Browsing by Author "Mohammad Abdollahi"

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Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)
(Nature Research, 2020) Damaris K. Kinyoki; Jennifer M. Ross; Alice Lazzar-Atwood; Sandra B. Munro; Lauren E. Schaeffer; Mahdieh Abbasalizad-Farhangi; Masoumeh Abbasi; Hedayat Abbastabar; Ahmed Abdelalim; Amir Abdoli; Mohammad Abdollahi; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Nebiyu Dereje Abebe; Teshome Abuka Abebo; Kedir Hussein Abegaz; Hassan Abolhassani; Lucas Guimarães Abreu; Michael R. M. Abrigo; Abdelrahman I. Abushouk; Manfred Mario Kokou Accrombessi; Dilaram Acharya; Maryam Adabi; Akindele Olupelumi Adebiyi; Isaac Akinkunmi Adedeji; Victor Adekanmbi; Abiodun Moshood Adeoye; Olatunji O. Adetokunboh; Davoud Adham; Posi Emmanuel Aduroja; Shailesh M. Advani; Mohsen Afarideh; Mohammad Aghaali; Anurag Agrawal; Tauseef Ahmad; Keivan Ahmadi; Sepideh Ahmadi; Muktar Beshir Ahmed; Rushdia Ahmed; Olufemi Ajumobi; Chalachew Genet Akal; Temesgen Yihunie Akalu; Tomi Akinyemiju; Blessing Akombi; Ziyad Al-Aly; Samiah Alam; Genet Melak Alamene; Turki M. Alanzi; Jacqueline Elizabeth Alcalde Rabanal; Niguse Meles Alema; Beriwan Abdulqadir Ali; Muhammad Ali; Mehran Alijanzadeh; Cyrus Alinia; Vahid Alipour; Hesam Alizade; Syed Mohamed Aljunid; Afshin Almasi; Amir Almasi-Hashiani; Hesham M. Al-Mekhlafi; Rajaa M. Al-Raddadi; Khalid Altirkawi; Nelson Alvis-Guzman; Nelson J. Alvis-Zakzuk; Azmeraw T. Amare; Adeladza Kofi Amegah; Saeed Amini; Mostafa Amini Rarani; Fatemeh Amiri; Arianna Maever Loreche Amit; Nahla Hamed Anber; Catalina Liliana Andrei; Fereshteh Ansari; Alireza Ansari-Moghaddam; Zelalem Alamrew Anteneh; Carl Abelardo T. Antonio; Ernoiz Antriyandarti; Davood Anvari; Razique Anwer; Seth Christopher Yaw Appiah; Jalal Arabloo; Morteza Arab-Zozani; Ephrem Mebrahtu Araya; Zohreh Arefi; Olatunde Aremu; Johan Ärnlöv; Afsaneh Arzani; Mehran Asadi-Aliabadi; Ali A. Asadi-Pooya; Samaneh Asgari; Babak Asghari; Alebachew Fasil Ashagre; Anemaw A. Asrat; Bahar Ataeinia; Hagos Tasew Atalay; Desta Debalkie Atnafu; Maha Moh’d Wahbi Atout; Marcel Ausloos; Euripide F. G. A. Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Martin Amogre Ayanore; Yared A. Asmare Aynalem; Abbas Azadmehr; Samad Azari; Ghasem Azarian; Zelalem Nigussie Azene; Ebrahim Babaee; Alaa Badawi; Ashish D. Badiye; Mohamad Amin Bahrami; Atif Amin A. Baig; Ahad Bakhtiari; Shankar M. Bakkannavar; Senthilkumar Balakrishnan; Ayele Geleto Bali; Maciej Banach; Palash Chandra Banik; Zahra Baradaran-Seyed; Adhanom Gebreegziabher Baraki; Miguel A. Barboza; Till Winfried Bärnighausen; Lingkan Barua; Huda Basaleem; Sanjay Basu; Mohsen Bayati; Mulat Tirfie Bayih; Habtamu Wondifraw Baynes; Neeraj Bedi; Masoud Behzadifar; Meysam Behzadifar; Yibeltal Alemu Bekele; Derrick A. Bennett; Dessalegn Ajema Berbada; Kidanemaryam Berhe; Abadi Kidanemariam Berhe; Adam E. Berman; Robert S. Bernstein; Reshmi Bhageerathy; Dinesh Bhandari; Pankaj Bharadwaj; Natalia V. Bhattacharjee; Krittika Bhattacharyya; Ali Bijani; Boris Bikbov; Ver Bilano; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Setognal Birara; Minuye Biniam Biniam Birhane; Minyichil Birhanu; Raaj Kishore Biswas; Zebenay Workneh Bitew; Kassawmar Angaw Bogale; Somayeh Bohlouli; Srinivasa Rao Bolla; Archith Boloor; Antonio M. Borzì; Shiva Borzouei; Oliver J. Brady; Nicola Luigi Bragazzi; Dejana Braithwaite; Nikolay Ivanovich Briko; Gabrielle Britton; Shyam S. Budhathoki; Sharath Burugina Nagaraja; Reinhard Busse; Zahid A. Butt; Lucero Cahuana-Hurtado; Luis Alberto Cámera; Ismael R. Campos-Nonato; Jorge Cano; Josip Car; Rosario Cárdenas; Juan J. Carrero; Félix Carvalho; João Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Franz Castro; Ester Cerin; Collins Chansa; Jaykaran Charan; Pranab Chatterjee; Vijay Kumar Chattu; Bal Govind Chauhan; Ali Reza Chavshin; Mohammad Chehrazi; Tesfaye Yitna Chichiabellu; Ken Lee Chin; Devasahayam J. Christopher; Dinh-Toi Chu; Flavia M. Cicuttini; Michael L. Collison; Michael A. Cork; Natalie Cormier; Paolo Angelo Cortesi; Vera M. Costa; Abel Fekadu Fekadu Dadi; Baye Dagnew; Saad M. A. Dahlawi; Giovanni Damiani; Amira Hamed Darwish; Ahmad Daryani; Jai K. Das; Rajat Das Gupta; Claudio Dávila-Cervantes; Nicole Davis Weaver; Diego De Leo; Jan-Walter De Neve; Feleke Mekonnen Demeke; Asmamaw Bizuneh Demis; Dereje Bayissa Demissie; Gebre Teklemariam Demoz; Edgar Denova-Gutiérrez; Kebede Deribe; Rupak Desai; Beruk Berhanu Desalegn; Assefa Desalew; Aniruddha Deshpande; Sagnik Dey; Samath Dhamminda Dharmaratne; Preeti Dhillon; Meghnath Dhimal; Govinda Prasad Dhungana; Mostafa Dianati Nasab; Daniel Diaz; Zahra Sadat Dibaji Forooshani; Girmaye Deye Dinsa; Isaac Oluwafemi Dipeolu; Shirin Djalalinia; Hoa Thi Do; Huyen Phuc Do; Paul Narh Doku; Fariba Dorostkar; Leila Doshmangir; Manisha Dubey; Bereket Duko Adema; Susanna J. Dunachie; Bruce B. Duncan; Ewerton Cousin; Andre R. Durães; Lucas Earl; Hamed Ebrahimzadeh Leylabadlo; Aziz Eftekhari; Iman El Sayed; Maysaa El Sayed Zaki; Maha El Tantawi; Iffat Elbarazi; Demelash Abewa Elemineh; Shaimaa I. El-Jaafary; Ziad El-Khatib; Aisha Elsharkawy; Yasser Mohamed El-Sherbiny; Iqbal R. F. Elyazar; Mohammad Hassan Emamian; Shymaa Enany; Daniel Adane Endalew; Melese Linger Endalifer; Khalil Eskandari; Sharareh Eskandarieh; Saman Esmaeilnejad; Alireza Esteghamati; Arash Etemadi; Atkilt Esaiyas Etisso; Jessica Fanzo; Mohammad Farahmand; Anwar Faraj; Sajjad Farashi; Mohammad Fareed; Andrea Farioli; Andre Faro; Farshad Farzadfar; Hossein Farzam; Syeda Sadia Fatima; Nazir Fattahi; Nelsensius Klau Fauk; Ali Akbar Fazaeli; Netsanet Fentahun; Tomas Y. Ferede; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; João C. Fernandes; Garumma Tolu Feyissa; Irina Filip; Florian Fischer; Carsten Flohr; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Masoud Foroutan; Jana Förster; Joel Msafiri Francis; Takeshi Fukumoto; Reta Tsegaye Gayesa; Biniyam Sahiledengle Geberemariyam; Tsegaye Tewelde Gebrehiwot; Hadush Gebremariam; Kidane Tadesse Gebremariam; Ketema Bizuwork Bizuwork Gebremedhin; Gebreamlak Gebremedhn Gebremeskel; Assefa Ayalew Ayalew Gebreslassie; Gebretsadkan G. G. Gebretsadik; Getnet Azeze Gedefaw; Yilma Chisha Dea Geramo; Hailay Abrha Gesesew; Birhanu Geta; Agegnehu Bante Getenet; Kebede Embaye Gezae; Fatemeh Ghaffarifar; Mansour Ghafourifard; Alireza Ghajar; Mahsa Ghajarzadeh; Ahmad Ghashghaee; Hesam Ghiasvand; Asadollah Gholamian; Syed Amir Gilani; Tiffany K. Gill; Ibrahim Abdelmageed Ginawi; Srinivas Goli; Nelson G. M. Gomes; Sameer Vali Gopalani; Houman Goudarzi; Alessandra C. Goulart; Arunkumar Govindakarnavar; Ayman Grada; Michal Grivna; Rafael Alves Guimarães; Rashid Abdi Guled; Yuming Guo; Rahul Gupta; Rajeev Gupta; Nima Hafezi-Nejad; Michael Tamene Haile; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Brian J. Hall; Iman Halvaei; Randah R. Hamadeh; Yadollah Hamidi; Demelash Woldeyohannes Handiso; Graeme J. Hankey; Hamidreza Haririan; Ninuk Hariyani; Ahmed I. Hasaballah; Md. Mehedi Hasan; Milad Hasankhani; Edris Hasanpoor; Amir Hasanzadeh; Maryam Hashemian; Soheil Hassanipour; Hamid Yimam Hassen; Rasmus Havmoeller; Corinna Hawkes; Khezar Hayat; Desta Haftu Hayelom; Behnam Heidari; Reza Heidari-Soureshjani; Delia Hendrie; Andualem Henok; Nathaniel J. Henry; Mario Herrero; Claudiu Herteliu; Fatemeh Heydarpour; Hagos D. de Hidru; Chi Linh Hoang; Hans W. Hoek; Michael K. Hole; Ramesh Holla; Gillian Hollerich; Enayatollah Homaie Rad; Sung Hwi Hong; Praveen Hoogar; Masako Horino; Naznin Hossain; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Mohamed Hsairi; Guoqing Hu; Tanvir M. Huda; Ayesha Humayun; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Milena D. Ilic; Mohammad Hasan Imani-Nasab; Leeberk Raja Inbaraj; Usman Iqbal; Seyed Sina Naghibi Irvani; Sheikh Mohammed Shariful Islam; Chidozie C. D. Iwu; Chinwe Juliana Iwu; Neda Izadi; Jalil Jaafari; Anelisa Jaca; Farhad Jadidi-Niaragh; Nader Jafari Balalami; Morteza Jafarinia; Mohammad Ali Jahani; Mihajlo Jakovljevic; Amir Jalali; Farzad Jalilian; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Fyezah Jehan; Ensiyeh Jenabi; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Peng Jia; Oommen John; Yetunde O. John-Akinola; Kimberly B. Johnson; Jost B. Jonas; Nitin Joseph; Farahnaz Joukar; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk Jürisson; Ali Kabir; Zubair Kabir; Amaha Kahsay; Molla Kahssay; Hamed Kalani; Leila L. Kalankesh; Rohollah Kalhor; Zahra Kamiab; Tanuj Kanchan; Umesh Kapil; Neeti Kapoor; Manoochehr Karami; Behzad Karami Matin; André Karch; Mohd A. Karim; Surendra Karki; Amir Kasaeian; Gebremicheal Gebreslassie Kasahun; Habtamu Kebebe Kasaye; Tesfaye Dessale Kassa; Hagazi Gebremedhin Kassaye; Nicholas J. Kassebaum; Ali Kazemi Karyani; Andre Pascal Kengne; Daniel Bekele Ketema; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Mojtaba Khaksarian; Nauman Khalid; Ibrahim A. Khalil; Rovshan Khalilov; Asad Khan; Ejaz Ahmad Khan; Md Nuruzzaman Khan; Mohammad Saud Khan; Muhammad Shahzeb Khan; Khaled Khatab; Amir Khater; Mona M. Khater; Mahalqua Nazli Khatib; Maryam Khayamzadeh; Maryam Khazaei-Pool; Mohammad Khazaei; Salman Khazaei; Mohammad Taghi Khodayari; Mohammad Hossein Khosravi; Roba Khundkar; Ali Kiadaliri; Neda Kianipour; Daniel N. Kiirithio; Yun Jin Kim; Ruth W. Kimokoti; Adnan Kisa; Sezer Kisa; Tufa Kolola; Hamidreza Komaki; Shivakumar K. M. Kondlahalli; Ali Koolivand; Parvaiz A. Koul; Ai Koyanagi; Moritz U. G. Kraemer; Kewal Krishan; Kris J. Krohn; Nuworza Kugbey; Manasi Kumar; Pushpendra Kumar; Vivek Kumar; Om P. Kurmi; Oluwatosin Kuti; Carlo La Vecchia; Ben Lacey; Deepesh P. Lad; Aparna Lal; Dharmesh Kumar Lal; Faris Hasan Lami; Prabhat Lamichhane; Justin J. Lang; Van C. Lansingh; Savita Lasrado; Georgy Lebedev; Paul H. Lee; Shaun Wen Huey Lee; Mostafa Leili; Ian D. Letourneau; Sonia Lewycka; Shanshan Li; Lee-Ling Lim; Shai Linn; Shiwei Liu; Simin Liu; Rakesh Lodha; Joshua Longbottom; Jaifred Christian F. Lopez; Stefan Lorkowski; Erlyn Rachelle King Macarayan; Mohammed Madadin; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Dhaval P. Maghavani; Phetole Walter Mahasha; Narayan Bahadur Mahotra; Venkatesh Maled; Afshin Maleki; Shokofeh Maleki; Deborah Carvalho Malta; Ali Manafi; Farzad Manafi; Navid Manafi; Narendar Dawanu Manohar; Fariborz Mansour-Ghanaei; Borhan Mansouri; Mohammad Ali Mansournia; Chabila Christopher Mapoma; Dadi Marami; Laurie B. Marczak; Carlos Alberto Marrugo Arnedo; Francisco Rogerlândio Martins-Melo; Anthony Masaka; Benjamin Ballard Massenburg; Pallab K. Maulik; Benjamin K. Mayala; Mohsen Mazidi; Man Mohan Mehndiratta; Freshteh Mehri; Kala M. Mehta; Wahengbam Bigyananda Meitei; Fantahun Ayenew Mekonnen; Teferi Mekonnen; Gebrekiros Gebremichael Meles; Hagazi Gebre Meles; Addisu Melese; Walter Mendoza; Ritesh G. Menezes; Meresa Berwo Mengesha; George A. Mensah; Tuomo J. Meretoja; Tomasz Miazgowski; Neda Milevska Kostova; Ted R. Miller; Edward J. Mills; G.K. Mini; Seyed Mostafa Mir; Mohammad Miri; Hamed Mirjalali; Erkin M. Mirrakhimov; Hamed Mirzaei; Maryam Mirzaei; Roya Mirzaei; Mehdi Mirzaei-Alavijeh; Prasanna Mithra; Babak Moazen; Efat Mohamadi; Amjad Mohamadi-Bolbanabad; Karzan Abdulmuhsin Mohammad; Yousef Mohammad; Dara K. Mohammad; Aso Mohammad Darwesh; Naser Mohammad Gholi Mezerji; Abdollah Mohammadian-Hafshejani; Mousa Mohammadnia-Afrouzi; Milad Mohammadoo-Khorasani; Reza Mohammadpourhodki; Salahuddin Mohammed; Shafiu Mohammed; Jemal Abdu Mohammed; Ammas Siraj Mohammed; Farnam Mohebi; Amin Mokari; Ali H. Mokdad; Julio Cesar Montañez; Pablo A. Montero-Zamora; Yoshan Moodley; Maryam Moossavi; Ghobad Moradi; Masoud Moradi; Yousef Moradi; Mohammad Moradi-Joo; Maziar Moradi-Lakeh; Farhad Moradpour; Rahmatollah Moradzadeh; Paula Moraga; Shane Douglas Morrison; Abbas Mosapour; Jonathan F. Mosser; Simin Mouodi; Amin Mousavi Khaneghah; Dariush Mozaffarian; Ulrich Otto Mueller; Christopher J. L. Murray; G.V.S. Murthy; Kamarul Imran Musa; Ghulam Mustafa; Saravanan Muthupandian; Behnam Nabavizadeh; Mehdi Naderi; Girish N. Nadkarni; Ahamarshan Jayaraman Nagarajan; Mohsen Naghavi; Aliya Naheed; Gurudatta Naik; Farid Najafi; Jobert Richie Nansseu; K. M. Venkat Narayan; Bruno Ramos Nascimento; Vinod Nayak; Javad Nazari; Duduzile Edith Ndwandwe; Ionut Negoi; Ruxandra Irina Negoi; Josephine W. Ngunjiri; Cuong Tat Nguyen; Huong Lan Thi Nguyen; Dabere Nigatu; Yeshambel T. Nigatu; Rajan Nikbakhsh; Dina Nur Anggraini Ningrum; Chukwudi A. Nnaji; Vuong Minh Nong; Jean Jacques Noubiap; Christoph Nowak; Bogdan Oancea; Richard Ofori-Asenso; Onome Bright Oghenetega; In-Hwan Oh; Olanrewaju Oladimeji; Morteza Oladnabi; Andrew T. Olagunju; Tinuke O. Olagunju; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Mojisola Morenike Oluwasanu; Muktar Omer Omer; Obinna E. Onwujekwe; Kwaku Oppong Asante; Eyal Oren; Orish Ebere Orisakwe; Alberto Ortiz; Osayomwanbo Osarenotor; Aaron E. Osgood-Zimmerman; Mayowa Ojo Owolabi; Mahesh P. A; Jagadish Rao Padubidri; Keyvan Pakshir; Adrian Pana; Songhomitra Panda-Jonas; Hadi Parsian; Tahereh Pashaei; Deepak Kumar Pasupula; Sangram Kishor Patel; Ashish Pathak; Mona Pathak; Sanghamitra Pati; Ajay Patle; George C. Patton; Kebreab Paulos; Hamidreza Pazoki Toroudi; Veincent Christian Filipino Pepito; Norberto Perico; William A. Petri; Brandon V. Pickering; David M. Pigott; Majid Pirestani; Bakhtiar Piroozi; Meghdad Pirsaheb; Khem Narayan Pokhrel; Maarten J. Postma; Hadi Pourjafar; Farshad Pourmalek; Reza Pourmirza Kalhori; Akram Pourshams; Hossein Poustchi; Sergio I. Prada; Liliana Preotescu; Dimas Ria Angga Pribadi; Zahiruddin Quazi Syed; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Alireza Rafiei; Fakher Rahim; Vafa Rahimi-Movaghar; Muhammad Aziz Rahman; Sajjad ur Rahman; Rajesh Kumar Rai; Ali Rajabpour-Sanati; Fatemeh Rajati; Kiana Ramezanzadeh; Saleem Muhammad Rana; Chhabi Lal Ranabhat; Sowmya J. Rao; Davide Rasella; Vahid Rashedi; Prateek Rastogi; Priya Rathi; Salman Rawaf; David Laith Rawaf; Lal Rawal; Sarah E. Ray; Giuseppe Remuzzi; Vishnu Renjith; Andre M. N. Renzaho; Serge Resnikoff; Nima Rezaei; Shahab Rezaeian; Mohammad Sadegh Rezai; Aziz Rezapour; Seyed Mohammad Riahi; Ana Isabel Ribeiro; Jennifer Rickard; Alina Rodriguez; Leonardo Roever; Elias Merdassa Roro; Gholamreza Roshandel; Ali Rostami; Enrico Rubagotti; Anas M. Saad; Seyedmohammad Saadatagah; Yogesh Damodar Sabde; Siamak Sabour; Ehsan Sadeghi; Masoumeh Sadeghi; Saeed Safari; Yahya Safari; Hamid Safarpour; Rajesh Sagar; Amirhossein Sahebkar; Mohammad Ali Sahraian; S. Mohammad Sajadi; Mohammad Reza Salahshoor; Nasir Salam; Farkhonde Salehi; Saleh Salehi Zahabi; Hosni Salem; Marwa R. Rashad Salem; Yahya Salimi; Hamideh Salimzadeh; Hossein Samadi Kafil; Evanson Zondani Sambala; Abdallah M. Samy; Itamar S. Santos; Bruno Piassi Sao Jose; Sivan Yegnanarayana Iyer Saraswathy; Abdur Razzaque Sarker; Benn Sartorius; Arash Sarveazad; Brijesh Sathian; Maheswar Satpathy; Sonia Saxena; Mehdi Sayyah; Alyssa N. Sbarra; Megan F. Schipp; Maria Inês Schmidt; Aletta Elisabeth Schutte; David C. Schwebel; Anbissa Muleta Senbeta; Subramanian Senthilkumaran; Seyedmojtaba Seyedmousavi; Faramarz Shaahmadi; Omid Shafaat; Saeed Shahabi; Masood Ali Shaikh; Ali S. Shalash; Mehran Shams-Beyranvand; Amir Shamshirian; Morteza Shamsizadeh; Mohammed Shannawaz; Kiomars Sharafi; Mehdi Sharif; Rajesh Sharma; Hatem Samir Shehata; Abbas Sheikhtaheri; Kenji Shibuya; Wondimeneh Shibabaw Shiferaw; Mika Shigematsu; Jae Il Shin; Rahman Shiri; Reza Shirkoohi; Ivy Shiue; Kerem Shuval; Soraya Siabani; Tariq J. Siddiqi; Inga Dora Sigfusdottir; Diego Augusto Santos Silva; Biagio Simonetti; Ambrish Singh; Pushpendra Singh; Virendra Singh; Jasvinder A. Singh; Pankaj Kumar Singh; Dhirendra Narain Sinha; Yitagesu Sintayehu; Malede Mequanent M. Sisay; Amin Soheili; Bija Soleymani; Farzaneh Soltani; Shahin Soltani; Joan B. Soriano; Muluken Bekele Sorrie; Sergey Soshnikov; Ireneous N. Soyiri; Adel Spotin; Chandrashekhar T. Sreeramareddy; Rajni Kant Kant Srivastava; Antonina Starodubova; Agus Sudaryanto; Mu’awiyyah Babale Sufiyan; Hafiz Ansar Rasul Suleria; Gerhard Sulo; Bruno F. Sunguya; Bryan L. Sykes; Rafael Tabarés-Seisdedos; Takahiro Tabuchi; Birkneh Tilahun Tadesse; Amir Taherkhani; Koku Sisay Tamirat; Segen Gebremeskel Tassew; Nuno Taveira; Berhane Fseha Teklehaimanot; Gebretsadkan Hintsa Tekulu; Mohamad-Hani Temsah; Abdullah Sulieman Terkawi; Zemenu Tadesse Tessema; Nihal Thomas; Mariya Vladimirovna Titova; Kenean Getaneh Tlaye; Hamid Reza Tohidinik; Marcello Tonelli; Marcos Roberto Tovani-Palone; Eugenio Traini; Khanh Bao Tran; Manjari Tripathi; Riaz Uddin; Irfan Ullah; Bhaskaran Unnikrishnan; Era Upadhyay; Ushotanefe Useh; Muhammad Shariq Usman; Olalekan A. Uthman; Marco Vacante; Masoud Vaezghasemi; Pascual R. Valdez; John VanderHeide; Elena Varavikova; Santosh Varughese; Tommi Juhani Vasankari; Yasser Vasseghian; Yousef Veisani; Srinivasaraghavan Venkatesh; Narayanaswamy Venketasubramanian; Madhur Verma; Simone Vidale; Francesco S. Violante; Vasily Vlassov; Sebastian Vollmer; Rade Vukovic; Yasir Waheed; Haidong Wang; Yafeng Wang; Yuan-Pang Wang; Girmay Teklay Weldesamuel; Andrea Werdecker; Taweewat Wiangkham; Kirsten E. Wiens; Tissa Wijeratne; Haileab Fekadu Wolde; Dawit Zewdu Wondafrash; Tewodros Eshete Wonde; Adam Belay Wondmieneh; Ai-Min Wu; Gelin Xu; Abbas Yadegar; Ali Yadollahpour; Seyed Hossein Yahyazadeh Jabbari; Tomohide Yamada; Yuichiro Yano; Sanni Yaya; Vahid Yazdi-Feyzabadi; Alex Yeshaneh; Yigizie Yeshaw; Yordanos Gizachew Yeshitila; Mekdes Tigistu Yilma; Paul Yip; Naohiro Yonemoto; Seok-Jun Yoon; Yoosik Youm; Mustafa Z. Younis; Zabihollah Yousefi; Hebat-Allah Salah A. Yousof; Chuanhua Yu; Hasan Yusefzadeh; Telma Zahirian Moghadam; Leila Zaki; Sojib Bin Zaman; Mohammad Zamani; Maryam Zamanian; Hamed Zandian; Hadi Zarafshan; Nejimu Biza Zepro; Taddese Alemu Zerfu; Taye Abuhay Zewale; Yunquan Zhang; Zhi-Jiang Zhang; Xiu-Ju Zhao; Sanjay Zodpey; Kamiar Zomorodian; Francis Bruno Zotor; Ashkan Afshin; Simon I. Hay
An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s).
Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 subnational locations, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023
(Elsevier B.V., 2025) Simon I. Hay; Kanyin Liane Ong; Damian Francesco Santomauro; A. Bhoomadevi; Mohammad Amin Aalipour; Hasan Abualruz; Hazim S. Ababneh; Ukachukwu Okoroafor Abaraogu; Biruk Beletew Abate; Cristiana Abbafati; Nasir Abbas; Mitra Abbasifard; Mohsen Abbasi-Kangevari; Samar Abd ElHafeez; Ashraf N. Abdalla; Mohammed Altigani Abdalla; Emad M. Abdallah; Barkhad Aden Abdeeq; Nadin M. Abdel Razeq; Ahmed Abdelrahman Abdelgalil; Reda S. Abdel-Hameed; Michael Abdelmasseh; Mahmoud Hassan Abdelnabi; Wael M. Abdel-Rahman; Sherief M. Abd-Elsalam; Sepideh Abdi; Mohammad Abdollahi; Meriem Abdoun; Arman Abdous; Jeza Muhamad Abdul Aziz; Deldar Morad Abdulah; Rizwan Suliankatchi Abdulkader; Adam Ibrahim Abdullahi; Auwal S. Abdullahi; Toufik Abdul-Rahman; Kulmira Abdykerimova; Habtamu Abebe Getahun; Aidin Abedi; Armita Abedi; Asrat Agalu Abejew; Roberto Ariel Abeldaño Zuñiga; E. S. Abhilash; Shehab Uddin Al Abid; Syed Hani Abidi; Alemwork Abie; Olugbenga Olusola Abiodun; Olumide A. Abiodun; Richard Gyan Aboagye; Shady M. Abohashem; Hassan Abolhassani; Ulric Sena Abonie; Nagah M. Abourashed; Mohamed Riad Abouzid; Dmitry Abramov; Lucas Guimarães Abreu; Dariush Abtahi; Rana K. Abu Farha; Fuad Hamdi Abuadas; Aminu Kende Abubakar; Bilyaminu Abubakar; Eman F. Abu-Gharbieh; Sawsan Hammad Abuhammad; Ahmad Yousef Abuhelwa; Hana J. Abukhadijah; Niveen M.E. Abu-Rmeileh; Salahdein Aburuz; Dina Hamdi Abushanab; Raghu Ram Achar; Anirudh B. Acharya; Apurba Acharya; Ilana N. Ackerman; Juan Manuel Acuna; Ousman Adal; Lisa Christine Adams; Lawan H. Adamu; Mesafint Molla Adane; Zenaw Debasu Addisu; Isaac Yeboah Addo; Oluwafemi Atanda Adeagbo; Tajudeen Adesanmi Adebisi; Isaac Akinkunmi Adedeji; David Adedia; Kamoru A. Adedokun; Rufus A. Adedoyin; Oluwatobi E. Adegbile; Oyelola Abdulwasiu Adegboye; Nurudeen A. Adegoke; Olumide Thomas Adeleke; Isaac A. Adesina; Miracle Ayomikun Adesina; Habeeb Omoponle Adewuyi; Temitayo Esther Adeyeoluwa; Olorunsola I. Adeyomoye; Kishor Adhikari; Ripon Kumar Adhikary; Usha Sachidananda Adiga; Mohd Adnan; Qorinah Estiningtyas Sakilah Adnani; Prince Owusu Adoma; Leticia Akua Adzigbli
Background For more than three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has provided a framework to quantify health loss due to diseases, injuries, and associated risk factors. This paper presents GBD 2023 findings on disease and injury burden and risk-attributable health loss, offering a global audit of the state of world health to inform public health priorities. This work captures the evolving landscape of health metrics across age groups, sexes, and locations, while reflecting on the remaining post-COVID-19 challenges to achieving our collective global health ambitions. Methods The GBD 2023 combined analysis estimated years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 375 diseases and injuries, and risk-attributable burden associated with 88 modifiable risk factors. Of the more than 310 000 total data sources used for all GBD 2023 (about 30% of which were new to this estimation round), more than 120 000 sources were used for estimation of disease and injury burden and 59 000 for risk factor estimation, and included vital registration systems, surveys, disease registries, and published scientific literature. Data were analysed using previously established modelling approaches, such as disease modelling meta-regression version 2.1 (DisMod-MR 2.1) and comparative risk assessment methods. Diseases and injuries were categorised into four levels on the basis of the established GBD cause hierarchy, as were risk factors using the GBD risk hierarchy. Estimates stratified by age, sex, location, and year from 1990 to 2023 were focused on disease-specific time trends over the 2010–23 period and presented as counts (to three significant figures) and age-standardised rates per 100 000 person-years (to one decimal place). For each measure, 95% uncertainty intervals [UIs] were calculated with the 2·5th and 97·5th percentile ordered values from a 250-draw distribution. Findings Total numbers of global DALYs grew 6·1% (95% UI 4·0–8·1), from 2·64 billion (2·46–2·86) in 2010 to 2·80 billion (2·57–3·08) in 2023, but age-standardised DALY rates, which account for population growth and ageing, decreased by 12·6% (11·0–14·1), revealing large long-term health improvements. Non-communicable diseases (NCDs) contributed 1·45 billion (1·31–1·61) global DALYs in 2010, increasing to 1·80 billion (1·63–2·03) in 2023, alongside a concurrent 4·1% (1·9–6·3) reduction in age-standardised rates. Based on DALY counts, the leading level 3 NCDs in 2023 were ischaemic heart disease (193 million [176–209] DALYs), stroke (157 million [141–172]), and diabetes (90·2 million [75·2–107]), with the largest increases in age-standardised rates since 2010 occurring for anxiety disorders (62·8% [34·0–107·5]), depressive disorders (26·3% [11·6–42·9]), and diabetes (14·9% [7·5–25·6]). Remarkable health gains were made for communicable, maternal, neonatal, and nutritional (CMNN) diseases, with DALYs falling from 874 million (837–917) in 2010 to 681 million (642–736) in 2023, and a 25·8% (22·6–28·7) reduction in age-standardised DALY rates. During the COVID-19 pandemic, DALYs due to CMNN diseases rose but returned to pre-pandemic levels by 2023. From 2010 to 2023, decreases in age-standardised rates for CMNN diseases were led by rate decreases of 49·1% (32·7–61·0) for diarrhoeal diseases, 42·9% (38·0–48·0) for HIV/AIDS, and 42·2% (23·6–56·6) for tuberculosis. Neonatal disorders and lower respiratory infections remained the leading level 3 CMNN causes globally in 2023, although both showed notable rate decreases from 2010, declining by 16·5% (10·6–22·0) and 24·8% (7·4–36·7), respectively. Injury-related age-standardised DALY rates decreased by 15·6% (10·7–19·8) over the same period. Differences in burden due to NCDs, CMNN diseases, and injuries persisted across age, sex, time, and location. Based on our risk analysis, nearly 50% (1·27 billion [1·18–1·38]) of the roughly 2·80 billion total global DALYs in 2023 were attributable to the 88 risk factors analysed in GBD. Globally, the five level 3 risk factors contributing the highest proportion of risk-attributable DALYs were high systolic blood pressure (SBP), particulate matter pollution, high fasting plasma glucose (FPG), smoking, and low birthweight and short gestation—with high SBP accounting for 8·4% (6·9–10·0) of total DALYs. Of the three overarching level 1 GBD risk factor categories—behavioural, metabolic, and environmental and occupational—risk-attributable DALYs rose between 2010 and 2023 only for metabolic risks, increasing by 30·7% (24·8–37·3); however, age-standardised DALY rates attributable to metabolic risks decreased by 6·7% (2·0–11·0) over the same period. For all but three of the 25 leading level 3 risk factors, age-standardised rates dropped between 2010 and 2023—eg, declining by 54·4% (38·7–65·3) for unsafe sanitation, 50·5% (33·3–63·1) for unsafe water source, and 45·2% (25·6–72·0) for no access to handwashing facility, and by 44·9% (37·3–53·5) for child growth failure. The three leading level 3 risk factors for which age-standardised attributable DALY rates rose were high BMI (10·5% [0·1 to 20·9]), drug use (8·4% [2·6 to 15·3]), and high FPG (6·2% [–2·7 to 15·6]; non-significant). Interpretation Our findings underscore the complex and dynamic nature of global health challenges. Since 2010, there have been large decreases in burden due to CMNN diseases and many environmental and behavioural risk factors, juxtaposed with sizeable increases in DALYs attributable to metabolic risk factors and NCDs in growing and ageing populations. This long-observed consequence of the global epidemiological transition was only temporarily interrupted by the COVID-19 pandemic. The substantially decreasing CMNN disease burden, despite the 2008 global financial crisis and pandemic-related disruptions, is one of the greatest collective public health successes known. However, these achievements are at risk of being reversed due to major cuts to development assistance for health globally, the effects of which will hit low-income countries with high burden the hardest. Without sustained investment in evidence-based interventions and policies, progress could stall or reverse, leading to widespread human costs and geopolitical instability. Moreover, the rising NCD burden necessitates intensified efforts to mitigate exposure to leading risk factors—eg, air pollution, smoking, and metabolic risks, such as high SBP, BMI, and FPG—including policies that promote food security, healthier diets, physical activity, and equitable and expanded access to potential treatments, such as GLP-1 receptor agonists. Decisive, coordinated action is needed to address long-standing yet growing health challenges, including depressive and anxiety disorders. Yet this can be only part of the solution. Our response to the NCD syndemic—the complex interaction of multiple health risks, social determinants, and systemic challenges—will define the future landscape of global health. To ensure human wellbeing, economic stability, and social equity, global action to sustain and advance health gains must prioritise reducing disparities by addressing socioeconomic and demographic determinants, ensuring equitable health-care access, tackling malnutrition, strengthening health systems, and improving vaccination coverage. We live in times of great opportunity. Funding Gates Foundation and Bloomberg Philanthropies. © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
(Elsevier B.V., 2024) Austin E. Schumacher; Hmwe Hmwe Kyu; Amirali Aali; Cristiana Abbafati; Jaffar Abbas; Rouzbeh Abbasgholizadeh; Madineh Akram Abbasi; Mohammadreza Abbasian; Samar Abd ElHafeez; Michael Abdelmasseh; Sherief Abd-Elsalam; Ahmed Abdelwahab; Mohammad Abdollahi; Meriem Abdoun; Auwal Abdullahi; Ame Mehadi Abdurehman; Mesfin Abebe; Aidin Abedi; Armita Abedi; Tadesse M. Abegaz; Roberto Ariel Abeldaño Zuñiga; E.S. Abhilash; Olugbenga Olusola Abiodun; Richard Gyan Aboagye; Hassan Abolhassani; Mohamed Abouzid; Lucas Guimarães Abreu; Woldu Aberhe Abrha; Michael R.M. Abrigo; Dariush Abtahi; Samir Abu Rumeileh; Niveen M.E. Abu-Rmeileh; Salahdein Aburuz; Ahmed Abu-Zaid; Juan Manuel Acuna; Tim Adair; Isaac Yeboah Addo; Oladimeji M. Adebayo; Oyelola A. Adegboye; Victor Adekanmbi; Bashir Aden; Abiola Victor Adepoju; Charles Oluwaseun Adetunji; Temitayo Esther Adeyeoluwa; Olorunsola Israel Adeyomoye; Rishan Adha; Amin Adibi; Wirawan Adikusuma; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Abel Afework; Aanuoluwapo Adeyimika Afolabi; Ali Afraz; Shadi Afyouni; Saira Afzal; Pradyumna Agasthi; Shahin Aghamiri; Antonella Agodi; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M. Ahmad; Tauseef Ahmad; Keivan Ahmadi; Amir Mahmoud Ahmadzade; Mohadese Ahmadzade; Ayman Ahmed; Haroon Ahmed; Luai A. Ahmed; Muktar Beshir Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Olufemi Ajumobi; Gizachew Taddesse Akalu; Essona Matatom Akara; Karolina Akinosoglou; Sreelatha Akkala; Samuel Akyirem; Hanadi Al Hamad; Syed Mahfuz Al Hasan; Ammar Al Homsi; Mohammad Al Qadire; Moein Ala; Timothy Olukunle Aladelusi; Tareq Mohammed Ali Al-Ahdal; Samer O. Alalalmeh; Ziyad Al-Aly; Khurshid Alam; Manjurul Alam; Zufishan Alam; Rasmieh Mustafa Al-Amer; Fahad Mashhour Alanezi; Turki M. Alanzi; Mohammed Albashtawy; Mohammad T. AlBataineh; Robert W. Aldridge; Sharifullah Alemi; Ayman Al-Eyadhy; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Fadwa Alhalaiqa Naji Alhalaiqa; Mohammed Khaled Al-Hanawi; Abid Ali; Akhtar Ali; Beriwan Abdulqadir Ali; Hassam Ali; Mohammed Usman Ali; Rafat Ali; Syed Shujait Shujait Ali; Zahid Ali; Shohreh Alian Samakkhah; Gianfranco Alicandro; Sheikh Mohammad Alif; Mohammad Aligol; Rasoul Alimi; Ahmednur Adem Aliyi; Adel Al-Jumaily; Syed Mohamed Aljunid; Wael Almahmeed; Sabah Al-Marwani; Sadeq Ali Ali Al-Maweri; Joseph Uy Almazan; Hesham M. Al-Mekhlafi; Omar Almidani; Mahmoud A. Alomari; Nivaldo Alonso; Jaber S. Alqahtani; Ahmed Yaseen Alqutaibi; Salman Khalifah Al-Sabah; Awais Altaf; Jaffar A. Al-Tawfiq; Khalid A. Altirkawi; Farrukh Jawad Alvi; Hassan Alwafi; Yaser Mohammed Al-Worafi; Hany Aly; Karem H. Alzoubi; Azmeraw T. Amare; Edward Kwabena Ameyaw; Abebe Feyissa Amhare; Tarek Tawfik Amin; Alireza Amindarolzarbi; Javad Aminian Dehkordi; Sohrab Amiri; Hubert Amu; Dickson A. Amugsi; Jimoh Amzat; Robert Ancuceanu; Deanna Anderlini; Pedro Prata Andrade; Catalina Liliana Andrei; Tudorel Andrei; Dhanalakshmi Angappan; Abhishek Anil; Afifa Anjum; Catherine M. Antony; Ernoiz Antriyandarti; Iyadunni Adesola Anuoluwa; Sumadi Lukman Anwar; Anayochukwu Edward Anyasodor; Seth Christopher Yaw Appiah; Muhammad Aqeel; Jalal Arabloo; Razman Arabzadeh Bahri; Morteza Arab-Zozani; Mosab Arafat; Ana Margarida Araújo; Aleksandr Y. Aravkin; Abdulfatai Aremu; Hany Ariffin; Timur Aripov; Benedetta Armocida; Mahwish Arooj; Anton A. Artamonov; Kurnia Dwi Artanti; Judie Arulappan; Idowu Thomas Aruleba; Raphael Taiwo Aruleba; Ashokan Arumugam; Malke Asaad; Saeed Asgary; Mubarek Yesse Ashemo; Muhammad Ashraf; Marvellous O. Asika; Seyyed Shamsadin Athari; Maha Moh'd Wahbi Atout; Alok Atreya; Sameh Attia; Avinash Aujayeb; Abolfazl Avan; Adedapo Wasiu Awotidebe; Beatriz Paulina Ayala Quintanilla; Martin Amogre Ayanore; Getnet Melaku Ayele; Jose L. Ayuso-Mateos; Seyed Mohammad Ayyoubzadeh; Sina Azadnajafabad; Gulrez Shah Azhar; Shahkaar Aziz; Ahmed Y. Azzam; Mina Babashahi; Abraham Samuel Babu; Muhammad Badar; Alaa Badawi; Ashish D. Badiye; Soroush Baghdadi; Nasser Bagheri; Sara Bagherieh; Sulaiman Bah; Saeed Bahadorikhalili; Jianjun Bai; Ruhai Bai; Jennifer L. Baker; Shankar M. Bakkannavar; Abdulaziz T. Bako; Senthilkumar Balakrishnan; Saliu A. Balogun; Ovidiu Constantin Baltatu; Kiran Bam; Maciej Banach; Soham Bandyopadhyay; Biswajit Banik; Palash Chandra Banik; Hansi Bansal; Shirin Barati; Martina Barchitta; Mainak Bardhan; Suzanne Lyn Barker-Collo; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Ronald D. Barr; Lope H. Barrero; Zarrin Basharat; Asma'u I.J. 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Gnedovskaya; Laszlo Göbölös; Amit Goel; Mohamad Goldust; Mahaveer Golechha; Pouya Goleij; Arefeh Golestanfar; Davide Golinelli; Philimon N. Gona; Houman Goudarzi; Amir Hossein Goudarzian; Anmol Goyal; Scott Greenhalgh; Michal Grivna; Giovanni Guarducci; Mohammed Ibrahim Mohialdeen Gubari; Mesay Dechasa Gudeta; Avirup Guha; Stefano Guicciardi; Damitha Asanga Gunawardane; Sasidhar Gunturu; Cui Guo; Anish Kumar Gupta; Bhawna Gupta; Indarchand Ratanlal Gupta; Rajat Das Gupta; Sapna Gupta; Veer Bala Gupta; Vijai Kumar Gupta; Vivek Kumar Gupta; Reyna Alma Gutiérrez; Farrokh Habibzadeh; Parham Habibzadeh; Vladimir Hachinski; Mohammad Haddadi; Rasool Haddadi; Nils Haep; Adel Hajj Ali; Esam S. Halboub; Sobia Ahsan Halim; Brian J. Hall; Sebastian Haller; Rabih Halwani; Randah R. Hamadeh; Kanaan Hamagharib Abdullah; Samer Hamidi; Mohammad Hamiduzzaman; Ahmad Hammoud; Nasrin Hanifi; Graeme J. Hankey; Md Abdul Hannan; Md Nuruzzaman Haque; Harapan Harapan; Josep Maria Haro; Ahmed I. Hasaballah; Faizul Hasan; Ikramul Hasan; M Tasdik Hasan; Hamidreza Hasani; Mohammad Hasanian; Ali Hasanpour-Dehkordi; Abbas M. Hassan; Amr Hassan; Hossein Hassanian-Moghaddam; Soheil Hassanipour; Johannes Haubold; Rasmus J. Havmoeller; Simon I. Hay; Youssef Hbid; Jeffrey J. Hebert; Omar E. Hegazi; Golnaz Heidari; Mohammad Heidari; Mahsa Heidari-Foroozan; Reza Heidari-Soureshjani; Bartosz Helfer; Claudiu Herteliu; Hamed Hesami; Dineshani Hettiarachchi; Demisu Zenbaba Heyi; Kamal Hezam; Yuta Hiraike; Howard J. Hoffman; Ramesh Holla; Nobuyuki Horita; Md Belal Hossain; Md Mahbub Hossain; Sahadat Hossain; Mohammad-Salar Hosseini; Hassan Hosseinzadeh; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mohamed Hsairi; Vivian Chia-Rong Hsieh; Chengxi Hu; Junjie Huang; Md Nazmul Huda; Fernando N. Hugo; Michael Hultström; Javid Hussain; Salman Hussain; Nawfal R. Hussein; Le Duc Huy; Hong-Han Huynh; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Oluwatope Olaniyi Idowu; Desta Ijo; Kevin S. Ikuta; Mehran Ilaghi; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mustapha Immurana; Leeberk Raja Inbaraj; Arnaud Iradukunda; Farideh Iravanpour; Kenneth Chukwuemeka Iregbu; Md Rabiul Islam; Mohammad Mainul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Nahlah Elkudssiah Ismail; Gaetano Isola; Masao Iwagami; Chidozie C.D. Iwu; Chinwe Juliana Iwu-Jaja; Mahalaxmi Iyer; Linda Merin; Jalil Jaafari; Louis Jacob; Kathryn H. Jacobsen; Farhad Jadidi-Niaragh; Morteza Jafarinia; Khushleen Jaggi; Kasra Jahankhani; Nader Jahanmehr; Haitham Jahrami; Akhil Jain; Nityanand Jain; Ammar Abdulrahman Jairoun; Mihajlo Jakovljevic; Reza Jalilzadeh Yengejeh; Elham Jamshidi; Chinmay T. Jani; Mark M. Janko; Abubakar Ibrahim Jatau; Sathish Kumar Jayapal; Shubha Jayaram; Jayakumar Jeganathan; Alelign Tasew Jema; Digisie Mequanint Jemere; Wonjeong Jeong; Anil K. Jha; Ravi Prakash Jha; John S. Ji; Heng Jiang; Yingzhao Jin; Yinzi Jin; Olatunji Johnson; Nabi Jomehzadeh; Darwin Phan Jones; Tamas Joo; Abel Joseph; Nitin Joseph; Charity Ehimwenma Joshua; Jacek Jerzy Jozwiak; Mikk Jürisson; Billingsley Kaambwa; Ali Kabir; Hannaneh Kabir; Zubair Kabir; Vidya Kadashetti; Farima Kahe; Pradnya Vishal Kakodkar; Rizwan Kalani; Leila R. Kalankesh; Feroze Kaliyadan; Sanjay Kalra; Ashwin Kamath; Arun Kamireddy; Thanigaivelan Kanagasabai; Himal Kandel; Edmund Wedam Kanmiki; Kehinde Kazeem Kanmodi; Rami S. Kantar; Neeti Kapoor; Mehrdad Karajizadeh; Behzad Karami Matin; Shama D. Karanth; Ibraheem M. Karaye; Asima Karim; Hanie Karimi; Salah Eddin Karimi; Arman Karimi Behnagh; Samad Karkhah; Ajit K. Karna; Faizan Zaffar Kashoo; Hengameh Kasraei; Nigussie Assefa Kassaw; Nicholas J. Kassebaum; Molly B. Kassel; Adarsh Katamreddy; Srinivasa Vittal Katikireddi; Patrick D.M.C. Katoto; Joonas H. Kauppila; Navjot Kaur; Neda Kaydi; Jeanne Françoise Kayibanda; Gbenga A. 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Kinzel; Girmay Tsegay Kiross; Adnan Kisa; Sezer Kisa; Juniper Boroka Kiss; Mika Kivimäki; Desmond Klu; Ann Kristin Skrindo Knudsen; Ali-Asghar Kolahi; Farzad Kompani; Gerbrand Koren; Soewarta Kosen; Karel Kostev; Ashwin Laxmikant Kotnis; Parvaiz A. Koul; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Michael A. Kravchenko; Kewal Krishan; Hare Krishna; Vijay Krishnamoorthy; Yuvaraj Krishnamoorthy; Kris J. Krohn; Barthelemy Kuate Defo; Connor M. Kubeisy; Burcu Kucuk Bicer; Md Abdul Kuddus; Mohammed Kuddus; Ilari Kuitunen; Omar Kujan; Mukhtar Kulimbet; Vishnutheertha Kulkarni; Ashish Kumar; Harish Kumar; Nithin Kumar; Rahul Kumar; Shiv Kumar; Madhulata Kumari; Almagul Kurmanova; Om P. Kurmi; Asep Kusnali; Dian Kusuma; Tezer Kutluk; Ambily Kuttikkattu; Evans F. 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Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
