Journal article
Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016
The Lancet (British edition), Vol.390(10100), pp.1151-1210
09/16/2017
DOI: 10.1016/S0140-6736(17)32152-9
PMCID: PMC5605883
PMID: 28919116
Abstract
Background Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends.
Methods We estimated cause-specific deaths and years of life lost (YLLs) by age, sex, geography, and year. YLLs were calculated from the sum of each death multiplied by the standard life expectancy at each age. We used the GBD cause of death database composed of: vital registration (VR) data corrected for under-registration and garbage coding; national and subnational verbal autopsy (VA) studies corrected for garbage coding; and other sources including surveys and surveillance systems for specific causes such as maternal mortality. To facilitate assessment of quality, we reported on the fraction of deaths assigned to GBD Level 1 or Level 2 causes that cannot be underlying causes of death (major garbage codes) by location and year. Based on completeness, garbage coding, cause list detail, and time periods covered, we provided an overall data quality rating for each location with scores ranging from 0 stars (worst) to 5 stars (best). We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to generate estimates for each location, year, age, and sex. We assessed observed and expected levels and trends of cause-specific deaths in relation to the Socio-demographic Index (SDI), a summary indicator derived from measures of average income per capita, educational attainment, and total fertility, with locations grouped into quintiles by SDI. Relative to GBD 2015, we expanded the GBD cause hierarchy by 18 causes of death for GBD 2016.
Findings The quality of available data varied by location. Data quality in 25 countries rated in the highest category (5 stars), while 48, 30, 21, and 44 countries were rated at each of the succeeding data quality levels. Vital registration or verbal autopsy data were not available in 27 countries, resulting in the assignment of a zero value for data quality. Deaths from non-communicable diseases (NCDs) represented 72.3% (95% uncertainty interval [UI] 71.2-73.2) of deaths in 2016 with 19.3% (18.5-20.4) of deaths in that year occurring from communicable, maternal, neonatal, and nutritional (CMNN) diseases and a further 8.43% (8.00-8.67) from injuries. Although age-standardised rates of death from NCDs decreased globally between 2006 and 2016, total numbers of these deaths increased; both numbers and age-standardised rates of death from CMNN causes decreased in the decade 2006-16-age-standardised rates of deaths from injuries decreased but total numbers varied little. In 2016, the three leading global causes of death in children under-5 were lower respiratory infections, neonatal preterm birth complications, and neonatal encephalopathy due to birth asphyxia and trauma, combined resulting in 1.80 million deaths (95% UI 1.59 million to 1.89 million). Between 1990 and 2016, a profound shift toward deaths at older ages occurred with a 178% (95% UI 176-181) increase in deaths in ages 90-94 years and a 210% (208-212) increase in deaths older than age 95 years. The ten leading causes by rates of age-standardised YLL significantly decreased from 2006 to 2016 (median annualised rate of change was a decrease of 2.89%); the median annualised rate of change for all other causes was lower (a decrease of 1.59%) during the same interval. Globally, the five leading causes of total YLLs in 2016 were cardiovascular diseases; diarrhoea, lower respiratory infections, and other common infectious diseases; neoplasms; neonatal disorders; and HIV/AIDS and tuberculosis. At a finer level of disaggregation within cause groupings, the ten leading causes of total YLLs in 2016 were ischaemic heart disease, cerebrovascular disease, lower respiratory infections, diarrhoeal diseases, road injuries, malaria, neonatal preterm birth complications, HIV/AIDS, chronic obstructive pulmonary disease, and neonatal encephalopathy due to birth asphyxia and trauma. Ischaemic heart disease was the leading cause of total YLLs in 113 countries for men and 97 countries for women. Comparisons of observed levels of YLLs by countries, relative to the level of YLLs expected on the basis of SDI alone, highlighted distinct regional patterns including the greater than expected level of YLLs from malaria and from HIV/AIDS across sub-Saharan Africa; diabetes mellitus, especially in Oceania; interpersonal violence, notably within Latin America and the Caribbean; and cardiomyopathy and myocarditis, particularly in eastern and central Europe. The level of YLLs from ischaemic heart disease was less than expected in 117 of 195 locations. Other leading causes of YLLs for which YLLs were notably lower than expected included neonatal preterm birth complications in many locations in both south Asia and southeast Asia, and cerebrovascular disease in western Europe.
