Browsing by Author "Solomon M. Abay"

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Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016
(Lancet Publishing Group, 2018) Max G. Griswold; Nancy Fullman; Caitlin Hawley; Nicholas Arian; Stephanie R. M. Zimsen; Hayley D. Tymeson; Vidhya Venkateswaran; Austin Douglas Tapp; Mohammad H. Forouzanfar; Joseph S. Salama; Kalkidan Hassen Abate; Degu Abate; Solomon M. Abay; Cristiana Abbafati; Rizwan Suliankatchi Abdulkader; Zegeye Abebe; Victor Aboyans; Mohammed Mehdi Abrar; Pawan Acharya; Olatunji O. Adetokunboh; Tara Ballav Adhikari; Jose C. Adsuar; Mohsen Afarideh; Emilie Elisabet Agardh; Gina Agarwal; Sargis Aghasi Aghayan; Sutapa Agrawal; Muktar Beshir Ahmed; Mohammed Akibu; Tomi Akinyemiju; Nadia Akseer; Deena H. Al Asfoor; Ziyad Al-Aly; Fares Alahdab; Khurshid Alam; Ammar Albujeer; Kefyalew Addis Alene; Raghib Ali; Syed Danish Ali; Mehran Alijanzadeh; Syed Mohamed Aljunid; Ala'A Alkerwi; Peter Allebeck; Nelson Alvis-Guzman; Azmeraw T. Amare; Leopold N. Aminde; Walid Ammar; Yaw Ampem Amoako; Gianna Gayle Herrera Amul; Catalina Liliana Andrei; Colin Angus; Mustafa Geleto Ansha; Carl Abelardo T. Antonio; Olatunde Aremu; Johan Ärnlöv; Al Artaman; Krishna K. Aryal; Reza Assadi; Marcel Ausloos; Leticia Avila-Burgos; Euripide F. G. A. Avokpaho; Ashish Awasthi; Henok Tadesse Ayele; Rakesh Ayer; Tambe B. Ayuk; Peter S. Azzopardi; Hamid Badali; Alaa Badawi; Maciej Banach; Suzanne Lyn Barker-Collo; Lope H. Barrero; Huda Basaleem; Estifanos Baye; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Yannick Béjot; Abate Bekele Belachew; Saba Abraham Belay; Derrick A. Bennett; Isabela M. Bensenor; Eduardo Bernabe; Robert S. Bernstein; Addisu Shunu Beyene; Tina Beyranvand; Soumyadeeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Ali Bijani; Nigus Bililign; Sait Mentes Birlik; Charles Birungi; Hailemichael Bizuneh; Peter Bjerregaard; Tone Bjørge; Guilherme Borges; Cristina Bosetti; Soufiane Boufous; Nicola Luigi Bragazzi; Hermann Brenner; Zahid A. Butt; Lucero Cahuana-Hurtado; Bianca Calabria; Ismael R. Campos-Nonato; Julio Cesar Campuzano Rincon; Giulia Carreras; Juan J. Carrero; Félix Carvalho; Carlos A. Castañeda-Orjuela; Jacqueline Castillo Rivas; Ferrán Catalá-López; Jung-Chen Chang; Fiona J. Charlson; Aparajita Chattopadhyay; Pankaj Chaturvedi; Rajiv Chowdhury; Devasahayam J. Christopher; Sheng-Chia Chung; Liliana G. Ciobanu; Rafael M. Claro; Sara Conti; Ewerton Cousin; Michael H. Criqui; Berihun Assefa Dachew; Paul I. Dargan; Ahmad Daryani; José Das Neves; Kairat Davletov; Filipa De Castro; Barbora De Courten; Jan-Walter De Neve; Louisa Degenhardt; Gebre Teklemariam Demoz; Don C. Des Jarlais; Subhojit Dey; Rupinder Singh Dhaliwal; Samath Dhamminda Dharmaratne; Meghnath Dhimal; David Teye Doku; Kerrie E. Doyle; Manisha Dubey; Eleonora Dubljanin; Bruce B. Duncan; Hedyeh Ebrahimi; Dumessa Edessa; Maysaa El Sayed Zaki; Sergei Petrovich Ermakov; Holly E. Erskine; Alireza Esteghamati; Mahbobeh Faramarzi; Andrea Farioli; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Valery L. Feigin; Mariana Santos Felisbino-Mendes; Eduarda Fernandes; Alize J. Ferrari; Cleusa P. Ferri; Daniel Obadare Fijabi; Irina Filip; Jonas David Finger; Florian Fischer; Abraham D. Flaxman; Richard Charles Franklin; Neal D. Futran; Silvano Gallus; Morsaleh Ganji; Fortune Gbetoho Gankpe; Gebremedhin Berhe Gebregergs; Tsegaye Tewelde Gebrehiwot; Johanna M. Geleijnse; Reza Ghadimi; Lilian A. Ghandour; Mamata Ghimire; Paramjit Singh Gill; Ibrahim Abdelmageed Ginawi; Ababi Zergaw Z. Giref; Philimon N. Gona; Sameer Vali Gopalani; Carolyn C. Gotay; Alessandra C. Goulart; Felix Greaves; Giuseppe Grosso; Yuming Guo; Rahul Gupta; Rajeev Gupta; Vipin Gupta; Reyna Alma Gutiérrez; Murthy Gvs; Nima Hafezi-Nejad; Tekleberhan Beyene Hagos; Gessessew Bugssa Hailu; Randah R. Hamadeh; Samer Hamidi; Graeme J. Hankey; Hilda L. Harb; Sivadasanpillai Harikrishnan; Josep Maria Haro; Hamid Yimam Hassen; Rasmus Havmoeller; Simon I. Hay; Behzad Heibati; Andualem Henok; Ileana Heredia-Pi; Norberto Francisco Hernández-Llanes; Claudiu Herteliu; Desalegn Ts Tsegaw Hibstu; Praveen Hoogar; Nobuyuki Horita; H. Dean Hosgood; Mostafa Hosseini; Mihaela Hostiuc; Guoqing Hu; Hsiang Huang; Abdullatif Husseini; Bulat Idrisov; Bogdan Vasile Ileanu; Olayinka Stephen Ilesanmi; Seyed Sina Naghibi Irvani; Sheikh Mohammed Shariful Islam; Maria D. Jackson; Mihajlo Jakovljevic; Moti Tolera Jalu; Achala Upendra Jayatilleke; Ravi Prakash Jha; Jost B. Jonas; Jacek Jerzy Jozwiak; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Umesh Kapil; Amir Kasaeian; Tesfaye D. Dessale Kassa; Srinivasa Vittal Katikireddi; Norito Kawakami; Seifu Kebede; Adane Teshome Kefale; Peter Njenga Keiyoro; Andre Pascal Kengne; Yousef Khader; Morteza Abdullatif Khafaie; Ibrahim A. Khalil; Md Nuruzzaman Khan; Young-Ho Khang; Mona M. Khater; Jagdish Khubchandani; Cho-Il Kim; Daniel Kim; Yun Jin Kim; Ruth W. Kimokoti; Adnan Kisa; Mika Kivimäki; Sonali Kochhar; Soewarta Kosen; Parvaiz A. Koul; Ai Koyanagi; Kewal Krishan; Barthelemy Kuate Defo; Burcu Kucuk Bicer; Veena S. Kulkarni; Pushpendra Kumar; Alessandra Lafranconi; Arjun Lakshmana Balaji; Ratilal Lalloo; Tea Lallukka; Hilton Lam; Faris Hasan Lami; Qing Lan; Justin J. Lang; Sonia Lansky; Anders O. Larsson; Arman Latifi; Janet L. Leasher; Paul H. Lee; James Leigh; Mall Leinsalu; Janni Leung; Miriam Levi; Yichong Li; Lee-Ling Lim; Shai Linn; Shiwei Liu; Andrea Lobato-Cordero; Alan D. Lopez; Paulo A. Lotufo; Erlyn Rachelle King Macarayan; Isis Eloah Machado; Fabiana Madotto; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Deborah Carvalho Malta; Chabila Christopher Mapoma; Jose Martinez-Raga; Pallab K. Maulik; Mohsen Mazidi; Martin McKee; Varshil Mehta; Toni Meier; Tesfa Mekonen; Kidanu Gebremariam Meles; Addisu Melese; Peter T. N. Memiah; Walter Mendoza; Desalegn Tadese Mengistu; George A. Mensah; Tuomo J. Meretoja; Haftay Berhane Mezgebe; Tomasz Miazgowski; Ted R. Miller; Gk Mini; Andreea Mirica; Erkin M. Mirrakhimov; Babak Moazen; Karzan Abdulmuhsin Mohammad; Noushin Mohammadifard; Shafiu Mohammed; Lorenzo Monasta; Paula Moraga; Lidia Morawska; Seyyed Meysam Mousavi; Satinath Mukhopadhyay; Kamarul Imran Musa; Aliya Naheed; Gurudatta Naik; Farid Najafi; Vinay Nangia; Jobert Richie Nansseu; Mudavath Siva Durga Prasad Nayak; Chakib Nejjari; Subas Neupane; Sudan Prasad Neupane; Josephine W. Ngunjiri; Cuong Tat Nguyen; Long Hoang Nguyen; Trang Huyen Nguyen; Dina Nur Anggraini Ningrum; Yirga Legesse Nirayo; Jean Jacques Noubiap; Richard Ofori-Asenso; Felix Akpojene Ogbo; In-Hwan Oh; Olanrewaju Oladimeji; Andrew T. Olagunju; Pedro R. Olivares; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Anu Mary Oommen; Eyal Oren; Heather M. Orpana; Doris D. V. Ortega-Altamirano; Justin R. Ortiz; Erika Ota; Mayowa Ojo Owolabi; Abayomi Samuel Oyekale; P.A. Mahesh; Adrian Pana; Eun-Kee Park; Charles D. H. Parry; Hadi Parsian; Ajay Patle; George C. Patton; Deepak Paudel; Max Petzold; Michael R. Phillips; Julian David Pillay; Maarten J. Postma; Farshad Pourmalek; Dorairaj Prabhakaran; Mostafa Qorbani; Amir Radfar; Anwar Rafay; Alireza Rafiei; Fakher Rahim; Afarin Rahimi-Movaghar; Mahfuzar Rahman; Muhammad Aziz Rahman; Rajesh Kumar Rai; Sasa Rajsic; Sree Bhushan Raju; Usha Ram; Saleem M. Rana; Chhabi Lal Ranabhat; David Laith Rawaf; Salman Rawaf; Robert C. Reiner; Cesar Reis; Andre M. N. Renzaho; Mohammad Sadegh Rezai; Leonardo Roever; Luca Ronfani; Robin Room; Gholamreza Roshandel; Ali Rostami; Gregory A. Roth; Ambuj Roy; Yogesh Damodar Sabde; Basema Saddik; Saeid Safiri; Amirhossein Sahebkar; Zikria Saleem; Joshua A. Salomon; Sundeep Santosh Salvi; Juan Sanabria; Maria Dolores Sanchez-Niño; Damian Francesco Santomauro; Itamar S. Santos; Milena M. M. Santric Milicevic; Abdur Razzaque Sarker; Rodrigo Sarmiento-Suárez; Nizal Sarrafzadegan; Benn Sartorius; Maheswar Satpathy; Monika Sawhney; Sonia Saxena; Mete Saylan; Michael P. Schaub; Maria Inês Schmidt; Ione J. C. Schneider; Ben Schöttker; Aletta Elisabeth Schutte; Falk Schwendicke; Sadaf G. Sepanlou; Masood Ali Shaikh; Mehdi Sharif; Jun She; Aziz Sheikh; Jiabin Shen; Mekonnen Sisay Shiferaw; Mika Shigematsu; Rahman Shiri; Kawkab Shishani; Ivy Shiue; Sharvari Rahul Shukla; Inga Dora Sigfusdottir; Diego Augusto Santos Silva; Natacha Torres Da Silva; Dayane Gabriele Alves Silveira; Dhirendra Narain Sinha; Freddy Sitas; Adauto Martins Soares Filho; Moslem Soofi; Reed J. D. Sorensen; Joan B. Soriano; Chandrashekhar T. Sreeramareddy; Nadine Steckling; Dan J. Stein; Mu'Awiyyah Babale Sufiyan; Patrick J. Sur; Bryan L. Sykes; Rafael Tabarés-Seisdedos; Takahiro Tabuchi; Mohammad Tavakkoli; Arash Tehrani-Banihashemi; Merhawi Gebremedhin Tekle; Subash Thapa; Nihal Thomas; Roman Topor-Madry; Fotis Topouzis; Bach Xuan Tran; Christopher E. Troeger; Thomas Clement Truelsen; Nikolaos Tsilimparis; Stefanos Tyrovolas; Kingsley Nnanna Ukwaja; Irfan Ullah; Olalekan A. Uthman; Pascual R. Valdez; Job F. M. Van Boven; Tommi Juhani Vasankari; Narayanaswamy Venketasubramanian; Francesco S. Violante; Sergey Konstantinovitch Vladimirov; Vasily Vlassov; Stein Emil Vollset; Theo Vos; Fasil Wagnew Shiferaw Wagnew; Yasir Waheed; Yuan-Pang Wang; Elisabete Weiderpass; Fitsum Weldegebreal; Kidu Gidey Weldegwergs; Andrea Werdecker; Ronny Westerman; Harvey A. Whiteford; Justyna Widecka; Tissa Wijeratne; Grant M. A. Wyper; Gelin Xu; Tomohide Yamada; Yuichiro Yano; Pengpeng Ye; Ebrahim M. Yimer; Paul Yip; Biruck Desalegn Yirsaw; Engida Yisma; Naohiro Yonemoto; Seok-Jun Yoon; Marcel Yotebieng; Mustafa Z. Younis; Geevar Zachariah; Zoubida Zaidi; Mohammad Zamani; Xueying Zhang; Sanjay Zodpey; Ali H. Mokdad; Mohsen Naghavi; Christopher J. L. Murray; Emmanuela Gakidou
Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted lifeyears (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older. Methods: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health. Findings: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5-3·0) of age-standardised female deaths and 6·8% (5·8-8·0) of agestandardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2-4·3) of female deaths and 12·2% (10·8-13·6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2·3% (95% UI 2·0-2·6) and male attributable DALYs were 8·9% (7·8-9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0-1·7] of total deaths), road injuries (1·2% [0·7-1·9]), and self-harm (1·1% [0·6-1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2-33·3) of total alcohol-attributable female deaths and 18·9% (15·3-22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0-0·8) standard drinks per week. Interpretation: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption. Funding Bill & Melinda Gates Foundation. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Erratum: Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017 (The Lancet (2018) 392(10159) (1736–1788)(S0140673618322037)(10.1016/S0140-6736(18)32203-7))
(Lancet Publishing Group, 2018) Gregory A. Roth; Degu Abate; Kalkidan Hassen Abate; Solomon M. Abay; Cristiana Abbafati; Nooshin Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Haftom Temesgen Abebe; Molla Abebe; Zegeye Abebe; Ayenew Negesse Abejie; Semaw F. Abera; Olifan Zewdie Abil; Haftom Niguse Abraha; Aklilu Roba Abrham; Laith Jamal Abu-Raddad; Manfred Mario Kokou Accrombessi; Dilaram Acharya; Abdu A. Adamu; Oladimeji M. Adebayo; Rufus Adesoji Adedoyin; Victor Adekanmbi; Olatunji O. Adetokunboh; Beyene Meressa Adhena; Mina G. Adib; Amha Admasie; Ashkan Afshin; Gina Agarwal; Kareha M. Agesa; Anurag Agrawal; Sutapa Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Muktar Beshir Ahmed; Sayem Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Mohammad Esmaeil Akbari; Rufus Olusola Akinyemi; Nadia Akseer; Ziyad Al-Aly; Ayman Al-Eyadhy; Rajaa M. Al-Raddadi; Fares Alahdab; Khurshid Alam; Tahiya Alam; Animut Alebel; Kefyalew Addis Alene; Mehran Alijanzadeh; Reza Alizadeh-Navaei; Syed Mohamed Aljunid; Ala'a Alkerwi; Francois Alla; Peter Allebeck; Jordi Alonso; Khalid Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Leopold N. Aminde; Erfan Amini; Walid Ammar; Yaw Ampem Amoako; Nahla Hamed Anber; Catalina Liliana Andrei; Sofia Androudi; Megbaru Debalkie Animut; Mina Anjomshoa; Hossein Ansari; Mustafa Geleto Ansha; Carl Abelardo T. Antonio; Palwasha Anwari; Olatunde Aremu; Johan Arnlov; Amit Arora; Monika Arora; Al Artaman; Krishna K. Aryal; Hamid Asayesh; Ephrem Tsegay Asfaw; Zerihun Ataro; Suleman Atique; Sachin R. Atre; Marcel Ausloos; Euripide F.G.A. Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Yohanes Ayele; Rakesh Ayer; Peter S. Azzopardi; Arefeh Babazadeh; Umar Bacha; Hamid Badali; Alaa Badawi; Ayele Geleto Bali; Katherine E. Ballesteros; Maciej Banach; Kajori Banerjee; Marlena S. Bannick; Joseph Adel Mattar Banoub; Miguel A. Barboza; Suzanne Lyn Barker-Collo; Till Winfried Barnighausen; Simon Barquera; Lope H. Barrero; Quique Bassat; Sanjay Basu; Bernhard T. Baune; Habtamu Wondifraw Baynes; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Yannick Bejot; Bayu Begashaw Bekele; Abate Bekele Belachew; Ezra Belay; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Derrick A. Bennett; Isabela M. Bensenor; Adam E. Berman; Eduardo Bernabe; Robert S. Bernstein; Gregory J. Bertolacci; Mircea Beuran; Tina Beyranvand; Ashish Bhalla; Suraj Bhattarai; Soumyadeeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Molly H. Biehl; Ali Bijani; Boris Bikbov; Ver Bilano; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Donal Bisanzio; Tuhin Biswas; Brigette F. Blacker; Berrak Bora Basara; Rohan Borschmann; Cristina Bosetti; Kayvan Bozorgmehr; Oliver J. Brady; Luisa C. Brant; Carol Brayne; Alexandra Brazinova; Nicholas J.K. Breitborde; Hermann Brenner; Paul Svitil Briant; Gabrielle Britton; Traolach Brugha; Reinhard Busse; Zahid A. Butt; Charlton S.K.H. Callender; Ismael R. Campos-Nonato; Julio Cesar Campuzano Rincon; Jorge Cano; Mate Car; Rosario Cardenas; Giulia Carreras; Juan J. Carrero; Austin Carter; Felix Carvalho; Carlos A. Castaneda-Orjuela; Jacqueline Castillo Rivas; Chris D. Castle; Clara Castro; Franz Castro; Ferran Catala-Lopez; Ester Cerin; Yazan Chaiah; Jung-Chen Chang; Fiona J. Charlson; Pankaj Chaturvedi; Peggy Pei-Chia Chiang; Odgerel Chimed-Ochir; Vesper Hichilombwe Chisumpa; Abdulaal Chitheer; Rajiv Chowdhury; Hanne Christensen; Devasahayam J. Christopher; Sheng-Chia Chung; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Aaron J. Cohen; Leslie Trumbull Cooper; Paolo Angelo Cortesi; Monica Cortinovis; Ewerton Cousin; Benjamin C. Cowie; Michael H. Criqui; Elizabeth A. Cromwell; Christopher Stephen Crowe; John A. Crump; Matthew Cunningham; Alemneh Kabeta Daba; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Anh Kim Dang; Paul I. Dargan; Ahmad Daryani; Siddharth K. Das; Rajat Das Gupta; Jose Das Neves; Tamirat Tesfaye Dasa; Aditya Prasad Dash; Adrian C. Davis; Nicole Davis Weaver; Dragos Virgil Davitoiu; Kairat Davletov; Fernando Pio De La Hoz; Jan-Walter De Neve; Meaza Girma Degefa; Louisa Degenhardt; Tizta T. Degfie; Selina Deiparine; Gebre Teklemariam Demoz; Balem Betsu Demtsu; Edgar Denova-Gutierrez; Kebede Deribe; Nikolaos Dervenis; Don C. Des Jarlais; Getenet Ayalew Dessie; Subhojit Dey; Samath D. Dharmaratne; Daniel Dicker; Mesfin Tadese Dinberu; Eric L. Ding; M. Ashworth Dirac; Shirin Djalalinia; Klara Dokova; David Teye Doku; Christl A. Donnelly; E. Ray Dorsey; Pratik P. Doshi; Dirk Douwes-Schultz; Kerrie E. Doyle; Tim R. Driscoll; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bruce B. Duncan; Andre R. Duraes; Hedyeh Ebrahimi; Soheil Ebrahimpour; Dumessa Edessa; David Edvardsson; Anne Elise Eggen; Charbel El Bcheraoui; Maysaa El Sayed Zaki; Ziad El-Khatib; Hajer Elkout; Christian Lycke Ellingsen; Matthias Endres; Aman Yesuf Endries; Benjamin Er; Holly E. Erskine; Babak Eshrati; Sharareh Eskandarieh; Reza Esmaeili; Alireza Esteghamati; Mahdi Fakhar; Hamed Fakhim; Mahbobeh Faramarzi; Mohammad Fareed; Farzaneh Farhadi; Carla Sofia Esá Farinha; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Mohammad Hosein Farzaei; Valery L. Feigin; Andrea B. Feigl; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Alize J. Ferrari; Garumma Tolu Feyissa; Irina Filip; Samuel Finegold; Florian Fischer; Christina Fitzmaurice; Nataliya A. Foigt; Kyle J. Foreman; Carla Fornari; Tahvi D. Frank; Takeshi Fukumoto; John E. Fuller; Nancy Fullman; Thomas Furst; Joao M. Furtado; Neal D. Futran; Silvano Gallus; Alberto L. Garcia-Basteiro; Miguel A. Garcia-Gordillo; William M. Gardner; Abadi Kahsu Gebre; Tsegaye Tewelde Gebrehiwot; Amanuel Tesfay Gebremedhin; Bereket Gebremichael; Teklu Gebrehiwo Gebremichael; Tilayie Feto Gelano; Johanna M. Geleijnse; Ricard Genova-Maleras; Yilma Chisha Dea Geramo; Peter W. Gething; Kebede Embaye Gezae; Mohammad Rasoul Ghadami; Reza Ghadimi; Khalil Ghasemi Falavarjani; Maryam Ghasemi-Kasman; Mamata Ghimire; Katherine B. Gibney; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Ibrahim Abdelmageed Ginawi; Maurice Giroud; Giorgia Giussani; Shifalika Goenka; Ellen M. Goldberg; Srinivas Goli; Hector Gomez-Dantes; Philimon N. Gona; Sameer Vali Gopalani; Taren M. Gorman; Atsushi Goto; Alessandra C. Goulart; Elena V. Gnedovskaya; Ayman Grada; Giuseppe Grosso; Harish Chander Gugnani; Andre Luiz Sena Guimaraes; Yuming Guo; Prakash C. Gupta; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Reyna Alma Gutierrez; Bishal Gyawali; Juanita A. Haagsma; Nima Hafezi-Nejad; Tekleberhan B. Hagos; Tewodros Tesfa Hailegiyorgis; Gessessew Bugssa Hailu; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Alexis J. Handal; Graeme J. Hankey; Hilda L. Harb; Sivadasanpillai Harikrishnan; Josep Maria Haro; Mehedi Hasan; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Roderick J. Hay; Simon I. Hay; Yihua