(Elsevier B.V., 2024) Mohsen Naghavi; Kanyin Liane Ong; Amirali Aali; Hazim S. Ababneh; Yohannes Habtegiorgis Abate; Cristiana Abbafati; Rouzbeh Abbasgholizadeh; Mohammadreza Abbasian; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Samar Abd ElHafeez; Michael Abdelmasseh; Sherief Abd-Elsalam; Ahmed Abdelwahab; Mohammad Abdollahi; Mohammad-Amin Abdollahifar; Meriem Abdoun; Deldar Morad Abdulah; Auwal Abdullahi; Mesfin Abebe; Samrawit Shawel Abebe; Aidin Abedi; Kedir Hussein Abegaz; E.S. Abhilash; Hassan Abidi; Olumide Abiodun; Richard Gyan Aboagye; Hassan Abolhassani; Meysam Abolmaali; Mohamed Abouzid; Girma Beressa Aboye; Lucas Guimaraes Abreu; Woldu Aberhe Abrha; Dariush Abtahi; Samir Abu Rumeileh; Hasan Abualruz; Bilyaminu Abubakar; Eman Abu-Gharbieh; Niveen Me Abu-Rmeileh; Salahdein Aburuz; Ahmed Abu-Zaid; Manfred Mario Kokou Accrombessi; Tadele Girum Adal; Abdu A. Adamu; Isaac Yeboah Addo; Giovanni Addolorato; Akindele Olupelumi Adebiyi; Victor Adekanmbi; Abiola Victor Adepoju; Charles Oluwaseun Adetunji; Juliana Bunmi Adetunji; Temitayo Esther Adeyeoluwa; Daniel Adedayo Adeyinka; Olorunsola Israel Adeyomoye; Biruk Adie Admass; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Aanuoluwapo Adeyimika Afolabi; Muhammad Sohail Afzal; Saira Afzal; Suneth Buddhika Agampodi; Pradyumna Agasthi; Manik Aggarwal; Shahin Aghamiri; Feleke Doyore Agide; Antonella Agodi; Anurag Agrawal; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M Ahmad; Sajjad Ahmad; Shahzaib Ahmad; Tauseef Ahmad; Keivan Ahmadi; Amir Mahmoud Ahmadzade; Ali Ahmed; Ayman Ahmed; Haroon Ahmed; Luai A. 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Alhabib; Fadwa Alhalaiqa Naji Alhalaiqa; Mohammed Khaled Al-Hanawi; Abid Ali; Amjad Ali; Liaqat Ali; Mohammed Usman Ali; Rafat Ali; Shahid Ali; Syed Shujait Shujait Ali; Gianfranco Alicandro; Sheikh Mohammad Alif; Reyhaneh Alikhani; Yousef Alimohamadi; Ahmednur Adem Aliyi; Mohammad A. M. Aljasir; Syed Mohamed Aljunid; Francois Alla; Peter Allebeck; Sabah Al-Marwani; Sadeq Ali Ali Al-Maweri; Joseph Uy Almazan; Hesham M. Al-Mekhlafi; Louay Almidani; Omar Almidani; Mahmoud A. Alomari; Basem Al-Omari; Jordi Alonso; Jaber S. Alqahtani; Shehabaldin Alqalyoobi; Ahmed Yaseen Alqutaibi; Salman Khalifah Al-Sabah; Zaid Altaany; Awais Altaf; Jaffar A. Al-Tawfiq; Khalid A. Altirkawi; Deborah Oyine Aluh; Nelson Alvis-Guzman; Hassan Alwafi; Yaser Mohammed Al-Worafi; Hany Aly; Safwat Aly; Karem H. Alzoubi; Reza Amani; Azmeraw T. Amare; Prince M. Amegbor; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Alireza Amindarolzarbi; Sohrab Amiri; Mohammad Hosein Amirzade-Iranaq; Hubert Amu; Dickson A. Amugsi; Ganiyu Adeniyi Amusa; Robert Ancuceanu; Deanna Anderlini; David B. Anderson; Pedro Prata Andrade; Catalina Liliana Andrei; Tudorel Andrei; Colin Angus; Abhishek Anil; Sneha Anil; Amir Anoushiravani; Hossein Ansari; Ansariadi Ansariadi; Alireza Ansari-Moghaddam; Catherine M. Antony; Ernoiz Antriyandarti; Davood Anvari; Saeid Anvari; Saleha Anwar; Sumadi Lukman Anwar; Razique Anwer; Anayochukwu Edward Anyasodor; Muhammad Aqeel; Juan Pablo Arab; Jalal Arabloo; Mosab Arafat; Aleksandr Y. Aravkin; Demelash Areda; Abdulfatai Aremu; Olatunde Aremu; Hany Ariffin; Mesay Arkew; Benedetta Armocida; Michael Benjamin Arndt; Johan Arnlov; Mahwish Arooj; Anton A. Artamonov; Judie Arulappan; Raphael Taiwo Aruleba; Ashokan Arumugam; Malke Asaad; Mohsen Asadi-Lari; Akeza Awealom Asgedom; Mona Asghariahmadabad; Mohammad Asghari-Jafarabadi; Muhammad Ashraf; Armin Aslani; Thomas Astell-Burt; Mohammad Athar; Seyyed Shamsadin Athari; Bantalem Tilaye Tilaye Atinafu; Habtamu Wondmagegn Atlaw; Prince Atorkey; Maha Moh'D Wahbi Atout; Alok Atreya; Avinash Aujayeb; Marcel Ausloos; Abolfazl Avan; Atalel Fentahun Awedew; Amlaku Mulat Aweke; Beatriz Paulina Ayala Quintanilla; Haleh Ayatollahi; Jose L. Ayuso-Mateos; Seyed Mohammad Ayyoubzadeh; Sina Azadnajafabad; Rui M. S. Azevedo; Ahmed Y. Azzam; B.B. Darshan; Abraham Samuel Babu; Muhammad Badar; Ashish D. Badiye; Soroush Baghdadi; Nasser Bagheri; Sara Bagherieh; Sulaiman Bah; Saeed Bahadorikhalili; Najmeh Bahmanziari; Ruhai Bai; Atif Amin Baig; Jennifer L. Baker; Abdulaziz T. 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Ashworth Dirac; Shirin Djalalinia; Thao Huynh Phuong Do; Camila Bruneli Do Prado; Saeid Doaei; Masoud Dodangeh; Milad Dodangeh; Sushil Dohare; Klara Georgieva Dokova; Christiane Dolecek; Regina-Mae Villanueva Dominguez; Wanyue Dong; Deepa Dongarwar; Mario D'Oria; Fariba Dorostkar; E. Ray Dorsey; Wendel Mombaque Dos Santos; Rajkumar Doshi; Leila Doshmangir; Robert Kokou Dowou; Tim Robert Driscoll; Haneil Larson Dsouza; Viola Dsouza; Mi Du; John Dube; Bruce B. Duncan; Andre Rodrigues Duraes; Senbagam Duraisamy; Oyewole Christopher Durojaiye; Laura Dwyer-Lindgren; Paulina Agnieszka Dzianach; Arkadiusz Marian Dziedzic; Abdel Rahman E'Mar; Ejemai Eboreime; Alireza Ebrahimi; Chidiebere Peter Echieh; Hisham Atan Edinur; David Edvardsson; Kristina Edvardsson; Defi Efendi; Ferry Efendi; Diyan Ermawan Effendi; Terje Andreas Eikemo; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Iman El Sayed; Iffat Elbarazi; Teshome Bekele Elema; Noha Mousaad Elemam; Frank J. Elgar; Islam Y. Elgendy; Ghada Metwally Tawfik ElGohary; Hala Rashad Elhabashy; Muhammed Elhadi; Waseem El-Huneidi; Legesse Tesfaye Elilo; Omar Abdelsadek Abdou Elmeligy; Mohamed A. Elmonem; Mohammed Elshaer; Ibrahim Elsohaby; Theophilus I. Emeto; Luchuo Engelbert Bain; Ryenchindorj Erkhembayar; Christopher Imokhuede Esezobor; Babak Eshrati; Sharareh Eskandarieh; Juan Espinosa-Montero; Habtamu Esubalew; Farshid Etaee; Natalia Fabin; Adewale Oluwaseun Fadaka; Adeniyi Francis Fagbamigbe; Ayesha Fahim; Saman Fahimi; Aliasghar Fakhri-Demeshghieh; Luca Falzone; Mohammad Fareed; Carla Sofia E Sa Farinha; Moezalislam Ezzat Mahmoud Faris; Pawan Sirwan Faris; Andre Faro; Abidemi Omolara Fasanmi; Ali Fatehizadeh; Hamed Fattahi; Nelsensius Klau Fauk; Pooria Fazeli; Valery L. Feigin; Alireza Feizkhah; Ginenus Fekadu; Xiaoru Feng; Seyed-Mohammad Fereshtehnejad; Abdullah Hamid Feroze; Daniela Ferrante; Alize J. 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Background: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings: The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation: Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
(Elsevier B.V., 2020) Cristiana Abbafati; Kaja M. Abbas; Mohammad Abbasi; Mitra Abbasifard; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Foad Abd-Allah; Ahmed Abdelalim; Mohammad Abdollahi; Ibrahim Abdollahpour; Aidin Abedi; Parisa Abedi; Kedir Hussein Abegaz; Hassan Abolhassani; Akine Eshete Abosetugn; Victor Aboyans; Elissa M. Abrams; Lucas Guimarães Abreu; Michael R.M. Abrigo; Abdulaziz Khalid Abu Haimed; Ahmed Abualhasan; Eman Abu-Gharbieh; Laith Jamal Abu-Raddad; Abdelrahman I. Abushouk; Alyssa Acebedo; Ilana N. Ackerman; Maryam Adabi; Tim Adair; Abdu A. Adamu; Oladimeji M. Adebayo; Isaac Akinkunmi Adedeji; Victor Adekanmbi; Jaimie D. Adelson; Abiodun Moshood Adeoye; Olatunji O. Adetokunboh; Davoud Adham; Shailesh M. Advani; Mohsen Afarideh; Mahdi Afshari; Ashkan Afshin; Emilie E. Agardh; Gina Agarwal; Pradyumna Agasthi; Kareha M. Agesa; Mohammad Aghaali; Seyed Mohammad Kazem Aghamir; Anurag Agrawal; Tauseef Ahmad; Alireza Ahmadi; Keivan Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Ehsan Ahmadpour; Muktar Beshir Ahmed; Budi Aji; Temesgen Yihunie Akalu; Rufus Olusola Akinyemi; Tomi Akinyemiju; Blessing Akombi; Chisom Joyqueenet Akunna; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Noore Alam; Samiah Alam; Tahiya Alam; Fahad Mashhour Alanezi; Turki M. Alanzi; Samuel B. Albertson; Jacqueline Elizabeth Alcalde-Rabanal; Niguse Meles Alema; Biresaw Wassihun Alemu; Yihun Mulugeta Alemu; Khalid F. Alhabib; Robert Kaba Alhassan; Muhammad Ali; Saqib Ali; Gianfranco Alicandro; Mehran Alijanzadeh; Cyrus Alinia; Vahid Alipour; Hesam Alizade; Syed Mohamed Aljunid; François Alla; Peter Allebeck; Majid Abdulrahman Hamad Almadi; Ali Almasi; Amir Almasi-Hashiani; Nihad A. Almasri; Hesham M. Al-Mekhlafi; Abdulaziz M. Almulhim; Jordi Alonso; Rajaa M. Al-Raddadi; Khalid A. Altirkawi; Arwa Khalid Alumran; Nelson Alvis-Guzman; Nelson J. 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Cooper; Barbara Corso; Paolo Angelo Cortesi; Vera Marisa Costa; Ewerton Cousin; Richard G. Cowden; Benjamin C. Cowie; Elizabeth A. Cromwell; Andrew J. Croneberger; Di H. Cross; Marita Cross; Christopher Stephen Crowe; Jessica A. Cruz; Steven Cummins; Matthew Cunningham; Saad M.A. Dahlawi; Haijiang Dai; Hancheng Dai; Albertino Antonio Moura Damasceno; Giovanni Damiani; Emanuele D'Amico; Lalit Dandona; Rakhi Dandona; Parnaz Daneshpajouhnejad; William James Dangel; Anna-Karin Danielsson; Jiregna Darega Gela; Paul I. Dargan; Aso Mohammad Darwesh; Ahmad Daryani; Jai K. Das; Rajat Das Gupta; José das Neves; Aditya Prasad Dash; Gail Davey; Claudio Alberto Dávila-Cervantes; Adrian C. Davis; Dragos Virgil Davitoiu; Kairat Davletov; Diego De Leo; Jan-Walter De Neve; Frances E. Dean; Nicole K. DeCleene; Amanda Deen; Louisa Degenhardt; Marissa DeLang; Robert Paul Dellavalle; Feleke Mekonnen Demeke; Gebre Teklemariam Demoz; Desalegn Getnet Demsie; Edgar Denova-Gutiérrez; Nebiyu Dereje Dereje; Kebede Deribe; Nikolaos Dervenis; Rupak Desai; Assefa Desalew; Getenet Ayalew Dessie; Keshab Deuba; Samath Dhamminda Dharmaratne; Govinda Prasad Dhungana; Mostafa Dianatinasab; Diana Dias da Silva; Daniel Diaz; Zahra Sadat Dibaji Forooshani; Martin Dichgans; Alireza Didarloo; Zachary V. Dingels; Ilse N. Dippenaar; M. Ashworth Dirac; Shirin Djalalinia; Hoa Thi Do; Klara Dokova; David Teye Doku; Christiane Dolecek; Andrew J. Dolgert; Fariba Dorostkar; Chirag P. Doshi; Pratik P. Doshi; Leila Doshmangir; Abdel Douiri; Matthew C. Doxey; Kerrie E. Doyle; Tim Robert Driscoll; Eleonora Dubljanin; Susanna J. Dunachie; Bruce B. Duncan; Andre Rodrigues Duraes; Arielle Wilder Eagan; Hedyeh Ebrahimi; Mohammad Ebrahimi Kalan; David Edvardsson; Andem Effiong; Joshua R. Ehrlich; Nevine El Nahas; Iman El Sayed; Maysaa El Sayed Zaki; Maha El Tantawi; Iffat Elbarazi; Islam Y. Elgendy; Hala Rashad Elhabashy; Shaimaa I. El-Jaafary; Aisha Elsharkawy; Iqbal R.F. Elyazar; Mohammad Hassan Emamian; Sophia Emmons-Bell; Holly E. Erskine; Babak Eshrati; Khalil Eskandari; Sharareh Eskandarieh; Saman Esmaeilnejad; Firooz Esmaeilzadeh; Alireza Esteghamati; Sadaf Esteghamati; Kara Estep; Arash Etemadi; Atkilt Esaiyas Etisso; Oluchi Ezekannagha; Jessica Fanzo; Tamer Farag; Mohammad Farahmand; Anwar Faraj; Emerito Jose A. Faraon; Mohammad Fareed; Roghiyeh Faridnia; Carla Sofia e Sá Farinha; Andrea Farioli; Pawan Sirwan Faris; Andre Faro; Mithila Faruque; Farshad Farzadfar; Nazir Fattahi; Ali Akbar Fazaeli; Mehdi Fazlzadeh; Valery L. Feigin; Rachel Feldman; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Giannina Ferrara; Pietro Ferrara; Alize J. Ferrari; Manuela L. Ferreira; Garumma Tolu Feyissa; Irina Filip; Florian Fischer; James L. Fisher; Ryan Fitzgerald; Carsten Flohr; Luisa Sorio Flor; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Lisa M. Force; Carla Fornari; Masoud Foroutan; Jack T. Fox; Joel Msafiri Francis; Tahvi D. Frank; Richard Charles Franklin; Marisa Freitas; Weijia Fu; Takeshi Fukumoto; Kai Fukutaki; John E. Fuller; Nancy Fullman; João M. Furtado; Mohamed M. Gad; Abhay Motiramji Gaidhane; Emmanuela Gakidou; Natalie C. Galles; Silvano Gallus; Amiran Gamkrelidze; Alberto L. Garcia-Basteiro; William M. Gardner; Biniyam Sahiledengle Geberemariyam; Abiyu Mekonnen Gebrehiwot; Ketema Bizuwork Gebremedhin; Gebreamlak Gebremedhn Gebremeskel; Leake G. Gebremeskel; Begashaw Melaku Gebresillassie; Assefa Ayalew Ayalew Ayalew Gebreslassie; Yilma Chisha Dea Geramo; Abraham Geremew; Anna Gershberg Hayoon; Hailay Abrha Gesesew; Peter W. Gething; Kebede Embaye Gezae; Maryam Ghadimi; Keyghobad Ghadiri; Fatemeh Ghaffarifar; Mansour Ghafourifard; Alireza Ghajar; Farhad Ghamari; Ahmad Ghashghaee; Hesam Ghiasvand; Nermin Ghith; Asadollah Gholamian; Rakesh Ghosh; Simona Giampaoli; Syed Amir Gilani; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Ibrahim Abdelmageed Ginawi; Themba G. Ginindza; Mojgan Gitimoghaddam; Giorgia Giussani; Mustefa Glagn; Ekaterina Vladimirovna Glushkova; Elena V. Gnedovskaya; Myron Anthony Godinho; Salime Goharinezhad; Mahaveer Golechha; Srinivas Goli; Ricardo Santiago Gomez; Philimon N. Gona; Sameer Vali Gopalani; Emily Goren; Giuseppe Gorini; Taren M. Gorman; Harrison Chase Gottlich; Houman Goudarzi; Amir Hossein Goudarzian; Alessandra C. Goulart; Bárbara Niegia Garcia Goulart; Ayman Grada; Felix Greaves; Michal Grivna; Giuseppe Grosso; Mohammed Ibrahim Mohialdeen Gubari; Nachiket Gudi; Harish Chander Gugnani; Andre Luiz Sena Guimaraes; Rafael Alves Guimarães; Rashid Abdi Guled; Teklemariam Gultie; Gaorui Guo; Yuming Guo; Rahul Gupta; Rajeev Gupta; Subodh Sharan Gupta; Tarun Gupta; Juanita A. Haagsma; Vladimir Hachinski; Beatrix Haddock; Nima Hafezi-Nejad; Abdul Hafiz; Hailey Hagins; Lydia M. Haile; Teklehaimanot Gereziher Haile; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Brian J. Hall; Iman Halvaei; Randah R. Hamadeh; Kanaan Hamagharib Abdullah; Sajid Hameed; Samer Hamidi; Erin B. Hamilton; Melanie S. Hammer; Chieh Han; Hannah Han; Demelash Woldeyohannes Handiso; Asif Hanif; Graeme J. Hankey; Hamidreza Haririan; Josep Maria Haro; James D. Harvey; Ahmed I. Hasaballah; Md Mehedi Hasan; Edris Hasanpoor; Amir Hasanzadeh; Maryam Hashemian; Abdiwahab Hashi; Amr Hassan; Shoaib Hassan; Soheil Hassanipour; Hadi Hassankhani; Rasmus J. Havmoeller; Roderick J. Hay; Simon I. Hay; Khezar Hayat; Behzad Heibati; Behnam Heidari; Golnaz Heidari; Reza Heidari-Soureshjani; Delia Hendrie; Kiana Henny; Andualem Henok; Hannah J. Henrikson; Nathaniel J. Henry; Molly E. Herbert; Claudiu Herteliu; Fatemeh Heydarpour; Thomas R. Hird; Hung Chak Ho; Hans W. Hoek; Michael K. Hole; Ramesh Holla; Bruce Hollingsworth; Praveen Hoogar; Kathleen Pillsbury Hopf; Nobuyuki Horita; H. Dean Hosgood; Naznin Hossain; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Damian G. Hoy; Mohamed Hsairi; Thomas Hsiao; Vivian Chia-Rong Hsieh; Guoqing Hu; Kejia Hu; Tanvir M. Huda; Fernando N. Hugo; Ayesha Humayun; Rabia Hussain; Chantal K. Huynh; Bing-Fang Hwang; Vincent C. Iannucci; Ivo Iavicoli; Charles Ugochukwu Ibeneme; Segun Emmanuel Ibitoye; Nayu Ikeda; Kevin S. Ikuta; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mohammad Hasan Imani-Nasab; Leeberk Raja Inbaraj; Helen Ippolito; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; M. Mofizul Islam; Md. Mohaimenul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Hiroyasu Iso; Rebecca Q. Ivers; Chidozie C.D. Iwu; Chinwe Juliana Iwu; Ihoghosa Osamuyi Iyamu; Jalil Jaafari; Kathryn H. Jacobsen; Farhad Jadidi-Niaragh; Hussain Jafari; Morteza Jafarinia; Deepa Jahagirdar; Mohammad Ali Jahani; Nader Jahanmehr; Mihajlo Jakovljevic; Amir Jalali; Farzad Jalilian; Spencer L. James; Hosna Janjani; Manthan Dilipkumar Janodia; Tahereh Javaheri; Javad Javidnia; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Ensiyeh Jenabi; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Peng Jia; Lars Johansson; Oommen John; Yetunde O. John-Akinola; Catherine Owens Johnson; Sarah Charlotte Johnson; Jost B. Jonas; Tamas Joo; Ankur Joshi; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; Ali Kabir; Zubair Kabir; Hamed Kalani; Rizwan Kalani; Leila R. Kalankesh; Rohollah Kalhor; Aruna M. Kamath; Zahra Kamiab; Tanuj Kanchan; Neeti Kapoor; Behzad Karami Matin; Marina Karanikolos; André Karch; Mohd Anisul Karim; Salah Eddin Karimi; Seyed Asaad Karimi; Seyed M. Karimi; Ayele Semachew Kasa; Getachew Mullu Kassa; Nicholas J. Kassebaum; Srinivasa Vittal Katikireddi; Norito Kawakami; Gbenga A. Kayode; Ali Kazemi Karyani; Suzanne H. Keddie; Peter Njenga Keiyoro; Cathleen Keller; Laura Kemmer; Parkes J. Kendrick; Maia Kereselidze; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Nauman Khalid; Mohammad Khammarnia; Ejaz Ahmad Khan; Gulfaraz Khan; Maseer Khan; Young-Ho Khang; Khaled Khatab; Amir M. Khater; Mona M. Khater; Mahalaqua Nazli Khatib; Maryam Khayamzadeh; Salman Khazaei; Habibolah Khazaie; Mohammad Taghi Khodayari; Abdullah T. Khoja; Jagdish Khubchandani; Roba Khundkar; Neda Kianipour; Christian Kieling; Cho-Il Kim; Daniel Kim; Young-Eun Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Adnan Kisa; Sezer Kisa; Katarzyna Kissimova-Skarbek; Niranjan Kissoon; Mika Kivimäki; Cameron J. Kneib; Luke D. Knibbs; Megan Knight; Ann Kristin Skrindo Knudsen; Jonathan M. Kocarnik; Sonali Kochhar; David S.Q. Koh; Stefan Kohler; Tufa Kolola; Hamidreza Komaki; Jacek A. Kopec; Anna V. Korotkova; Vladimir Andreevich Korshunov; Soewarta Kosen; Anirudh Kotlo; Parvaiz A. Koul; Ai Koyanagi; Moritz U.G. Kraemer; Michael A. Kravchenko; Kewal Krishan; Kris J. Krohn; Hans Kromhout; K.S. Shaji; Barthelemy Kuate Defo; Burcu Bicer Kucuk; Nuworza Kugbey; Vaman Kulkarni; G. Anil Kumar; Manasi Kumar; Nithin Kumar; Pushpendra Kumar; Vivek Kumar; Girikumar Kumaresh; Om P. Kurmi; Dian Kusuma; Hmwe Hmwe Kyu; Carlo La Vecchia; Ben Lacey; Dharmesh Kumar Lal; Ratilal Lalloo; Tea Lallukka; Jennifer O. Lam; Faris Hasan Lami; Qing Lan; Iván Landires; Justin J. Lang; Sinéad M. Langan; Van Charles Lansingh; Sonia Lansky; Heidi Jane Larson; Samantha Leigh Larson; Anders O. Larsson; Savita Lasrado; Zohra S. Lassi; Kathryn Mei-Ming Lau; Paolo Lauriola; Pablo M. Lavados; Jeffrey V. Lazarus; Lisiane F. Leal; Janet L. Leasher; Jorge R. Ledesma; Paul H. Lee; Shaun Wen Huey Lee; Andrew T. Leever; Kate E. LeGrand; James Leigh; Matilde Leonardi; Haley Lescinsky; Janni Leung; Miriam Levi; Sarah Lewington; Bingyu Li; Shanshan Li; Lee-Ling Lim; Christine Lin; Ro-Ting Lin; Christine Linehan; Shai Linn; Stefan Listl; Hung-Chun Liu; Shiwei Liu; Simin Liu; Xuefeng Liu; Yang Liu; Zichen Liu; Justin Lo; Rakesh Lodha; Giancarlo Logroscino; Katharine J. Looker; Alan D. Lopez; Jaifred Christian F. Lopez; Platon D. Lopukhov; Stefan Lorkowski; Paulo A. Lotufo; Rafael Lozano; Alton Lu; Tim C.D. Lucas; Alessandra Lugo; Raimundas Lunevicius; Ronan A. Lyons; Jianing Ma; Daiane Borges Machado; Jennifer H. MacLachlan; Mohammed Madadin; Emilie R. Maddison; Ralph Maddison; Fabiana Madotto; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Phetole Walter Mahasha; Mokhtar Mahdavi Mahdavi; Morteza Mahmoudi; Hue Thi Mai; Azeem Majeed; Jeadran N. Malagón-Rojas; Venkatesh Maled; Afshin Maleki; Shokofeh Maleki; Reza Malekzadeh; Deborah Carvalho Malta; Abdullah A. Mamun; Amir Manafi; Navid Manafi; Ana Laura Manda; Helena Manguerra; Fariborz Mansour-Ghanaei; Borhan Mansouri; Mohammad Ali Mansournia; Ana M. Mantilla Herrera; Chabila Christopher Mapoma; Joemer C. Maravilla; Ashley Marks; Randall V. Martin; Santi Martini; Francisco Rogerlândio Martins-Melo; Ira Martopullo; Anthony Masaka; Seyedeh Zahra Masoumi; João Massano; Benjamin Ballard Massenburg; Claudia I. Mastrogiacomo; Manu Raj Mathur; Kunihiro Matsushita; Pallab K. Maulik; Erin A. May; Mohsen Mazidi; Colm McAlinden; John J. McGrath; Martin McKee; Carlo Eduardo Medina-Solís; Birhanu Geta Meharie; Man Mohan Mehndiratta; Entezar Mehrabi Nasab; Fereshteh Mehri; Ravi Mehrotra; Kala M. Mehta; Wahengbam Bigyananda Meitei; Teferi Mekonnen; Addisu Melese; Peter T.N. Memiah; Ziad A. Memish; Walter Mendoza; Ritesh G. Menezes; Endalkachew Worku Mengesha; Meresa Berwo Mengesha; George A. Mensah; Alibek Mereke; Seid Tiku Mereta; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Bartosz Miazgowski; Tomasz Miazgowski; Irmina Maria Michalek; Kebadnew Mulatu Mihretie; Ted R. Miller; Edward J. Mills; George J. Milne; G.K. Mini; Mohammad Miri; Andreea Mirica; Erkin M. Mirrakhimov; Hamed Mirzaei; Maryam Mirzaei; Roya Mirzaei; Mehdi Mirzaei-Alavijeh; Awoke Temesgen Misganaw; Philip B. Mitchell; Prasanna Mithra; Babak Moazen; Masoud Moghadaszadeh; Bahram Mohajer; Osama Mohamad; Efat Mohamadi; Dara K. Mohammad; Yousef Mohammad
Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
(Elsevier B.V., 2020) Cristiana Abbafati; Kaja M. Abbas; Mohsen Abbasi-Kangevari; Foad Abd-Allah; Ahmed Abdelalim; Mohammad Abdollahi; Ibrahim Abdollahpour; Kedir Hussein Abegaz; Hassan Abolhassani; Victor Aboyans; Lucas Guimarães Abreu; Michael R.M. Abrigo; Ahmed Abualhasan; Laith Jamal Abu-Raddad; Abdelrahman I. Abushouk; Maryam Adabi; Victor Adekanmbi; Abiodun Moshood Adeoye; Olatunji O. Adetokunboh; Davoud Adham; Shailesh M. Advani; Ashkan Afshin; Gina Agarwal; Seyed Mohammad Kazem Aghamir; Anurag Agrawal; Tauseef Ahmad; Keivan Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Muktar Beshir Ahmed; Temesgen Yihunie Akalu; Rufus Olusola Akinyemi; Tomi Akinyemiju; Blessing Akombi; Chisom Joyqueenet Akunna; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Samiah Alam; Tahiya Alam; Fahad Mashhour Alanezi; Turki M. Alanzi; Biresaw Wassihun Alemu; Khalid F. Alhabib; Muhammad Ali; Saqib Ali; Gianfranco Alicandro; Cyrus Alinia; Vahid Alipour; Hesam Alizade; Syed Mohamed Aljunid; François Alla; Peter Allebeck; Amir Almasi-Hashiani; Hesham M. Al-Mekhlafi; Jordi Alonso; Khalid A. Altirkawi; Mostafa Amini-Rarani; Fatemeh Amiri; Dickson A. Amugsi; Robert Ancuceanu; Deanna Anderlini; Jason A. Anderson; Catalina Liliana Andrei; Tudorel Andrei; Colin Angus; Mina Anjomshoa; Fereshteh Ansari; Alireza Ansari-Moghaddam; Ippazio Cosimo Antonazzo; Carl Abelardo T. Antonio; Catherine M. Antony; Ernoiz Antriyandarti; Davood Anvari; Razique Anwer; Seth Christopher Yaw Appiah; Jalal Arabloo; Morteza Arab-Zozani; Aleksandr Y. Aravkin; Filippo Ariani; Bahram Armoon; Johan Ärnlöv; Afsaneh Arzani; Mehran Asadi-Aliabadi; Ali A. Asadi-Pooya; Charlie Ashbaugh; Michael Assmus; Zahra Atafar; Desta Debalkie Atnafu; Maha Moh'd Wahbi Atout; Floriane Ausloos; Marcel Ausloos; Beatriz Paulina Ayala Quintanilla; Getinet Ayano; Martin Amogre Ayanore; Samad Azari; Ghasem Azarian; Zelalem Nigussie Azene; Alaa Badawi; Ashish D. Badiye; Mohammad Amin Bahrami; Mohammad Hossein Bakhshaei; Ahad Bakhtiari; Shankar M. Bakkannavar; Alberto Baldasseroni; Kylie Ball; Shoshana H. Ballew; Daniela Balzi; Maciej Banach; Srikanta K. Banerjee; Agegnehu Bante Bante; Adhanom Gebreegziabher Baraki; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Lope H. Barrero; Celine M. Barthelemy; Lingkan Barua; Sanjay Basu; Bernhard T. Baune; Mohsen Bayati; Jacob S. Becker; Neeraj Bedi; Ettore Beghi; Yannick Béjot; Michelle L. Bell; Fiona B. Bennitt; Isabela M. Bensenor; Kidanemaryam Berhe; Adam E. Berman; Akshaya Srikanth Bhagavathula; Reshmi Bhageerathy; Neeraj Bhala; Dinesh Bhandari; Krittika Bhattacharyya; Zulfiqar A. Bhutta; Ali Bijani; Boris Bikbov; Muhammad Shahdaat Bin Sayeed; Antonio Biondi; Binyam Minuye Birihane; Catherine Bisignano; Raaj Kishore Biswas; Helen Bitew; Somayeh Bohlouli; Mehdi Bohluli; Alexandra S. Boon-Dooley; Guilherme Borges; Antonio Maria Borzì; Shiva Borzouei; Cristina Bosetti; Soufiane Boufous; Dejana Braithwaite; Michael Brauer; Nicholas J.K. Breitborde; Susanne Breitner; Hermann Brenner; Paul Svitil Briant; Andrey Nikolaevich Briko; Nikolay Ivanovich Briko; Gabrielle B. Britton; Dana Bryazka; Blair R. Bumgarner; Katrin Burkart; Richard Thomas Burnett; Sharath Burugina Nagaraja; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Leah E. Cahill; Luis Alberto Cámera; Ismael R. Campos-Nonato; Rosario Cárdenas; Giulia Carreras; Juan J. Carrero; Felix Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Franz Castro; Kate Causey; Christopher R. Cederroth; Kelly M. Cercy; Ester Cerin; Joht Singh Chandan; Kai-Lan Chang; Fiona J. Charlson; Vijay Kumar Chattu; Sarika Chaturvedi; Nicolas Cherbuin; Odgerel Chimed-Ochir; Daniel Youngwhan Cho; Jee-Young Jasmine Choi; Hanne Christensen; Dinh-Toi Chu; Michael T. Chung; Sheng-Chia Chung; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Thomas Khaled Dwayne Classen; Aaron J. Cohen; Kelly Compton; Owen R. Cooper; Vera Marisa Costa; Ewerton Cousin; Richard G. Cowden; Di H. Cross; Jessica A. Cruz; Saad M.A. Dahlawi; Albertino Antonio Moura Damasceno; Giovanni Damiani; Lalit Dandona; Rakhi Dandona; William James Dangel; Anna-Karin Danielsson; Paul I. Dargan; Aso Mohammad Darwesh; Ahmad Daryani; Jai K. Das; Rajat Das Gupta; José das Neves; Claudio Alberto Dávila-Cervantes; Dragos Virgil Davitoiu; Diego De Leo; Louisa Degenhardt; Marissa DeLang; Robert Paul Dellavalle; Feleke Mekonnen Demeke; Gebre Teklemariam Demoz; Desalegn Getnet Demsie; Edgar Denova-Gutiérrez; Nikolaos Dervenis; Govinda Prasad Dhungana; Mostafa Dianatinasab; Diana Dias da Silva; Daniel Diaz; Zahra Sadat Dibaji Forooshani; Shirin Djalalinia; Hoa Thi Do; Klara Dokova; Fariba Dorostkar; Leila Doshmangir; Tim Robert Driscoll; Bruce B. Duncan; Andre Rodrigues Duraes; Arielle Wilder Eagan; David Edvardsson; Nevine El Nahas; Iman El Sayed; Maha El Tantawi; Iffat Elbarazi; Islam Y. Elgendy; Shaimaa I. El-Jaafary; Iqbal R.F. Elyazar; Sophia Emmons-Bell; Holly E. Erskine; Sharareh Eskandarieh; Saman Esmaeilnejad; Alireza Esteghamati; Kara Estep; Arash Etemadi; Atkilt Esaiyas Etisso; Jessica Fanzo; Mohammad Farahmand; Mohammad Fareed; Roghiyeh Faridnia; Andrea Farioli; Andre Faro; Mithila Faruque; Farshad Farzadfar; Nazir Fattahi; Mehdi Fazlzadeh; Valery L. Feigin; Rachel Feldman; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Giannina Ferrara; Alize J. Ferrari; Manuela L. Ferreira; Irina Filip; Florian Fischer; James L. Fisher; Luisa Sorio Flor; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Lisa M. Force; Masoud Foroutan; Richard Charles Franklin; Marisa Freitas; Weijia Fu; Takeshi Fukumoto; João M. Furtado; Mohamed M. Gad; Emmanuela Gakidou; Silvano Gallus; Alberto L. Garcia-Basteiro; William M. Gardner; Biniyam Sahiledengle Geberemariyam; Assefa Ayalew Ayalew Ayalew Gebreslassie; Abraham Geremew; Anna Gershberg Hayoon; Peter W. Gething; Maryam Ghadimi; Keyghobad Ghadiri; Fatemeh Ghaffarifar; Mansour Ghafourifard; Farhad Ghamari; Ahmad Ghashghaee; Hesam Ghiasvand; Nermin Ghith; Asadollah Gholamian; Rakesh Ghosh; Paramjit Singh Gill; Themba G. Ginindza; Giorgia Giussani; Elena V. Gnedovskaya; Salime Goharinezhad; Sameer Vali Gopalani; Giuseppe Gorini; Houman Goudarzi; Alessandra C. Goulart; Felix Greaves; Michal Grivna; Giuseppe Grosso; Mohammed Ibrahim Mohialdeen Gubari; Harish Chander Gugnani; Rafael Alves Guimarães; Rashid Abdi Guled; Gaorui Guo; Yuming Guo; Rajeev Gupta; Tarun Gupta; Beatrix Haddock; Nima Hafezi-Nejad; Abdul Hafiz; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Brian J. Hall; Iman Halvaei; Randah R. Hamadeh; Samer Hamidi; Melanie S. Hammer; Graeme J. Hankey; Hamidreza Haririan; Josep Maria Haro; Ahmed I. Hasaballah; Md Mehedi Hasan; Edris Hasanpoor; Abdiwahab Hashi; Soheil Hassanipour; Hadi Hassankhani; Rasmus J. Havmoeller; Simon I. Hay; Khezar Hayat; Golnaz Heidari; Reza Heidari-Soureshjani; Hannah J. Henrikson; Molly E. Herbert; Claudiu Herteliu; Fatemeh Heydarpour; Thomas R. Hird; Hans W. Hoek; Ramesh Holla; Praveen Hoogar; H. Dean Hosgood; Naznin Hossain; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Mohamed Hsairi; Vivian Chia-Rong Hsieh; Guoqing Hu; Kejia Hu; Tanvir M. Huda; Ayesha Humayun; Chantal K. Huynh; Bing-Fang Hwang; Vincent C. Iannucci; Segun Emmanuel Ibitoye; Nayu Ikeda; Kevin S. Ikuta; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Leeberk Raja Inbaraj; Helen Ippolito; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; M. Mofizul Islam; Sheikh Mohammed Shariful Islam; Hiroyasu Iso; Rebecca Q. Ivers; Chidozie C.D. Iwu; Chinwe Juliana Iwu; Ihoghosa Osamuyi Iyamu; Jalil Jaafari; Kathryn H. Jacobsen; Hussain Jafari; Morteza Jafarinia; Mohammad Ali Jahani; Mihajlo Jakovljevic; Farzad Jalilian; Spencer L. James; Hosna Janjani; Tahereh Javaheri; Javad Javidnia; Panniyammakal Jeemon; Ensiyeh Jenabi; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Lars Johansson; Oommen John; Yetunde O. John-Akinola; Catherine Owens Johnson; Jost B. Jonas; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; Ali Kabir; Zubair Kabir; Hamed Kalani; Rizwan Kalani; Leila R. Kalankesh; Rohollah Kalhor; Tanuj Kanchan; Neeti Kapoor; Behzad Karami Matin; André Karch; Mohd Anisul Karim; Getachew Mullu Kassa; Srinivasa Vittal Katikireddi; Gbenga A. Kayode; Ali Kazemi Karyani; Peter Njenga Keiyoro; Cathleen Keller; Laura Kemmer; Parkes J. Kendrick; Nauman Khalid; Mohammad Khammarnia; Ejaz Ahmad Khan; Maseer Khan; Khaled Khatab; Mona M. Khater; Mahalaqua Nazli Khatib; Maryam Khayamzadeh; Salman Khazaei; Christian Kieling; Yun Jin Kim; Ruth W. Kimokoti; Adnan Kisa; Sezer Kisa; Mika Kivimäki; Luke D. Knibbs; Ann Kristin Skrindo Knudsen; Jonathan M. Kocarnik; Sonali Kochhar; Jacek A. Kopec; Vladimir Andreevich Korshunov; Parvaiz A. Koul; Ai Koyanagi; Moritz U.G. Kraemer; Kewal Krishan; Kris J. Krohn; Hans Kromhout; Barthelemy Kuate Defo; G. Anil Kumar; Vivek Kumar; Om P. Kurmi; Dian Kusuma; Carlo La Vecchia; Ben Lacey; Dharmesh Kumar Lal; Ratilal Lalloo; Tea Lallukka; Faris Hasan Lami; Iván Landires; Justin J. Lang; Sinéad M. Langan; Anders O. Larsson; Savita Lasrado; Paolo Lauriola; Jeffrey V. Lazarus; Paul H. Lee; Shaun Wen Huey Lee; Kate E. Legrand; James Leigh; Matilde Leonardi; Haley Lescinsky; Janni Leung; Miriam Levi; Shanshan Li; Lee-Ling Lim; Shai Linn; Shiwei Liu; Simin Liu; Yang Liu; Justin Lo; Alan D. Lopez; Jaifred Christian F. Lopez; Platon D. Lopukhov; Stefan Lorkowski; Paulo A. Lotufo; Alton Lu; Alessandra Lugo; Emilie R. Maddison; Phetole Walter Mahasha; Mokhtar Mahdavi Mahdavi; Morteza Mahmoudi; Azeem Majeed; Afshin Maleki; Shokofeh Maleki; Reza Malekzadeh; Deborah Carvalho Malta; Abdullah A. Mamun; Ana Laura Manda; Helena Manguerra; Fariborz Mansour-Ghanaei; Borhan Mansouri; Mohammad Ali Mansournia; Ana M. Mantilla Herrera; Joemer C. Maravilla; Ashley Marks; Randall V. Martin; Santi Martini; Francisco Rogerlândio Martins-Melo; Anthony Masaka; Seyedeh Zahra Masoumi; Manu Raj Mathur; Kunihiro Matsushita; Pallab K. Maulik; Colm McAlinden; John J. McGrath; Martin McKee; Man Mohan Mehndiratta; Fereshteh Mehri; Kala M. Mehta; Ziad A. Memish; Walter Mendoza; Ritesh G. Menezes; Endalkachew Worku Mengesha; Alibek Mereke; Seid Tiku Mereta; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Bartosz Miazgowski; Tomasz Miazgowski; Irmina Maria Michalek; Ted R. Miller; Edward J. Mills; G.K. Mini; Mohammad Miri; Andreea Mirica; Erkin M. Mirrakhimov; Hamed Mirzaei; Maryam Mirzaei; Roya Mirzaei; Mehdi Mirzaei-Alavijeh; Awoke Temesgen Misganaw; Prasanna Mithra; Babak Moazen; Dara K. Mohammad; Yousef Mohammad; Naser Mohammad Gholi Mezerji; Abdollah Mohammadian-Hafshejani; Noushin Mohammadifard; Reza Mohammadpourhodki; Ammas Siraj Mohammed; Hussen Mohammed; Jemal Abdu Mohammed; Shafiu Mohammed; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Meghan D. Mooney; Ghobad Moradi; Masoud Moradi; Maziar Moradi-Lakeh; Rahmatollah Moradzadeh; Paula Moraga; Lidia Morawska; Joana Morgado-Da-Costa; Shane Douglas Morrison; Abbas Mosapour; Jonathan F. Mosser; Simin Mouodi; Seyyed Meysam Mousavi; Amin Mousavi Khaneghah; Ulrich Otto Mueller; Satinath Mukhopadhyay; Erin C. Mullany; Kamarul Imran Musa; Saravanan Muthupandian; Ashraf F. Nabhan; Mehdi Naderi; Ahamarshan Jayaraman Nagarajan; Gabriele Nagel; Mohsen Naghavi; Behshad Naghshtabrizi; Mukhammad David Naimzada; Farid Najafi; Vinay Nangia; Jobert Richie Nansseu; Morteza Naserbakht; Vinod C. Nayak; Ionut Negoi; Josephine W. Ngunjiri; Cuong Tat Nguyen; Huong Lan Thi Nguyen; Ming Nguyen; Yeshambel T. 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Background: Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods: GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk–outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk–outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk–outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings: The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95% uncertainty interval [UI] 9·51–12·1) deaths (19·2% [16·9–21·3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12–9·31) deaths (15·4% [14·6–16·2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253–350) DALYs (11·6% [10·3–13·1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0–9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10–24 years, alcohol use for those aged 25–49 years, and high systolic blood pressure for those aged 50–74 years and 75 years and older. Interpretation: Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global Burden of Cardiovascular Diseases and Risks, 1990-2022
(Elsevier Inc., 2023) George A. Mensah; Valentin Fuster; Christopher J.L. Murray; Gregory A. Roth; George A. Mensah; Yohannes Habtegiorgis Abate; Mohammadreza Abbasian; Foad Abd-Allah; Ashkan Abdollahi; Mohammad Abdollahi; Deldar Morad Abdulah; Auwal Abdullahi; Ayele Mamo Abebe; Aidin Abedi; Armita Abedi; Olugbenga Olusola Abiodun; Hiwa Abubaker Ali; Eman Abu-Gharbieh; Niveen M.E. Abu-Rmeileh; Salahdein Aburuz; Abdelrahman I. Abushouk; Ahmed Abu-Zaid; Tigist Demssew Adane; Nicola J. Adderley; Oladimeji M. Adebayo; Bashir Aden; Temitayo Esther Adeyeoluwa; Olorunsola Israel Adeyomoye; Qorinah Estiningtyas Sakilah Adnani; Fatemeh Afrashteh; Shadi Afyouni; Saira Afzal; Pradyumna Agasthi; Antonella Agodi; Constanza Elizabeth Aguilera Arriagada; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M. Ahmad; Ayman Ahmed; Haroon Ahmed; Muktar Beshir Ahmed; Syed Anees Ahmed; Marjan Ajami; Karolina Akinosoglou; Moein Ala; Tareq Mohammed Ali AL-Ahdal; Samer O. Alalalmeh; Ziyad Al-Aly; Nazmul Alam; Rasmieh Mustafa Al-Amer; Alaa Alashi; Mohammed Albashtawy; Mohammad T. AlBataineh; Haileselasie Berhane Alema; Sharifullah Alemi; Yihun Mulugeta Alemu; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Fadwa Alhalaiqa Naji Alhalaiqa; Mohammed Usman Ali; Rafat Ali; Syed Shujait Shujait Ali; Gianfranco Alicandro; Reyhaneh Alikhani; Syed Mohamed Aljunid; François Alla; Wael Almahmeed; Sabah Al-Marwani; Jordi Alonso; Rajaa M. Al-Raddadi; Farrukh Jawad Alvi; Nelson Alvis-Guzman; Nelson J. Alvis-Zakzuk; Hassan Alwafi; Hany Aly; Prince M. Amegbor; Tarek Tawfik Amin; Alireza Amindarolzarbi; Mostafa Amini-Rarani; Sohrab Amiri; Enrico Ammirati; Tanu Anand; Robert Ancuceanu; Deanna Anderlini; Abhishek Anil; Golnoosh Ansari; Philip Emeka Anyanwu; Anayochukwu Edward Anyasodor; Geminn Louis Carace Apostol; Jalal Arabloo; Mosab Arafat; Aleksandr Y. Aravkin; Olatunde Aremu; Benedetta Armocida; Johan Ärnlöv; Oluwaseyi Olalekan Arowosegbe; Anton A. Artamonov; Kurnia Dwi Artanti; Judie Arulappan; Idowu Thomas Aruleba; Ashokan Arumugam; Zahra Aryan; Mohammad Asghari-Jafarabadi; Thomas Astell-Burt; Mahshid Ataei; Mohammad Athar; Alok Atreya; Avinash Aujayeb; Adedapo Wasiu Awotidebe; Amdehiwot A. Aynalem; Zahra Azizi; Ahmed Y. Azzam; Abraham Samuel Babu; Muhammad Badar; Feras Bader; Ashish D. Badiye; Arvind Bagga; Sara Bagherieh; Farshad Bahrami Asl; Ruhai Bai; Jennifer L. Baker; Shankar M. Bakkannavar; Abdulaziz T. Bako; Ravleen Kaur Bakshi; Saliu A. Balogun; Ovidiu Constantin Baltatu; Kiran Bam; MacIej Banach; Soham Bandyopadhyay; Biswajit Banik; Palash Chandra Banik; Kannu Bansal; Hamid Reza Baradaran; Franca Barbic; Martina Barchitta; Mainak Bardhan; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Francesco Barone-Adesi; Sandra Barteit; Lingkan Barua; Azadeh Bashiri; Mohsen Bayati; Nebiyou Simegnew Bayileyegn; Emad Behboudi; Amir Hossein Behnoush; Yannick Béjot; Sefealem Assefa Belay; Melaku Ashagrie Belete; Uzma Iqbal Belgaumi; Michelle L. Bell; Luis Belo; Salaheddine Bendak; Bright Benfor; Derrick A. Bennett; Isabela M. Bensenor; Catherine P. Benziger; Azizullah Beran; Adam E. Berman; Amiel Nazer C. Bermudez; Gregory J. Bertolacci; Habtamu B. Beyene; Kebede A. Beyene; Akshaya Srikanth Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Prarthna V. Bhardwaj; Vivek Bhat; Gurjit Kaur Bhatti; Jasvinder Singh Bhatti; Boris Bikbov; Andras Bikov; Marina G. Birck; Bijit Biswas; Saeid Bitaraf; Aadam Olalekan Bodunrin; Eyob Ketema Bogale; Kassawmar Angaw Bogale; Archith Boloor; Milad Bonakdar Hashemi; Hamed Borhany; Edward J. Boyko; Dejana Braithwaite; Luisa C. Brant; Michael Brauer; Susanne Breitner; Andrey Briko; Lemma N. Bulto; Yasser Bustanji; Zahid A. Butt; Daniela Calina; Fan Cao; Rosario Cárdenas; Sinclair Carr; Giulia Carreras; Juan J. Carrero; Márcia Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Maria Sofia Cattaruzza; Luca Cegolon; Ester Cerin; Yaacoub Chahine; Jeffrey Shi Kai Chan; Mei Yen Chan; Raymond N.C. Chan; Periklis Charalampous; Jaykaran Charan; Vijay Kumar Chattu; An-Tian Chen; Catherine S. Chen; Haowei Chen; Suma Sri Chennapragada; Derek S. Chew; Gerald Chi; Patrick R. Ching; Abdulaal Chitheer; So Mi Jemma Cho; William C.S. Cho; Bryan Chong; Hitesh Chopra; Rahul Choudhary; Enayet Karim Chowdhury; Rajiv Chowdhury; Dinh-Toi Chu; Isaac Sunday Chukwu; Arrigo Francesco Giuseppe Cicero; Zinhle Cindi; Iolanda Cioffi; Kaleb Coberly; Sean Coffey; Alyssa Columbus; Joao Conde; Sara Conti; Barbara Corso; Sandra Cortés; Paolo Angelo Cortesi; Vera Marisa Costa; Rosa A.S. Couto; Emma Johnson Cowart; Michael H. Criqui; Jessica A. Cruz; Sriharsha Dadana; Omid Dadras; Xiaochen Dai; Zhaoli Dai; Maxwell Ayindenaba Dalaba; Albertino Antonio Moura Damasceno; Giovanni Damiani; Emanuele D'Amico; Saswati Das; Subasish Das; Mohsen Dashti; Mohammad Dashtkoohi; Maedeh Dastmardi; Kairat Davletov; Aklilu Tamire Debele; Shayom Debopadhaya; Nicole K. DeCleene; Ivan Delgado-Enciso; Juana Maria Delgado-Saborit; Berecha Hundessa Demessa; Andreas K. Demetriades; Xinlei Deng; Edgar Denova-Gutiérrez; Nebiyu Dereje Dereje; Awoke Masrie Asrat Derese; Hardik Dineshbhai Desai; Rupak Desai; Vinoth Gnana Chellaiyan Devanbu; Syed Masudur Rahman Dewan; Sourav Dey; Vishal R. Dhulipala; Daniel Diaz; Michael J. Diaz; Delaney D. Ding; Ricardo Jorge Dinis-Oliveira; Thanh Chi Do; Thao Huynh Phuong Do; Saeid Doaei; Sushil Dohare; Wanyue Dong; Mario D'Oria; Wendel Mombaque Dos Santos; Abdel Douiri; Robert Kokou Dowou; Ashel Chelsea Dsouza; Haneil Larson Dsouza; Viola Dsouza; Mi Du; Andre Rodrigues Duraes; Oyewole Christopher Durojaiye; Sulagna Dutta; Arkadiusz Marian Dziedzic; Alireza Ebrahimi; Defi Efendi; Ferry Efendi; Diyan Ermawan Effendi; Ebrahim Eini; Michael Ekholuenetale; Temitope Cyrus Ekundayo; Iman El Sayed; Maha El Tantawi; Iffat Elbarazi; Frank J. Elgar; Islam Y. Elgendy; Muhammed Elhadi; Waseem El-Huneidi; Mehdi Emamverdi; Theophilus I. Emeto; Ryenchindorj Erkhembayar; Tesfahun C. 