Interpretation The past 37 years have featured declining rates of communicable, maternal, neonatal, and nutritional diseases across all quintiles of SDI, with faster than expected gains for many locations relative to their SDI. A global shift towards deaths at older ages suggests success in reducing many causes of early death. YLLs have increased globally for causes such as diabetes mellitus or some neoplasms, and in some locations for causes such as drug use disorders, and conflict and terrorism. Increasing levels of YLLs might reflect outcomes from conditions that required high levels of care but for which effective treatments remain elusive, potentially increasing costs to health systems. Copyright (C) The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Details
- Title: Subtitle
- Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016
- Creators
- Mohsen Naghavi - University of WashingtonAmanuel Alemu Abajobir - The University of QueenslandCristiana Abbafati - Univ Roma La Sapienza, Rome, ItalyKaja M. Abbas - Cairo UniversityFoad Abd-Allah - Cairo UniversitySemaw Ferede Abera - Mekelle UniversityVictor Aboyans - Dupuytren Univ Hosp, Limoges, FranceOlatunji Adetokunboh - Stellenbosch UniversityJohan Arnlov - Dalarna UniversityAshkan Afshin - University of WashingtonAnurag Agrawal - CSIR, Inst Genom & Integrat Biol, Delhi, IndiaAliasghar Ahmad Kiadaliri - Lund UniversityAlireza Ahmadi - Kermanshah Univ Med Sci, Kermanshah, IranMuktar Beshir Ahmed - Jimma UniversityAmani Nidhal Aichour - University Ferhat Abbas of SetifIbtihel Aichour - Natl Inst Nursing Educ, Setif, AlgeriaMiloud Taki Eddine Aichour - High Natl Sch Vet Med, Algiers, AlgeriaSneha Aiyar - University of WashingtonAyman Al-Eyadhy - King Saud UniversityFares Alahdab - Mayo Clin Fdn Med Educ & Res, Rochester, MN USAZiyad Al-Aly - Washington Univ, St Louis, MO USAKhurshid Alam - The University of MelbourneNoore Alam - Dept Hlth, Brisbane, Qld, AustraliaTahiya Alam - University of WashingtonKefyalew Addis Alene - University of GondarSyed Danish Ali - University of LondonReza Alizadeh-Navaei - Mazandaran Univ Med Sci, Gastrointestinal Canc Res Ctr, Sari, IranJuma M. Alkaabi - United Arab Emirates UniversityAla'a Alkerwi - Luxembourg Inst Hlth, Strassen, LuxembourgFrancois Alla - Univ Lorraine, Sch Publ Hlth, Nancy, FrancePeter Allebeck - Karolinska InstitutetChristine Allen - University of WashingtonRajaa Al-Raddadi - Joint Program Family & Community Med, Jeddah, Saudi ArabiaUbai Alsharif - Charité - Universitätsmedizin BerlinKhalid A. Altirkawi - King Saud UniversityNelson Alvis-Guzman - University of CartagenaAzmeraw T. Amare - The University of AdelaideErfan Amini - University of TehranWalid Ammar - Minist Publ Hlth, Beirut, LebanonYaw Ampem Amoako - Komfo Anokye Teaching Hosp, Dept Med, Kumasi, GhanaNahla Anber - Mansoura UniversityHjalte H. Andersen - Aalborg UniversityCatalina Liliana Andrei - Carol Davila Univ Med & Pharm, Bucharest, RomaniaSofia Androudi - University of ThessalyHossein Ansari - Zahedan Univ Med Sci, Dept Epidemiol & Biostat, Hlth Promot Res Ctr, Zahedan, IranCarl Abelardo T. Antonio - University of the Philippines ManilaPalwasha AnwariMegha Arora - University of WashingtonAl Artaman - University of ManitobaKrishna Kumar Aryal - Nepal Hlth Res Council, Kathmandu, NepalHamid Asayesh - Qom Univ Med Sci, Sch Paramed, Dept Emergency Med, Qom, IranSolomon W. Asgedom - Mekelle UniversityTesfay