He; Akbar Hedayatizadeh-Omran; Mohamed I. Hegazy; Behzad Heibati; Mohsen Heidari; Delia Hendrie; Andualem Henok; Nathaniel J. Henry; Claudiu Herteliu; Fatemeh Heydarpour; Pouria Heydarpour; Sousan Heydarpour; Desalegn Tsegaw Hibstu; Hans W. Hoek; Michael K. Hole; Enayatollah Homaie Rad; Praveen Hoogar; H. Dean Hosgood; Seyed Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Peter J. Hotez; Damian G. Hoy; Thomas Hsiao; Guoqing Hu; John J. Huang; Abdullatif Husseini; Mohammedaman Mama Hussen; Susan Hutfless; Bulat Idrisov; Olayinka Stephen Ilesanmi; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; Nazrul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Kathryn H. Jacobsen; Leila Jahangiry; Nader Jahanmehr; Sudhir Kumar Jain; Mihajlo Jakovljevic; Moti Tolera Jalu; Spencer L. James; Mehdi Javanbakht; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Kathy J. Jenkins; Ravi Prakash Jha; Vivekanand Jha; Catherine O. Johnson; Sarah C. Johnson; Jost B. Jonas; Ankur Joshi; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk Jurisson; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Rizwan Kalani; Manoochehr Karami; Behzad Karami Matin; Andre Karch; Corine Karema; Hamidreza Karimi-Sari; Amir Kasaeian; Dessalegn H. Kassa; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Nicholas J. Kassebaum; Srinivasa Vittal Katikireddi; Anil Kaul; Zhila Kazemi; Ali Kazemi Karyani; Dhruv Satish Kazi; Adane Teshome Kefale; Peter Njenga Keiyoro; Grant Rodgers Kemp; Andre Pascal Kengne; Andre Keren; Chandrasekharan Nair Kesavachandran; Yousef Saleh Khader; Behzad Khafaei; Morteza Abdullatif Khafaie; Alireza Khajavi; Nauman Khalid; Ibrahim A. Khalil; Ejaz Ahmad Khan; Muhammad Shahzeb Khan; Muhammad Ali Khan; Young-Ho Khang; Mona M. Khater; Abdullah T. Khoja; Ardeshir Khosravi; Mohammad Hossein Khosravi; Jagdish Khubchandani; Aliasghar A. Kiadaliri; Getiye D. Kibret; Zelalem Teklemariam Kidanemariam; Daniel N. Kiirithio; Daniel Kim; Young-Eun Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Adnan Kisa; Katarzyna Kissimova-Skarbek; Mika Kivimaki; Ann Kristin Skrindo Knudsen; Jonathan M. Kocarnik; Sonali Kochhar; Yoshihiro Kokubo; Tufa Kolola; Jacek A. Kopec; Parvaiz A. Koul; Ai Koyanagi; Michael A. Kravchenko; Kewal Krishan; Barthelemy Kuate Defo; Burcu Kucuk Bicer; G. 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GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1736–88—The bottom row in figure 7 was cut off. This correction has been made to the online version as of Nov 9, 2018, and has been made to the printed Article. © 2018 Elsevier Ltd
Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: A systematic analysis for the Global Burden of Disease Study 2017
(Lancet Publishing Group, 2018) Daniel Dicker; Grant Nguyen; Degu Abate; Kalkidan Hassen Abate; Solomon M. Abay; Cristiana Abbafati; Nooshin Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Omar Abdel-Rahman; Alireza Abdi; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Ahmed Abdulahi Abdurahman; Haftom Temesgen Abebe; Molla Abebe; Zegeye Abebe; Teshome Abuka Abebo; Victor Aboyans; Haftom Niguse Abraha; Aklilu Roba Abrham; Laith Jamal Abu-Raddad; Niveen ME Abu-Rmeileh; Manfred Mario Kokou Accrombessi; Pawan Acharya; Oladimeji M. Adebayo; Isaac Akinkunmi Adedeji; Rufus Adesoji Adedoyin; Victor Adekanmbi; Olatunji O. Adetokunboh; Beyene Meressa Adhena; Tara Ballav Adhikari; Mina G. Adib; ArsÃ¨ne Kouablan Adou; Jose C. 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Harb; Sivadasanpillai Harikrishnan; Hamidreza Haririan; Josep Maria Haro; Mehedi Hasan; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Roderick J. Hay; Simon I. Hay; Yihua He; Akbar Hedayatizadeh-Omran; Mohamed I. Hegazy; Behzad Heibati; Mohsen Heidari; Delia Hendrie; Andualem Henok; Nathaniel J. Henry; Ileana Heredia-Pi; Claudiu Herteliu; Fatemeh Heydarpour; Pouria Heydarpour; Sousan Heydarpour; Desalegn Tsegaw Hibstu; Hans W. Hoek; Michael K. Hole; Enayatollah Homaie Rad; Praveen Hoogar; Masako Horino; H Dean Hosgood; Seyed Mostafa Hosseini; Mehdi Hosseinzadeh; Sorin Hostiuc; Mihaela Hostiuc; Peter J. Hotez; Damian G. Hoy; Mohamed Hsairi; Aung Soe Htet; Guoqing Hu; John J. Huang; Abdullatif Husseini; Mohammedaman Mama Hussen; Susan Hutfless; Kim Moesgaard Iburg; Ehimario U. Igumbor; Chad Thomas Ikeda; Olayinka Stephen Ilesanmi; Usman Iqbal; Seyed Sina Naghibi Irvani; Oluwaseyi Oluwakemi Isehunwa; Sheikh Mohammed Shariful Islam; Farhad Islami; Leila Jahangiry; Nader Jahanmehr; Rajesh Jain; Sudhir Kumar Jain; Mihajlo Jakovljevic; Spencer L. James; Mehdi Javanbakht; Sudha Jayaraman; Achala Upendra Jayatilleke; Sun Ha Jee; Panniyammakal Jeemon; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Sarah Charlotte Johnson; Jost B. Jonas; Ankur Joshi; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk JÃ¼risson; K. Madhanraj; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Molla Kahssay; Rizwan Kalani; Umesh Kapil; Manoochehr Karami; Behzad Karami Matin; AndrÃ© Karch; Corine Karema; Narges Karimi; Seyed M. Karimi; Hamidreza Karimi-Sari; Amir Kasaeian; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Zemenu Yohannes Kassa; Nicholas J. Kassebaum; Marzieh Katibeh; Srinivasa Vittal Katikireddi; Anil Kaul; Norito Kawakami; Hossein Kazemeini; Zhila Kazemi; Ali Kazemi Karyani; K.C. Prakash; Seifu Kebede; Peter Njenga Keiyoro; Grant Rodgers Kemp; Andre Pascal Kengne; Andre Keren; Maia Kereselidze; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Alireza Khajavi; Nauman Khalid; Ibrahim A. Khalil; Ejaz Ahmad Khan; Gulfaraz Khan; Muhammad Shahzeb Khan; Muhammad Ali Khan; Young-Ho Khang; Tripti Khanna; Mona M. Khater; Alireza Khatony; Habibolah Khazaie; Abdullah T. Khoja; Ardeshir Khosravi; Mohammad Hossein Khosravi; Jagdish Khubchandani; Aliasghar A. Kiadaliri; Getiye D Dejenu Kibret; Cho-Il Kim; Daniel Kim; Jun Y. Kim; Young-Eun Kim; Ruth W. Kimokoti; Yohannes Kinfu; Sanjay Kinra; Adnan Kisa; Katarzyna Kissimova-Skarbek; Niranjan Kissoon; Mika KivimÃ¤ki; Marcus E. Kleber; Luke D. Knibbs; Ann Kristin Skrindo Knudsen; Sonali Kochhar; Yoshihiro Kokubo; Tufa Kolola; Jacek A. Kopec; Margaret N. Kosek; Soewarta Kosen; Parvaiz A. Koul; Ai Koyanagi; Michael A. Kravchenko; Kewal Krishan; Sanjay Krishnaswami; Barthelemy Kuate Defo; Burcu Kucuk Bicer; Andreas A. Kudom; Ernst J. Kuipers; Xie Rachel Kulikoff; G Anil Kumar; Manasi Kumar; Pushpendra Kumar; Fekede Asefa Kumsa; Michael J. Kutz; Sheetal D. Lad; Alessandra Lafranconi; Dharmesh Kumar Lal; Ratilal Lalloo; Hilton Lam; Faris Hasan Lami; Qing Lan; SinÃ©ad M. Langan; Van C. Lansingh; Sonia Lansky; Heidi Jane Larson; Dennis Odai Laryea; Zohra S. Lassi; Arman Latifi; Pablo M. Lavados; Avula Laxmaiah; Jeffrey V. Lazarus; Georgy Lebedev; Paul H. Lee; James Leigh; Cheru Tesema Leshargie; Samson Leta; Miriam Levi; Shanshan Li; Yichong Li; Xiaohong Li; Juan Liang; Xiaofeng Liang; Misgan Legesse Liben; Lee-Ling Lim; Stephen S. Lim; Miteku Andualem Limenih; Shai Linn; Shiwei Liu; Yang Liu; Rakesh Lodha; Giancarlo Logroscino; Chris Lonsdale; Scott A. Lorch; Stefan Lorkowski; Paulo A. Lotufo; Rafael Lozano; Tim C D. Lucas; Raimundas Lunevicius; Ronan A. Lyons; Stefan Ma; Crispin Mabika; Erlyn Rachelle King Macarayan; Mark T. Mackay; Emilie R. Maddison; Ralph Maddison; Fabiana Madotto; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Dhaval P. Maghavani; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Manzoor Ahmad Malik; Deborah Carvalho Malta; Abdullah A. Mamun; Wondimu Ayele Manamo; Ana-Laura Manda; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Chabila Christopher Mapoma; Dadi Marami; Joemer C. Maravilla; Wagner Marcenes; Shakhnazarova Marina; Jose Martinez-Raga; Sheila C O. Martins; Francisco RogerlÃ¢ndio Martins-Melo; Winfried MÃ¤rz; Melvin B. Marzan; Tivani Phosa Mashamba-Thompson; Felix Masiye; Benjamin Ballard Massenburg; Pallab K. Maulik; Mohsen Mazidi; John J. McGrath; Martin McKee; Suresh Mehata; Sanjay Madhav Mehendale; Man Mohan Mehndiratta; Ravi Mehrotra; Kala M. Mehta; Varshil Mehta; Tesfa Mekonen; Tefera Chane Mekonnen; Hagazi Gebre Meles; Kidanu Gebremariam Meles; Addisu Melese; Mulugeta Melku; Peter T N. Memiah; Ziad A. 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Background: Assessments of age-specifc mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Afairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specifc mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in diferent components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings: Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation: This analysis of age-sex-specifc mortality shows that there are remarkably complex patterns in population mortality across countries. The fndings of this study highlight global successes, such as the large decline in under-5 mortality, which refects signifcant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing. © 2018 The Author(s).
Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017
(Lancet Publishing Group, 2018) Gregory A. Roth; Degu Abate; Kalkidan Hassen Abate; Solomon M. Abay; Cristiana Abbafati; Nooshin Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Haftom Temesgen Abebe; Molla Abebe; Zegeye Abebe; Ayenew Negesse Abejie; Semaw F. Abera; Olifan Zewdie Abil; Haftom Niguse Abraha; Aklilu Roba Abrham; Laith Jamal Abu-Raddad; Manfred Mario Kokou Accrombessi; Dilaram Acharya; Abdu A. Adamu; Oladimeji M. Adebayo; Rufus Adesoji Adedoyin; Victor Adekanmbi; Olatunji O. Adetokunboh; Beyene Meressa Adhena; Mina G. Adib; Amha Admasie; Ashkan Afshin; Gina Agarwal; Kareha M. Agesa; Anurag Agrawal; Sutapa Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Muktar Beshir Ahmed; Sayem Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Mohammad Esmaeil Akbari; Rufus Olusola Akinyemi; Nadia Akseer; Ziyad Al-Aly; Ayman Al-Eyadhy; Rajaa M. Al-Raddadi; Fares Alahdab; Khurshid Alam; Tahiya Alam; Animut Alebel; Kefyalew Addis Alene; Mehran Alijanzadeh; Reza Alizadeh-Navaei; Syed Mohamed Aljunid; Ala'a Alkerwi; Francois Alla; Peter Allebeck; Jordi Alonso; Khalid Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Leopold N. Aminde; Erfan Amini; Walid Ammar; Yaw Ampem Amoako; Nahla Hamed Anber; Catalina Liliana Andrei; Sofia Androudi; Megbaru Debalkie Animut; Mina Anjomshoa; Hossein Ansari; Mustafa Geleto Ansha; Carl Abelardo T. Antonio; Palwasha Anwari; Olatunde Aremu; Johan Arnlov; Amit Arora; Monika Arora; Al Artaman; Krishna K. Aryal; Hamid Asayesh; Ephrem Tsegay Asfaw; Zerihun Ataro; Suleman Atique; Sachin R. Atre; Marcel Ausloos; Euripide F.G.A. Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Yohanes Ayele; Rakesh Ayer; Peter S. Azzopardi; Arefeh Babazadeh; Umar Bacha; Hamid Badali; Alaa Badawi; Ayele Geleto Bali; Katherine E. Ballesteros; Maciej Banach; Kajori Banerjee; Marlena S. Bannick; Joseph Adel Mattar Banoub; Miguel A. Barboza; Suzanne Lyn Barker-Collo; Till Winfried Barnighausen; Simon Barquera; Lope H. Barrero; Quique Bassat; Sanjay Basu; Bernhard T. Baune; Habtamu Wondifraw Baynes; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Yannick Bejot; Bayu Begashaw Bekele; Abate Bekele Belachew; Ezra Belay; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Derrick A. Bennett; Isabela M. Bensenor; Adam E. Berman; Eduardo Bernabe; Robert S. Bernstein; Gregory J. Bertolacci; Mircea Beuran; Tina Beyranvand; Ashish Bhalla; Suraj Bhattarai; Soumyadeeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Molly H. Biehl; Ali Bijani; Boris Bikbov; Ver Bilano; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Donal Bisanzio; Tuhin Biswas; Brigette F. Blacker; Berrak Bora Basara; Rohan Borschmann; Cristina Bosetti; Kayvan Bozorgmehr; Oliver J. Brady; Luisa C. Brant; Carol Brayne; Alexandra Brazinova; Nicholas J.K. Breitborde; Hermann Brenner; Paul Svitil Briant; Gabrielle Britton; Traolach Brugha; Reinhard Busse; Zahid A. Butt; Charlton S.K.H. Callender; Ismael R. Campos-Nonato; Julio Cesar Campuzano Rincon; Jorge Cano; Mate Car; Rosario Cardenas; Giulia Carreras; Juan J. Carrero; Austin Carter; Felix Carvalho; Carlos A. Castaneda-Orjuela; Jacqueline Castillo Rivas; Chris D. Castle; Clara Castro; Franz Castro; Ferran Catala-Lopez; Ester Cerin; Yazan Chaiah; Jung-Chen Chang; Fiona J. Charlson; Pankaj Chaturvedi; Peggy Pei-Chia Chiang; Odgerel Chimed-Ochir; Vesper Hichilombwe Chisumpa; Abdulaal Chitheer; Rajiv Chowdhury; Hanne Christensen; Devasahayam J. Christopher; Sheng-Chia Chung; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Aaron J. Cohen; Leslie Trumbull Cooper; Paolo Angelo Cortesi; Monica Cortinovis; Ewerton Cousin; Benjamin C. Cowie; Michael H. Criqui; Elizabeth A. Cromwell; Christopher Stephen Crowe; John A. Crump; Matthew Cunningham; Alemneh Kabeta Daba; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Anh Kim Dang; Paul I. Dargan; Ahmad Daryani; Siddharth K. Das; Rajat Das Gupta; Jose Das Neves; Tamirat Tesfaye Dasa; Aditya Prasad Dash; Adrian C. Davis; Nicole Davis Weaver; Dragos Virgil Davitoiu; Kairat Davletov; Fernando Pio De La Hoz; Jan-Walter De Neve; Meaza Girma Degefa; Louisa Degenhardt; Tizta T. Degfie; Selina Deiparine; Gebre Teklemariam Demoz; Balem Betsu Demtsu; Edgar Denova-Gutierrez; Kebede Deribe; Nikolaos Dervenis; Don C. Des Jarlais; Getenet Ayalew Dessie; Subhojit Dey; Samath D. Dharmaratne; Daniel Dicker; Mesfin Tadese Dinberu; Eric L. Ding; M. Ashworth Dirac; Shirin Djalalinia; Klara Dokova; David Teye Doku; Christl A. Donnelly; E. Ray Dorsey; Pratik P. Doshi; Dirk Douwes-Schultz; Kerrie E. Doyle; Tim R. Driscoll; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bruce B. Duncan; Andre R. Duraes; Hedyeh Ebrahimi; Soheil Ebrahimpour; Dumessa Edessa; David Edvardsson; Anne Elise Eggen; Charbel El Bcheraoui; Maysaa El Sayed Zaki; Ziad El-Khatib; Hajer Elkout; Christian Lycke Ellingsen; Matthias Endres; Aman Yesuf Endries; Benjamin Er; Holly E. Erskine; Babak Eshrati; Sharareh Eskandarieh; Reza Esmaeili; Alireza Esteghamati; Mahdi Fakhar; Hamed Fakhim; Mahbobeh Faramarzi; Mohammad Fareed; Farzaneh Farhadi; Carla Sofia Esá Farinha; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Mohammad Hosein Farzaei; Valery L. Feigin; Andrea B. Feigl; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Alize J. Ferrari; Garumma Tolu Feyissa; Irina Filip; Samuel Finegold; Florian Fischer; Christina Fitzmaurice; Nataliya A. Foigt; Kyle J. Foreman; Carla Fornari; Tahvi D. Frank; Takeshi Fukumoto; John E. Fuller; Nancy Fullman; Thomas Furst; Joao M. Furtado; Neal D. Futran; Silvano Gallus; Alberto L. Garcia-Basteiro; Miguel A. Garcia-Gordillo; William M. Gardner; Abadi Kahsu Gebre; Tsegaye Tewelde Gebrehiwot; Amanuel Tesfay Gebremedhin; Bereket Gebremichael; Teklu Gebrehiwo Gebremichael; Tilayie Feto Gelano; Johanna M. Geleijnse; Ricard Genova-Maleras; Yilma Chisha Dea Geramo; Peter W. Gething; Kebede Embaye Gezae; Mohammad Rasoul Ghadami; Reza Ghadimi; Khalil Ghasemi Falavarjani; Maryam Ghasemi-Kasman; Mamata Ghimire; Katherine B. Gibney; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Ibrahim Abdelmageed Ginawi; Maurice Giroud; Giorgia Giussani; Shifalika Goenka; Ellen M. Goldberg; Srinivas Goli; Hector Gomez-Dantes; Philimon N. Gona; Sameer Vali Gopalani; Taren M. Gorman; Atsushi Goto; Alessandra C. Goulart; Elena V. Gnedovskaya; Ayman Grada; Giuseppe Grosso; Harish Chander Gugnani; Andre Luiz Sena Guimaraes; Yuming Guo; Prakash C. Gupta; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Reyna Alma Gutierrez; Bishal Gyawali; Juanita A. Haagsma; Nima Hafezi-Nejad; Tekleberhan B. Hagos; Tewodros Tesfa Hailegiyorgis; Gessessew Bugssa Hailu; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Alexis J. Handal; Graeme J. Hankey; Hilda L. Harb; Sivadasanpillai Harikrishnan; Josep Maria Haro; Mehedi Hasan; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Roderick J. Hay; Simon I. Hay; Yihua He; Akbar Hedayatizadeh-Omran; Mohamed I. Hegazy; Behzad Heibati; Mohsen Heidari; Delia Hendrie; Andualem Henok; Nathaniel J. Henry; Claudiu Herteliu; Fatemeh Heydarpour; Pouria Heydarpour; Sousan Heydarpour; Desalegn Tsegaw Hibstu; Hans W. Hoek; Michael K. Hole; Enayatollah Homaie Rad; Praveen Hoogar; H. Dean Hosgood; Seyed Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Peter J. Hotez; Damian G. Hoy; Thomas Hsiao; Guoqing Hu; John J. Huang; Abdullatif Husseini; Mohammedaman Mama Hussen; Susan Hutfless; Bulat Idrisov; Olayinka Stephen Ilesanmi; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; Nazrul Islam; Sheikh Mohammed Shariful Islam; Farhad Islami; Kathryn H. Jacobsen; Leila Jahangiry; Nader Jahanmehr; Sudhir Kumar Jain; Mihajlo Jakovljevic; Moti Tolera Jalu; Spencer L. James; Mehdi Javanbakht; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Kathy J. Jenkins; Ravi Prakash Jha; Vivekanand Jha; Catherine O. Johnson; Sarah C. Johnson; Jost B. Jonas; Ankur Joshi; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk Jurisson; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Rizwan Kalani; Manoochehr Karami; Behzad Karami Matin; Andre Karch; Corine Karema; Hamidreza Karimi-Sari; Amir Kasaeian; Dessalegn H. Kassa; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Nicholas J. 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Background: Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods: The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries—Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings: At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5–74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6% (17·9–19·6), and injuries 8·0% (7·7–8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7% (21·5–23·9), representing an additional 7·61 million (7·20–8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9% (7·0–8·8). The number of deaths for CMNN causes decreased by 22·2% (20·0–24·0) and the death rate by 31·8% (30·1–33·3). Total deaths from injuries increased by 2·3% (0·5–4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7% (12·2–15·1) to 57·9 deaths (55·9–59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000–289 000) globally in 2007 to 352 000 (334 000–363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0% (88·8–148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4% (32·2–40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6% (31·2–36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990—neonatal disorders, lower respiratory infections, and diarrhoeal diseases—were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation: Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Funding: Bill & Melinda Gates Foundation. © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
