Browsing by Author "Caitlin Hawley"

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Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016
(Lancet Publishing Group, 2018) Max G. Griswold; Nancy Fullman; Caitlin Hawley; Nicholas Arian; Stephanie R. M. Zimsen; Hayley D. Tymeson; Vidhya Venkateswaran; Austin Douglas Tapp; Mohammad H. Forouzanfar; Joseph S. Salama; Kalkidan Hassen Abate; Degu Abate; Solomon M. Abay; Cristiana Abbafati; Rizwan Suliankatchi Abdulkader; Zegeye Abebe; Victor Aboyans; Mohammed Mehdi Abrar; Pawan Acharya; Olatunji O. Adetokunboh; Tara Ballav Adhikari; Jose C. Adsuar; Mohsen Afarideh; Emilie Elisabet Agardh; Gina Agarwal; Sargis Aghasi Aghayan; Sutapa Agrawal; Muktar Beshir Ahmed; Mohammed Akibu; Tomi Akinyemiju; Nadia Akseer; Deena H. Al Asfoor; Ziyad Al-Aly; Fares Alahdab; Khurshid Alam; Ammar Albujeer; Kefyalew Addis Alene; Raghib Ali; Syed Danish Ali; Mehran Alijanzadeh; Syed Mohamed Aljunid; Ala'A Alkerwi; Peter Allebeck; Nelson Alvis-Guzman; Azmeraw T. Amare; Leopold N. Aminde; Walid Ammar; Yaw Ampem Amoako; Gianna Gayle Herrera Amul; Catalina Liliana Andrei; Colin Angus; Mustafa Geleto Ansha; Carl Abelardo T. Antonio; Olatunde Aremu; Johan Ärnlöv; Al Artaman; Krishna K. Aryal; Reza Assadi; Marcel Ausloos; Leticia Avila-Burgos; Euripide F. G. A. Avokpaho; Ashish Awasthi; Henok Tadesse Ayele; Rakesh Ayer; Tambe B. Ayuk; Peter S. Azzopardi; Hamid Badali; Alaa Badawi; Maciej Banach; Suzanne Lyn Barker-Collo; Lope H. Barrero; Huda Basaleem; Estifanos Baye; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Yannick Béjot; Abate Bekele Belachew; Saba Abraham Belay; Derrick A. Bennett; Isabela M. Bensenor; Eduardo Bernabe; Robert S. Bernstein; Addisu Shunu Beyene; Tina Beyranvand; Soumyadeeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Ali Bijani; Nigus Bililign; Sait Mentes Birlik; Charles Birungi; Hailemichael Bizuneh; Peter Bjerregaard; Tone Bjørge; Guilherme Borges; Cristina Bosetti; Soufiane Boufous; Nicola Luigi Bragazzi; Hermann Brenner; Zahid A. Butt; Lucero Cahuana-Hurtado; Bianca Calabria; Ismael R. Campos-Nonato; Julio Cesar Campuzano Rincon; Giulia Carreras; Juan J. Carrero; Félix Carvalho; Carlos A. Castañeda-Orjuela; Jacqueline Castillo Rivas; Ferrán Catalá-López; Jung-Chen Chang; Fiona J. Charlson; Aparajita Chattopadhyay; Pankaj Chaturvedi; Rajiv Chowdhury; Devasahayam J. Christopher; Sheng-Chia Chung; Liliana G. Ciobanu; Rafael M. Claro; Sara Conti; Ewerton Cousin; Michael H. Criqui; Berihun Assefa Dachew; Paul I. Dargan; Ahmad Daryani; José Das Neves; Kairat Davletov; Filipa De Castro; Barbora De Courten; Jan-Walter De Neve; Louisa Degenhardt; Gebre Teklemariam Demoz; Don C. Des Jarlais; Subhojit Dey; Rupinder Singh Dhaliwal; Samath Dhamminda Dharmaratne; Meghnath Dhimal; David Teye Doku; Kerrie E. Doyle; Manisha Dubey; Eleonora Dubljanin; Bruce B. Duncan; Hedyeh Ebrahimi; Dumessa Edessa; Maysaa El Sayed Zaki; Sergei Petrovich Ermakov; Holly E. Erskine; Alireza Esteghamati; Mahbobeh Faramarzi; Andrea Farioli; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Valery L. Feigin; Mariana Santos Felisbino-Mendes; Eduarda Fernandes; Alize J. Ferrari; Cleusa P. Ferri; Daniel Obadare Fijabi; Irina