Journal article
Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017
The Lancet (British edition), Vol.392(10159), pp.1684-1735
11/10/2018
DOI: 10.1016/S0140-6736(18)31891-9
PMCID: PMC6227504
PMID: 30496102
Abstract
Background Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally.
Methods The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systetns, sample registration systetns, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950.
Findings Globally, 18.7% (95% uncertainty interval 18.4-19.0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58.8% (58.2-59.3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48.1 years (46.5-49.6) to 70.5 years (70.1-70.8) for men and from 52.9 years (51.7-54.0) to 75.6 years (75.3-75.9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49.1 years (46.5-51.7) for men in the Central African Republic to 87.6 years (86.9-88.1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216.0 deaths (196.3-238.1) per 1000 livebirths in 1950 to 38.9 deaths (35.6-42.83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5.4 million (5.2-5.6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult tnales, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development.
Interpretation This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, wotnen, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing. Copyright C) 2018 The Author(s). Published by Elsevier Ltd.
Details
- Title: Subtitle
- Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017
- Creators
- Daniel Dicker - Institute for Health Metrics and EvaluationGrant Nguyen - Institute for Health Metrics and EvaluationDegu Abate - Institute for Health Metrics and EvaluationLkidan Hassen Abate - Jimma UniversitySolomon M. Abay - Institute for Health Metrics and EvaluationCristiana Abbafati - Institute for Health Metrics and EvaluationNooshin Abbasi - Institute for Health Metrics and EvaluationHcdayat Abbastabar - University of TehranFoad Abd-Allah - Institute for Health Metrics and EvaluationJeinal Abdela - Haramaya UniversityAhmed Abdelalim - Institute for Health Metrics and EvaluationOmar Abdel-Rahman - Institute for Health Metrics and EvaluationAlireza Abdi - Institute for Health Metrics and EvaluationIbrahim Abdollahpour - Institute for Health Metrics and EvaluationRizwan Suliankatchi Abdulkader - Institute for Health Metrics and EvaluationAhmed Abdulahi Abdurahman - University of TehranHaftom Temesgen Abebe - Institute for Health Metrics and EvaluationMolla Abebe - Institute for Health Metrics and EvaluationZegeye Abebe - University of GondarTeshome Abuka Abebo - Institute for Health Metrics and EvaluationVictor Aboyans - Institute for Health Metrics and EvaluationHaftom Niguse Abraha - Mekelle UniversityAklilu Roba Abrham - Haramaya UniversityLaith Jamal Abu-Raddad - Institute for Health Metrics and EvaluationNiveen Ml Abu-Rmeileh - Birzeit UniversityManfred Mario Kokou Areas Mbessi - Benin Clin Res Inst IRCB, Cotonou, BeninPawan Acharya - Institute for Health Metrics and EvaluationOladimeji M. Adebayo - Institute for Health Metrics and EvaluationIsaac Akinkimmi Adedeji - Olabisi Ortabardo Univ, Dept Sociol, Agolwoye, NigeriaRufus Adesoji Adedoyin - Institute for Health Metrics and EvaluationVictor Adekanmbi - Institute for Health Metrics and EvaluationOlatunji O. Adetokunboh - Institute for Health Metrics and EvaluationBeyene Meressa Adhena - Institute for Health Metrics and EvaluationTara Banal Adhikari - Ctr Social Sci & Publ Hlth Res Nepal, Nepal Hlth Res Environm, Kathmandu, NepalMina G. Adib - Institute for Health Metrics and EvaluationArsene Kouablan Adou - Institute for Health Metrics and EvaluationJose C. Adsuar - Institute for Health Metrics and EvaluationMohsen Afaridern - University of TehranAshkan Afshin - Institute for Health Metrics and EvaluationGina Agarwal - Institute for Health Metrics and EvaluationRakesh Aggarwal - Institute for Health Metrics and EvaluationSargis Agbasi Aghayan - Institute for Health Metrics and EvaluationSutapa Agrawal - Institute for Health Metrics and EvaluationAnurag Agrawal - Institute for Health Metrics and EvaluationMehdi Ahmadi - Institute for Health Metrics and EvaluationAlireza Ahmadi - Institute for Health Metrics and EvaluationHamid Ahmadieh - Institute for Health Metrics and EvaluationMohamed Lemine Cheikh Brahim Ahmed - Institute for Health Metrics and EvaluationSayem Ahmed - International Centre for Diarrhoeal Disease ResearchMuktar Beshir Ahmed - Institute for Health Metrics and EvaluationAmani Nidhal Aichour - Institute for Health Metrics and EvaluationIbtihel Aichour - Institute for Health Metrics and EvaluationMiloud Taki Eddine Aichour - Institute for Health Metrics and EvaluationAli S. Akanda - Institute for Health Metrics and EvaluationMohammad Esmaeil Akbari - Institute for Health Metrics and EvaluationMohammed Akibu - Institute for Health Metrics and EvaluationRufus Olusola Akinyemi - Institute for Health Metrics and EvaluationTomi Akinyemiju - Institute for Health Metrics and EvaluationNadia Akseer - Institute for Health Metrics and EvaluationFares AlandabZiyad Al-Aly - Institute for Health Metrics and EvaluationKhurshid Alam - Institute for Health Metrics and EvaluationAnimut Alebel - Institute for Health Metrics and EvaluationAlicia V. Aleman - Institute for Health Metrics and EvaluationKefyalew Addis Alene - Institute for Health Metrics and EvaluationAyman Al-Eyadhy - Institute for Health Metrics and EvaluationRaghib Ali - Institute for Health Metrics and EvaluationMehran Alijanzadely - Qazvin Univ Med Sci, Qazvin, IranReza Alizadeh-Navaei - Institute for Health Metrics and EvaluationSyed Mohamed Aljunid - Kuwait UniversityAla'a Alkerwi - Luxembourg Inst Hlth, Dept Populat Hlth, Strasser, LuxembourgFrancois Alla - Institute for Health Metrics and EvaluationPeter Allebeck - Institute for Health Metrics and EvaluationChristine A. Allen - Institute for Health Metrics and EvaluationJordi Alonso - Institute for Health Metrics and EvaluationRajaa M. Al-Raddadi - Institute for Health Metrics and EvaluationUbai Alsharif - Institute for Health Metrics and EvaluationKhalid Altirkawi - Institute for Health Metrics and EvaluationNelson Alvis-Cituman - University of CartagenaAzmeraw T. Amare - Institute for Health Metrics and EvaluationErfan Amini - Institute for Health Metrics and EvaluationWalid Ammar - Institute for Health Metrics and EvaluationYaw Ampem Amoako - Institute for Health Metrics and EvaluationNahla Hamed Anber - Institute for Health Metrics and EvaluationCatalina Liliana Andrei - Institute for Health Metrics and EvaluationSofia Androudi - Institute for Health Metrics and EvaluationMegbani Debalkie AnimutMina Anjomshoa - Institute for Health Metrics and EvaluationDegefaye Zelalem Anlay - Institute for Health Metrics and EvaluationHossein Ansari - Institute for Health Metrics and EvaluationAnsariadi Ansariadi - Institute for Health Metrics and EvaluationMustafa Geleto Ansha - Institute for Health Metrics and EvaluationCarl Abelardo T. Antonio - Institute for Health Metrics and EvaluationSeth Christopher Yaw Appiah - Institute for Health Metrics and EvaluationOlatunde Aremu - Institute for Health Metrics and EvaluationHabtarnu Abera Areri - Univ Addis Ababa, Scltool Nursing & Midwifery, Addis Ababa, EthiopiaJohan Arnlov - Institute for Health Metrics and EvaluationMegha AromaAl Artaman - Institute for Health Metrics and EvaluationKrishna K. Aryal - Schulman, Ronca & BucuvalasGBD 2017 Mortality CollaboratorsDavid C Schwebel (Contributor) - Research Administration
- Resource Type
- Journal article
- Publication Details
- The Lancet (British edition), Vol.392(10159), pp.1684-1735
- DOI
- 10.1016/S0140-6736(18)31891-9
- PMID
- 30496102
- PMCID
- PMC6227504
- NLM abbreviation
- Lancet
- ISSN
- 0140-6736
- eISSN
- 1474-547X
- Publisher
- Elsevier
- Number of pages
- 52
- Grant note
- University of Melbourne Public Health England Norwegian Institute of Public Health Bill AMP; Melinda Gates Foundation; CGIAR St. Jude Children's Research Hospital United States Agency for International Development (USAID); CGIAR; Norwegian Agency for Development Cooperation - NORAD MR/M015084/1; MR/R015600/1; MC_U147585819 / MRC; UK Research & Innovation (UKRI); Medical Research Council UK (MRC) R01MH110163 / National Institute of Mental Health of the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) P30AG047845 / National Institute on Aging of the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA)
- Language
- English
- Date published
- 11/10/2018
- Academic Unit
- Research Administration
- Record Identifier
- 9984949459402771
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