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Background: How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted lifeyears (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severityof ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-speci?c mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Sociodemographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9-6·7), from 57·0 years (54·6-59·1) in 1990 to 63·3 years (60·5-65·7) in 2017. The increase varied from 3·8 years (3·4-4·1) in high SDI countries to 10·5 years (9·8-11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4-1·7) in Saint Vincent and the Grenadines (62·4 years [59·9-64·7] in 1990 to 63·5 years [60·9-65·8] in 2017) to 23·7 years (21·9-25·6) in Eritrea (30·7 years [28·9-32·2] in 1990 to 54·4 years [51·5-57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6-2·3) in Algeria to 11·9 years (10·9-12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4-78·7]) and males (72·6 years [69·8-75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7-50·2] for females and 42·8 years [40·1-45·6] for males). Globally, in 2017, the ?ve leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8-43·5) for communicable diseases and by 49·8% (47·9-51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8-43·0), although age-standardised DALY rates decreased by 18·1% (16·0-20·2). Interpretation With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low SDI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
(Lancet Publishing Group, 2018) Spencer L. James; Degu Abate; Kalkidan Hassen Abate; Solomon M. Abay; Cristiana Abbafati; Nooshin Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Zegeye Abebe; Semaw F. Abera; Olifan Zewdie Abil; Haftom Niguse Abraha; Laith Jamal Abu-Raddad; Niveen M.E. Abu-Rmeileh; Manfred Mario Kokou Accrombessi; Dilaram Acharya; Pawan Acharya; Ilana N. Ackerman; Abdu A. Adamu; Oladimeji M. Adebayo; Victor Adekanmbi; Olatunji O. Adetokunboh; Mina G. Adib; Jose C. Adsuar; Kossivi Agbelenko Afanvi; Mohsen Afarideh; Ashkan Afshin; Gina Agarwal; Kareha M. Agesa; Rakesh Aggarwal; Sargis Aghasi Aghayan; Sutapa Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Muktar Beshir Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Tomi Akinyemiju; Nadia Akseer; Ziyad Al-Aly; Ayman Al-Eyadhy; Hesham M. Al-Mekhlafi; Rajaa M. 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Ballew; Maciej Banach; Joseph Adel Mattar Banoub; Amrit Banstola; Aleksandra Barac; Miguel A. Barboza; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Lope H. Barrero; Bernhard T. Baune; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Yannick Béjot; Abate Bekele Belachew; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Isabela M. Bensenor; Eduardo Bernabe; Robert S. Bernstein; Mircea Beuran; Tina Beyranvand; Neeraj Bhala; Suraj Bhattarai; Soumyadeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Ali Bijani; Boris Bikbov; Ver Bilano; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Donal Bisanzio; Brigette F. Blacker; Fiona M. Blyth; Ibrahim R. Bou-Orm; Soufiane Boufous; Rupert Bourne; Oliver J. Brady; Michael Brainin; Luisa C. Brant; Alexandra Brazinova; Nicholas J.K. Breitborde; Hermann Brenner; Paul Svitil Briant; Andrew M. Briggs; Andrey Nikolaevich Briko; Gabrielle Britton; Traolach Brugha; Rachelle Buchbinder; Reinhard Busse; Zahid A. Butt; Lucero Cahuana-Hurtado; Jorge Cano; Rosario Cárdenas; Juan J. Carrero; Austin Carter; Félix Carvalho; Carlos A. Castañeda-Orjuela; Jacqueline Castillo Rivas; Franz Castro; Ferrán Catalá-López; Kelly M. Cercy; Ester Cerin; Yazan Chaiah; Alex R. Chang; Hsing-Yi Chang; Jung-Chen Chang; Fiona J. Charlson; Aparajita Chattopadhyay; Vijay Kumar Chattu; Pankaj Chaturvedi; Peggy Pei-Chia Chiang; Ken Lee Chin; Abdulaal Chitheer; Jee-Young J. Choi; Rajiv Chowdhury; Hanne Christensen; Devasahayam J. Christopher; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Rafael M. Claro; Daniel Collado-Mateo; Cyrus Cooper; Josef Coresh; Paolo Angelo Cortesi; Monica Cortinovis; Megan Costa; Ewerton Cousin; Michael H. Criqui; Elizabeth A. Cromwell; Marita Cross; John A. Crump; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Paul I. Dargan; Ahmad Daryani; Rajat Das Gupta; José Das Neves; Tamirat Tesfaye Dasa; Gail Davey; Adrian C. Davis; Dragos Virgil Davitoiu; Barbora De Courten; Fernando Pio De La Hoz; Diego De Leo; Jan-Walter De Neve; Meaza Girma Degefa; Louisa Degenhardt; Selina Deiparine; Robert P. Dellavalle; Gebre Teklemariam Demoz; Kebede Deribe; Nikolaos Dervenis; Don C. Des Jarlais; Getenet Ayalew Dessie; Subhojit Dey; Samath Dhamminda Dharmaratne; Mesfin Tadese Dinberu; M. Ashworth Dirac; Shirin Djalalinia; Linh Doan; Klara Dokova; David Teye Doku; E. Ray Dorsey; Kerrie E. Doyle; Tim Robert Driscoll; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bruce B. Duncan; Andre R. Duraes; Hedyeh Ebrahimi; Soheil Ebrahimpour; Michelle Marie Echko; David Edvardsson; Andem Effiong; Joshua R. Ehrlich; Charbel El Bcheraoui; Maysaa El Sayed Zaki; Ziad El-Khatib; Hajer Elkout; Iqbal R.F. Elyazar; Ahmadali Enayati; Aman Yesuf Endries; Benjamin Er; Holly E. Erskine; Babak Eshrati; Sharareh Eskandarieh; Alireza Esteghamati; Sadaf Esteghamati; Hamed Fakhim; Vahid Fallah Omrani; Mahbobeh Faramarzi; Mohammad Fareed; Farzaneh Farhadi; Talha A. Farid; Carla Sofia Esá Farinha; Andrea Farioli; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Valery L. Feigin; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Alize J. Ferrari; Garumma Tolu Feyissa; Irina Filip; Florian Fischer; Christina Fitzmaurice; Nataliya A. Foigt; Kyle J. Foreman; Jack Fox; Tahvi D. Frank; Takeshi Fukumoto; Nancy Fullman; Thomas Fürst; João M. Furtado; Neal D. Futran; Seana Gall; Morsaleh Ganji; Fortune Gbetoho Gankpe; Alberto L. Garcia-Basteiro; William M. Gardner; Abadi Kahsu Gebre; Amanuel Tesfay Gebremedhin; Teklu Gebrehiwo Gebremichael; Tilayie Feto Gelano; Johanna M. Geleijnse; Ricard Genova-Maleras; Yilma Chisha Dea Geramo; Peter W. Gething; Kebede Embaye Gezae; Keyghobad Ghadiri; Khalil Ghasemi Falavarjani; Maryam Ghasemi-Kasman; Mamata Ghimire; Rakesh Ghosh; Aloke Gopal Ghoshal; Simona Giampaoli; Paramjit Singh Gill; Tiffany K. Gill; Ibrahim Abdelmageed Ginawi; Giorgia Giussani; Elena V. Gnedovskaya; Ellen M. Goldberg; Srinivas Goli; Hector Gómez-Dantés; Philimon N. Gona; Sameer Vali Gopalani; Taren M. Gorman; Alessandra C. Goulart; Bárbara Niegia Garcia Goulart; Ayman Grada; Morgan E. Grams; Giuseppe Grosso; Harish Chander Gugnani; Yuming Guo; Prakash C. Gupta; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Bishal Gyawali; Juanita A. Haagsma; Vladimir Hachinski; Nima Hafezi-Nejad; Hassan Haghparast Bidgoli; Tekleberhan B. Hagos; Gessessew Bugssa Hailu; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Alexis J. Handal; Graeme J. Hankey; Yuantao Hao; Hilda L. Harb; Sivadasanpillai Harikrishnan; Josep Maria Haro; Mehedi Hasan; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Caitlin N. Hawley; Roderick J. Hay; Simon I. Hay; Akbar Hedayatizadeh-Omran; Behzad Heibati; Delia Hendrie; Andualem Henok; Claudiu Herteliu; Sousan Heydarpour; Desalegn Tsegaw Hibstu; Huong Thanh Hoang; Hans W. Hoek; Howard J. Hoffman; Michael K. Hole; Enayatollah Homaie Rad; Praveen Hoogar; H. Dean Hosgood; Seyed Mostafa Hosseini; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Peter J. Hotez; Damian G. Hoy; Mohamed Hsairi; Aung Soe Htet; Guoqing Hu; John J. Huang; Chantal K. Huynh; Kim Moesgaard Iburg; Chad Thomas Ikeda; Bogdan Ileanu; Olayinka Stephen Ilesanmi; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; Sheikh Mohammed; Shariful Islam; Farhad Islami; Kathryn H. Jacobsen; Leila Jahangiry; Nader Jahanmehr; Sudhir Kumar Jain; Mihajlo Jakovljevic; Mehdi Javanbakht; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Catherine O. Johnson; Jost B. Jonas; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk Jürisson; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Rizwan Kalani; Tanuj Kanchan; Manoochehr Karami; Behzad Karami Matin; André Karch; Corine Karema; Narges Karimi; Seyed M. Karimi; Amir Kasaeian; Dessalegn H. Kassa; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Nicholas J. Kassebaum; Srinivasa Vittal Katikireddi; Norito Kawakami; Ali Kazemi Karyani; Masoud Masoud Keighobadi; Peter Njenga Keiyoro; Laura Kemmer; Grant Rodgers Kemp; Andre Pascal Kengne; Andre Keren; Yousef Saleh Khader; Behzad Khafaei; Morteza Abdullatif Khafaie; Alireza Khajavi; Ibrahim A. Khalil; Ejaz Ahmad Khan; Muhammad Shahzeb Khan; Muhammad Ali Khan; Young-Ho Khang; Mohammad Khazaei; Abdullah T. Khoja; Ardeshir Khosravi; Mohammad Hossein Khosravi; Aliasghar A. Kiadaliri; Daniel N. Kiirithio; Cho-Il Kim; Daniel Kim; Pauline Kim; Young-Eun Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Adnan Kisa; Katarzyna Kissimova-Skarbek; Mika Kivimäki; Ann Kristin Skrindo Knudsen; Jonathan M. Kocarnik; Sonali Kochhar; Yoshihiro Kokubo; Tufa Kolola; Jacek A. Kopec; Soewarta Kosen; Georgios A. Kotsakis; Parvaiz A. Koul; Ai Koyanagi; Michael A. Kravchenko; Kewal Krishan; Kristopher J. Krohn; Barthelemy Kuate Defo; Burcu Kucuk Bicer; G. Anil Kumar; Manasi Kumar; Hmwe Hmwe Kyu; Deepesh P. Lad; Sheetal D. Lad; Alessandra Lafranconi; Ratilal Lalloo; Tea Lallukka; Faris Hasan Lami; Van C. Lansingh; Arman Latifi; Kathryn Mei-Ming Lau; Jeffrey V. Lazarus; Janet L. Leasher; Jorge R. Ledesma; Paul H. Lee; James Leigh; Janni Leung; Miriam Levi; Sonia Lewycka; Shanshan Li; Yichong Li; Yu Liao; Misgan Legesse Liben; Lee-Ling Lim; Stephen S. Lim; Shiwei Liu; Rakesh Lodha; Katharine J. Looker; Alan D. Lopez; Stefan Lorkowski; Paulo A. Lotufo; Nicola Low; Rafael Lozano; Tim C.D. Lucas; Lydia R. Lucchesi; Raimundas Lunevicius; Ronan A. Lyons; Stefan Ma; Erlyn Rachelle King Macarayan; Mark T. Mackay; Fabiana Madotto; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Dhaval P. Maghavani; Narayan Bahadur Mahotra; Hue Thi Mai; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Deborah Carvalho Malta; Abdullah A. Mamun; Ana-Laura Manda; Helena Manguerra; Treh Manhertz; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Chabila Christopher Mapoma; Joemer C. Maravilla; Wagner Marcenes; Ashley Marks; Francisco Rogerlândio Martins-Melo; Ira Martopullo; Winfried März; Melvin B. Marzan; Tivani Phosa Mashamba-Thompson; Benjamin Ballard Massenburg; Manu Raj Mathur; Kunihiro Matsushita; Pallab K. Maulik; Mohsen Mazidi; Colm McAlinden; John J. McGrath; Martin McKee; Man Mohan Mehndiratta; Ravi Mehrotra; Kala M. Mehta; Varshil Mehta; Fabiola Mejia-Rodriguez; Tesfa Mekonen; Addisu Melese; Mulugeta Melku; Michele Meltzer; Peter T.N. Memiah; Ziad A. Memish; Walter Mendoza; Desalegn Tadese Mengistu; Getnet Mengistu; George A. Mensah; Seid Tiku Mereta; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Naser Mohammad Gholi Mezerji; Bartosz Miazgowski; Tomasz Miazgowski; Anoushka I. Millear; Ted R. Miller; Benjamin Miltz; G.K. Mini; Mojde Mirarefin; Erkin M. Mirrakhimov; Awoke Temesgen Misganaw; Philip B. Mitchell; Habtamu Mitiku; Babak Moazen; Bahram Mohajer; Karzan Abdulmuhsin Mohammad; Noushin Mohammadifard; Mousa Mohammadnia-Afrouzi; Mohammed A. Mohammed; Shafiu Mohammed; Farnam Mohebi; Modhurima Moitra; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Yoshan Moodley; Mahmood Moosazadeh; Ghobad Moradi; Maziar Moradi-Lakeh; Mehdi Moradinazar; Paula Moraga; Lidia Morawska; Ilais Moreno Velásquez; Joana Morgado-Da-Costa; Shane Douglas Morrison; Marilita M. Moschos; Seyyed Meysam Mousavi; Kalayu Brhane Mruts; Achenef Asmamaw Muche; Kindie Fentahun Muchie; Ulrich Otto Mueller; Oumer Sada Muhammed; Satinath Mukhopadhyay; Kate Muller; John Everett Mumford; Manoj Murhekar; Jonah Musa; Kamarul Imran Musa; Ghulam Mustafa; Ashraf F. Nabhan; Chie Nagata; Mohsen Naghavi; Aliya Naheed; Azin Nahvijou; Gurudatta Naik; Nitish Naik; Farid Najafi; Luigi Naldi; Hae Sung Nam; Vinay Nangia; Jobert Richie Nansseu; Bruno Ramos Nascimento; Gopalakrishnan Natarajan; Nahid Neamati; Ionut Negoi; Ruxandra Irina Negoi; Subas Neupane; Charles Richard James Newton; Josephine W. Ngunjiri; Anh Quynh Nguyen; Ha Thu Nguyen; Huong Lan Thi Nguyen; Huong Thanh Nguyen; Long Hoang Nguyen; Minh Nguyen; Nam Ba Nguyen; Son Hoang Nguyen; Emma Nichols; Dina Nur Anggraini Ningrum; Molly R. Nixon; Nomonde Nolutshungu; Shuhei Nomura; Ole F. Norheim; Mehdi Noroozi; Bo Norrving; Jean Jacques Noubiap; Hamid Reza Nouri; Malihe Nourollahpour Shiadeh; Mohammad Reza Nowroozi; Elaine O. 