Filip; Jonas David Finger; Florian Fischer; Abraham D. Flaxman; Richard Charles Franklin; Neal D. Futran; Silvano Gallus; Morsaleh Ganji; Fortune Gbetoho Gankpe; Gebremedhin Berhe Gebregergs; Tsegaye Tewelde Gebrehiwot; Johanna M. Geleijnse; Reza Ghadimi; Lilian A. Ghandour; Mamata Ghimire; Paramjit Singh Gill; Ibrahim Abdelmageed Ginawi; Ababi Zergaw Z. Giref; Philimon N. Gona; Sameer Vali Gopalani; Carolyn C. Gotay; Alessandra C. Goulart; Felix Greaves; Giuseppe Grosso; Yuming Guo; Rahul Gupta; Rajeev Gupta; Vipin Gupta; Reyna Alma Gutiérrez; Murthy Gvs; Nima Hafezi-Nejad; Tekleberhan Beyene Hagos; Gessessew Bugssa Hailu; Randah R. Hamadeh; Samer Hamidi; Graeme J. Hankey; Hilda L. Harb; Sivadasanpillai Harikrishnan; Josep Maria Haro; Hamid Yimam Hassen; Rasmus Havmoeller; Simon I. Hay; Behzad Heibati; Andualem Henok; Ileana Heredia-Pi; Norberto Francisco Hernández-Llanes; Claudiu Herteliu; Desalegn Ts Tsegaw Hibstu; Praveen Hoogar; Nobuyuki Horita; H. Dean Hosgood; Mostafa Hosseini; Mihaela Hostiuc; Guoqing Hu; Hsiang Huang; Abdullatif Husseini; Bulat Idrisov; Bogdan Vasile Ileanu; Olayinka Stephen Ilesanmi; Seyed Sina Naghibi Irvani; Sheikh Mohammed Shariful Islam; Maria D. Jackson; Mihajlo Jakovljevic; Moti Tolera Jalu; Achala Upendra Jayatilleke; Ravi Prakash Jha; Jost B. Jonas; Jacek Jerzy Jozwiak; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Umesh Kapil; Amir Kasaeian; Tesfaye D. Dessale Kassa; Srinivasa Vittal Katikireddi; Norito Kawakami; Seifu Kebede; Adane Teshome Kefale; Peter Njenga Keiyoro; Andre Pascal Kengne; Yousef Khader; Morteza Abdullatif Khafaie; Ibrahim A. Khalil; Md Nuruzzaman Khan; Young-Ho Khang; Mona M. Khater; Jagdish Khubchandani; Cho-Il Kim; Daniel Kim; Yun Jin Kim; Ruth W. Kimokoti; Adnan Kisa; Mika Kivimäki; Sonali Kochhar; Soewarta Kosen; Parvaiz A. Koul; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; Burcu Kucuk Bicer; Veena S. Kulkarni; Pushpendra Kumar; Alessandra Lafranconi; Arjun Lakshmana Balaji; Ratilal Lalloo; Tea Lallukka; Hilton Lam; Faris Hasan Lami; Qing Lan; Justin J. Lang; Sonia Lansky; Anders O. Larsson; Arman Latifi; Janet L. Leasher; Paul H. Lee; James Leigh; Mall Leinsalu; Janni Leung; Miriam Levi; Yichong Li; Lee-Ling Lim; Shai Linn; Shiwei Liu; Andrea Lobato-Cordero; Alan D. Lopez; Paulo A. Lotufo; Erlyn Rachelle King Macarayan; Isis Eloah Machado; Fabiana Madotto; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Deborah Carvalho Malta; Chabila Christopher Mapoma; Jose Martinez-Raga; Pallab K. Maulik; Mohsen Mazidi; Martin McKee; Varshil Mehta; Toni Meier; Tesfa Mekonen; Kidanu Gebremariam Meles; Addisu Melese; Peter T. N. Memiah; Walter Mendoza; Desalegn Tadese Mengistu; George A. Mensah; Tuomo J. Meretoja; Haftay Berhane Mezgebe; Tomasz Miazgowski; Ted R. Miller; Gk Mini; Andreea Mirica; Erkin M. Mirrakhimov; Babak Moazen; Karzan Abdulmuhsin Mohammad; Noushin Mohammadifard; Shafiu Mohammed; Lorenzo Monasta; Paula Moraga; Lidia Morawska; Seyyed Meysam Mousavi; Satinath Mukhopadhyay; Kamarul Imran Musa; Aliya Naheed; Gurudatta Naik; Farid Najafi; Vinay Nangia; Jobert Richie Nansseu; Mudavath Siva Durga Prasad Nayak; Chakib Nejjari; Subas Neupane; Sudan Prasad Neupane; Josephine