Journal article
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
The Lancet (British edition), Vol.392(10159), pp.1736-1788
11/10/2018
DOI: 10.1016/S0140-6736(18)32203-7
PMCID: PMC6227606
PMID: 30496103
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 (CODErn), 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 (NC Ds) 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 186% (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% (7.08.8). The number of deaths for CMNN causes decreased by 222% (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, respirator}, 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. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.
Details
- Title: Subtitle
- 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
- Creators
- Gregory A. Roth - Institute for Health Metrics and EvaluationDegu Abate - Institute for Health Metrics and EvaluationKalkidan Hassen Abate - Institute for Health Metrics and EvaluationSolomon M. Abay - Institute for Health Metrics and EvaluationCristiana Abbafati - Institute for Health Metrics and EvaluationNooshin Abbasi - Institute for Health Metrics and EvaluationHedayat Abbastabar - Institute for Health Metrics and EvaluationLoad Abd-Allah - Cairo UniversityJemal Abdela - Institute for Health Metrics and EvaluationAhmed Abdelalim - Institute for Health Metrics and EvaluationIbrahim Abdollahpour - Institute for Health Metrics and EvaluationRizwan Suliankatchi Abdulkader - Institute for Health Metrics and EvaluationHaftom Temesgen Abebe - Institute for Health Metrics and EvaluationMolla Abebe - Institute for Health Metrics and EvaluationZegeye Abebe - University of GondarAyenew Negesse Abejie - Institute for Health Metrics and EvaluationSemaw F. Abera - Mekelle UniversityOlifan Zewdie Abil - Wollega UniversityHaftom Niguse Abraha - Mekelle UniversityAklilu Roba Abrham - Haramaya UniversityLaith Jamal Abu-Raddad - Institute for Health Metrics and EvaluationManfred Mario Kokou Accrombessi - Benin Clin Res Inst IRCB, Epidemiol, Cotonou, BeninDilaram Acharya - Institute for Health Metrics and EvaluationAbdu A. Adamu - Institute for Health Metrics and EvaluationOladimeji Adebayo - Institute for Health Metrics and EvaluationRufus Adesoji Adedoyin - Institute for Health Metrics and EvaluationVictor Adekanmbi - Institute for Health Metrics and EvaluationOlatunii Adookunboh - University of Cape TownBeyene Meressa Adhena - Institute for Health Metrics and EvaluationMina G. Adib - Institute for Health Metrics and EvaluationAniha Admasie - Wolaita Sodo UniversityAshkan Afshin - Institute for Health Metrics and EvaluationGina Agarwal - Institute for Health Metrics and EvaluationKarelia M. Agesa - University of WashingtonAnurag Agrawal - Institute for Health Metrics and EvaluationSutapa Agrawal - Institute for Health Metrics and EvaluationAlireza Ahmadi - Institute for Health Metrics and EvaluationMelidi Ahmadi - Ahvaz Jundishapur Univ Med Sci, Environm Technol Res Ctr, Ahvaz, IranMuktar Beshir Ahmed - Institute for Health Metrics and EvaluationSayem Ahmed - International Centre for Diarrhoeal Disease ResearchAmani Nidhal Aichour - Institute for Health Metrics and EvaluationIbtihel Aichour - Institute for Health Metrics and EvaluationMiloud Taki Fddine Aichour - Higher Natl Sch Vet Med, Algiers, AlgeriaMohammad Esmaeil Akbari - Institute for Health Metrics and EvaluationRufus Olusola Akinyeniti - University of IbadanNadia Akseer - Institute for Health Metrics and EvaluationZiyad Al-Aly - Institute for Health Metrics and EvaluationAyman Al-Eyadhy - Institute for Health Metrics and EvaluationRajaa M. Al-Raddadi - Institute for Health Metrics and EvaluationFares Alandab - Mayo Clin, Fdn Med Educ & Res, Evidence Based Practice Ctr, Rochester, MN USAKhurshid Alam - Institute for Health Metrics and EvaluationTahiya Alam - University of WashingtonAnimut Alebel - Institute for Health Metrics and EvaluationKefyalew Addis Alene - Institute for Health Metrics