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Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings: Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs 1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). Interpretation: Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016
(Lancet Publishing Group, 2018) Nancy Fullman; Jamal Yearwood; Solomon M. Abay; Cristiana Abbafati; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Zegeye Abebe; Teshome Abuka Abebo; Victor Aboyans; Haftom Niguse Abraha; Daisy M.X. Abreu; Laith J. Abu-Raddad; Akilew Awoke Adane; Rufus Adesoji Adedoyin; Olatunji Adetokunboh; Tara Ballav Adhikari; Mohsen Afarideh; Ashkan Afshin; Gina Agarwal; Dominic Agius; Anurag Agrawal; Sutapa Agrawal; Aliasghar Ahmad Kiadaliri; Miloud Taki Eddine Aichour; Mohammed Akibu; Rufus Olusola Akinyemi; Tomi F. Akinyemiju; Nadia Akseer; Faris Hasan Al Lami; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Tahiya Alam; Deena Alasfoor; Mohammed I. Albittar; Kefyalew Addis Alene; Ayman Al-Eyadhy; Syed Danish Ali; Mehran Alijanzadeh; Syed M. Aljunid; Ala'a Alkerwi; François Alla; Peter Allebeck; Christine Allen; Mahmoud A. Alomari; Rajaa Al-Raddadi; Ubai Alsharif; Khalid A. Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Kebede Amenu; Walid Ammar; Yaw Ampem Amoako; Nahla Anber; Catalina Liliana Andrei; Sofia Androudi; Carl Abelardo T. Antonio; Valdelaine E.M. Araújo; Olatunde Aremu; Johan Ärnlöv; Al Artaman; Krishna Kumar Aryal; Hamid Asayesh; Ephrem Tsegay Asfaw; Solomon Weldegebreal Asgedom; Rana Jawad Asghar; Mengistu Mitiku Ashebir; Netsanet Abera Asseffa; Tesfay Mehari Atey; Sachin R. Atre; Madhu S. Atteraya; Leticia Avila-Burgos; Euripide Frinel G. Arthur Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Animut Alebel Ayalew; Henok Tadesse Ayele; Rakesh Ayer; Tambe Betrand Ayuk; Peter Azzopardi; Natasha Azzopardi-Muscat; Tesleem Kayode Babalola; Hamid Badali; Alaa Badawi; Maciej Banach; Amitava Banerjee; Amrit Banstola; Ryan M. Barber; Miguel A. Barboza; Suzanne L. Barker-Collo; Till Bärnighausen; Simon Barquera; Lope H. Barrero; Quique Bassat; Sanjay Basu; Bernhard T. Baune; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Bayu Begashaw Bekele; Abate Bekele Belachew; Saba Abraham Belay; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Derrick A. Bennett; James R. Bennett; Isabela M. Bensenor; Derbew Fikadu Berhe; Eduardo Bernabé; Robert Steven Bernstein; Mircea Beuran; Ashish Bhalla; Paurvi Bhatt; Soumyadeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Ali Bijani; Boris Bikbov; Charles Birungi; Stan Biryukov; Hailemichael Bizuneh; Ian W. Bolliger; Kaylin Bolt; Ibrahim R. Bou-Orm; Kayvan Bozorgmehr; Oliver Jerome Brady; Alexandra Brazinova; Nicholas J.K. Breitborde; Hermann Brenner; Gabrielle Britton; Traolach S. Brugha; Zahid A. Butt; Lucero Cahuana-Hurtado; Ismael Ricardo Campos-Nonato; Julio Cesar Campuzano; Josip Car; Mate Car; Rosario Cárdenas; Juan Jesus Carrero; Felix Carvalho; Carlos A. Castañeda-Orjuela; Jacqueline Castillo Rivas; Ferrán Catalá-López; Kelly Cercy; Julian Chalek; Hsing-Yi Chang; Jung-Chen Chang; Aparajita Chattopadhyay; Pankaj Chaturvedi; Peggy Pei-Chia Chiang; Vesper Hichilombwe Chisumpa; Jee-Young J. Choi; Hanne Christensen; Devasahayam Jesudas Christopher; Sheng-Chia Chung; Liliana G. Ciobanu; Massimo Cirillo; Danny Colombara; Sara Conti; Cyrus Cooper; Leslie Cornaby; Paolo Angelo Cortesi; Monica Cortinovis; Alexandre Costa Pereira; Ewerton Cousin; Michael H. Criqui; Elizabeth A. Cromwell; Christopher Stephen Crowe; John A. Crump; Alemneh Kabeta Daba; Berihun Assefa Dachew; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Paul I. Dargan; Ahmad Daryani; Maryam Daryani; Jai Das; Siddharth Kumar Das; José Das Neves; Nicole Davis Weaver; Kairat Davletov; Barbora De Courten; Diego De Leo; Jan-Walter De Neve; Robert P. Dellavalle; Gebre Demoz; Kebede Deribe; Don C. Des Jarlais; Subhojit Dey; Samath D. Dharmaratne; Meghnath Dhimal; Shirin Djalalinia; David Teye Doku; Kate Dolan; E. Ray Dorsey; Kadine Priscila Bender Dos Santos; Kerrie E. Doyle; Tim R. Driscoll; Manisha Dubey; Eleonora Dubljanin; Bruce Bartholow Duncan; Michelle Echko; Dumessa Edessa; David Edvardsson; Joshua R. Ehrlich; Erika Eldrenkamp; Ziad El-Khatib; Matthias Endres; Aman Yesuf Endries; Babak Eshrati; Sharareh Eskandarieh; Alireza Esteghamati; Mahdi Fakhar; Tamer Farag; Mahbobeh Faramarzi; Emerito Jose Aquino Faraon; André Faro; Farshad Farzadfar; Adesegun Fatusi; Mir Sohail Fazeli; Valery L. Feigin; Andrea B. Feigl; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; João C. Fernandes; Daniel Obadare Fijabi; Irina Filip; Florian Fischer; Christina Fitzmaurice; Abraham D. Flaxman; Luisa Sorio Flor; Nataliya Foigt; Kyle J. Foreman; Joseph J. Frostad; Thomas Fürst; Neal D. Futran; Emmanuela Gakidou; Silvano Gallus; Ketevan Gambashidze; Amiran Gamkrelidze; Morsaleh Ganji; Abadi Kahsu Gebre; Tsegaye Tewelde Gebrehiwot; Amanuel Tesfay Gebremedhin; Yalemzewod Assefa Gelaw; Johanna M. Geleijnse; Demeke Geremew; Peter W. Gething; Reza Ghadimi; Khalil Ghasemi Falavarjani; Maryam Ghasemi-Kasman; Paramjit Singh Gill; Ababi Zergaw Giref; Maurice Giroud; Melkamu Dedefo Gishu; Giorgia Giussani; William W. Godwin; Srinivas Goli; Hector Gomez-Dantes; Philimon N. Gona; Amador Goodridge; Sameer Vali Gopalani; Yevgeniy Goryakin; Alessandra Carvalho Goulart; Ayman Grada; Max Griswold; Giuseppe Grosso; Harish Chander Gugnani; Yuming Guo; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Tarun Gupta; Vipin Gupta; Juanita A. Haagsma; Vladimir Hachinski; Nima Hafezi-Nejad; Gessessew Bugssa Hailu; Randah Ribhi Hamadeh; Samer Hamidi; Graeme J. Hankey; Hilda L. Harb; Heather C. Harewood; Sivadasanpillai Harikrishnan; Josep Maria Haro; Hamid Yimam Hassen; Rasmus Havmoeller; Caitlin Hawley; Simon I. Hay; Jiawei He; Stephen J.C. Hearps; Mohamed I. Hegazy; Behzad Heibati; Mohsen Heidari; Delia Hendrie; Nathaniel J. Henry; Victor Hugo Herrera Ballesteros; Claudiu Herteliu; Desalegn Tsegaw Hibstu; Molla Kahssay Hiluf; Hans W. Hoek; Enayatollah Homaie Rad; Nobuyuki Horita; H. Dean Hosgood; Mostafa Hosseini; Seyed Reza Hosseini; Mihaela Hostiuc; Sorin Hostiuc; Damian G. Hoy; Mohamed Hsairi; Aung Soe Htet; Guoqing Hu; John J. Huang; Kim Moesgaard Iburg; Fachmi Idris; Ehimario Uche Igumbor; Chad Ikeda; Bogdan Vasile Ileanu; Olayinka S. Ilesanmi; Kaire Innos; Seyed Sina Naghibi Irvani; Caleb M.S. Irvine; Farhad Islami; Troy A. Jacobs; Kathryn H. Jacobsen; Nader Jahanmehr; Rajesh Jain; Sudhir Kumar Jain; Mihajlo M. Jakovljevic; Moti Tolera Jalu; Amr A. Jamal; Mehdi Javanbakht; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Ravi Prakash Jha; Vivekanand Jha; Jacek Józwiak; Oommen John; Sarah Charlotte Johnson; Jost B. Jonas; Vasna Joshua; Mikk Jürisson; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Rizwan Kalani; Chittaranjan Kar; Marina Karanikolos; André Karch; Corine Kakizi Karema; Seyed M. Karimi; Amir Kasaeian; Dessalegn Haile Kassa; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Nicholas J. Kassebaum; Srinivasa Vittal Katikireddi; Anil Kaul; Norito Kawakami; Konstantin Kazanjan; Seifu Kebede; Peter Njenga Keiyoro; Grant Rodgers Kemp; Andre Pascal Kengne; Maia Kereselidze; Ezra Belay Ketema; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Alireza Khajavi; Ibrahim A. Khalil; Ejaz Ahmad Khan; Gulfaraz Khan; Md Nuruzzaman Khan; Muhammad Ali Khan; Mukti Nath Khanal; Young-Ho Khang; Mona M. Khater; Abdullah Tawfih Abdullah Khoja; Ardeshir Khosravi; Jagdish Khubchandani; Getiye Dejenu Kibret; Daniel Ngari Kiirithio; Daniel Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Sanjay Kinra; Adnan Kisa; Niranjan Kissoon; Sonali Kochhar; Yoshihiro Kokubo; Jacek A. Kopec; Soewarta Kosen; Parvaiz A. Koul; Ai Koyanagi; Michael Kravchenko; Kewal Krishan; Kristopher J. Krohn; Barthelemy Kuate Defo; G. Anil Kumar; Pushpendra Kumar; Michael Kutz; Igor Kuzin; Hmwe H. Kyu; Deepesh Pravinkumar Lad; Alessandra Lafranconi; Dharmesh Kumar Lal; Ratilal Lalloo; Hilton Lam; Qing Lan; Justin J. Lang; Van C. Lansingh; Sonia Lansky; Anders Larsson; Arman Latifi; Jeffrey Victor Lazarus; Janet L. Leasher; Paul H. Lee; Yirga Legesse; James Leigh; Cheru Tesema Leshargie; Samson Leta; Janni Leung; Ricky Leung; Miriam Levi; Yongmei Li; Juan Liang; Misgan Legesse Liben; Lee-Ling Lim; Stephen S. Lim; Margaret Lind; Shai Linn; Stefan Listl; Patrick Y. Liu; Shiwei Liu; Rakesh Lodha; Alan D. Lopez; Scott A. Lorch; Stefan Lorkowski; Paulo A. Lotufo; Timothy C.D. Lucas; Raimundas Lunevicius; Grégoire Lurton; Ronan A. Lyons; Fadi Maalouf; Erlyn Rachelle King Macarayan; Mark T. Mackay; Emilie R. Maddison; Fabiana Madotto; Hassan Magdy Abd El Razek; Mohammed Magdy Abd El Razek; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Rajesh Malhotra; Deborah Carvalho Malta; Abdullah