Brenner, Hermann

AU - Briant, Paul Svitil

AU - Britton, Gabrielle

AU - Brugha, Traolach

AU - Busse, Reinhard

AU - Butt, Zahid A.

AU - Callender, Charlton S.K.H.

AU - Campos-Nonato, Ismael R.

AU - Campuzano Rincon, Julio Cesar

AU - Cano, Jorge

AU - Car, Mate

AU - Cárdenas, Rosario

AU - Carreras, Giulia

AU - Carrero, Juan J.

AU - Carter, Austin

AU - Carvalho, Félix

AU - Castañeda-Orjuela, Carlos A.

AU - Castillo Rivas, Jacqueline

AU - Castle, Chris D.

AU - Castro, Clara

AU - Castro, Franz

AU - Catalá-López, Ferrán

AU - Cerin, Ester

AU - Chaiah, Yazan

AU - Chang, Jung Chen

AU - Charlson, Fiona J.

AU - Chaturvedi, Pankaj

AU - Chiang, Peggy Pei Chia

AU - Chimed-Ochir, Odgerel

AU - Chisumpa, Vesper Hichilombwe

AU - Chitheer, Abdulaal

AU - Chowdhury, Rajiv

AU - Christensen, Hanne

AU - Christopher, Devasahayam J.

AU - Chung, Sheng Chia

AU - Cicuttini, Flavia M.

AU - Ciobanu, Liliana G.

AU - Cirillo, Massimo

AU - Cohen, Aaron J.

AU - Cooper, Leslie Trumbull

AU - Cortesi, Paolo Angelo

AU - Cortinovis, Monica

AU - Cousin, Ewerton

AU - Cowie, Benjamin C.

AU - Criqui, Michael H.

AU - Cromwell, Elizabeth A.

AU - Crowe, Christopher Stephen

AU - Crump, John A.

AU - Cunningham, Matthew

AU - Daba, Alemneh Kabeta

AU - Dadi, Abel Fekadu

AU - Dandona, Lalit

AU - Dandona, Rakhi

AU - Dang, Anh Kim

AU - Dargan, Paul I.

AU - Daryani, Ahmad

AU - Das, Siddharth K.

AU - Gupta, Rajat Das

AU - Neves, José Das

AU - Dasa, Tamirat Tesfaye

AU - Dash, Aditya Prasad

AU - Davis, Adrian C.

AU - Davis Weaver, Nicole

AU - Davitoiu, Dragos Virgil

AU - Davletov, Kairat

AU - De La Hoz, Fernando Pio

AU - De Neve, Jan Walter

AU - Degefa, Meaza Girma

AU - Degenhardt, Louisa

AU - Degfie, Tizta T.

AU - Deiparine, Selina

AU - Demoz, Gebre Teklemariam

AU - Demtsu, Balem Betsu

AU - Denova-Gutiérrez, Edgar

AU - Deribe, Kebede

AU - Dervenis, Nikolaos

AU - Des Jarlais, Don C.

AU - Dessie, Getenet Ayalew

AU - Dey, Subhojit

AU - Dharmaratne, Samath D.

AU - Dicker, Daniel

AU - Dinberu, Mesfin Tadese

AU - Ding, Eric L.

AU - Doyle, Kerrie E.

AU - Islam, Nazrul

AU - Islam, Sheikh Mohammed Shariful

AU - Kinfu, Yohannes

AU - McGrath, John J.

AU - Nguyen, Anh Quynh

AU - Nguyen, Huong Thanh

AU - Nguyen, Minh

AU - Rahman, Mohammad Hifz Ur

AU - Stokes, Mark A.

PY - 2018/11/10

Y1 - 2018/11/10

N2 - Background: Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods: The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries—Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings: At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5–74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6% (17·9–19·6), and injuries 8·0% (7·7–8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7% (21·5–23·9), representing an additional 7·61 million (7·20–8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9% (7·0–8·8). The number of deaths for CMNN causes decreased by 22·2% (20·0–24·0) and the death rate by 31·8% (30·1–33·3). Total deaths from injuries increased by 2·3% (0·5–4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7% (12·2–15·1) to 57·9 deaths (55·9–59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000–289 000) globally in 2007 to 352 000 (334 000–363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0% (88·8–148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4% (32·2–40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6% (31·2–36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990—neonatal disorders, lower respiratory infections, and diarrhoeal diseases—were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation: Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Funding: Bill & Melinda Gates Foundation.

AB - Background: Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods: The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries—Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings: At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5–74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6% (17·9–19·6), and injuries 8·0% (7·7–8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7% (21·5–23·9), representing an additional 7·61 million (7·20–8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9% (7·0–8·8). The number of deaths for CMNN causes decreased by 22·2% (20·0–24·0) and the death rate by 31·8% (30·1–33·3). Total deaths from injuries increased by 2·3% (0·5–4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7% (12·2–15·1) to 57·9 deaths (55·9–59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000–289 000) globally in 2007 to 352 000 (334 000–363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0% (88·8–148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4% (32·2–40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6% (31·2–36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990—neonatal disorders, lower respiratory infections, and diarrhoeal diseases—were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation: Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Funding: Bill & Melinda Gates Foundation.

KW - Adolescent

KW - Adult

KW - Age Distribution

KW - Aged

KW - Aged, 80 and over

KW - Cause of Death/trends

KW - Child

KW - Child, Preschool

KW - Female

KW - Global Burden of Disease/statistics & numerical data

KW - Global Health/statistics & numerical data

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Life Expectancy

KW - Male

KW - Middle Aged

KW - Sex Distribution

KW - Socioeconomic Factors

KW - Young Adult

UR - http://www.scopus.com/inward/record.url?scp=85056166310&partnerID=8YFLogxK

U2 - 10.1016/S0140-6736(18)32203-7

DO - 10.1016/S0140-6736(18)32203-7

M3 - Article

VL - 392

SP - 1736

EP - 1788

JO - Lancet

JF - Lancet

SN - 0140-6736

IS - 10159

ER -