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Ribeiro; Daniela Ribeiro; Reza Rikhtegar; Leonardo Roever; Debby Syahru Romadlon; Luca Ronfani; Himanshu Sehar Sekhar Rout; Nitai Roy; Priyanka Roy; Andrzej Rynkiewicz; Aly M.A. Saad; Zahra Saadatian; Siamak Sabour; Simona Sacco; Rajesh Sachdeva; Basema Saddik; Erfan Sadeghi; Umar Saeed; Fahimeh Safaeinejad; Fatemeh Saheb Sharif-Askari; Narjes Saheb Sharif-Askari; Amirhossein Sahebkar; Soumya Swaroop Sahoo; Seyed Aidin Sajedi; Mirza Rizwan Sajid; Joseph W. Sakshaug; Nasir Salam; Afeez Abolarinwa Salami; Mohamed A. Saleh; Sana Salehi; Marwa Rashad Salem; Mohammed Z.Y. Salem; Sara Samadzadeh; Saad Samargandy; Vijaya Paul Samuel; Abdallah M. Samy; Juan Sanabria; Rama Krishna Sanjeev; Milena M. Santric-Milicevic; Muhammad Arif Nadeem Saqib; Made Ary Sarasmita; Aswini Saravanan; Yaser Sarikhani; Tanmay Sarkar; Rodrigo Sarmiento-Suárez; Gargi Sachin Sarode; Sachin C. Sarode; Thirunavukkarasu Sathish; Anudeep Sathyanarayan; Monika Sawhney; Mehdi Sayyah; Benedikt Michael Schaarschmidt
[No abstract available]
Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
(Elsevier B.V., 2024) Natalia V. Bhattacharjee; Austin E. Schumacher; Amirali Aali; Yohannes Habtegiorgis Abate; Rouzbeh Abbasgholizadeh; Mohammadreza Abbasian; Mohsen Abbasi-Kangevari; Hedayat Abbastabar; Samar Abd ElHafeez; Sherief Abd-Elsalam; Mohammad Abdollahi; Mohammad-Amin Abdollahifar; Meriem Abdoun; Auwal Abdullahi; Mesfin Abebe; Samrawit Shawel Abebe; Olumide Abiodun; Hassan Abolhassani; Meysam Abolmaali; Mohamed Abouzid; Girma Beressa Aboye; Lucas Guimarães Abreu; Woldu Aberhe Abrha; Michael R.M. Abrigo; Dariush Abtahi; Hasan Abualruz; Bilyaminu Abubakar; Eman Abu-Gharbieh; Niveen M.E. Abu-Rmeileh; Tadele Girum Girum Adal; Mesafint Molla Adane; Oluwafemi Atanda Adeagbo Adeagbo; Rufus Adesoji Adedoyin; Victor Adekanmbi; Bashir Aden; Abiola Victor Adepoju; Olatunji O. Adetokunboh; Juliana Bunmi Adetunji; Daniel Adedayo Adeyinka; Olorunsola Israel Adeyomoye; Qorinah Estiningtyas Sakilah Adnani; Saryia Adra; Rotimi Felix Afolabi; Shadi Afyouni; Muhammad Sohail Afzal; Saira Afzal; Shahin Aghamiri; Antonella Agodi; Williams Agyemang-Duah; Bright Opoku Ahinkorah; Austin J. Ahlstrom; Aqeel Ahmad; Danish Ahmad; Firdos Ahmad; Muayyad M. Ahmad; Sajjad Ahmad; Tauseef Ahmad; Ali Ahmed; Ayman Ahmed; Haroon Ahmed; Luai A. Ahmed; Meqdad Saleh Ahmed; Syed Anees Ahmed; Marjan Ajami; Budi Aji; Gizachew Taddesse Akalu; Hossein Akbarialiabad; Rufus Olusola Akinyemi; Mohammed Ahmed Akkaif; Sreelatha Akkala; Hanadi Al Hamad; Syed Mahfuz Al Hasan; Mohammad Al Qadire; Tareq Mohammed Ali AL-Ahdal; Samer O. Alalalmeh; Tariq A. Alalwan; Ziyad Al-Aly; Khurshid Alam; Rasmieh Mustafa Al-Amer; Fahad Mashhour Alanezi; Turki M. Alanzi; Almaza Albakri; Mohammed Albashtawy; Mohammad T. AlBataineh; Hediyeh Alemi; Sharifullah Alemi; Yihun Mulugeta Alemu; Ayman Al-Eyadhy; Adel Ali Saeed Al-Gheethi; Khalid F. Alhabib; Noora Alhajri; Fadwa Alhalaiqa Naji Alhalaiqa; Robert Kaba Alhassan; Abid Ali; Beriwan Abdulqadir Ali; Liaqat Ali; Mohammed Usman Ali; Rafat Ali; Syed Shujait Shujait Ali; Sheikh Mohammad Alif; Mohammad Aligol; Mehran Alijanzadeh; Mohammad A.M. Aljasir; Syed Mohamed Aljunid; Sabah Al-Marwani; Joseph Uy Almazan; Hesham M. Al-Mekhlafi; Omar Almidani; Mahmoud A. Alomari; Basem Al-Omari; Jaber S. Alqahtani; Ahmed Yaseen Alqutaibi; Rajaa M. Al-Raddadi; Salman Khalifah Al-Sabah; Awais Altaf; Jaffar A. Al-Tawfiq; Khalid A. Altirkawi; Deborah Oyine Aluh; Farrukh Jawad Alvi; Nelson Alvis-Guzman; Hassan Alwafi; Yaser Mohammed Al-Worafi; Hany Aly; Safwat Aly; Karem H. Alzoubi; Edward Kwabena Ameyaw; Tarek Tawfik Amin; Alireza Amindarolzarbi; Mostafa Amini-Rarani; Sohrab Amiri; Irene Gyamfuah Ampomah; Dickson A. Amugsi; Ganiyu Adeniyi Amusa; Robert Ancuceanu; Deanna Anderlini; Pedro Prata Andrade; Catalina Liliana Andrei; Tudorel Andrei; Abhishek Anil; Sneha Anil; Adnan Ansar; Alireza Ansari-Moghaddam; Catherine M. Antony; Ernoiz Antriyandarti; Saeid Anvari; Saleha Anwar; Razique Anwer; Anayochukwu Edward Anyasodor; Jalal Arabloo; Razman Arabzadeh Bahri; Elshaimaa A. Arafa; Mosab Arafat; Ana Margarida Araujo; Aleksandr Y. Aravkin; Abdulfatai Aremu; Timur Aripov; Mesay Arkew; Benedetta Armocida; Johan Ärnlöv; Mahwish Arooj; Anton A. Artamonov; Judie Arulappan; Raphael Taiwo Aruleba; Ashokan Arumugam; Mohsen Asadi-Lari; Zatollah Asemi; Saeed Asgary; Mona Asghariahmadabad; Mohammad Asghari-Jafarabadi; Mubarek Yesse Ashemo; Muhammad Ashraf; Tahira Ashraf; Marvellous O. Asika; Seyyed Shamsadin Athari; Maha Moh'd Wahbi Atout; Alok Atreya; Avinash Aujayeb; Marcel Ausloos; Abolfazl Avan; Amlaku Mulat Aweke; Getnet Melaku Ayele; Seyed Mohammad Ayyoubzadeh; Sina Azadnajafabad; Rui M.S. Azevedo; Ahmed Y. Azzam; Muhammad Badar; Ashish D. Badiye; Soroush Baghdadi; Nasser Bagheri; Sara Bagherieh; Najmeh Bahmanziari; Ruhai Bai; Atif Amin Baig; Jennifer L. Baker; Abdulaziz T. Bako; Ravleen Kaur Bakshi; Madhan Balasubramanian; Ovidiu Constantin Baltatu; Kiran Bam; MacIej Banach; Soham Bandyopadhyay; Biswajit Banik; Palash Chandra Banik; Hansi Bansal; Mehmet Firat Baran; Martina Barchitta; Mainak Bardhan; Erfan Bardideh; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Francesco Barone-Adesi; Hiba Jawdat Barqawi; Amadou Barrow; Sandra Barteit; Zarrin Basharat; Asma'u I.J. Bashir; Hameed Akande Bashiru; Afisu Basiru; Joao Diogo Basso; Sanjay Basu; Abdul-Monim Mohammad Batiha; Kavita Batra; Bernhard T. Baune; Mohsen Bayati; Tahmina Begum; Emad Behboudi; Amir Hossein Behnoush; Maryam Beiranvand; Diana Fernanda Bejarano Ramirez; Alehegn Bekele; Sefealem Assefa Belay; Uzma Iqbal Belgaumi; Michelle L. Bell; Olorunjuwon Omolaja Bello; Apostolos Beloukas; Isabela M. Bensenor; Zombor Berezvai; Alemshet Yirga Berhie; Amiel Nazer C. Bermudez; Paulo J.G. Bettencourt; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Prarthna V. Bhardwaj; Sonu Bhaskar; Vivek Bhat; Gurjit Kaur Bhatti; Jasvinder Singh Bhatti; Manpreet S. Bhatti; Rajbir Bhatti; Antonio Biondi; Catherine Bisignano; Atanu Biswas; Raaj Kishore Biswas; Veera R. Bitra; Tone Bjørge; Elye Bliss; Micheal Kofi Boachie; Anca Vasilica Bobirca; Virginia Bodolica; Aadam Olalekan Bodunrin; Eyob Ketema Bogale; Kassawmar Angaw Bogale; Milad Bonakdar Hashemi; Berrak Bora Basara; Souad Bouaoud; Dejana Braithwaite; Michael Brauer; Nicholas J.K. Breitborde; Dana Bryazka; Norma B. Bulamu; Danilo Buonsenso; Katrin Burkart; Richard A. Burns; Yasser Bustanji; Nadeem Shafique Butt; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Daniela Calina; Ismael R. Campos-Nonato; Fan Cao; Shujin Cao; Angelo Capodici; Giulia Carreras; Andrea Carugno; Carlos A. Castañeda-Orjuela; Giulio Castelpietra; Maria Sofia Cattaruzza; Arthur Caye; Luca Cegolon; Francieli Cembranel; Ester Cerin; Joshua Chadwick; Yaacoub Chahine; Chiranjib Chakraborty; Julian Chalek; Jeffrey Shi Kai Chan; Periklis Charalampous; Vijay Kumar Chattu; Sarika Chaturvedi; Malizgani Paul Chavula; An-Tian Chen; Haowei Chen; Simiao Chen; Gerald Chi; Fatemeh Chichagi; Ju-Huei Chien; Patrick R. Ching; William C.S. Cho; Sungchul Choi; Bryan Chong; Hitesh Chopra; Sonali Gajanan Choudhari; Devasahayam J. Christopher; Dinh-Toi Chu; Isaac Sunday Chukwu; Eric Chung; Sheng-Chia Chung; Zinhle Cindi; Iolanda Cioffi; Raffaela Ciuffreda; Rafael M. Claro; Kaleb Coberly; Alyssa Columbus; Haley Comfort; Joao Conde; Michael H. Criqui; Natalia Cruz-Martins; Silvia Magali Cuadra-Hernández; Sriharsha Dadana; Omid Dadras; Tukur Dahiru; Zhaoli Dai; Bronte Dalton; Giovanni Damiani; Aso Mohammad Darwesh; Jai K. Das; Saswati Das; Mohsen Dashti; Anna Dastiridou; Claudio Alberto Dávila-Cervantes; Kairat Davletov; Aklilu Tamire Debele; Shayom Debopadhaya; Somayeh Delavari; Ivan Delgado-Enciso; Dessalegn Demeke; Berecha Hundessa Demessa; Xinlei Deng; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Hardik Dineshbhai Desai; Rupak Desai; Vinoth Gnana Chellaiyan Devanbu; Arkadeep Dhali; Kuldeep Dhama; Meghnath Dhimal; Vishal R. Dhulipala; Diana Dias Da Silva; Daniel Diaz; Michael J. Diaz; Adriana Dima; Delaney D. Ding; M. Ashworth Dirac; Thanh Chi Do; Thao Huynh Phuong Do; Camila Bruneli Do Prado; Sushil Dohare; Wanyue Dong; Mario D'Oria; Wendel Mombaque Dos Santos; Leila Doshmangir; Robert Kokou Dowou; Ashel Chelsea Dsouza; Haneil Larson Dsouza; Viola Dsouza; John Dube; Joe Duprey; Andre Rodrigues Duraes; Senbagam Duraisamy; Oyewole Christopher Durojaiye; Sulagna Dutta; Laura Dwyer-Lindgren; Paulina Agnieszka Dzianach; Arkadiusz Marian Dziedzic; Alireza Ebrahimi; Hisham Atan Edinur; Kristina Edvardsson; Ferry Efendi; Terje Andreas Eikemo; Michael Ekholuenetale; Maha El Tantawi; Noha Mousaad Elemam; Ghada Metwally Tawfik ElGohary; Muhammed Elhadi; Legesse Tesfaye Elilo; Omar Abdelsadek Abdou Elmeligy; Mohamed A. Elmonem; Mohammed Elshaer; Ibrahim Elsohaby; Amir Emami Zeydi; Luchuo Engelbert Bain; Sharareh Eskandarieh; Francesco Esposito; Kara Estep; Farshid Etaee; Natalia Fabin; Adeniyi Francis Fagbamigbe; Saman Fahimi; Aliasghar Fakhri-Demeshghieh; Luca Falzone; Ali Faramarzi; MoezAlIslam Ezzat Mahmoud Faris; Sam Farmer; Andre Faro; Abidemi Omolara Fasanmi; Ali Fatehizadeh; Nelsensius Klau Fauk; Pooria Fazeli; Valery L. Feigin; Seyed-Mohammad Fereshtehnejad; Abdullah Hamid Feroze; Pietro Ferrara; Nuno Ferreira; Getahun Fetensa; Irina Filip; Florian Fischer; Joanne Flavel; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Behzad Foroutan; Matteo Foschi; Kayode Raphael Fowobaje; Kate Louise Francis; Alberto Freitas; Takeshi Fukumoto; John E. Fuller; Blima Fux; Peter Andras Gaal; Muktar A. Gadanya; Abhay Motiramji Gaidhane; Yaseen Galali; Silvano Gallus; Aravind P. Gandhi; Balasankar Ganesan; Mohammad Arfat Ganiyani; M.A. Garcia-Gordillo; Naval Garg; Rupesh K. Gautam; Federica Gazzelloni; Semiu Olatunde Gbadamosi; Miglas W. Gebregergis; Mesfin Gebrehiwot; Tesfay Brhane Gebremariam; Teferi Gebru Gebremeskel; Yohannes Fikadu Geda; Simona Roxana Georgescu; Urge Gerema; Habtamu Geremew; Motuma Erena Getachew; Peter W. Gething; MohammadReza Ghasemi; Ghazal Ghasempour Dabaghi; Afsaneh Ghasemzadeh; Fariba Ghassemi; Ramy Mohamed Ghazy; Sailaja Ghimire; Asadollah Gholamian; Ali Gholamrezanezhad; Mahsa Ghorbani; Aloke Gopal Ghoshal; Arun Digambarrao Ghuge; Artyom Urievich Gil; Tiffany K. Gill; Matteo Giorgi; Alem Girmay; James C. Glasbey; Laszlo Göbölös; Amit Goel; Ali Golchin; Mahaveer Golechha; Pouya Goleij; Sameer Vali Gopalani; Houman Goudarzi; Alessandra C. Goulart; Anmol Goyal; Simon Matthew Graham; Michal Grivna; Shi-Yang Guan; Giovanni Guarducci; Mohammed Ibrahim Mohialdeen Gubari; Mesay Dechasa Gudeta; Stefano Guicciardi; Snigdha Gulati; David Gulisashvili; Damitha Asanga Gunawardane; Cui Guo; Anish Kumar Gupta; Bhawna Gupta; Manoj Kumar Gupta; Mohak Gupta; Sapna Gupta; Veer Bala Gupta; Vijai Kumar Gupta; Vivek Kumar Gupta; Annie Haakenstad; Farrokh Habibzadeh; Najah R. Hadi; Nils Haep; Ramtin Hajibeygi; Sebastian Haller; Rabih Halwani; Randah R. Hamadeh; Nadia M. Hamdy; Sajid Hameed; Samer Hamidi; Qiuxia Han; Alexis J. Handal; Graeme J. Hankey; Md Nuruzzaman Haque; Josep Maria Haro; Ahmed I. Hasaballah; Ikramul Hasan; Mohammad Jahid Hasan; S.M. Mahmudul Hasan; Hamidreza Hasani; Md Saquib Hasnain; Amr Hassan; Ikrama Hassan; Soheil Hassanipour; Hadi Hassankhani; Simon I. Hay; Jeffrey J. Hebert; Omar E. Hegazi; Mohammad Heidari; Bartosz Helfer; Mehdi Hemmati; Brenda Yuliana Herrera-Serna; Claudiu Herteliu; Kamran Hessami; Kamal Hezam; Yuta Hiraike; Nguyen Quoc Hoan; Ramesh Holla; Nobuyuki Horita; Md Mahbub Hossain; Mohammad Bellal Hossain Hossain; Hassan Hosseinzadeh; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mohamed Hsairi; Vivian Chia-Rong Hsieh; Chengxi Hu; Junjie Huang; M. Mamun Huda; Ayesha Humayun; Javid Hussain; Nawfal R. Hussein; Hong-Han Huynh; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Pulwasha Maria Iftikhar; Olayinka Stephen Ilesanmi; Irena M. Ilic; Milena D. Ilic; Mustapha Immurana; Leeberk Raja Inbaraj; Afrin Iqbal; Md. Rabiul Islam; Nahlah Elkudssiah Ismail; Hiroyasu Iso; Gaetano Isola; Masao Iwagami; Mahalaxmi Iyer; J. Linda Merin; Jalil Jaafari; Louis Jacob; Farhad Jadidi-Niaragh; Khushleen Jaggi; Kasra Jahankhani; Nader Jahanmehr; Haitham Jahrami; Akhil Jain; Nityanand Jain; Ammar Abdulrahman Jairoun; Mihajlo Jakovljevic; Elham Jamshidi; Sabzali Javadov; Tahereh Javaheri; Sathish Kumar Jayapal; Shubha Jayaram; Sun Ha Jee; Jayakumar Jeganathan; Anil K. Jha; Ravi Prakash Jha; Heng Jiang; Mohammad Jokar; Jost B. Jonas; Tamas Joo; Nitin Joseph; Charity Ehimwenma Joshua; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; K. Vaishali; Billingsley Kaambwa; Abdulkareem Kabir; Ali Kabir; Hannaneh Kabir; Zubair Kabir; Rizwan Kalani; Leila R. Kalankesh; Feroze Kaliyadan; Sanjay Kalra; Rajesh Kamath; Sagarika Kamath; Tanuj Kanchan; Edmund Wedam Kanmiki; Kehinde Kazeem Kanmodi; S. Suthanthira Kannan; Sushil Kumar Kansal; Rami S. Kantar; Neeti Kapoor; Mehrdad Karajizadeh; Manoochehr Karami; Ibraheem M. Karaye; Faizan Zaffar Kashoo; Hengameh Kasraei; Nicholas J. Kassebaum; Molly B. Kassel; Joonas H. Kauppila; Foad Kazemi; Sara Kazeminia; John H. Kempen; Evie Shoshannah Kendal; Kamyab Keshtkar; Mohammad Keykhaei; Himanshu Khajuria; Amirmohammad Khalaji; Nauman Khalid; Anees Ahmed Khalil; Alireza Khalilian; Faham Khamesipour; Ajmal Khan; Asaduzzaman Khan; Ikramullah Khan; M. Nuruzzaman Khan; Maseer Khan; Mohammad Jobair Khan; Moien A.B. Khan; Young-Ho Khang; Shaghayegh Khanmohammadi; Khaled Khatab; Armin Khavandegar; Hamid Reza Khayat Kashani; Feriha Fatima Khidri; Moein Khormali; Mohammad Ali Khosravi; Mahmood Khosrowjerdi; Wondwosen Teklesilasie Kidane; Zemene Demelash Kifle; Julie Sojin Kim; Min Seo Kim; Ruth W. Kimokoti; Kasey E. Kinzel; Girmay Tsegay Kiross; Adnan Kisa; Sezer Kisa; Ali-Asghar Kolahi; Farzad Kompani; Gerbrand Koren; Oleksii Korzh; Soewarta Kosen; Sindhura Lakshmi Koulmane Laxminarayana; Kewal Krishan; Varun Krishna; Vijay Krishnamoorthy; Barthelemy Kuate Defo; Connor M. Kubeisy; Burcu Kucuk Bicer; Md Abdul Kuddus; Mohammed Kuddus; Ilari Kuitunen; Mukhtar Kulimbet; Harish Kumar; Satyajit Kundu; Kunle Rotimi Kunle; Om P. Kurmi; Asep Kusnali; Dian Kusuma; Evans F. Kyei; Ilias Kyriopoulos; Carlo La Vecchia; Ben Lacey; Muhammad Awwal Ladan; Lucie Laflamme; Chandrakant Lahariya; Daphne Teck Ching Lai; Dharmesh Kumar Lal; Ratilal Lalloo; Judit Lám; Demetris Lamnisos; Ivan Landires; Francesco Lanfranchi; Berthold Langguth; Ariane Laplante-Lévesque; Heidi Jane Larson; Anders O. Larsson; Savita Lasrado; Kamaluddin Latief; Kaveh Latifinaibin; Long Khanh Dao Le; Nhi Huu Hanh Le; Trang Diep Thanh Le; Caterina Ledda; Munjae Lee; Paul H. Lee; Seung Won Lee; Yo Han Lee; Gebretsadik Kiros Lema; Elvynna Leong; Temesgen L. Lerango; An Li; Ming-Chieh Li; Shanshan Li; Wei Li; Xiaopan Li; Virendra S. Ligade; Stephen S. Lim; Ro-Ting Lin; Paulina A. Lindstedt; Stefan Listl; Gang Liu; Jue Liu; Xiaofeng Liu; Xuefeng Liu; Yuewei Liu; Erand Llanaj; Ruben López-Bueno; Platon D. Lopukhov; Laszlo Lorenzovici; Paulo A. Lotufo; Jailos Lubinda; Giancarlo Lucchetti; Alessandra Lugo; Raimundas Lunevicius; Hengliang Lv; Zheng Feei Ma; Kelsey Lynn Maass; Monika MacHoy; Áurea M. Madureira-Carvalho; Mohammed Magdy Abd El Razek; Azzam A. Maghazachi; Soleiman Mahjoub; Mansour Adam Mahmoud; Azeem Majeed; Jeadran N. Malagón-Rojas; Elaheh Malakan Rad; Kashish Malhotra; Ahmad Azam Malik; Iram Malik; Deborah Carvalho Malta; Abdullah A. Mamun; Yosef Manla; Yasaman Mansoori; Ali Mansour; Borhan Mansouri; Zeinab Mansouri; Mohammad Ali Mansournia; Joemer C. Maravilla; Mirko Marino; Abdoljalal Marjani; Gabriel Martinez; Ramon Martinez-Piedra; Francisco Rogerlandio Martins-Melo; Miquel Martorell; Sharmeen Maryam; Roy Rillera Marzo; Alireza Masoudi; Jishanth Mattumpuram; Richard James Maude; Andrea Maugeri; Erin A. May; Mahsa Mayeli; Maryam Mazaheri; John J. McGrath; Martin McKee; Anna Laura Wensel McKowen; Susan A. McLaughlin; Steven M. 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Mokdad; Peyman Mokhtarzadehazar; Hossein Molavi Vardanjani; Sabrina Molinaro; Lorenzo Monasta; Mohammad Ali Moni; Maryam Moradi; Yousef Moradi; Paula Moraga; Rafael Silveira Moreira; Negar Morovatdar; Shane Douglas Morrison; Jakub Morze; Abbas Mosapour; Elias Mossialos; Rohith Motappa; Parsa Mousavi; Amin Mousavi Khaneghah; Christine Mpundu-Kaambwa; Sumaira Mubarik; Lorenzo Muccioli; Francesk Mulita; Kavita Munjal; Efren Murillo-Zamora; Jonah Musa; Fungai Musaigwa; Ana-Maria Musina; Sathish Muthu; Saravanan Muthupandian; Muhammad Muzaffar; Woojae Myung; Ahamarshan Jayaraman Nagarajan; Gabriele Nagel; Pirouz Naghavi; Ganesh R. Naik; Gurudatta Naik; Mukhammad David Naimzada; Firzan Nainu; Vinay Nangia; Sreenivas Narasimha Swamy; Bruno Ramos Nascimento; Gustavo G. Nascimento; Abdallah Y. Naser; Mohammad Javad Nasiri; Zuhair S. Natto; Javaid Nauman; Muhammad Naveed; Biswa Prakash Nayak; Vinod C. Nayak; Rawlance Ndejjo; Sabina Onyinye Nduaguba; Hadush Negash; Chernet Tafere Negesse; Ionut Negoi; Ruxandra Irina Negoi; Seyed Aria Nejadghaderi; Chakib Nejjari; Samata Nepal; Henok Biresaw Netsere; Georges Nguefack-Tsague; Josephine W. Ngunjiri; Dang H. Nguyen; Hau Thi Hien Nguyen; Phuong The Nguyen; QuynhAnh P. Nguyen; Van Thanh Nguyen; Robina Khan Niazi; Yeshambel T. Nigatu; Taxiarchis Konstantinos Nikolouzakis; Ali Nikoobar; Amin Reza Nikpoor; Chukwudi A. Nnaji; Lawrence Achilles Nnyanzi; Efaq Ali Noman; Shuhei Nomura; Mamoona Noreen; Nafise Noroozi; Chisom Adaobi Nri-Ezedi; Mengistu H. Nunemo; Virginia Nuñez-Samudio; Dieta Nurrika; Jerry John Nutor; Bogdan Oancea; Kehinde O. Obamiro; Ismail A. Odetokun; Nkechi Martina Odogwu; Martin James O'Donnell; Oluwakemi Ololade Odukoya; Ayodipupo Sikiru Oguntade; James Odhiambo Oguta; In-Hwan Oh; Sylvester Reuben Okeke; Akinkunmi Paul Okekunle; Osaretin Christabel Okonji; Patrick Godwin Okwute; Andrew T. Olagunju; Omotola O. Olasupo; Matthew Idowu Olatubi; Glaucia Maria Moraes Oliveira; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Gideon Olamilekan Oluwatunase; Hany A. Omar; Goran Latif Omer; Obinna E. Onwujekwe; Michal Ordak; Orish Ebere Orisakwe; Verner N. Orish; Doris V. Ortega-Altamirano; Alberto Ortiz; Esteban Ortiz-Prado; Wael M.S. Osman; Uchechukwu Levi Osuagwu; Olayinka Osuolale; Adrian Otoiu; Stanislav S. Otstavnov; Amel Ouyahia; Guoqing Ouyang; Mayowa O. Owolabi; Yaz Ozten; P.A. Mahesh Padukudru; Mohammad Taha Pahlevan Fallahy; Feng Pan; Hai-Feng Pan; Adrian Pana; Paramjot Panda; Songhomitra Panda-Jonas