A. Mamun; Helena Manguerra; Treh Manhertz; Mohammad Ali Mansournia; Lorenzo G. Mantovani; Tsegahun Manyazewal; Chabila C. Mapoma; Christopher Margono; Jose Martinez-Raga; Sheila Cristina Ouriques Martins; Francisco Rogerlândio Martins-Melo; Ira Martopullo; Winfried März; Benjamin Ballard Massenburg; Manu Raj Mathur; Pallab K. Maulik; Mohsen Mazidi; Colm McAlinden; John J. McGrath; Martin McKee; Suresh Mehata; Ravi Mehrotra; Kala M. Mehta; Varshil Mehta; Toni Meier; Fabiola Mejia-Rodriguez; Kidanu Gebremariam Meles; Mulugeta Melku; Peter Memiah; Ziad A. Memish; Walter Mendoza; Degu Abate Mengiste; Desalegn Tadese Mengistu; Bereket Gebremichael Menota; George A. Mensah; Atte Meretoja; Tuomo J. Meretoja; Haftay Berhane Mezgebe; Tomasz Miazgowski; Renata Micha; Robert Milam; Anoushka Millear; Ted R. Miller; G.K. Mini; Shawn Minnig; Andreea Mirica; Erkin M. Mirrakhimov; Awoke Misganaw; Philip B. Mitchell; Fitsum Weldegebreal Mlashu; Babak Moazen; Karzan Abdulmuhsin Mohammad; Roghayeh Mohammadibakhsh; Ebrahim Mohammed; Mohammed A. Mohammed; Shafiu Mohammed; Ali H. Mokdad; Glen Liddell D. Mola; Mariam Molokhia; Fatemeh Momeniha; Lorenzo Monasta; Julio Cesar Montañez Hernandez; Mahmood Moosazadeh; Maziar Moradi-Lakeh; Paula Moraga; Lidia Morawska; Ilais Moreno Velasquez; Rintaro Mori; Shane D. Morrison; Mark Moses; Seyyed Meysam Mousavi; Ulrich O. Mueller; Manoj Murhekar; Gudlavalleti Venkata Satyanarayana Murthy; Srinivas Murthy; Jonah Musa; Kamarul Imran Musa; Ghulam Mustafa; Saravanan Muthupandian; Chie Nagata; Gabriele Nagel; Mohsen Naghavi; Aliya Naheed; Gurudatta A. Naik; Nitish Naik; Farid Najafi; Luigi Naldi; Vinay Nangia; Jobert Richie Njingang Nansseu; K.M. Venkat Narayan; Bruno Ramos Nascimento; Ionut Negoi; Ruxandra Irina Negoi; Charles R. Newton; Josephine Wanjiku Ngunjiri; Grant Nguyen; Long Nguyen; Trang Huyen Nguyen; Emma Nichols; Dina Nur Anggraini Ningrum; Ellen Nolte; Vuong Minh Nong; Ole F. Norheim; Bo Norrving; Jean Jacques N. Noubiap; Alypio Nyandwi; Carla Makhlouf Obermeyer; Richard Ofori-Asenso; Felix Akpojene Ogbo; In-Hwan Oh; Olanrewaju Oladimeji; Andrew Toyin Olagunju; Tinuke Oluwasefunmi Olagunju; Pedro R. Olivares; Patricia Pereira Vasconcelos De Oliveira; Helen E. Olsen; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Kanyin Ong; John Nelson Opio; Eyal Oren; Doris V. Ortega-Altamirano; Alberto Ortiz; Raziye Ozdemir; Mahesh Pa; Amanda W. Pain; Marcos Roberto Tovani Palone; Adrian Pana; Songhomitra Panda-Jonas; Jeyaraj D. Pandian; Eun-Kee Park; Hadi Parsian; Tejas Patel; Sanghamitra Pati; Snehal T. Patil; Ajay Patle; George C. Patton; Vishnupriya Rao Paturi; Deepak Paudel; Marcel De Moares Pedroso; Sandra P. Pedroza; David M. Pereira; Norberto Perico; Hannah Peterson; Max Petzold; Niloofar Peykari; Michael Robert Phillips; Frédéric B. Piel; David M. Pigott; Julian David Pillay; Michael A. Piradov; Suzanne Polinder; Constance D. Pond; Maarten J. Postma; Farshad Pourmalek; Swayam Prakash; V. Prakash; Narayan Prasad; Noela Marie Prasad; Caroline Purcell; Mostafa Qorbani; Hedley Knewjen Quintana; Amir Radfar; Anwar Rafay; Alireza Rafiei; Kazem Rahimi; Afarin Rahimi-Movaghar; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Muhammad Aziz Rahman; Sajjad Ur Rahman; Rajesh Kumar Rai; Sree Bhushan Raju; Usha Ram; Saleem M. Rana; Zane Rankin; Davide Rasella; David Laith Rawaf; Salman Rawaf; Sarah E. Ray; Christian Aspacia Razo-García; Priscilla Reddy; Robert C. Reiner; Cesar Reis; Marissa B. Reitsma; Giuseppe Remuzzi; Andre M.N. Renzaho; Serge Resnikoff; Satar Rezaei; Mohammad Sadegh Rezai; Antonio L. Ribeiro; Maria Jesus Rios Blancas; Juan A. Rivera; Leonardo Roever; Luca Ronfani; Gholamreza Roshandel; Ali Rostami; Gregory A. Roth; Dietrich Rothenbacher; Ambuj Roy; Nobhojit Roy; George Mugambage Ruhago; Yogesh Damodar Sabde; Perminder S. Sachdev; Nafis Sadat; Mahdi Safdarian; Saeid Safiri; Rajesh Sagar; Amirhossein Sahebkar; Mohammad Ali Sahraian; Haniye Sadat Sajadi; Joseph Salama; Payman Salamati; Raphael De Freitas Saldanha; Hamideh Salimzadeh; Joshua A. Salomon; Abdallah M. Samy; Juan Ramon Sanabria; Parag K. Sancheti; Maria Dolores Sanchez-Niño; Damian Santomauro; Itamar S. Santos; Milena M. 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Singh; Lavanya Singh; Narinder Pal Singh; Virendra Singh; Dhirendra Narain Sinha; Abiy Hiruye Sinke; Mekonnen Sisay; Vegard Skirbekk; Karen Sliwa; Alison Smith; Adauto Martins Soares Filho; Badr H.A. Sobaih; Melek Somai; Samir Soneji; Moslem Soofi; Reed J.D. Sorensen; Joan B. Soriano; Ireneous N. Soyiri; Luciano A. Sposato; Chandrashekhar T. Sreeramareddy; Vinay Srinivasan; Jeffrey D. Stanaway; Vasiliki Stathopoulou; Nicholas Steel; Dan J. Stein; Mark Andrew Stokes; Lela Sturua; Muawiyyah Babale Sufiyan; Rizwan Abdulkader Suliankatchi; Bruno F. Sunguya; Patrick J. Sur; Bryan L. Sykes; P.N. Sylaja; Cassandra E.I. Szoeke; Rafael Tabarés-Seisdedos; Santosh Kumar Tadakamadla; Andualem Henok Tadesse; Getachew Redae Taffere; Nikhil Tandon; Amare Tariku Tariku; Nuno Taveira; Arash Tehrani-Banihashemi; Girma Temam Shifa; Mohamad-Hani Temsah; Abdullah Sulieman Terkawi; Azeb Gebresilassie Tesema; Dawit Jember Tesfaye; Belay Tessema; J.S. Thakur; Nihal Thomas; Matthew J. Thompson; Taavi Tillmann; Quyen G. To; Ruoyan Tobe-Gai; Marcello Tonelli; Roman Topor-Madry; Fotis Topouzis; Anna Torre; Miguel Tortajada; Bach Xuan Tran; Khanh Bao Tran; Avnish Tripathi; Srikanth Prasad Tripathy; Christopher Troeger; Thomas Truelsen; Derrick Tsoi; Lorainne Tudor Car; Kald Beshir Tuem; Stefanos Tyrovolas; Uche S. Uchendu; Kingsley Nnanna Ukwaja; Irfan Ullah; Rachel Updike; Olalekan A. Uthman; Benjamin S. Chudi Uzochukwu; Pascual Rubén Valdez; Job F.M. Van Boven; Santosh Varughese; Tommi Vasankari; Narayanaswamy Venketasubramanian; Francesco S. Violante; Sergey K. Vladimirov; Vasiliy Victorovich Vlassov; Stein Emil Vollset; Theo Vos; Fasil Wagnew; Yasir Waheed; Mitchell T. Wallin; Judd L. Walson; Yafeng Wang; Yuan-Pang Wang; Molla Mesele Wassie; Marcia R. Weaver; Elisabete Weiderpass; Robert G. Weintraub; Jordan Weiss; Kidu Gidey Weldegwergs; Andrea Werdecker; T. Eoin West; Ronny Westerman; Richard G. White; Harvey A. 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Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8-98·1) in Iceland, followed by 96·6 (94·9-97·9) in Norway and 96·1 (94·5-97·3) in the Netherlands, to values as low as 18·6 (13·1-24·4) in the Central African Republic, 19·0 (14·3-23·7) in Somalia, and 23·4 (20·2-26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1-93·6) in Beijing to 48·0 (43·4-53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6-68·8) in Goa to 34·0 (30·3-38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view - and subsequent provision - of quality health care for all populations. Copyright © 2018 The Author(s). Published by Elsevier Ltd.
Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
(Lancet Publishing Group, 2018) Rafael Lozano; Nancy Fullman; Degu Abate; Solomon M. Abay; Cristiana Abbafati; Nooshin Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Omar Abdel-Rahman; Alireza Abdi; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Nebiyu Dereje Abebe; Zegeye Abebe; Ayenew Negesse Abejie; Semaw F. Abera; Olifan Zewdie Abil; Victor Aboyans; Haftom Niguse Abraha; Aklilu Roba Abrham; Laith Jamal Abu-Raddad; Niveen Me Abu-Rmeileh; Gebre Y. Abyu; Manfred Mario Kokou Accrombessi; Dilaram Acharya; Pawan Acharya; Abdu A. Adamu; Oladimeji M. Adebayo; Isaac Akinkunmi Adedeji; Rufus Adesoji Adedoyin; Victor Adekanmbi; Olatunji O. Adetokunboh; Beyene Meressa Adhena; Tara Ballav Adhikari; Mina G. Adib; Arsène Kouablan Adou; Jose C. Adsuar; Mohsen Afarideh; Mahdi Afshari; Ashkan Afshin; Gina Agarwal; Sargis Aghasi Aghayan; Dominic Agius; Anurag Agrawal; Sutapa Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Muktar Beshir Ahmed; Sayem Ahmed; Temesgen Yihunie Akalu; Ali S. Akanda; Mohammad Esmaeil Akbari; Mohammed Akibu; Rufus Olusola Akinyemi; Tomi Akinyemiju; Nadia Akseer; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Tahiya Alam; Ammar Albujeer; Animut Alebel; Kefyalew Addis Alene; Ayman Al-Eyadhy; Samia Alhabib; Raghib Ali; Mehran Alijanzadeh; Reza Alizadeh-Navaei; Syed Mohamed Aljunid; Ala'a Alkerwi; François Alla; Peter Allebeck; Christine A. Allen; Ali Almasi; Fatma Al-Maskari; Hesham M. Al-Mekhlafi; Jordi Alonso; Rajaa M. Al-Raddadi; Ubai Alsharif; Khalid Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Kebede Amenu; Erfan Amini; Walid Ammar; Nahla Hamed Anber; Jason A. 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Cercy; Ester Cerin; Yazan Chaiah; Julian Chalek; Hsing-Yi Chang; Jung-Chen Chang; Aparajita Chattopadhyay; Vijay Kumar Chattu; Pankaj Chaturvedi; Peggy Pei-Chia Chiang; Ken Lee Chin; Vesper Hichilombwe Chisumpa; Abdulaal Chitheer; Jee-Young J. Choi; Rajiv Chowdhury; Hanne Christensen; Devasahayam J. Christopher; Sheng-Chia Chung; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Rafael M. Claro; Thomas Khaled Dwayne Claßen; Aaron J. Cohen; Daniel Collado-Mateo; Cyrus Cooper; Leslie Trumbull Cooper; Leslie Cornaby; Monica Cortinovis; Megan Costa; Ewerton Cousin; Elizabeth A. Cromwell; Christopher Stephen Crowe; Matthew Cunningham; Alemneh Kabeta Daba; Abel Fekadu Dadi; Lalit Dandona; Rakhi Dandona; Anh Kim Dang; Paul I. Dargan; Ahmad Daryani; Siddharth K. Das; Rajat Das Gupta; José Das Neves; Tamirat Tesfaye Dasa; Aditya Prasad Dash; Adrian C. 