Mehari Atey - Mekelle UniversityLeticia Avila-Burgos - Natl Inst Publ Hlth, Cuernavaca, Morelos, MexicoEuripide Frinel G. Arthur Avokpaho - IRCB, Cotonou, BeninAshish Awasthi - Sanjay Gandhi Postgrad Inst Med Sci, Lucknow, Uttar Pradesh, IndiaBeatriz PaulinaAyala Quintanilla - La Trobe UniversityYannick Bejot - Univ Burgundy, Univ Hosp & Med Sch Dijon, Dijon, FranceTesleem Kayode Babalola - University of LagosUmar Bacha - Univ Management & Technol, Sch Hlth Sci, Lahore, PakistanKalpana Balakrishnan - University of MadrasAleksandra Barac - University of BelgradeMiguel A. Barboza - CCSS, Hosp Dr Rafael Calder n Guardia, San Jose, Costa RicaSuzanne L. Barker-Collo - University of AucklandSimon Barquera - Natl Inst Publ Hlth, Cuernavaca, Morelos, MexicoLars Barregard - University of GothenburgLope H. Barrero - Pontificia Univ Javeriana Bogota, Dept Ind Engn, Sch Engn, Bogota, ColombiaBernhard T. Baune - The University of AdelaideNeeraj Bedi - Coll Publ Hlth & Trop Med, Jazan, Saudi ArabiaEttore Beghi - IRCCS, Ist Ric Farmacol Mario Negri, Milan, ItalyBayu Begashaw Bekele - University of GondarMichelle L. Bell - University of New HavenJames R. Bennett - University of WashingtonIsabela M. Bensenor - Univ Sao Paulo, Sao Paulo, BrazilAdugnaw Berhane - Debre Berhan UniversityEduardo Bernabe - Kings Coll London, London, EnglandBalem Demtsu Betsu - Mekelle UniversityMircea Beuran - Carol Davila Univ Med & Pharm, Bucharest, RomaniaSamir Bhatt - Imperial Coll London, Dept Infect Dis Epidemiol, London, EnglandSibhatu Biadgilign - Independent Publ Hlth Consultants, Addis Ababa, EthiopiaKelly Bienhoff - University of WashingtonBoris Bikbov - IRCCS, Ist Ric Farmacol Mario Negri, Bergamo, ItalyDonal Bisanzio - University of OxfordRupert R. A. Bourne - Anglia Ruskin UniversityNicholas J. K. Breitborde - The Ohio State UniversityLemma NegesaBulto Bulto - Haramaya UniversityBlair R. Bumgarner - University of WashingtonZahid A. Butt - Al Shifa Trust Eye Hosp, Rawalpindi, PakistanRosario Cardenas - Metropolitan Autonomous Univ, Mexico City, DF, MexicoLucero Cahuana-Hurtado - Natl Inst Publ Hlth, Cuernavaca, Morelos, MexicoEwan Cameron - University of OxfordJulio Cesar Campuzano - Natl Inst Publ Hlth, Cuernavaca, Morelos, MexicoJosip Car - Imperial Coll London, London, EnglandJuan Jesus Carrero - Karolinska InstitutetAustin Carter - University of WashingtonDaniel C. Casey - University of WashingtonCarlos A. Castaneda-Orjuela - Colombian Natl Hlth Observ, Inst Nacl Salud, Bogota, ColombiaFerran Catala-Lopez - Univ Valencia, INCLIVA Hlth Res Inst, Dept Med, Valencia, SpainGBD 2016 Causes of Death CollaboratorsDavid C Schwebel (Contributor) - Research Administration
- Resource Type
- Journal article
- Publication Details
- The Lancet (British edition), Vol.390(10100), pp.1151-1210
- DOI
- 10.1016/S0140-6736(17)32152-9
- PMID
- 28919116
- PMCID
- PMC5605883
- NLM abbreviation
- Lancet
- ISSN
- 0140-6736
- eISSN
- 1474-547X
- Publisher
- Elsevier
- Number of pages
- 60
- Grant note
- MR/K00669X/1; G0400491; MC_UU_12017/15; MC_UU_12017/13; MC_U147585827; MC_UP_A620_1015; MC_UU_12011/2; MR/K013351/1; MC_U147585819 / MRC; UK Research & Innovation (UKRI); Medical Research Council UK (MRC) Bill AMP; Melinda Gates Foundation; CGIAR
- Language
- English
- Date published
- 09/16/2017
- Academic Unit
- Research Administration
- Record Identifier
- 9984949456402771
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