W. Ngunjiri; Cuong Tat Nguyen; Long Hoang Nguyen; Trang Huyen Nguyen; Dina Nur Anggraini Ningrum; Yirga Legesse Nirayo; Jean Jacques Noubiap; Richard Ofori-Asenso; Felix Akpojene Ogbo; In-Hwan Oh; Olanrewaju Oladimeji; Andrew T. Olagunju; Pedro R. Olivares; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Anu Mary Oommen; Eyal Oren; Heather M. Orpana; Doris D. V. Ortega-Altamirano; Justin R. Ortiz; Erika Ota; Mayowa Ojo Owolabi; Abayomi Samuel Oyekale; P.A. Mahesh; Adrian Pana; Eun-Kee Park; Charles D. H. Parry; Hadi Parsian; Ajay Patle; George C. Patton; Deepak Paudel; Max Petzold; Michael R. Phillips; Julian David Pillay; Maarten J. Postma; Farshad Pourmalek; Dorairaj Prabhakaran; Mostafa Qorbani; Amir Radfar; Anwar Rafay; Alireza Rafiei; Fakher Rahim; Afarin Rahimi-Movaghar; Mahfuzar Rahman; Muhammad Aziz Rahman; Rajesh Kumar Rai; Sasa Rajsic; Sree Bhushan Raju; Usha Ram; Saleem M. Rana; Chhabi Lal Ranabhat; David Laith Rawaf; Salman Rawaf; Robert C. Reiner; Cesar Reis; Andre M. N. Renzaho; Mohammad Sadegh Rezai; Leonardo Roever; Luca Ronfani; Robin Room; Gholamreza Roshandel; Ali Rostami; Gregory A. Roth; Ambuj Roy; Yogesh Damodar Sabde; Basema Saddik; Saeid Safiri; Amirhossein Sahebkar; Zikria Saleem; Joshua A. Salomon; Sundeep Santosh Salvi; Juan Sanabria; Maria Dolores Sanchez-Niño; Damian Francesco Santomauro; Itamar S. Santos; Milena M. M. Santric Milicevic; Abdur Razzaque Sarker; Rodrigo Sarmiento-Suárez; Nizal Sarrafzadegan; Benn Sartorius; Maheswar Satpathy; Monika Sawhney; Sonia Saxena; Mete Saylan; Michael P. Schaub; Maria Inês Schmidt; Ione J. C. Schneider; Ben Schöttker; Aletta Elisabeth Schutte; Falk Schwendicke; Sadaf G. Sepanlou; Masood Ali Shaikh; Mehdi Sharif; Jun She; Aziz Sheikh; Jiabin Shen; Mekonnen Sisay Shiferaw; Mika Shigematsu; Rahman Shiri; Kawkab Shishani; Ivy Shiue; Sharvari Rahul Shukla; Inga Dora Sigfusdottir; Diego Augusto Santos Silva; Natacha Torres Da Silva; Dayane Gabriele Alves Silveira; Dhirendra Narain Sinha; Freddy Sitas; Adauto Martins Soares Filho; Moslem Soofi; Reed J. D. Sorensen; Joan B. Soriano; Chandrashekhar T. Sreeramareddy; Nadine Steckling; Dan J. Stein; Mu'Awiyyah Babale Sufiyan; Patrick J. Sur; Bryan L. Sykes; Rafael Tabarés-Seisdedos; Takahiro Tabuchi; Mohammad Tavakkoli; Arash Tehrani-Banihashemi; Merhawi Gebremedhin Tekle; Subash Thapa; Nihal Thomas; Roman Topor-Madry; Fotis Topouzis; Bach Xuan Tran; Christopher E. Troeger; Thomas Clement Truelsen; Nikolaos Tsilimparis; Stefanos Tyrovolas; Kingsley Nnanna Ukwaja; Irfan Ullah; Olalekan A. Uthman; Pascual R. Valdez; Job F. M. Van Boven; Tommi Juhani Vasankari; Narayanaswamy Venketasubramanian; Francesco S. Violante; Sergey Konstantinovitch Vladimirov; Vasily Vlassov; Stein Emil Vollset; Theo Vos; Fasil Wagnew Shiferaw Wagnew; Yasir Waheed; Yuan-Pang Wang; Elisabete Weiderpass; Fitsum Weldegebreal; Kidu Gidey Weldegwergs; Andrea Werdecker; Ronny Westerman; Harvey A. Whiteford; Justyna Widecka; Tissa Wijeratne; Grant M. A. Wyper; Gelin Xu; Tomohide Yamada; Yuichiro Yano; Pengpeng Ye; Ebrahim M. Yimer; Paul Yip; Biruck Desalegn Yirsaw; Engida Yisma; Naohiro Yonemoto; Seok-Jun Yoon; Marcel Yotebieng; Mustafa Z. Younis; Geevar Zachariah; Zoubida Zaidi; Mohammad Zamani; Xueying Zhang; Sanjay Zodpey; Ali H. Mokdad; Mohsen Naghavi; Christopher J. L. Murray; Emmanuela Gakidou
Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted lifeyears (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older. Methods: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health. Findings: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5-3·0) of age-standardised female deaths and 6·8% (5·8-8·0) of agestandardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2-4·3) of female deaths and 12·2% (10·8-13·6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2·3% (95% UI 2·0-2·6) and male attributable DALYs were 8·9% (7·8-9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0-1·7] of total deaths), road injuries (1·2% [0·7-1·9]), and self-harm (1·1% [0·6-1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2-33·3) of total alcohol-attributable female deaths and 18·9% (15·3-22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0-0·8) standard drinks per week. Interpretation: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption. Funding Bill & Melinda Gates Foundation. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016
(Lancet Publishing Group, 2018) Nancy Fullman; Jamal Yearwood; Solomon M. Abay; Cristiana Abbafati; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Zegeye Abebe; Teshome Abuka Abebo; Victor Aboyans; Haftom Niguse Abraha; Daisy M.X. Abreu; Laith J. Abu-Raddad; Akilew Awoke Adane; Rufus Adesoji Adedoyin; Olatunji Adetokunboh; Tara Ballav Adhikari; Mohsen Afarideh; Ashkan Afshin; Gina Agarwal; Dominic Agius; Anurag Agrawal; Sutapa Agrawal; Aliasghar Ahmad Kiadaliri; Miloud Taki Eddine Aichour; Mohammed Akibu; Rufus Olusola Akinyemi; Tomi F. Akinyemiju; Nadia Akseer; Faris Hasan Al Lami; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Tahiya Alam; Deena Alasfoor; Mohammed I. Albittar; Kefyalew Addis Alene; Ayman Al-Eyadhy; Syed Danish Ali; Mehran Alijanzadeh; Syed M. Aljunid; Ala'a Alkerwi; François Alla; Peter Allebeck; Christine Allen; Mahmoud A. Alomari; Rajaa Al-Raddadi; Ubai Alsharif; Khalid A. Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Kebede Amenu; Walid Ammar; Yaw Ampem Amoako; Nahla Anber; Catalina Liliana Andrei; Sofia Androudi; Carl Abelardo T. Antonio; Valdelaine E.M. Araújo; Olatunde Aremu; Johan Ärnlöv; Al Artaman; Krishna Kumar Aryal; Hamid Asayesh; Ephrem Tsegay Asfaw; Solomon Weldegebreal Asgedom; Rana Jawad Asghar; Mengistu Mitiku Ashebir; Netsanet Abera Asseffa; Tesfay Mehari Atey; Sachin R. Atre; Madhu S. Atteraya; Leticia Avila-Burgos; Euripide Frinel G. Arthur Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Animut Alebel Ayalew; Henok Tadesse Ayele; Rakesh Ayer; Tambe Betrand Ayuk; Peter Azzopardi; Natasha Azzopardi-Muscat; Tesleem Kayode Babalola; Hamid Badali; Alaa Badawi; Maciej Banach; Amitava Banerjee; Amrit Banstola; Ryan M. Barber; Miguel A. Barboza; Suzanne L. Barker-Collo; Till Bärnighausen; Simon Barquera; Lope H. Barrero; Quique Bassat; Sanjay Basu; Bernhard T. Baune; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Bayu Begashaw Bekele; Abate Bekele Belachew; Saba Abraham