Background: Accurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. Methods: To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10–54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values—a metric assessing gain in forecasting accuracy—by comparing predicted versus observed ASFRs from the past 15 years (2007–21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. Findings: During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63–5·06) to 2·23 (2·09–2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137–147), declining to 129 million (121–138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1—canonically considered replacement-level fertility—in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7–29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59–2·08) in 2050 and 1·59 (1·25–1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6–43·1) in 2050 and 54·3% (47·1–59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions—decreasing, for example, in south Asia from 24·8% (23·7–25·8) in 2021 to 16·7% (14·3–19·1) in 2050 and 7·1% (4·4–10·1) in 2100—but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40–1·92) in 2050 and 1·62 (1·35–1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. Interpretation: Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world. Funding: Bill & Melinda Gates Foundation. © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global, regional, and national mortality among young people aged 10–24 years, 1950–2019: a systematic analysis for the Global Burden of Disease Study 2019
(Elsevier B.V., 2021) Joseph L. 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Deanna Anderlini; Catalina Liliana Andrei; Sofia Androudi; Fereshteh Ansari; Iman Ansari; Carl Abelardo T Antonio; Davood Anvari; Razique Anwer; Seth Christopher Yaw Appiah; Jalal Arabloo; Morteza Arab-Zozani; Johan Ärnlöv; Malke Asaad; Mehran Asadi-Aliabadi; Ali A Asadi-Pooya; Maha Moh'd Wahbi Atout; Marcel Ausloos; Elvis Korku Avenyo; Leticia Avila-Burgos; Beatriz Paulina Ayala Quintanilla; Getinet Ayano; Yared Asmare Aynalem; Samad Azari; Zelalem Nigussie Azene; Mohammad Hossein Bakhshaei; Shankar M Bakkannavar; MacIej Banach; Palash Chandra Banik; Miguel A Barboza; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Sanjay Basu; Bernhard T Baune; Mohsen Bayati; Neeraj Bedi; Ettore Beghi; Tariku Tesfaye Bekuma; Arielle Wilder Bell; Michelle L Bell; Corina Benjet; Isabela M Bensenor; Abadi Kidanemariam Berhe; Kidanemaryam Berhe; Adam E Berman; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Krittika Bhattacharyya; Suraj Bhattarai; Zulfiqar A Bhutta; Ali Bijani; Boris Bikbov; Antonio Biondi; Tesega Tesega Mengistu Birhanu; Raaj Kishore Biswas; Somayeh Bohlouli; Srinivasa Rao Bolla; Archith Boloor; Rohan Borschmann; Soufiane Boufous; Nicola Luigi Bragazzi; Dejana Braithwaite; Nicholas J K Breitborde; Hermann Brenner; Gabrielle B Britton; Richard A Burns; Sharath Burugina Nagaraja; Zahid A Butt; Florentino Luciano Caetano Dos Santos; Luis Alberto Cámera; Ismael R Campos-Nonato; Julio Cesar Campuzano Rincon; Rosario Cárdenas; Giulia Carreras; Juan J Carrero; Felix Carvalho; Joao Mauricio Castaldelli-Maia; Carlos A Castañeda-Orjuela; Giulio Castelpietra; Ferrán Catalá-López; Ester Cerin; Joht Singh Chandan; Hsing-Yi Chang; Jung-Chen Chang; Jaykaran Charan; Vijay Kumar Chattu; Sarika Chaturvedi; Jee-Young Jasmine Choi; Mohiuddin Ahsanul Kabir Chowdhury; Devasahayam J Christopher; Dinh-Toi Chu; Michael T Chung; Sheng-Chia Chung; Flavia M Cicuttini; Traian Vasile Constantin; Vera Marisa Costa; Saad M A Dahlawi; Haijiang Dai; Xiaochen Dai; Giovanni Damiani; Lalit Dandona; Rakhi Dandona; Parnaz Daneshpajouhnejad; Aso Mohammad Darwesh; Claudio Alberto Dávila-Cervantes; Kairat Davletov; Fernando Pio De La Hoz; Diego De Leo; Nikolaos Dervenis; Rupak Desai; Assefa Desalew; Keshab Deuba; Samath Dhamminda Dharmaratne; Govinda Prasad Dhungana; Mostafa Dianatinasab; Diana Dias Da Silva; Daniel Diaz; Alireza Didarloo; Shirin Djalalinia; Fariba Dorostkar; Chirag P Doshi; Leila Doshmangir; Kerrie E Doyle; Andre Rodrigues Duraes; Mohammad Ebrahimi Kalan; Sanam Ebtehaj; David Edvardsson; Maha El Tantawi; Islam Y Elgendy; Shaimaa I El-Jaafary; Aisha Elsharkawy; Babak Eshrati; Sharareh Eskandarieh; Saman Esmaeilnejad; Firooz Esmaeilzadeh; Sadaf Esteghamati; Andre Faro; Farshad Farzadfar; Nazir Fattahi; Valery L Feigin; Tomas Y Ferede; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Pietro Ferrara; Irina Filip; Florian Fischer; James L Fisher; Nataliya A Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Masoud Foroutan; Takeshi Fukumoto; Mohamed M Gad; Abhay Motiramji Gaidhane; Silvano Gallus; Teshome Gebre; Ketema Bizuwork Gebremedhin; Gebreamlak Gebremedhn Gebremeskel; Leake Gebremeskel; Assefa Ayalew Gebreslassie; Hailay Abrha Gesesew; Keyghobad Ghadiri; Mansour Ghafourifard; Farhad Ghamari; Ahmad Ghashghaee; Syed Amir Gilani; Elena V Gnedovskaya; Myron Anthony Godinho; Mahaveer Golechha; Srinivas Goli; Philimon N Gona; Sameer Vali Gopalani; Giuseppe Gorini; Michal Grivna; Mohammed Ibrahim Mohialdeen Gubari; Harish Chander Gugnani; Rafael Alves Guimarães; Yuming Guo; Rajeev Gupta; Juanita A Haagsma; Nima Hafezi-Nejad; Teklehaimanot Gereziher Haile; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Brian J Hall; Randah R Hamadeh; Kanaan Hamagharib Abdullah; Samer Hamidi; Demelash Woldeyohannes Handiso; Asif Hanif; Graeme J Hankey; Hamidreza Haririan; Josep Maria Haro; Ahmed I Hasaballah; Abdiwahab Hashi; Amr Hassan; Soheil Hassanipour; Hadi Hassankhani; Khezar Hayat; Reza Heidari-Soureshjani; Claudiu Herteliu; Fatemeh Heydarpour; Hung Chak Ho; Michael K Hole; Ramesh Holla; Praveen Hoogar; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Mohamed Hsairi; Tanvir M Huda; Ayesha Humayun; Rabia Hussain; Bing-Fang Hwang; Ivo Iavicoli; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Irena M Ilic; Milena D Ilic; Leeberk Raja Inbaraj; Nirun Intarut; Usman Iqbal; Seyed Sina Naghibi Irvani; M Mofizul Islam; Sheikh Mohammed Shariful Islam; Hiroyasu Iso; Rebecca Q Ivers; Mohammad Ali Jahani; Mihajlo Jakovljevic; Amir Jalali; Manthan Dilipkumar Janodia; Tahereh Javaheri; Panniyammakal Jeemon; Ensiyeh Jenabi; Ravi Prakash Jha; Vivekanand Jha; John S Ji; Jost B Jonas; Kelly M Jones; Farahnaz Joukar; Jacek Jerzy Jozwiak; Petur B Juliusson; Mikk Jürisson; Ali Kabir; Zubair Kabir; Leila R Kalankesh; Rohollah Kalhor; Naser Kamyari; Tanuj Kanchan; Andr Karch; Salah Eddin Karimi; Supreet Kaur; Gbenga A Kayode; Peter Njenga Keiyoro; Nauman Khalid; Mohammad Khammarnia; Maseer Khan; Md Nuruzzaman Khan; Khaled Khatab; Mona M Khater; Mahalaqua Nazli Khatib; Maryam Khayamzadeh; Habibolah Khazaie; Abdullah T Khoja; Christian Kieling; Young-Eun Kim; Yun Jin Kim; Ruth W Kimokoti; Adnan Kisa; Sezer Kisa; Mika Kivimäki; Ali Koolivand; Soewarta Kosen; Ai Koyanagi; Kewal Krishan; Nuworza Kugbey; G Anil Kumar; Manasi Kumar; Nithin Kumar; Om P Kurmi; Dian Kusuma; Carlo La Vecchia; Ben Lacey; Dharmesh Kumar Lal; Ratilal Lalloo; Qing Lan; Iván Landires; Van Charles Lansingh; Anders O Larsson; Savita Lasrado; Zohra S Lassi; Paolo Lauriola; Paul H Lee; Shaun Wen Huey Lee; James Leigh; Matilde Leonardi; Janni Leung; Miriam Levi; Sonia Lewycka; Bingyu Li; Ming-Chieh Li; Shanshan Li; Lee-Ling Lim; Stephen S Lim; Xuefeng Liu; Stefan Lorkowski; Paulo A Lotufo; Raimundas Lunevicius; Ralph Maddison; Phetole Walter Mahasha; Mokhtar Mahdavi Mahdavi; Morteza Mahmoudi; Azeem Majeed; Afshin Maleki; Reza Malekzadeh; Deborah Carvalho Malta; Abdullah A Mamun; Borhan Mansouri; Mohammad Ali Mansournia; Gabriel Martinez; Jose Martinez-Raga; Francisco Rogerlândio Martins-Melo; Amanda J Mason-Jones; Seyedeh Zahra Masoumi; Manu Raj Mathur; Pallab K Maulik; John J McGrath; Man Mohan Mehndiratta; Fereshteh Mehri; Peter T N Memiah; Walter Mendoza; Ritesh G Menezes; Endalkachew Worku Mengesha; Atte Meretoja; Tuomo J Meretoja; Tomislav Mestrovic; Bartosz Miazgowski; Tomasz Miazgowski; Irmina Maria Michalek; Ted R Miller; G.K. Mini; Andreea Mirica; Erkin M Mirrakhimov; Hamed Mirzaei; Maryam Mirzaei; Babak Moazen; Dara K Mohammad; Shadieh Mohammadi; Abdollah Mohammadian-Hafshejani; Noushin Mohammadifard; Reza Mohammadpourhodki; Shafiu Mohammed; Lorenzo Monasta; Ghobad Moradi; Maziar Moradi-Lakeh; Rahmatollah Moradzadeh; Paula Moraga; Shane Douglas Morrison; Abbas Mosapour; Amin Mousavi Khaneghah; Ulrich Otto Mueller; Moses K Muriithi; Christopher J L Murray; Saravanan Muthupandian; Mehdi Naderi; Ahamarshan Jayaraman Nagarajan; Mohsen Naghavi; Mukhammad David Naimzada; Vinay Nangia; Vinod C Nayak; Javad Nazari; Rawlance Ndejjo; Ionut Negoi; Ruxandra Irina Negoi; Henok Biresaw Netsere; Georges Nguefack-Tsague; Diep Ngoc Nguyen; Huong Lan Thi Nguyen; Jing Nie; Dina Nur Anggraini Ningrum; Chukwudi A Nnaji; Shuhei Nomura; Jean Jacques Noubiap; Christoph Nowak; Virginia Nuñez-Samudio; Felix Akpojene Ogbo; Onome Bright Oghenetega; In-Hwan Oh; Morteza Oladnabi; Andrew T Olagunju; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Ahmed Omar Bali; Muktar Omer Omer; Obinna E Onwujekwe; Alberto Ortiz; Adrian Otoiu; Nikita Otstavnov; Stanislav S Otstavnov; Simon Øverland; Mayowa O Owolabi; Jagadish Rao Padubidri; Keyvan Pakshir; Raffaele Palladino; Adrian Pana; Songhomitra Panda-Jonas; Anamika Pandey; Carlo Irwin Able Panelo; Eun-Kee Park; Scott B Patten; Amy E Peden; Veincent Christian Filipino Pepito; Emmanuel K Peprah; Jeevan Pereira; Konrad Pesudovs; Hai Quang Pham; Michael R Phillips; Michael A Piradov; Meghdad Pirsaheb; Maarten J Postma; Faheem Hyder Pottoo; Hadi Pourjafar; Akram Pourshams; Sergio I Prada; Elisabetta Pupillo; Zahiruddin Quazi Syed; Mohammad Hasan Rabiee; Navid Rabiee; Amir Radfar; Ata Rafiee; Alberto Raggi; Fakher Rahim; Vafa Rahimi-Movaghar; Mohammad Hifz Ur Rahman; Muhammad Aziz Rahman; Kiana Ramezanzadeh; Chhabi Lal Ranabhat; Sowmya J Rao; Vahid Rashedi; Prateek Rastogi; Priya Rathi; David Laith Rawaf; Salman Rawaf; Lal Rawal; Reza Rawassizadeh; Andre M N Renzaho; Negar Rezaei; Nima Rezaei; Mohammad Sadegh Rezai; Seyed Mohammad Riahi; Jennifer Rickard; Leonardo Roever; Luca Ronfani; Gregory A Roth; Enrico Rubagotti; Susan Fred Rumisha; Godfrey M Rwegerera; Siamak Sabour; Perminder S Sachdev; Basema Saddik; Ehsan Sadeghi; Sahar Saeedi Moghaddam; Rajesh Sagar; Amirhossein Sahebkar; Mohammad Ali Sahraian; S Mohammad Sajadi; Marwa Rashad Salem; Hamideh Salimzadeh; Abdallah M Samy; Juan Sanabria; Milena M Santric-Milicevic; Sivan Yegnanarayana Iyer Saraswathy; Nizal Sarrafzadegan; Arash Sarveazad; Thirunavukkarasu Sathish; Davide Sattin; Deepak Saxena; Sonia Saxena; Silvia Schiavolin; David C Schwebel; Falk Schwendicke; Subramanian Senthilkumaran; Sadaf G Sepanlou; Feng Sha; Omid Shafaat; Saeed Shahabi; Amira A Shaheen; Masood Ali Shaikh; Saeed Shakiba; MohammadBagher Shamsi; Mohammed Shannawaz; Kiomars Sharafi; Aziz Sheikh; Sara Sheikhbahaei; B Suresh Kumar Shetty; Peilin Shi; Mika Shigematsu; Jae Il Shin; Rahman Shiri; Kerem Shuval; Soraya Siabani; Inga Dora Sigfusdottir; Rannveig Sigurvinsdottir; Diego Augusto Santos Silva; João Pedro Silva; Biagio Simonetti; Jasvinder A Singh; Virendra Singh; Abiy H Sinke; Valentin Yurievich Skryabin; Helen Slater; Emma U R Smith; Mohammad Reza Sobhiyeh; Eugene Sobngwi; Amin Soheili; Oluwaseyi Dolapo Somefun; Muluken Bekele Sorrie; Ireneous N Soyiri; Chandrashekhar T Sreeramareddy; Dan J Stein; Mark A Stokes; Agus Sudaryanto; Iyad Sultan; Rafael Tabarés-Seisdedos; Takahiro Tabuchi; Santosh Kumar Tadakamadla; Amir Taherkhani; Animut Tagele Tamiru; Md Ismail Tareque; Kavumpurathu Raman Thankappan; Rekha Thapar; Nihal Thomas; Mariya Vladimirovna Titova; Marcello Tonelli; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Ravensara S Travillian; Alexander C Tsai; Aristidis Tsatsakis; Lorainne Tudor Car; Riaz Uddin; Brigid Unim; Bhaskaran Unnikrishnan; Era Upadhyay; Marco Vacante; Sahel Valadan Tahbaz; Pascual R Valdez; Santosh Varughese; Tommi Juhani Vasankari; Narayanaswamy Venketasubramanian; Paul J Villeneuve; Francesco S Violante; Vasily Vlassov; Theo Vos; Giang Thu Vu; Yasir Waheed; Richard G Wamai; Yafeng Wang; Yanzhong Wang; Yuan-Pang Wang; Ronny Westerman; Nuwan Darshana Wickramasinghe; Ai-Min Wu; Chenkai Wu; Seyed Hossein Yahyazadeh Jabbari; Kazumasa Yamagishi; Yuichiro Yano; Sanni Yaya; Vahid Yazdi-Feyzabadi; Yordanos Gizachew Yeshitila; Paul Yip; Naohiro Yonemoto; Seok-Jun Yoon; Mustafa Z Younis; Taraneh Yousefinezhadi; Chuanhua Yu; Yong Yu; Deniz Yuce; Syed Saoud Zaidi; Sojib Bin Zaman; Mohammad Zamani; Maryam Zamanian; Hadi Zarafshan; Ahmad Zarei; Mikhail Sergeevich Zastrozhin; Yunquan Zhang; Zhi-Jiang Zhang; Xiu-Ju George Zhao; Cong Zhu; George C Patton; Russell M Viner
Background: Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10–24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods: We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10–24 years by age group (10–14 years, 15–19 years, and 20–24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10–24 years with that in children aged 0–9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10–24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). Findings: In 2019 there were 1·49 million deaths (95% uncertainty interval 1·39–1·59) worldwide in people aged 10–24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or maternal causes; 27·0% were due to non-communicable diseases; and 8·2% were due to self-harm. Since 1950, deaths in this age group decreased by 30·0% in females and 15·3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10–14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15–19 years was 1·3% in males and 1·6% in females, almost half that of males aged 1–4 years (2·4%), and around a third less than in females aged 1–4 years (2·5%). The proportion of global deaths in people aged 0–24 years that occurred in people aged 10–24 years more than doubled between 1950 and 2019, from 9·5% to 21·6%. Interpretation: Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10–24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group. Funding: Bill & Melinda Gates Foundation. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Hearing loss prevalence and years lived with disability, 1990-2019: Findings from the Global Burden of Disease Study 2019