and EvaluationMehran Alijanzadeh - Institute for Health Metrics and EvaluationReza Alizadeh-Navaei - Institute for Health Metrics and EvaluationSyed Mohamed Aljunid - Kuwait UniversityAla'a Alkerwi - Luxembourg Inst Hlth, Dept Populat Hlth, Strassen, LuxembourgFrancois Alla - Institute for Health Metrics and EvaluationPeter Allebeck - Institute for Health Metrics and EvaluationJordi Alonso - Institute for Health Metrics and EvaluationKhalid Altirkawi - Institute for Health Metrics and EvaluationNelson Alvis-Guzman - Institute for Health Metrics and EvaluationAzmeraw T. Amare - Institute for Health Metrics and EvaluationLeopold N. Aminde - Institute for Health Metrics and EvaluationErfan Amini - Institute for Health Metrics and EvaluationWalid Ammar - Institute for Health Metrics and EvaluationYaw Ampern Amoako - Komfo Anokye Teaching Hosp, Dept Internal Med, Kumasi, GhanaNahla Hamed Anber - Institute for Health Metrics and EvaluationCatalina Liliana Andrei - Institute for Health Metrics and EvaluationSofia Androudi - Institute for Health Metrics and EvaluationMegbaru Debalkie Animut - Institute for Health Metrics and EvaluationMina Anjomshoa - Institute for Health Metrics and EvaluationHossein Ansari - Institute for Health Metrics and EvaluationMustafa Geleto AnihaCarl Abelardo T. Antonio - Institute for Health Metrics and EvaluationPalwasha Anwari - Institute for Health Metrics and EvaluationOlatunde Aremu - Institute for Health Metrics and EvaluationJohan Arnlov - Institute for Health Metrics and EvaluationAmit Arora - Institute for Health Metrics and EvaluationMonika Arora - Institute for Health Metrics and EvaluationAl Artaman - Institute for Health Metrics and EvaluationKrishna K. Aryal - Abt Associates Nepal, Monitoring Evaluat & Operat Res Project, DfID Nepal Hlth Sect Programme 3, Lalitpur, NepalHamid Asayesh - Institute for Health Metrics and EvaluationEphremi Tsegay AsfawZerihun Ataro - Institute for Health Metrics and EvaluationSuleman Atique - Institute for Health Metrics and EvaluationSachin R. Atre - Institute for Health Metrics and EvaluationMarcel Ausloos - Institute for Health Metrics and EvaluationEuripide F. G. A. Avokpaho - Benin Clin Res Inst IRCB, Cotonou, BeninAshish Awasthi - Institute for Health Metrics and EvaluationBeatriz Paulina Ayala Quintattilla - La Trobe UniversityYohanes Ayele - Institute for Health Metrics and EvaluationRakesh Ayer - Institute for Health Metrics and EvaluationPeter S. Azzopardi - Institute for Health Metrics and EvaluationArefeh Babazadeh - Institute for Health Metrics and EvaluationUmar Bacha - Institute for Health Metrics and EvaluationHamid Badali - Institute for Health Metrics and EvaluationAlaa Badawi - Institute for Health Metrics and EvaluationAyele Geleto Bali - Haramaya UniversityGBD 2017 Causes of Death CollaboratorsDavid C Schwebel (Contributor) - Research Administration
- Resource Type
- Journal article
- Publication Details
- The Lancet (British edition), Vol.392(10159), pp.1736-1788
- DOI
- 10.1016/S0140-6736(18)32203-7
- PMID
- 30496103
- PMCID
- PMC6227606
- NLM abbreviation
- Lancet
- ISSN
- 0140-6736
- eISSN
- 1474-547X
- Publisher
- Elsevier
- Number of pages
- 53
- Grant note
- University of Melbourne MR/L003120/1; MR/R015600/1; MR/M015084/1 / MRC; UK Research & Innovation (UKRI); Medical Research Council UK (MRC) Public Health England GPO-A-00-08-000_D3-00 / USAID; United States Agency for International Development (USAID) Norwegian Institute of Public Health Bill AMP; Melinda Gates Foundation; CGIAR P30AG047845 / National Institute on Ageing of the National Institutes of Health United States Agency for International Development (USAID); CGIAR; Norwegian Agency for Development Cooperation - NORAD 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) St Jude Children's Research Hospital
- Language
- English
- Date published
- 11/10/2018
- Academic Unit
- Research Administration
- Record Identifier
- 9984949480202771
Metrics
7 Record Views