Belay; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Derrick A. Bennett; James R. Bennett; Isabela M. Bensenor; Derbew Fikadu Berhe; Eduardo Bernabé; Robert Steven Bernstein; Mircea Beuran; Ashish Bhalla; Paurvi Bhatt; Soumyadeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Ali Bijani; Boris Bikbov; Charles Birungi; Stan Biryukov; Hailemichael Bizuneh; Ian W. Bolliger; Kaylin Bolt; Ibrahim R. Bou-Orm; Kayvan Bozorgmehr; Oliver Jerome Brady; Alexandra Brazinova; Nicholas J.K. Breitborde; Hermann Brenner; Gabrielle Britton; Traolach S. Brugha; Zahid A. Butt; Lucero Cahuana-Hurtado; Ismael Ricardo Campos-Nonato; Julio Cesar Campuzano; Josip Car; Mate Car; Rosario Cárdenas; Juan Jesus Carrero; Felix Carvalho; Carlos A. Castañeda-Orjuela; Jacqueline Castillo Rivas; Ferrán Catalá-López; Kelly Cercy; Julian Chalek; Hsing-Yi Chang; Jung-Chen Chang; Aparajita Chattopadhyay; Pankaj Chaturvedi; Peggy Pei-Chia Chiang; Vesper Hichilombwe Chisumpa; Jee-Young J. Choi; Hanne Christensen; Devasahayam Jesudas Christopher; Sheng-Chia Chung; Liliana G. Ciobanu; Massimo Cirillo; Danny Colombara; Sara Conti; Cyrus Cooper; Leslie Cornaby; Paolo Angelo Cortesi; Monica Cortinovis; Alexandre Costa Pereira; Ewerton Cousin; Michael H. Criqui; Elizabeth A. Cromwell; Christopher Stephen Crowe; John A. Crump; Alemneh Kabeta Daba; Berihun Assefa Dachew; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Paul I. Dargan; Ahmad Daryani; Maryam Daryani; Jai Das; Siddharth Kumar Das; José Das Neves; Nicole Davis Weaver; Kairat Davletov; Barbora De Courten; Diego De Leo; Jan-Walter De Neve; Robert P. Dellavalle; Gebre Demoz; Kebede Deribe; Don C. Des Jarlais; Subhojit Dey; Samath D. Dharmaratne; Meghnath Dhimal; Shirin Djalalinia; David Teye Doku; Kate Dolan; E. Ray Dorsey; Kadine Priscila Bender Dos Santos; Kerrie E. Doyle; Tim R. Driscoll; Manisha Dubey; Eleonora Dubljanin; Bruce Bartholow Duncan; Michelle Echko; Dumessa Edessa; David Edvardsson; Joshua R. Ehrlich; Erika Eldrenkamp; Ziad El-Khatib; Matthias Endres; Aman Yesuf Endries; Babak Eshrati; Sharareh Eskandarieh; Alireza Esteghamati; Mahdi Fakhar; Tamer Farag; Mahbobeh Faramarzi; Emerito Jose Aquino Faraon; André Faro; Farshad Farzadfar; Adesegun Fatusi; Mir Sohail Fazeli; Valery L. Feigin; Andrea B. Feigl; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; João C. Fernandes; Daniel Obadare Fijabi; Irina Filip; Florian Fischer; Christina Fitzmaurice; Abraham D. Flaxman; Luisa Sorio Flor; Nataliya Foigt; Kyle J. Foreman; Joseph J. Frostad; Thomas Fürst; Neal D. Futran; Emmanuela Gakidou; Silvano Gallus; Ketevan Gambashidze; Amiran Gamkrelidze; Morsaleh Ganji; Abadi Kahsu Gebre; Tsegaye Tewelde Gebrehiwot; Amanuel Tesfay Gebremedhin; Yalemzewod Assefa Gelaw; Johanna M. Geleijnse; Demeke Geremew; Peter W. Gething; Reza Ghadimi; Khalil Ghasemi Falavarjani; Maryam Ghasemi-Kasman; Paramjit Singh Gill; Ababi Zergaw Giref; Maurice Giroud; Melkamu Dedefo Gishu; Giorgia Giussani; William W. Godwin; Srinivas Goli; Hector Gomez-Dantes; Philimon N. Gona; Amador Goodridge; Sameer Vali Gopalani; Yevgeniy Goryakin; Alessandra Carvalho Goulart; Ayman Grada; Max Griswold; Giuseppe Grosso; Harish Chander Gugnani; Yuming Guo; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Tarun