(Elsevier B.V., 2021) Lydia M. Haile; Kaloyan Kamenov; Paul Svitil Briant; Aislyn U. Orji; Jaimie D. Steinmetz; Amir Abdoli; Mohammad Abdollahi; Eman Abu-Gharbieh; Ashkan Afshin; Haroon Ahmed; Tarik Ahmed Rashid; Yonas Akalu; Fares Alahdab; Fahad Mashhour Alanezi; Turki M. Alanzi; Hanadi Al Hamad; Liaqat Ali; Vahid Alipour; Rajaa M. Al-Raddadi; Hubert Amu; Jalal Arabloo; Morteza Arab-Zozani; Judie Arulappan; Charlie Ashbaugh; Desta Debalkie Atnafu; Zaheer-Ud-Din Babar; Atif Amin Baig; Palash Chandra Banik; Till Winfried Bärnighausen; Amadou Barrow; Rose G. Bender; Akshaya Srikanth Bhagavathula; Nikha Bhardwaj; Pankaj Bhardwaj; Sadia Bibi; Ali Bijani; Katrin Burkart; Christopher R. Cederroth; Jaykaran Charan; Sonali Gajanan Choudhari; Dinh-Toi Chu; Rosa A.S. Couto; Amare Belachew Dagnew; Baye Dagnew; Saad M.A. Dahlawi; Xiaochen Dai; Lalit Dandona; Rakhi Dandona; Assefa Desalew; Deepak Dhamnetiya; Mandira Lamichhane Dhimal; Meghnath Dhimal; Kerrie E. Doyle; Bruce B. Duncan; Michael Ekholuenetale; Irina Filip; Florian Fischer; Richard Charles Franklin; Abhay Motiramji Gaidhane; Shilpa Gaidhane; Silvano Gallus; Farhad Ghamari; Ahmad Ghashghaee; Ghozali Ghozali; Syed Amir Gilani; Ionela-Roxana Glǎvan; Mahaveer Golechha; Barbara Niegia Garcia Goulart; Veer Bala Gupta; Vivek Kumar Gupta; Samer Hamidi; Billy Randall Hammond; Simon I. Hay; Khezar Hayat; Golnaz Heidari; Howard J. Hoffman; Kathleen Pillsbury Hopf; Mehdi Hosseinzadeh; Mowafa Househ; Rabia Hussain; Bing-Fang Hwang; Ivo Iavicoli; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Seyed Sina Naghibi Irvani; Sheikh Mohammed Shariful Islam; Masao Iwagami; Louis Jacob; Sathish Kumar Jayapal; Ravi Prakash Jha; Jost B. Jonas; Rohollah Kalhor; Nawzad Kameran Al-Salihi; Himal Kandel; Ayele Semachew Kasa; Gbenga A. Kayode; Rovshan Khalilov; Ejaz Ahmad Khan; Mahalaqua Nazli Khatib; Soewarta Kosen; Ai Koyanagi; G. Anil Kumar; Ivan Landires; Savita Lasrado; Stephen S. Lim; Xuefeng Liu; Stany W. Lobo; Alessandra Lugo; Alaa Makki; Walter Mendoza; Amanual Getnet Mersha; Kebadnew Mulatu Mihretie; Ted R. Miller; Sanjeev Misra; Teroj Abdulrahman Mohamed; Mokhtar Mohammadi; Abdollah Mohammadian-Hafshejani; Arif Mohammed; Ali H. Mokdad; Mohammad Ali Moni; Sandhya Neupane Kandel; Huong Lan Thi Nguyen; Molly R. Nixon; Jean Jacques Noubiap; Virginia Nuñez-Samudio; Bogdan Oancea; Victor Maduabuchi Oguoma; Andrew T. Olagunju; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Hans Orru; Mayowa O. Owolabi; Jagadish Rao Padubidri; Keyvan Pakshir; Shahina Pardhan; Fatemeh Pashazadeh Kan; Maja Pasovic; Shrikant Pawar; Hai Quang Pham; Marina Pinheiro; Akram Pourshams; Navid Rabiee; Mohammad Rabiee; Amir Radfar; Fakher Rahim; Vafa Rahimi-Movaghar; Mohammad Hifz Ur Rahman; Mosiur Rahman; Amir Masoud Rahmani; Juwel Rana; Chythra R. Rao; Sowmya J. Rao; Vahid Rashedi; David Laith Rawaf; Salman Rawaf; Andre M.N. Renzaho; Aziz Rezapour; Rezaul Karim Ripon; Voilet Rodrigues; Neeti Rustagi; Umar Saeed; Amirhossein Sahebkar; Abdallah M. Samy; Milena M. Santric-Milicevic; Brijesh Sathian; Maheswar Satpathy; Monika Sawhney; Winfried Schlee; Maria Ines Schmidt; Allen Seylani; Masood Ali Shaikh; Mohammed Shannawaz; Wondimeneh Shibabaw Shiferaw; Soraya Siabani; Anjali Singal; Jasvinder A. Singh; Jitendra Kumar Singh; Deepika Singhal; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Houman Sotoudeh; Emma Elizabeth Spurlock; Biruk Wogayehu Taddele; Animut Tagele Tamiru; Md Ismail Tareque; Rekha Thapar; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Saif Ullah; Sahel Valadan Tahbaz; Francesco S. Violante; Vasily Vlassov; Bay Vo; Avina Vongpradith; Giang Thu Vu; Jingkai Wei; Ali Yadollahpour; Seyed Hossein Yahyazadeh Jabbari; Yigizie Yeshaw; Vahit Yiǧit; Birhanu Wubale Yirdaw; Naohiro Yonemoto; Chuanhua Yu; Ismaeel Yunusa; Mohammad Zamani; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Zhi-Jiang Zhang; Jeff T. Zhao; Christopher J.L. Murray; Adrian C. Davis; Theo Vos; Shelly Chadha
Background: Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods: We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. Findings: An estimated 1·57 billion (95% uncertainty interval 1·51–1·64) people globally had hearing loss in 2019, accounting for one in five people (20·3% [19·5–21·1]). Of these, 403·3 million (357·3–449·5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430·4 million (381·7–479·6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127·1 million people [112·3–142·6]). Of all people with a hearing impairment, 62·1% (60·2–63·9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65·8% of the variation in national age-standardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2·45 billion (2·35–2·56) people will have hearing loss, a 56·1% (47·3–65·2) increase from 2019, despite stable age-standardised prevalence. Interpretation: As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings. Funding: Bill & Melinda Gates Foundation and WHO. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017
(Nature Research, 2020) Damaris K. Kinyoki; Jennifer M. Ross; Alice Lazzar-Atwood; Sandra B. Munro; Lauren E. Schaeffer; Mahdieh Abbasalizad-Farhangi; Masoumeh Abbasi; Hedayat Abbastabar; Ahmed Abdelalim; Amir Abdoli; Mohammad Abdollahi; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Nebiyu Dereje Abebe; Teshome Abuka Abebo; Kedir Hussein Abegaz; Hassan Abolhassani; Lucas Guimarães Abreu; Michael R. M. Abrigo; Abdelrahman I. Abushouk; Manfred Mario Kokou Accrombessi; Dilaram Acharya; Maryam Adabi; Akindele Olupelumi Adebiyi; Isaac Akinkunmi Adedeji; Victor Adekanmbi; Abiodun Moshood Adeoye; Olatunji O. Adetokunboh; Davoud Adham; Posi Emmanuel Aduroja; Shailesh M. Advani; Mohsen Afarideh; Mohammad Aghaali; Anurag Agrawal; Tauseef Ahmad; Keivan Ahmadi; Sepideh Ahmadi; Muktar Beshir Ahmed; Rushdia Ahmed; Olufemi Ajumobi; Chalachew Genet Akal; Temesgen Yihunie Akalu; Tomi Akinyemiju; Blessing Akombi; Ziyad Al-Aly; Samiah Alam; Genet Melak Alamene; Turki M. Alanzi; Jacqueline Elizabeth Alcalde Rabanal; Niguse Meles Alema; Beriwan Abdulqadir Ali; Muhammad Ali; Mehran Alijanzadeh; Cyrus Alinia; Vahid Alipour; Hesam Alizade; Syed Mohamed Aljunid; Afshin Almasi; Amir Almasi-Hashiani; Hesham M. Al-Mekhlafi; Rajaa M. Al-Raddadi; Khalid Altirkawi; Nelson Alvis-Guzman; Nelson J. Alvis-Zakzuk; Azmeraw T. Amare; Adeladza Kofi Amegah; Saeed Amini; Mostafa Amini Rarani; Fatemeh Amiri; Arianna Maever Loreche Amit; Nahla Hamed Anber; Catalina Liliana Andrei; Fereshteh Ansari; Alireza Ansari-Moghaddam; Zelalem Alamrew Anteneh; Carl Abelardo T. Antonio; Ernoiz Antriyandarti; Davood Anvari; Razique Anwer; Seth Christopher Yaw Appiah; Jalal Arabloo; Morteza Arab-Zozani; Ephrem Mebrahtu Araya; Zohreh Arefi; Olatunde Aremu; Johan Ärnlöv; Afsaneh Arzani; Mehran Asadi-Aliabadi; Ali A. Asadi-Pooya; Samaneh Asgari; Babak Asghari; Alebachew Fasil Ashagre; Anemaw A. Asrat; Bahar Ataeinia; Hagos Tasew Atalay; Desta Debalkie Atnafu; Maha Moh’d Wahbi Atout; Marcel Ausloos; Euripide F. G. A. Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Martin Amogre Ayanore; Yared A. Asmare Aynalem; Abbas Azadmehr; Samad Azari; Ghasem Azarian; Zelalem Nigussie Azene; Ebrahim Babaee; Alaa Badawi; Ashish D. Badiye; Mohamad Amin Bahrami; Atif Amin A. Baig; Ahad Bakhtiari; Shankar M. Bakkannavar; Senthilkumar Balakrishnan; Ayele Geleto Bali; Maciej Banach; Palash Chandra Banik; Zahra Baradaran-Seyed; Adhanom Gebreegziabher Baraki; Miguel A. Barboza; Till Winfried Bärnighausen; Lingkan Barua; Huda Basaleem; Sanjay Basu; Mohsen Bayati; Mulat Tirfie Bayih; Habtamu Wondifraw Baynes; Neeraj Bedi; Masoud Behzadifar; Meysam Behzadifar; Yibeltal Alemu Bekele; Derrick A. Bennett; Dessalegn Ajema Berbada; Kidanemaryam Berhe; Abadi Kidanemariam Berhe; Adam E. Berman; Robert S. Bernstein; Reshmi Bhageerathy; Dinesh Bhandari; Pankaj Bharadwaj; Natalia V. Bhattacharjee; Krittika Bhattacharyya; Ali Bijani; Boris Bikbov; Ver Bilano; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Setognal Birara; Minuye Biniam Biniam Birhane; Minyichil Birhanu; Raaj Kishore Biswas; Zebenay Workneh Bitew; Kassawmar Angaw Bogale; Somayeh Bohlouli; Srinivasa Rao Bolla; Archith Boloor; Antonio M. Borzì; Shiva Borzouei; Oliver J. Brady; Nicola Luigi Bragazzi; Dejana Braithwaite; Nikolay Ivanovich Briko; Gabrielle Britton; Shyam S. Budhathoki; Sharath Burugina Nagaraja; Reinhard Busse; Zahid A. Butt; Lucero Cahuana-Hurtado; Luis Alberto Cámera; Ismael R. Campos-Nonato; Jorge Cano; Josip Car; Rosario Cárdenas; Juan J. Carrero; Félix Carvalho; João Mauricio Castaldelli-Maia; Carlos A. Castañeda-Orjuela; Franz Castro; Ester Cerin; Collins Chansa; Jaykaran Charan; Pranab Chatterjee; Vijay Kumar Chattu; Bal Govind Chauhan; Ali Reza Chavshin; Mohammad Chehrazi; Tesfaye Yitna Chichiabellu; Ken Lee Chin; Devasahayam J. Christopher; Dinh-Toi Chu; Flavia M. 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Durães; Lucas Earl; Hamed Ebrahimzadeh Leylabadlo; Aziz Eftekhari; Iman El Sayed; Maysaa El Sayed Zaki; Maha El Tantawi; Iffat Elbarazi; Demelash Abewa Elemineh; Shaimaa I. El-Jaafary; Ziad El-Khatib; Aisha Elsharkawy; Yasser Mohamed El-Sherbiny; Iqbal R. F. Elyazar; Mohammad Hassan Emamian; Shymaa Enany; Daniel Adane Endalew; Melese Linger Endalifer; Khalil Eskandari; Sharareh Eskandarieh; Saman Esmaeilnejad; Alireza Esteghamati; Arash Etemadi; Atkilt Esaiyas Etisso; Jessica Fanzo; Mohammad Farahmand; Anwar Faraj; Sajjad Farashi; Mohammad Fareed; Andrea Farioli; Andre Faro; Farshad Farzadfar; Hossein Farzam; Syeda Sadia Fatima; Nazir Fattahi; Nelsensius Klau Fauk; Ali Akbar Fazaeli; Netsanet Fentahun; Tomas Y. Ferede; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; João C. Fernandes; Garumma Tolu Feyissa; Irina Filip; Florian Fischer; Carsten Flohr; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Artem Alekseevich Fomenkov; Masoud Foroutan; Jana Förster; Joel Msafiri Francis; Takeshi Fukumoto; Reta Tsegaye Gayesa; Biniyam Sahiledengle Geberemariyam; Tsegaye Tewelde Gebrehiwot; Hadush Gebremariam; Kidane Tadesse Gebremariam; Ketema Bizuwork Bizuwork Gebremedhin; Gebreamlak Gebremedhn Gebremeskel; Assefa Ayalew Ayalew Gebreslassie; Gebretsadkan G. G. Gebretsadik; Getnet Azeze Gedefaw; Yilma Chisha Dea Geramo; Hailay Abrha Gesesew; Birhanu Geta; Agegnehu Bante Getenet; Kebede Embaye Gezae; Fatemeh Ghaffarifar; Mansour Ghafourifard; Alireza Ghajar; Mahsa Ghajarzadeh; Ahmad Ghashghaee; Hesam Ghiasvand; Asadollah Gholamian; Syed Amir Gilani; Tiffany K. Gill; Ibrahim Abdelmageed Ginawi; Srinivas Goli; Nelson G. M. Gomes; Sameer Vali Gopalani; Houman Goudarzi; Alessandra C. Goulart; Arunkumar Govindakarnavar; Ayman Grada; Michal Grivna; Rafael Alves Guimarães; Rashid Abdi Guled; Yuming Guo; Rahul Gupta; Rajeev Gupta; Nima Hafezi-Nejad; Michael Tamene Haile; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Brian J. Hall; Iman Halvaei; Randah R. Hamadeh; Yadollah Hamidi; Demelash Woldeyohannes Handiso; Graeme J. Hankey; Hamidreza Haririan; Ninuk Hariyani; Ahmed I. Hasaballah; Md. Mehedi Hasan; Milad Hasankhani; Edris Hasanpoor; Amir Hasanzadeh; Maryam Hashemian; Soheil Hassanipour; Hamid Yimam Hassen; Rasmus Havmoeller; Corinna Hawkes; Khezar Hayat; Desta Haftu Hayelom; Behnam Heidari; Reza Heidari-Soureshjani; Delia Hendrie; Andualem Henok; Nathaniel J. Henry; Mario Herrero; Claudiu Herteliu; Fatemeh Heydarpour; Hagos D. de Hidru; Chi Linh Hoang; Hans W. Hoek; Michael K. Hole; Ramesh Holla; Gillian Hollerich; Enayatollah Homaie Rad; Sung Hwi Hong; Praveen Hoogar; Masako Horino; Naznin Hossain; Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Mohamed Hsairi; Guoqing Hu; Tanvir M. Huda; Ayesha Humayun; Bing-Fang Hwang; Segun Emmanuel Ibitoye; Olayinka Stephen Ilesanmi; Milena D. Ilic; Mohammad Hasan Imani-Nasab; Leeberk Raja Inbaraj; Usman Iqbal; Seyed Sina Naghibi Irvani; Sheikh Mohammed Shariful Islam; Chidozie C. D. Iwu; Chinwe Juliana Iwu; Neda Izadi; Jalil Jaafari; Anelisa Jaca; Farhad Jadidi-Niaragh; Nader Jafari Balalami; Morteza Jafarinia; Mohammad Ali Jahani; Mihajlo Jakovljevic; Amir Jalali; Farzad Jalilian; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Fyezah Jehan; Ensiyeh Jenabi; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Peng Jia; Oommen John; Yetunde O. John-Akinola; Kimberly B. Johnson; Jost B. Jonas; Nitin Joseph; Farahnaz Joukar; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk Jürisson; Ali Kabir; Zubair Kabir; Amaha Kahsay; Molla Kahssay; Hamed Kalani; Leila L. Kalankesh; Rohollah Kalhor; Zahra Kamiab; Tanuj Kanchan; Umesh Kapil; Neeti Kapoor; Manoochehr Karami; Behzad Karami Matin; André Karch; Mohd A. Karim; Surendra Karki; Amir Kasaeian; Gebremicheal Gebreslassie Kasahun; Habtamu Kebebe Kasaye; Tesfaye Dessale Kassa; Hagazi Gebremedhin Kassaye; Nicholas J. Kassebaum; Ali Kazemi Karyani; Andre Pascal Kengne; Daniel Bekele Ketema; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Mojtaba Khaksarian; Nauman Khalid; Ibrahim A. Khalil; Rovshan Khalilov; Asad Khan; Ejaz Ahmad Khan; Md Nuruzzaman Khan; Mohammad Saud Khan; Muhammad Shahzeb Khan; Khaled Khatab; Amir Khater; Mona M. Khater; Mahalqua Nazli Khatib; Maryam Khayamzadeh; Maryam Khazaei-Pool; Mohammad Khazaei; Salman Khazaei; Mohammad Taghi Khodayari; Mohammad Hossein Khosravi; Roba Khundkar; Ali Kiadaliri; Neda Kianipour; Daniel N. Kiirithio; Yun Jin Kim; Ruth W. Kimokoti; Adnan Kisa; Sezer Kisa; Tufa Kolola; Hamidreza Komaki; Shivakumar K. M. Kondlahalli; Ali Koolivand; Parvaiz A. Koul; Ai Koyanagi; Moritz U. G. Kraemer; Kewal Krishan; Kris J. Krohn; Nuworza Kugbey; Manasi Kumar; Pushpendra Kumar; Vivek Kumar; Om P. Kurmi; Oluwatosin Kuti; Carlo La Vecchia; Ben Lacey; Deepesh P. Lad; Aparna Lal; Dharmesh Kumar Lal; Faris Hasan Lami; Prabhat Lamichhane; Justin J. Lang; Van C. Lansingh; Savita Lasrado; Georgy Lebedev; Paul H. Lee; Shaun Wen Huey Lee; Mostafa Leili; Ian D. Letourneau; Sonia Lewycka; Shanshan Li; Lee-Ling Lim; Shai Linn; Shiwei Liu; Simin Liu; Rakesh Lodha; Joshua Longbottom; Jaifred Christian F. Lopez; Stefan Lorkowski; Erlyn Rachelle King Macarayan; Mohammed Madadin; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Dhaval P. Maghavani; Phetole Walter Mahasha; Narayan Bahadur Mahotra; Venkatesh Maled; Afshin Maleki; Shokofeh Maleki; Deborah Carvalho Malta; Ali Manafi; Farzad Manafi; Navid Manafi; Narendar Dawanu Manohar; Fariborz Mansour-Ghanaei; Borhan Mansouri; Mohammad Ali Mansournia; Chabila Christopher Mapoma; Dadi Marami; Laurie B. Marczak; Carlos Alberto Marrugo Arnedo; Francisco Rogerlândio Martins-Melo; Anthony Masaka; Benjamin Ballard Massenburg; Pallab K. Maulik; Benjamin K. Mayala; Mohsen Mazidi; Man Mohan Mehndiratta; Freshteh Mehri; Kala M. Mehta; Wahengbam Bigyananda Meitei; Fantahun Ayenew Mekonnen; Teferi Mekonnen; Gebrekiros Gebremichael Meles; Hagazi Gebre Meles; Addisu Melese; Walter Mendoza; Ritesh G. Menezes; Meresa Berwo Mengesha; George A. Mensah; Tuomo J. Meretoja; Tomasz Miazgowski; Neda Milevska Kostova; Ted R. Miller; Edward J. Mills; G.K. Mini; Seyed Mostafa Mir; Mohammad Miri; Hamed Mirjalali; Erkin M. Mirrakhimov; Hamed Mirzaei; Maryam Mirzaei; Roya Mirzaei; Mehdi Mirzaei-Alavijeh; Prasanna Mithra; Babak Moazen; Efat Mohamadi; Amjad Mohamadi-Bolbanabad; Karzan Abdulmuhsin Mohammad; Yousef Mohammad; Dara K. Mohammad; Aso Mohammad Darwesh; Naser Mohammad Gholi Mezerji; Abdollah Mohammadian-Hafshejani; Mousa Mohammadnia-Afrouzi; Milad Mohammadoo-Khorasani; Reza Mohammadpourhodki; Salahuddin Mohammed; Shafiu Mohammed; Jemal Abdu Mohammed; Ammas Siraj Mohammed; Farnam Mohebi; Amin Mokari; Ali H. Mokdad; Julio Cesar Montañez; Pablo A. Montero-Zamora; Yoshan Moodley; Maryam Moossavi; Ghobad Moradi; Masoud Moradi; Yousef Moradi; Mohammad Moradi-Joo; Maziar Moradi-Lakeh; Farhad Moradpour; Rahmatollah Moradzadeh; Paula Moraga; Shane Douglas Morrison; Abbas Mosapour; Jonathan F. Mosser; Simin Mouodi; Amin Mousavi Khaneghah; Dariush Mozaffarian; Ulrich Otto Mueller; Christopher J. L. Murray; G.V.S. Murthy; Kamarul Imran Musa; Ghulam Mustafa; Saravanan Muthupandian; Behnam Nabavizadeh; Mehdi Naderi; Girish N. Nadkarni; Ahamarshan Jayaraman Nagarajan; Mohsen Naghavi; Aliya Naheed; Gurudatta Naik; Farid Najafi; Jobert Richie Nansseu; K. M. Venkat Narayan; Bruno Ramos Nascimento; Vinod Nayak; Javad Nazari; Duduzile Edith Ndwandwe; Ionut Negoi; Ruxandra Irina Negoi; Josephine W. Ngunjiri; Cuong Tat Nguyen; Huong Lan Thi Nguyen; Dabere Nigatu; Yesdhambel T. Nigatu; Rajan Nikbakhsh; Dina Nur Anggraini Ningrum; Chukwudi A. Nnaji; Vuong Minh Nong; Jean Jacques Noubiap; Christoph Nowak; Bogdan Oancea; Richard Ofori-Asenso; Onome Bright Oghenetega; In-Hwan Oh; Olanrewaju Oladimeji; Morteza Oladnabi; Andrew T. Olagunju; Tinuke O. Olagunju; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Mojisola Morenike Oluwasanu; Muktar Omer Omer; Obinna E. Onwujekwe; Kwaku Oppong Asante; Eyal Oren; Orish Ebere Orisakwe; Alberto Ortiz; Osayomwanbo Osarenotor; Aaron E. Osgood-Zimmerman; Mayowa Ojo Owolabi; Mahesh P. A; Jagadish Rao Padubidri; Keyvan Pakshir; Adrian Pana; Songhomitra Panda-Jonas; Hadi Parsian; Tahereh Pashaei; Deepak Kumar Pasupula; Sangram Kishor Patel; Ashish Pathak; Mona Pathak; Sanghamitra Pati; Ajay Patle; George C. Patton; Kebreab Paulos; Hamidreza Pazoki Toroudi; Veincent Christian Filipino Pepito; Norberto Perico; William A. Petri; Brandon V. Pickering; David M. Pigott; Majid Pirestani; Bakhtiar Piroozi; Meghdad Pirsaheb; Khem Narayan Pokhrel; Maarten J. Postma; Hadi Pourjafar; Farshad Pourmalek; Reza Pourmirza Kalhori; Akram Pourshams; Hossein Poustchi; Sergio I. Prada; Liliana Preotescu; Dimas Ria Angga Pribadi; Zahiruddin Quazi Syed; Mohammad Rabiee; Navid Rabiee; Amir Radfar; Alireza Rafiei; Fakher Rahim; Vafa Rahimi-Movaghar; Muhammad Aziz Rahman; Sajjad ur Rahman; Rajesh Kumar Rai; Ali Rajabpour-Sanati; Fatemeh Rajati; Kiana Ramezanzadeh; Saleem Muhammad Rana; Chhabi Lal Ranabhat; Sowmya J. 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Singh; Pankaj Kumar Singh; Dhirendra Narain Sinha; Yitagesu Sintayehu; Malede Mequanent M. Sisay; Amin Soheili; Bija Soleymani; Farzaneh Soltani; Shahin Soltani; Joan B. Soriano; Muluken Bekele Sorrie; Sergey Soshnikov; Ireneous N. Soyiri; Adel Spotin; Chandrashekhar T. Sreeramareddy; Rajni Kant Kant Srivastava; Antonina Starodubova; Agus Sudaryanto; Mu’awiyyah Babale Sufiyan; Hafiz Ansar Rasul Suleria; Gerhard Sulo; Bruno F. Sunguya; Bryan L. Sykes; Rafael Tabarés-Seisdedos; Takahiro Tabuchi; Birkneh Tilahun Tadesse; Amir Taherkhani; Koku Sisay Tamirat; Segen Gebremeskel Tassew; Nuno Taveira; Berhane Fseha Teklehaimanot; Gebretsadkan Hintsa Tekulu; Mohamad-Hani Temsah; Abdullah Sulieman Terkawi; Zemenu Tadesse Tessema; Nihal Thomas; Mariya Vladimirovna Titova; Kenean Getaneh Tlaye; Hamid Reza Tohidinik; Marcello Tonelli; Marcos Roberto Tovani-Palone; Eugenio Traini; Khanh Bao Tran; Manjari Tripathi; Riaz Uddin; Irfan Ullah; Bhaskaran Unnikrishnan; Era Upadhyay; Ushotanefe Useh; Muhammad Shariq Usman; Olalekan A. Uthman; Marco Vacante; Masoud Vaezghasemi; Pascual R. Valdez; John VanderHeide; Elena Varavikova; Santosh Varughese; Tommi Juhani Vasankari; Yasser Vasseghian; Yousef Veisani; Srinivasaraghavan Venkatesh; Narayanaswamy Venketasubramanian; Madhur Verma; Simone Vidale; Francesco S. Violante; Vasily Vlassov; Sebastian Vollmer; Rade Vukovic; Yasir Waheed; Haidong Wang; Yafeng Wang; Yuan-Pang Wang; Girmay Teklay Weldesamuel; Andrea Werdecker; Taweewat Wiangkham; Kirsten E. Wiens; Tissa Wijeratne; Haileab Fekadu Wolde; Dawit Zewdu Wondafrash; Tewodros Eshete Wonde; Adam Belay Wondmieneh; Ai-Min Wu; Gelin Xu; Abbas Yadegar; Ali Yadollahpour; Seyed Hossein Yahyazadeh Jabbari; Tomohide Yamada; Yuichiro Yano; Sanni Yaya; Vahid Yazdi-Feyzabadi; Alex Yeshaneh; Yigizie Yeshaw; Yordanos Gizachew Yeshitila; Mekdes Tigistu Yilma; Paul Yip; Naohiro Yonemoto; Seok-Jun Yoon; Yoosik Youm; Mustafa Z. Younis; Zabihollah Yousefi; Hebat-Allah Salah A. Yousof; Chuanhua Yu; Hasan Yusefzadeh; Telma Zahirian Moghadam; Leila Zaki; Sojib Bin Zaman; Mohammad Zamani; Maryam Zamanian; Hamed Zandian; Hadi Zarafshan; Nejimu Biza Zepro; Taddese Alemu Zerfu; Taye Abuhay Zewale; Yunquan Zhang; Zhi-Jiang Zhang; Xiu-Ju Zhao; Sanjay Zodpey; Kamiar Zomorodian; Francis Bruno Zotor; Ashkan Afshin; Simon I. Hay
A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic. © 2020, The Author(s).
Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
(Lancet Publishing Group, 2020) Rafael Lozano; Nancy Fullman; John Everett Mumford; Megan Knight; Celine M Barthelemy; Cristiana Abbafati; Hedayat Abbastabar; Foad Abd-Allah; Mohammad Abdollahi; Aidin Abedi; Hassan Abolhassani; Akine Eshete Abosetugn; Lucas Guimarães Abreu; Michael R M Abrigo; Abdulaziz Khalid Abu Haimed; Abdelrahman I Abushouk; Maryam Adabi; Oladimeji M Adebayo; Victor Adekanmbi; Jaimie Adelson; Olatunji O Adetokunboh; Davoud Adham; Shailesh M Advani; Ashkan Afshin; Gina Agarwal; Pradyumna Agasthi; Seyed Mohammad Kazem Aghamir; Anurag Agrawal; Tauseef Ahmad; Rufus Olusola Akinyemi; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Samuel B Albertson; Yihun Mulugeta Alemu; Robert Kaba Alhassan; Muhammad Ali; Saqib Ali; Vahid Alipour; Syed Mohamed Aljunid; François Alla; Majid Abdulrahman Hamad Almadi; Ali Almasi; Amir Almasi-Hashiani; Nihad A Almasri; Hesham M Al-Mekhlafi; Abdulaziz M Almulhim; Jordi Alonso; Rajaa M Al-Raddadi; Khalid A Altirkawi; Nelson Alvis-Guzman; Nelson J Alvis-Zakzuk; Saeed Amini; Mostafa Amini-Rarani; Fatemeh Amiri; Arianna Maever L Amit; Dickson A Amugsi; Robert Ancuceanu; Deanna Anderlini; Catalina Liliana Andrei; Sofia Androudi; Fereshteh Ansari; Alireza Ansari-Moghaddam; Carl Abelardo T Antonio; Catherine M Antony; Ernoiz Antriyandarti; Davood Anvari; Razique Anwer; Jalal Arabloo; Morteza Arab-Zozani; Aleksandr Y Aravkin; Olatunde Aremu; Johan Ärnlöv; Malke Asaad; Mehran Asadi-Aliabadi; Ali A Asadi-Pooya; Seyyed Shamsadin Athari; Maha Moh'd Wahbi Atout; Marcel Ausloos; Leticia Avila-Burgos; Beatriz Paulina Ayala Quintanilla; Getinet Ayano; Martin Amogre Ayanore; Yared Asmare Aynalem; Getie Lake Aynalem; Muluken Altaye Ayza; Samad Azari; Peter S Azzopardi; Darshan B B; Ebrahim Babaee; Ashish D Badiye; Mohammad Amin Bahrami; Atif Amin Baig; Mohammad Hossein Bakhshaei; Ahad Bakhtiari; Shankar M Bakkannavar; Arun Balachandran; Maciej Banach; Srikanta K Banerjee; Palash Chandra Banik; Agegnehu Bante Bante; Simachew Animen Bante; Suzanne Lyn Barker-Collo; 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Ferrán Catalá-López; Christopher R Cederroth; Ester Cerin; Joht Singh Chandan; Angela Y Chang; Jaykaran Charan; Vijay Kumar Chattu; Sarika Chaturvedi; Ken Lee Chin; Daniel Youngwhan Cho; Jee-Young Jasmine Choi; Hanne Christensen; Dinh-Toi Chu; Michael T Chung; Liliana G Ciobanu; Massimo Cirillo; Kelly Compton; Paolo Angelo Cortesi; Vera Marisa Costa; Ewerton Cousin; Saad M A Dahlawi; Giovanni Damiani; Lalit Dandona; Rakhi Dandona; Jiregna Darega Gela; Aso Mohammad Darwesh; Ahmad Daryani; Aditya Prasad Dash; Gail Davey; Claudio Alberto Dávila-Cervantes; Kairat Davletov; Jan-Walter De Neve; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Rupak Desai; Samath Dhamminda Dharmaratne; Govinda Prasad Dhungana; Mostafa Dianatinasab; Diana Dias da Silva; Daniel Diaz; Ilse N Dippenaar; Hoa Thi Do; Fariba Dorostkar; Leila Doshmangir; Bruce B Duncan; Andre Rodrigues Duraes; Arielle Wilder Eagan; David Edvardsson; Iman El Sayed; Maha El Tantawi; Islam Y Elgendy; Iqbal RF Elyazar; Khalil Eskandari; 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Background: Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings: Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation: The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC. Funding: Bill & Melinda Gates Foundation. © 2020 Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020
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Artamonov; Zahra Aryan; Malke Asaad; Mulusew A. Asemahagn; Thomas Astell-Burt; Seyyed Shamsadin Athari; Desta Debalkie Atnafu; Prince Atorkey; Alok Atreya; Floriane Ausloos; Marcel Ausloos; Getinet Ayano; Martin Amogre Ayanore; Olatunde O. Ayinde; Jose L. Ayuso-Mateos; Sina Azadnajafabad; Melkalem Mamuye Azanaw; Mohammadreza Azangou-Khyavy; Amirhossein Azari Jafari; Ahmed Y. Azzam; Ashish D. Badiye; Nasser Bagheri; Sara Bagherieh; Mohan Bairwa; Shankar M. Bakkannavar; Ravleen Kaur Bakshi; Awraris Hailu Balchut Bilchut; T.W. Bärnighausen; Fabio Barra; Amadou Barrow; Pritish Baskaran; Luis Belo; Derrick A. Bennett; Isabela M. Bensenor; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Ashish Bhalla; Nikha Bhardwaj; Pankaj Bhardwaj; Sonu Bhaskar; Krittika Bhattacharyya; Vijayalakshmi S. Bhojaraja; Bagas Suryo Bintoro; Elena A. Elena Blokhina; Belay Boda Abule Bodicha; Archith Boloor; Cristina Bosetti; Dejana Braithwaite; Hermann Brenner; Nikolay Ivanovich Briko; Andre R. Brunoni; Zahid A. 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Gad; Silvano Gallus; Fabio Galvano; Balasankar Ganesan; Tushar Garg; Mesfin Gebrehiwot Damtew Gebrehiwot; Teferi Gebru Gebremeskel; Mathewos Alemu Gebremichael; Tadele Regasa Gemechu; Lemma Getacher; Motuma Erena Getachew; Abera Getachew Obsa; Asmare Getie; Amir Ghaderi; Mansour Ghafourifard; Alireza Ghajar; Seyyed-Hadi Ghamari; Lilian A. Ghandour; Mohammad Ghasemi Nour; Ahmad Ghashghaee; Sherief Ghozy; Franklin N. Glozah; Ekaterina Vladimirovna Glushkova; Justyna Godos; Amit Goel; Salime Goharinezhad; Mahaveer Golechha; Pouya Goleij; Mohamad Golitaleb; Felix Greaves; Michal Grivna; Giuseppe Grosso; Temesgen Worku Gudayu; Bhawna Gupta; Rajeev Gupta; Sapna Gupta; Veer Bala Gupta; Vivek Kumar Gupta; Nima Hafezi-Nejad; Arvin Haj-Mirzaian; Brian J. Hall; Rabih Halwani; Tiilahun Beyene Handiso; Graeme J. Hankey; Sanam Hariri; Josep Maria Haro; Ahmed I. Hasaballah; Hossein Hassanian-Moghaddam; Simon I. Hay; Khezar Hayat; Golnaz Heidari; Mohammad Heidari; Delia Hendrie; Claudiu Herteliu; Demisu Zenbaba Heyi; Kamal Hezam; Mbuzeleni Mbuzeleni Hlongwa; Ramesh Holla; Md. Mahbub Hossain; Sahadat Hossain; Seyed Kianoosh Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Guoqing Hu; Junjie Huang; Salman Hussain; Segun Emmanuel Ibitoye; Irena M. Ilic; Milena D. Ilic; Mustapha Immurana; Lalu Muhammad Irham; M. Mofizul Islam; Rakibul M. Islam; Sheikh Mohammed Shariful Islam; Hiroyasu Iso; Ramaiah Itumalla; Masao Iwagami; Roxana Jabbarinejad; Louis Jacob; Mihajlo Jakovljevic; Zahra Jamalpoor; Elham Jamshidi; Sathish Kumar Jayapal; Umesh Umesh Jayarajah; Ranil Jayawardena; Rime Jebai; Seyed Ali Jeddi; Alelign Tasew Jema; Ravi Prakash Jha; Har Ashish Jindal; Jost B. Jonas; Tamas Joo; Nitin Joseph; Farahnaz Joukar; Jacek Jerzy Jozwiak; Mikk Jürisson; Ali Kabir; Robel Hussen Kabthymer; Bhushan Dattatray Kamble; Himal Kandel; Girum Gebremeskel Kanno; Neeti Kapoor; Ibraheem M. Karaye; Salah Eddin Karimi; Bekalu Getnet Kassa; Rimple Jeet Kaur; Gbenga A. Kayode; Mohammad Keykhaei; Himanshu Khajuria; Rovshan Khalilov; Imteyaz A. Khan; Moien A.B. Khan; Hanna Kim; Jihee Kim; Min Seo Kim; Ruth W. Kimokoti; Mika Kivimäki; Vitalii Klymchuk; Ann Kristin Skrindo Knudsen; Ali-Asghar Kolahi; Vladimir Andreevich Korshunov; Ai Koyanagi; Kewal Krishan; Yuvaraj Krishnamoorthy; G. Anil Kumar; Narinder Kumar; Nithin Kumar; Ben Lacey; Tea Lallukka; Savita Lasrado; Jerrald Lau; Sang-Woong Lee; Wei-Chen Lee; Yo Han Lee; Lee-Ling Lim; Stephen S. Lim; Stany W. Lobo; Platon D. Lopukhov; Stefan Lorkowski; Rafael Lozano; Giancarlo Lucchetti; Farzan Madadizadeh; Áurea M. Madureira-Carvalho; Soleiman Mahjoub; Ata Mahmoodpoor; Rashidul Alam Mahumud; Alaa Makki; Mohammad-Reza Malekpour; Narayana Manjunatha; Borhan Mansouri; Mohammad Ali Mansournia; Jose Martinez-Raga; Francisco A. Martinez-Villa; Richard Matzopoulos; Pallab K. Maulik; Mahsa Mayeli; John J. McGrath; Jitendra Kumar Meena; Entezar Mehrabi Nasab; Ritesh G. Menezes; Gert B.M. Mensink; Alexios-Fotios A. Mentis; Atte Meretoja; Bedasa Taye Merga; Tomislav Mestrovic; Junmei Miao Jonasson; Bartosz Miazgowski; Ana Carolina Micheletti Gomide Nogueira De Sá; Ted R. Miller; G.K. Mini; Andreea Mirica; Antonio Mirijello; Seyyedmohammadsadeq Mirmoeeni; Erkin M. Mirrakhimov; Sanjeev Misra; Babak Moazen; Maryam Mobarakabadi; Marcello Moccia; Yousef Mohammad; Esmaeil Mohammadi; Abdollah Mohammadian-Hafshejani; Teroj Abdulrahman Mohammed; Nagabhishek Moka; Ali H. Mokdad; Sara Momtazmanesh; Yousef Moradi; Ebrahim Mostafavi; Sumaira Mubarik; Erin C. Mullany; Beemnet Tekabe Mulugeta; Efrén Murillo-Zamora; Christopher J.L. Murray; Julius C. Mwita; Mohsen Naghavi; Mukhammad David Naimzada; Vinay Nangia; Biswa Prakash Nayak; Ionut Negoi; Ruxandra Irina Negoi; Seyed Aria Nejadghaderi; Samata Nepal; Sudan Prasad Prasad Neupane; Sandhya Neupane Kandel; Yeshambel T. Nigatu; Ali Nowroozi; Khan M. Nuruzzaman; Chimezie Igwegbe Nzoputam; Kehinde O. Obamiro; Felix Akpojene Ogbo; Ayodipupo Sikiru Oguntade; Hassan Okati-Aliabad; Babayemi Oluwaseun Olakunde; Gláucia Maria Moraes Oliveira; Ahmed Omar Bali; Emad Omer; Doris V. Ortega-Altamirano; Adrian Otoiu; Stanislav S. Otstavnov; Bilcha Oumer; P.A. Mahesh; Alicia Padron-Monedero; Raffaele Palladino; Adrian Pana; Songhomitra Panda-Jonas; Anamika Pandey; Ashok Pandey; Shahina Pardhan; Tarang Parekh; Eun-Kee Park; Charles D.H. Parry; Fatemeh Pashazadeh Kan; Jay Patel; Siddhartha Pati; George C. Patton; Uttam Paudel; Shrikant Pawar; Amy E. Peden; Ionela-Roxana Petcu; Michael R. Phillips; Marina Pinheiro; Evgenii Plotnikov; Pranil Man Singh Pradhan; Akila Prashant; Jianchao Quan; Amir Radfar; Alireza Rafiei; Pankaja Raghav Raghav; Vafa Rahimi-Movaghar; Azizur Rahman; Md.Mosfequr Rahman; Mosiur Rahman; Amir Masoud Rahmani; Shayan Rahmani; Chhabi Lal Ranabhat; Priyanga Ranasinghe; Chythra R. Rao; Drona Prakash Rasali; Mohammad-Mahdi Rashidi; Zubair Ahmed Ratan; David Laith Rawaf; Salman Rawaf; Lal Rawal; Andre M.N. Renzaho; Negar Rezaei; Saeid Rezaei; Mohsen Rezaeian; Seyed Mohammad Riahi; Esperanza Romero-Rodríguez; Gregory A. Roth; Godfrey M. Rwegerera; Basema Saddik; Erfan Sadeghi; Reihaneh Sadeghian; Umar Saeed; Farhad Saeedi; Rajesh Sagar; Amirhossein Sahebkar; Harihar Sahoo; Mohammad Ali Sahraian; K.M. Saif-Ur-Rahman; Sarvenaz Salahi; Hamideh Salimzadeh; Abdallah M. Samy; Francesco Sanmarchi; Milena M. Santric-Milicevic; Yaser Sarikhani; Brijesh Sathian; Ganesh Kumar Saya; Mehdi Sayyah; Maria Inês Schmidt; Aletta Elisabeth Schutte; Michaël Schwarzinger; David C. Schwebel; Abdul-Aziz Seidu; Nachimuthu Senthil Kumar; SeyedAhmad SeyedAlinaghi; Allen Seylani; Feng Sha; Sarvenaz Shahin; Fariba Shahraki-Sanavi; Shayan Shahrokhi; Masood Ali Shaikh; Elaheh Shaker; Murad Ziyaudinovich Shakhmardanov; Mehran Shams-Beyranvand; Sara Sheikhbahaei; Rahim Ali Sheikhi; Adithi Shetty; Jeevan K. Shetty; Damtew Solomon Shiferaw; Mika Shigematsu; Rahman Shiri; Reza Shirkoohi; K.M. Shivakumar; Velizar Shivarov; Parnian Shobeiri; Roman Shrestha; Negussie Boti Sidemo; Inga Dora Sigfusdottir; Diego Augusto Santos Silva; Natacha Torres da Silva; Jasvinder A. Singh; Surjit Singh; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; David A. Sleet; Marco Solmi; Yonatan Solomon; Suhang Song; Yimeng Song; Reed J.D. Sorensen; Sergey Soshnikov; Ireneous N. Soyiri; Dan J. Stein; Sonu Hangma Subba; Miklós Szócska; Rafael Tabarés-Seisdedos; Takahiro Tabuchi; Majid Taheri; Ker-Kan Tan; Minale Tareke; Elvis Enowbeyang Tarkang; Gebremaryam Temesgen; Worku Animaw Temesgen; Mohamad-Hani Temsah; Kavumpurathu Raman Thankappan; Rekha Thapar; Nikhil Kenny Thomas; Chalachew Tiruneh; Jovana Todorovic; Marco Torrado; Mathilde Touvier; Marcos Roberto Tovani-Palone; Mai Thi Ngoc Tran; Sergi Trias-Llimós; Jaya Prasad Tripathy; Alireza Vakilian; Rohollah Valizadeh; Mehdi Varmaghani; Shoban Babu Varthya; Tommi Juhani Vasankari; Theo Vos; Birhanu Wagaye; Yasir Waheed; Mandaras Tariku Walde; Cong Wang; Yanzhong Wang; Yuan-Pang Wang; Ronny Westerman; Nuwan Darshana Wickramasinghe; Abate Dargie Wubetu; Suowen Xu; Kazumasa Yamagishi; Lin Yang; Gesila Endashaw E. Yesera; Arzu Yigit; Vahit Yiğit; Ayenew Engida Yimaw; Dong Keon Yon; Naohiro Yonemoto; Chuanhua Yu; Siddhesh Zadey; Mazyar Zahir; Iman Zare; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Zhi-Jiang Zhang; Chenwen Zhong; Mohammad Zmaili; Yves Miel H. Zuniga; Emmanuela Gakidou
Background: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods: For this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male. Interpretation: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019: A systematic analysis from the Global Burden of Disease Study 2019
(Elsevier Ltd, 2021) Parkes J. Kendrick; Marissa B. Reitsma; Mohsen Abbasi-Kangevari; Amir Abdoli; Mohammad Abdollahi; Aidin Abedi; E.S. Abhilash; Victor Aboyans; Oladimeji M. Adebayo; Shailesh M. Advani; Bright Opoku Ahinkorah; Sohail Ahmad; Keivan Ahmadi; Haroon Ahmed; Budi Aji; Yonas Akalu; Chisom Joyqueenet Akunna; Fares Alahdab; Ziyad Al-Aly; Fahad Mashhour Alanezi; Turki M. Alanzi; Khalid F. Alhabib; Tilahun Ali; Sheikh Mohammad Alif; Vahid Alipour; Syed Mohamed Aljunid; Mahmoud A. Alomari; Tarek Tawfik Amin; Saeed Amini; Hubert Amu; Robert Ancuceanu; Jason A. Anderson; Catalina Liliana Andrei; Tudorel Andrei; Alireza Ansari-Moghaddam; Benny Antony; Davood Anvari; Jalal Arabloo; Nicholas D. Arian; Monika Arora; Kurnia Dwi Artanti; Wondwossen Niguse Asmare; Desta Debalkie Atnafu; Marcel Ausloos; Asma Tahir Awan; Getinet Ayano; Getie Lake Aynalem; Samad Azari; B.B. Darshan; Ashish D. Badiye; Atif Amin Baig; Maciej Banach; Srikanta K. Banerjee; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Hiba Jawdat Barqawi; Sanjay Basu; Mohsen Bayati; Shahrzad Bazargan-Hejazi; Tariku Tesfaye Bekuma; Derrick A. Bennett; Isabela M. Bensenor; Habib Benzian; Catherine P. Benziger; Adam E. Berman; Akshaya Srikanth Bhagavathula; Neeraj Bhala; Nikha Bhardwaj; Pankaj Bhardwaj; Krittika Bhattacharyya; Sadia Bibi; Ali Bijani; Antonio Biondi; Dejana Braithwaite; Hermann Brenner; Andre R. Brunoni; Katrin Burkart; Sharath Burugina Nagaraja; Zahid A. Butt; Florentino Luciano Caetano Dos Santos; Josip Car; Giulia Carreras; Joao Mauricio Castaldelli-Maia; Maria Sofia Sofia Cattaruzza; Jung-Chen Chang; Pankaj Chaturvedi; Simiao Chen; Onyema Greg Chido-Amajuoyi; Dinh-Toi Chu; Sheng-Chia Chung; Liliana G. Ciobanu; Vera Marisa Costa; Rosa A. S. Couto; Baye Dagnew; Xiaochen Dai; Albertino Antonio Moura Damasceno; Giovanni Damiani; Lalit Dandona; Rakhi Dandona; Parnaz Daneshpajouhnejad; Jiregna Darega Gela; Meseret Derbew Molla; Abebaw Alemayehu Desta; Samath Dhamminda Dharmaratne; Meghnath Dhimal; Arielle Wilder Eagan; Mohammad Ebrahimi Kalan; Kristina Edvardsson; Andem Effiong; Maha El Tantawi; Iffat Elbarazi; Saman Esmaeilnejad; Ibtihal Fadhil; Emerito Jose A. Faraon; Medhat Farwati; Farshad Farzadfar; Mehdi Fazlzadeh; Valery L. Feigin; Rachel Feldman; Irina Filip; Filippos Filippidis; Florian Fischer; Luisa Sorio Flor; Nataliya A. Foigt; Morenike Oluwatoyin Folayan; Masoud Foroutan; Mohamed M. Gad; Silvano Gallus; Biniyam Sahiledengle Geberemariyam; Birhan Gebresillassie Gebregiorgis; Lemma Getacher; Abera Getachew Obsa; Mansour Ghafourifard; Reza Ghanei Gheshlagh; Ahmad Ghashghaee; Nermin Ghith; Gabriela Fernanda Gil; Paramjit Singh Gill; Ibrahim Abdelmageed Ginawi; Salime Goharinezhad; Mahaveer Golechha; Sameer Vali Gopalani; Giuseppe Gorini; Michal Grivna; Avirup Guha; Rafael Alves Guimarães; Yuming Guo; Rajat Das Gupta; Rajeev Gupta; Tarun Gupta; Vin Gupta; Nima Hafezi-Nejad; Mohammad Rifat Haider; Randah R. Hamadeh; Graeme J. Hankey; Arief Hargono; Simon I. Hay; Golnaz Heidari; Claudiu Herteliu; Kamal Hezam; Thomas R. Hird; Ramesh Holla; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mowafa Househ; Thomas Hsiao; Junjie Huang; Charles Ugochukwu Ibeneme; Segun Emmanuel Ibitoye; Irena M. Ilic; Milena D. Ilic; Leeberk Raja Inbaraj; Seyed Sina Naghibi Irvani; Jessica Y. Islam; Rakibul M. Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Hiroyasu Iso; Ramaiah Itumalla; Jalil Jaafari; Vardhmaan Jain; Mihajlo Jakovljevic; Sung-In Jang; Shubha Jayaram; Panniyammakal Jeemon; Ravi Prakas Jha; Jost B. Jonas; Mikk Jürisson; Ali Kabir; Zubair Kabir; Leila R. Kalankesh; Tanuj Kanchan; Himal Kandel; Neeti Kapoor; André Karch; Salah Eddin Karimi; Kindie Mitiku Kebede; Bayew Kelkay; Ryan David Kennedy; Yousef Saleh Khader; Ejaz Ahmad Khan; Maryam Khayamzadeh; Gyu Ri Kim; Ruth W. Kimokoti; Mika Kivimäki; Soewarta Kosen; Sindhura Lakshmi Koulmane Laxminarayana; Ai Koyanagi; Kewal Krishan; Nuworza Kugbey; G. Anil Kumar; Nithin Kumar; Om P. Kurmi; Dian Kusuma; Ben Lacey; Iván Landires; Savita Lasrado; Paolo Lauriola; Doo Woong Lee; Yo Han Lee; Janni Leung; Shanshan Li; Hualiang Lin; Wei Liu; Alessandra Lugo; Shilpashree Madhava Kunjathur; Azeem Majeed; Afshin Maleki; Reza Malekzadeh; Deborah Carvalho Malta; Abdullah A. Mamun; Narayana Manjunatha; Borhan Mansouri; Mohammad Ali Mansournia; Santi Martini; Manu Raj Mathur; Prashant Mathur; Mohsen Mazidi; Martin McKee; Carlo Eduardo Medina-Solís; Suresh Mehata; Walter Mendoza; Ritesh G. Menezes; Bartosz Miazgowski; Irmina Maria Michalek; Ted R. Miller; G.K. Mini; Andreea Mirica; Erkin M. Mirrakhimov; Hamed Mirzaei; Sanjeev Misra; Yousef Mohammad; Abdollah Mohammadian-Hafshejani; Shafiu Mohammed; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Mohammad Ali Moni; Rahmatollah Moradzadeh; Shane Douglas Morrison; Tilahun Belete Mossie; Sumaira Mubarik; Erin C. Mullany; Christopher J. L. Murray; Shankar Prasad Nagaraju; Mohsen Naghavi; Nitish Naik; Mahdi Nalini; Vinay Nangia; Atta Abbas Naqvi; Sreenivas Narasimha Swamy; Muhammad Naveed; Javad Nazari; Sabina O. Nduaguba; Ruxandra Irina Negoi; Sandhya Neupane Kandel; Huong Lan Thi Nguyen; Yeshambel T. Nigatu; Molly R. Nixon; Chukwudi A. Nnaji; Jean Jacques Noubiap; Christoph Nowak; Virginia Nuñez-Samudio; Felix Akpojene Ogbo; Ayodipupo Sikiru Oguntade; In-Hwan Oh; Andrew T. Olagunju; Mayowa O. Owolabi; P.A. Mahesh; Keyvan Pakshir; Liping Pan; Adrian Pana; Demosthenes Panagiotakos; Songhomitra Panda-Jonas; Ashok Pandey; Utsav Parekh; Eun-Cheol Park; Eun-Kee Park; Fatemeh Pashazadeh Kan; Mona Pathak; Shrikant Pawar; Richard G. Pestell; Hai Quang Pham; Marina Pinheiro; Khem Narayan Pokhrel; Akram Pourshams; Akila Prashant; Amir Radfar; Vafa Rahimi-Movaghar; Mohammad Hifz Ur Rahman; Muhammad Aziz Rahman; Amir Masoud Rahmani; Pradhum Ram; Juwel Rana; Chhabi Lal Ranabhat; Priya Rathi; David Laith Rawaf; Salman Rawaf; Reza Rawassizadeh; Andre M. N. Renzaho; Aziz Rezapour; Mavra A. Riaz; Leonardo Roever; Luca Ronfani; Gholamreza Roshandel; Ambuj Roy; Bedanta Roy; Basema Saddik; Amirhossein Sahebkar; Sana Salehi; Hamideh Salimzadeh; Abdallah M. Samy; Juan Sanabria; Milena M. Santric-Milicevic; Bruno Piassi Sao Jose; Brijesh Sathian; Monika Sawhney; Ganesh Kumar Saya; Falk Schwendicke; Abdul-Aziz Seidu; Nachimuthu Senthil Kumar; Sadaf G. Sepanlou; Omid Shafaat; Syed Mahboob Shah; Masood Ali Shaikh; Mohammed Shannawaz; Kiomars Sharafi; Aziz Sheikh; Sara Sheikhbahaei; Mika Shigematsu; Rahman Shiri; Kawkab Shishani; K.M. Shivakumar; Siddharudha Shivalli; Roman Shrestha; Soraya Siabani; Negussie Boti Sidemo; Inga Dora Sigfusdottir; Rannveig Sigurvinsdottir; João Pedro Silva; Ambrish Singh; Jasvinder A. Singh; Virendra Singh; Dhirendra Narain Sinha; Valentin Yurievich Skryabin; Anna Aleksandrovna Skryabina; Ali Soroush; Ireneous N. Soyiri; Chandrashekhar T. Sreeramareddy; Dan J. Stein; Paschalis Steiropoulos; Stefan Stortecky; Kurt Straif; Rizwan Suliankatchi Abdulkader; Gerhard Sulo; Johan Sundström; Takahiro Tabuchi; Eyayou Girma Tadesse; Animut Tagele Tamiru; Minale Tareke; Md Ismail Tareque; Ingan Ukur Tarigan; Bhaskar Thakur; Kavumpurathu Raman Thankappan; Rekha Thapar; Musliu Adetola Tolani; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Jaya Prasad Tripathy; Gebiyaw Wudie Tsegaye; Hayley D. Tymeson; Saif Ullah; Brigid Unim; Rachel L. Updike; Olalekan A. Uthman; Marco Vacante; Constantine Vardavas; Narayanaswamy Venketasubramanian; Madhur Verma; Simone Vidale; Bay Vo; Giang Thu Vu; Yasir Waheed; Yanzhong Wang; Kevin Welding; Andrea Werdecker; Joanna L. Whisnant; Nuwan Darshana Wickramasinghe; Befikadu Legesse Wubishet; Kazumasa Yamagishi; Yuichiro Yano; Vahid Yazdi-Feyzabadi; Yigizie Yeshaw; Mohammed Zewdu Yimmer; Naohiro Yonemoto; Zabihollah Yousefi; Chuanhua Yu; Ismaeel Yunusa; Hasan Yusefzadeh; Muhammed Shahriar Zaman; Mohammad Zamani; Maryam Zamanian; Mikhail Sergeevich Zastrozhin; Anasthasia Zastrozhina; Jianrong Zhang; Zhi-Jiang Zhang; Chenwen Zhong; Yves Miel H. Zuniga; Emmanuela Gakidou
Background: Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods: We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings: In 2019, 273·9 million (95% uncertainty interval 258·5 to 290·9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4·72% (4·46 to 5·01). 228·2 million (213·6 to 244·7; 83·29% [82·15 to 84·42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15–19 years was over 10% in seven locations in 2019. Although global age-standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: –1·21% [–1·26 to –1·16]), similar progress was not observed for chewing tobacco (0·46% [0·13 to 0·79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (−0·94% [–1·72 to –0·14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation: Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license