Gupta; Vipin Gupta; Juanita A. Haagsma; Vladimir Hachinski; Nima Hafezi-Nejad; Gessessew Bugssa Hailu; Randah Ribhi Hamadeh; Samer Hamidi; Graeme J. Hankey; Hilda L. Harb; Heather C. Harewood; Sivadasanpillai Harikrishnan; Josep Maria Haro; Hamid Yimam Hassen; Rasmus Havmoeller; Caitlin Hawley; Simon I. Hay; Jiawei He; Stephen J.C. Hearps; Mohamed I. Hegazy; Behzad Heibati; Mohsen Heidari; Delia Hendrie; Nathaniel J. Henry; Victor Hugo Herrera Ballesteros; Claudiu Herteliu; Desalegn Tsegaw Hibstu; Molla Kahssay Hiluf; Hans W. Hoek; Enayatollah Homaie Rad; Nobuyuki Horita; H. Dean Hosgood; Mostafa Hosseini; Seyed Reza Hosseini; Mihaela Hostiuc; Sorin Hostiuc; Damian G. Hoy; Mohamed Hsairi; Aung Soe Htet; Guoqing Hu; John J. Huang; Kim Moesgaard Iburg; Fachmi Idris; Ehimario Uche Igumbor; Chad Ikeda; Bogdan Vasile Ileanu; Olayinka S. Ilesanmi; Kaire Innos; Seyed Sina Naghibi Irvani; Caleb M.S. Irvine; Farhad Islami; Troy A. Jacobs; Kathryn H. Jacobsen; Nader Jahanmehr; Rajesh Jain; Sudhir Kumar Jain; Mihajlo M. Jakovljevic; Moti Tolera Jalu; Amr A. Jamal; Mehdi Javanbakht; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Ravi Prakash Jha; Vivekanand Jha; Jacek Józwiak; Oommen John; Sarah Charlotte Johnson; Jost B. Jonas; Vasna Joshua; Mikk Jürisson; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Rizwan Kalani; Chittaranjan Kar; Marina Karanikolos; André Karch; Corine Kakizi Karema; Seyed M. Karimi; Amir Kasaeian; Dessalegn Haile Kassa; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Nicholas J. Kassebaum; Srinivasa Vittal Katikireddi; Anil Kaul; Norito Kawakami; Konstantin Kazanjan; Seifu Kebede; Peter Njenga Keiyoro; Grant Rodgers Kemp; Andre Pascal Kengne; Maia Kereselidze; Ezra Belay Ketema; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Alireza Khajavi; Ibrahim A. Khalil; Ejaz Ahmad Khan; Gulfaraz Khan; Md Nuruzzaman Khan; Muhammad Ali Khan; Mukti Nath Khanal; Young-Ho Khang; Mona M. Khater; Abdullah Tawfih Abdullah Khoja; Ardeshir Khosravi; Jagdish Khubchandani; Getiye Dejenu Kibret; Daniel Ngari Kiirithio; Daniel Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Sanjay Kinra; Adnan Kisa; Niranjan Kissoon; Sonali Kochhar; Yoshihiro Kokubo; Jacek A. Kopec; Soewarta Kosen; Parvaiz A. Koul; Ai Koyanagi; Michael Kravchenko; Kewal Krishan; Kristopher J. Krohn; Barthelemy Kuate Defo; G. Anil Kumar; Pushpendra Kumar; Michael Kutz; Igor Kuzin; Hmwe H. Kyu; Deepesh Pravinkumar Lad; Alessandra Lafranconi; Dharmesh Kumar Lal; Ratilal Lalloo; Hilton Lam; Qing Lan; Justin J. Lang; Van C. Lansingh; Sonia Lansky; Anders Larsson; Arman Latifi; Jeffrey Victor Lazarus; Janet L. Leasher; Paul H. Lee; Yirga Legesse; James Leigh; Cheru Tesema Leshargie; Samson Leta; Janni Leung; Ricky Leung; Miriam Levi; Yongmei Li; Juan Liang; Misgan Legesse Liben; Lee-Ling Lim; Stephen S. Lim; Margaret Lind; Shai Linn; Stefan Listl; Patrick Y. Liu; Shiwei Liu; Rakesh Lodha; Alan D. Lopez; Scott A. Lorch; Stefan Lorkowski; Paulo A. Lotufo; Timothy C.D. Lucas; Raimundas Lunevicius; Grégoire Lurton; Ronan A. Lyons; Fadi Maalouf; Erlyn Rachelle King Macarayan; Mark T. Mackay; Emilie R. Maddison; Fabiana Madotto; Hassan Magdy Abd El Razek; Mohammed Magdy Abd El Razek; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Rajesh Malhotra; Deborah Carvalho Malta; Abdullah A. Mamun; Helena Manguerra; Treh Manhertz; Mohammad Ali Mansournia; Lorenzo G. Mantovani; Tsegahun Manyazewal; Chabila C. Mapoma; Christopher Margono; Jose Martinez-Raga; Sheila Cristina Ouriques Martins; Francisco Rogerlândio Martins-Melo; Ira Martopullo; Winfried März; Benjamin Ballard Massenburg; Manu Raj Mathur; Pallab K. Maulik; Mohsen Mazidi; Colm McAlinden; John J. McGrath; Martin McKee; Suresh Mehata; Ravi Mehrotra; Kala M. Mehta; Varshil Mehta; Toni Meier; Fabiola Mejia-Rodriguez; Kidanu Gebremariam Meles; Mulugeta Melku; Peter Memiah; Ziad A. Memish; Walter Mendoza; Degu Abate Mengiste; Desalegn Tadese Mengistu; Bereket Gebremichael Menota; George A. Mensah; Atte Meretoja; Tuomo J. Meretoja; Haftay Berhane Mezgebe; Tomasz Miazgowski; Renata Micha; Robert Milam; Anoushka Millear; Ted R. Miller; G.K. Mini; Shawn Minnig; Andreea Mirica; Erkin M. Mirrakhimov; Awoke Misganaw; Philip B. Mitchell; Fitsum Weldegebreal Mlashu; Babak Moazen; Karzan Abdulmuhsin Mohammad; Roghayeh Mohammadibakhsh; Ebrahim Mohammed; Mohammed A. Mohammed; Shafiu Mohammed; Ali H. Mokdad; Glen Liddell D. Mola; Mariam Molokhia; Fatemeh Momeniha; Lorenzo Monasta; Julio Cesar Montañez Hernandez; Mahmood Moosazadeh; Maziar Moradi-Lakeh; Paula Moraga; Lidia Morawska; Ilais Moreno Velasquez; Rintaro Mori; Shane D. Morrison; Mark Moses; Seyyed Meysam Mousavi; Ulrich O. 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Ortega-Altamirano; Alberto Ortiz; Raziye Ozdemir; Mahesh Pa; Amanda W. Pain; Marcos Roberto Tovani Palone; Adrian Pana; Songhomitra Panda-Jonas; Jeyaraj D. Pandian; Eun-Kee Park; Hadi Parsian; Tejas Patel; Sanghamitra Pati; Snehal T. Patil; Ajay Patle; George C. Patton; Vishnupriya Rao Paturi; Deepak Paudel; Marcel De Moares Pedroso; Sandra P. Pedroza; David M. Pereira; Norberto Perico; Hannah Peterson; Max Petzold; Niloofar Peykari; Michael Robert Phillips; Frédéric B. Piel; David M. Pigott; Julian David Pillay; Michael A. Piradov; Suzanne Polinder; Constance D. Pond; Maarten J. Postma; Farshad Pourmalek; Swayam Prakash; V. Prakash; Narayan Prasad; Noela Marie Prasad; Caroline Purcell; Mostafa Qorbani; Hedley Knewjen Quintana; Amir Radfar; Anwar Rafay; Alireza Rafiei; Kazem Rahimi; Afarin Rahimi-Movaghar; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Muhammad Aziz Rahman; Sajjad Ur Rahman; Rajesh Kumar Rai; Sree Bhushan Raju; Usha Ram; Saleem M. 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Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8-98·1) in Iceland, followed by 96·6 (94·9-97·9) in Norway and 96·1 (94·5-97·3) in the Netherlands, to values as low as 18·6 (13·1-24·4) in the Central African Republic, 19·0 (14·3-23·7) in Somalia, and 23·4 (20·2-26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1-93·6) in Beijing to 48·0 (43·4-53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6-68·8) in Goa to 34·0 (30·3-38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view - and subsequent provision - of quality health care for all populations. Copyright © 2018 The Author(s). Published by Elsevier Ltd.