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Elyazar; Ahmadali Enayati; Aman Yesuf Endries; Babak Eshrati; Sharareh Eskandarieh; Alireza Esteghamati; Sadaf Esteghamati; Kara Estep; Mahdi Fakhar; Hamed Fakhim; Jessica Fanzo; Mahbobeh Faramarzi; Mohammad Fareed; Farzaneh Farhadi; Talha A. Farid; Carla Sofia E. Sá Farinha; Andrea Farioli; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Mohammad Hosein Farzaei; Hossein Farzam; Ali Akbar Fazaeli; Mir Sohail Fazeli; Valery L. Feigin; Andrea B. Feigl; Wubalem Fekadu; Rachel Feldman; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Garumma Tolu Feyissa; Daniel Obadare Fijabi; Irina Filip; Samuel Finegold; Jonas David Finger; Florian Fischer; Christina Fitzmaurice; Luisa Sorio Flor; Nataliya A. Foigt; Kyle J. Foreman; Tahvi D. Frank; Richard Charles Franklin; Takeshi Fukumoto; Kai Fukutaki; John E. Fuller; Thomas Fürst; João M. Furtado; Emmanuela Gakidou; Silvano Gallus; Fortune Gbetoho Gankpe; Ron T. Gansevoort; Ana Cristina Garcia; Alberto L. Garcia-Basteiro; Miguel A. Garcia-Gordillo; William M. Gardner; Abadi Kahsu Gebre; Teshome Gebre; Gebremedhin Berhe Gebregergs; Tsegaye Tewelde Gebrehiwot; Amanuel Tesfay Gebremedhin; Bereket Gebremichael; Teklu Gebrehiwo Gebremichael; Tilayie Feto Gelano; Johanna M. Geleijnse; Yilma Chisha Dea Geramo; Sefonias Getachew; Peter W. Gething; Kebede Embaye Gezae; Mohammad Rasoul Ghadami; Reza Ghadimi; Keyghobad Ghadiri; Maryam Ghasemi-Kasman; Hesam Ghiasvand; Mamata Ghimire; Aloke Gopal Ghoshal; Simona Giampaoli; Paramjit Singh Gill; Tiffany K. Gill; Giorgia Giussani; Elena V. Gnedovskaya; Ellen M. Goldberg; Srinivas Goli; Philimon N. Gona; Amador Goodridge; Sameer Vali Gopalani; Taren M. Gorman; Atsushi Goto; Alessandra C. Goulart; Bárbara Niegia Garcia Goulart; Ayman Grada; Max G. Griswold; Giuseppe Grosso; Harish Chander C. Gugnani; Francis Guillemin; Andre Luiz Sena Guimaraes; Yuming Guo; Prakash C. Gupta; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Giang Hai Ha; Juanita A. 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Kassa; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Zemenu Yohannes Kassa; Nicholas J. Kassebaum; Srinivasa Vittal Katikireddi; Anil Kaul; Norito Kawakami; Zhila Kazemi; Ali Kazemi Karyani; Dhruv Satish Kazi; K.C. Prakash; Seifu Kebede; Peter Njenga Keiyoro; Laura Kemmer; Grant Rodgers Kemp; Andre Pascal Kengne; Andre Keren; Chandrasekharan Nair Kesavachandran; Yousef Saleh Khader; Behzad Khafaei; Morteza Abdullatif Khafaie; Alireza Khajavi; Nauman Khalid; Ibrahim A. Khalil; Ejaz Ahmad Khan; Muhammad Shahzeb Khan; Muhammad Ali Khan; Young-Ho Khang; Tripti Khanna; Mona M. Khater; Alireza Khatony; Zahra Khazaeipour; Habibolah Khazaie; Abdullah T. Khoja; Ardeshir Khosravi; Mohammad Hossein Khosravi; Jagdish Khubchandani; Aliasghar A. Kiadaliri; Helen W. Kiarie; Getiye D. Kibret; Daniel N. Kiirithio; Daniel Kim; Jun Y. Kim; Young-Eun Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Sanjay Kinra; Adnan Kisa; Katarzyna Kissimova-Skarbek; Niranjan Kissoon; Mika Kivimäki; Jonathan M. 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Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030. Funding: Bill & Melinda Gates Foundation. © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017
(Lancet Publishing Group, 2018) Christopher J.L. Murray; Charlton S.K.H. Callender; Xie Rachel Kulikoff; Vinay Srinivasan; Degu Abate; Kalkidan Hassen Abate; Solomon M. Abay; Nooshin Abbasi; Hedayat Abbastabar; Jemal Abdela; Ahmed Abdelalim; Omar Abdel-Rahman; Alireza Abdi; Nasrin Abdoli; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Haftom Temesgen Abebe; Molla Abebe; Zegeye Abebe; Teshome Abuka Abebo; Ayenew Negesse Abejie; Victor Aboyans; Haftom Niguse Abraha; Daisy Maria Xavier Abreu; Aklilu Roba Abrham; Laith Jamal Abu-Raddad; Niveen M.E. Abu-Rmeileh; Manfred Mario Kokou Accrombessi; Pawan Acharya; Abdu A. Adamu; Oladimeji M. Adebayo; Isaac Akinkunmi Adedeji; Victor Adekanmbi; Olatunji O. Adetokunboh; Beyene Meressa Adhena; Tara Ballav Adhikari; Mina G. Adib; Arsène Kouablan Adou; Jose C. Adsuar; Mohsen Afarideh; Ashkan Afshin; Gina Agarwal; Kareha M. Agesa; Sargis Aghasi Aghayan; Sutapa Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Muktar Beshir Ahmed; Sayem Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Ali S. Akanda; Mohammad Esmaeil Akbari; Mohammed Akibu; Rufus Olusola Akinyemi; Tomi Akinyemiju; Nadia Akseer; Fares Alahdab; Ziyad Al-Aly; Khurshid Alam; Animut Alebel; Alicia V. Aleman; Kefyalew Addis Alene; Ayman Al-Eyadhy; Raghib Ali; Mehran Alijanzadeh; Reza Alizadeh-Navaei; Syed Mohamed Aljunid; Ala'a Alkerwi; François Alla; Peter Allebeck; Ali Almasi; Jordi Alonso; Rajaa M. Al-Raddadi; Ubai Alsharif; Khalid Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Walid Ammar; Nahla Hamed Anber; Catalina Liliana Andrei; Sofia Androudi; Megbaru Debalkie Animut; Hossein Ansari; Mustafa Geleto Ansha; Carl Abelardo T. Antonio; Seth Christopher Yaw Appiah; Olatunde Aremu; Habtamu Abera Areri; Nicholas Arian; Johan Ärnlöv; Al Artaman; Krishna K. Aryal; Hamid Asayesh; Ephrem Tsegay Asfaw; Solomon Weldegebreal Asgedom; Reza Assadi; Tesfay Mehari Mehari Atey; Suleman Atique; Madhu Sudhan Atteraya; Marcel Ausloos; Euripide F.G.A. Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Yohanes Ayele; Rakesh Ayer; Tambe B. Ayuk; Peter S. Azzopardi; Tesleem Kayode Babalola; Arefeh Babazadeh; Hamid Badali; Alaa Badawi; Ayele Geleto Bali; Maciej Banach; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Lope H. Barrero; Huda Basaleem; Quique Bassat; Arindam Basu; Bernhard T. Baune; Habtamu Wondifraw Baynes; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Bayu Begashaw Bekele; Abate Bekele Belachew; Aregawi Gebreyesus Belay; Ezra Belay; Saba Abraham Belay; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Derrick A. Bennett; Isabela M. Bensenor; Gilles Bergeron; Adugnaw Berhane; Adam E. Berman; Eduardo Bernabe; Robert S. Bernstein; Gregory J. Bertolacci; Mircea Beuran; Suraj Bhattarai; Soumyadeep Bhaumik; Zulfiqar A. Bhutta; Belete Biadgo; Ali Bijani; Boris Bikbov; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Sait Mentes Birlik; Charles Birungi; Tuhin Biswas; Hailemichael Bizuneh; Archie Bleyer; Berrak Bora Basara; Cristina Bosetti; Soufiane Boufous; Oliver J. Brady; Nicola Luigi Bragazzi; Michael Brainin; Alexandra Brazinova; Nicholas J.K. Breitborde; Hermann Brenner; Jerry D. Brewer; Paul Svitil Briant; Gabrielle Britton; Roy Burstein; Reinhard Busse; Zahid A. Butt; Lucero Cahuana-Hurtado; Ismael R. Campos-Nonato; Julio Cesar Campuzano Rincon; Jorge Cano; Mate Car; Rosario Cárdenas; Juan J. Carrero; Félix Carvalho; Carlos A. Castañeda-Orjuela; Jacqueline Castillo Rivas; Franz Castro; Ferrán Catalá-López; Alanur Çavlin; Ester Cerin; Julian Chalek; Hsing-Yi Chang; Jung-Chen Chang; Aparajita Chattopadhyay; Pankaj Chaturvedi; Peggy Pei-Chia Chiang; Ken Lee Chin; Vesper Hichilombwe Chisumpa; Abdulaal Chitheer; Jee-Young J. Choi; Rajiv Chowdhury; Devasahayam J. Christopher; Flavia M. Cicuttini; Liliana G. Ciobanu; Massimo Cirillo; Rafael M. Claro; Daniel Collado-Mateo; Maria-Magdalena Constantin; Sara Conti; Cyrus Cooper; Leslie Trumbull Cooper; Leslie Cornaby; Paolo Angelo Cortesi; Monica Cortinovis; Megan Costa; Elizabeth A. Cromwell; Christopher Stephen Crowe; Petra Cukelj; Matthew Cunningham; Alemneh Kabeta Daba; Berihun Assefa Dachew; Lalit Dandona; Rakhi Dandona; Paul I. Dargan; Ahmad Daryani; Rajat Das Gupta; José Das Neves; Tamirat Tesfaye Dasa; Aditya Prasad Dash; Nicole Davis Weaver; Dragos Virgil Davitoiu; Kairat Davletov; Diego De Leo; Jan-Walter De Neve; Meaza Girma Degefa; Louisa Degenhardt; Tizta Tilahun Degfie; Selina Deiparine; Gebre Teklemariam Demoz; Balem Demtsu; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Don C. Des Jarlais; Getenet Ayalew Dessie; Samath D. Dharmaratne; Meghnath Dhimal; Daniel Dicker; Eric L. Ding; Girmaye Deye Dinsa; Shirin Djalalinia; Huyen Phuc Do; Klara Dokova; David Teye Doku; Kate A. Dolan; Kerrie E. Doyle; Tim R. Driscoll; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Andre R. Duraes; Soheil Ebrahimpour; David Edvardsson; Charbel El Bcheraoui; Ziad El-Khatib; Iqbal Rf Elyazar; Ahmadali Enayati; Aman Yesuf Endries; Sergey Petrovich Ermakov; Babak Eshrati; Sharareh Eskandarieh; Reza Esmaeili; Alireza Esteghamati; Sadaf Esteghamati; Kara Estep; Hamed Fakhim; Tamer Farag; Mahbobeh Faramarzi; Mohammad Fareed; Carla Sofia E. SáFarinha; Andre Faro; Maryam S. Farvid; Farshad Farzadfar; Mohammad Hosein Farzaei; Kairsten A. Fay; Mir Sohail Fazeli; Valery L. Feigin; Andrea B. Feigl; Fariba Feizy; Ama P. Fenny; Netsanet Fentahun; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Garumma Tolu Feyissa; Irina Filip; Samuel Finegold; Florian Fischer; Luisa Sorio Flor; Nataliya A. Foigt; Kyle J. Foreman; Carla Fornari; Thomas Fürst; Takeshi Fukumoto; John E. Fuller; Nancy Fullman; Emmanuela Gakidou; Silvano Gallus; Amiran Gamkrelidze; Morsaleh Ganji; Fortune Gbetoho Gankpe; Gregory M. Garcia; Miguel Á. Garcia-Gordillo; Abadi Kahsu Gebre; Teshome Gebre; Gebremedhin Berhe Gebregergs; Tsegaye Tewelde Gebrehiwot; Amanuel Tesfay Gebremedhin; Tilayie Feto Gelano; Yalemzewod Assefa Gelaw; Johanna M. Geleijnse; Ricard Genova-Maleras; Peter Gething; Kebede Embaye Gezae; Mohammad Rasoul Ghadami; Reza Ghadimi; Keyghobad Ghadiri; Khalil Ghasemi Falavarjani; Maryam Ghasemi-Kasman; Hesam Ghiasvand; Mamata Ghimire; Aloke Gopal Ghoshal; Paramjit Singh Gill; Tiffany K. Gill; Giorgia Giussani; Elena V. Gnedovskaya; Srinivas Goli; Ricardo Santiago Gomez; Hector Gómez-Dantés; Philimon N. Gona; Amador Goodridge; Sameer Vali Gopalani; Alessandra C. Goulart; Bárbara Niegia Garcia Goulart; Ayman Grada; Giuseppe Grosso; Harish Chander C. Gugnani; Jingwen Guo; Yuming Guo; Prakash C. Gupta; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Juanita A. Haagsma; Vladimir Hachinski; Nima Hafezi-Nejad; Tekleberhan B. Hagos; Tewodros Tesfa Hailegiyorgis; Gessessew Bugssa Hailu; Arvin Haj-Mirzaian; Arya Haj-Mirzaian; Randah R. Hamadeh; Samer Hamidi; Alexis J. Handal; Graeme J. Hankey; Yuantao Hao; Hilda L. Harb; Hamidreza Haririan; Josep Maria Haro; Mehedi Hasan; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Simon I. Hay; Yihua He; Akbar Hedayatizadeh-Omran; Mohamed I. Hegazy; Behzad Heibati; Behnam Heidari; Delia Hendrie; Andualem Henok; Nathaniel J. Henry; Claudiu Herteliu; Fatemeh Heydarpour; Desalegn T. Hibstu; Michael K. Hole; Enayatollah Homaie Rad; Praveen Hoogar; H. Dean Hosgood; Seyed Mostafa Hosseini; Meimanat M. Hosseini Chavoshi; Mehdi Hosseinzadeh; Mihaela Hostiuc; Sorin Hostiuc; Mohamed Hsairi; Thomas Hsiao; Guoqing Hu; John J. Huang; Kim Moesgaard Iburg; Ehimario U. Igumbor; Chad Thomas Ikeda; Olayinka Stephen Ilesanmi; Usman Iqbal; Asnake Ararsa Irenso; Seyed Sina Naghibi Irvani; Oluwaseyi Oluwakemi Isehunwa; Sheikh Mohammed Shariful Islam; Leila Jahangiry; Nader Jahanmehr; Sudhir Kumar Jain; Mihajlo Jakovljevic; Moti Tolera Jalu; Spencer L. James; Simerjot K. Jassal; Mehdi Javanbakht; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Jost B. Jonas; Jacek Jerzy Jozwiak; Suresh Banayya Jungari; Mikk Jürisson; Zubair Kabir; Rajendra Kadel; Amaha Kahsay; Rizwan Kalani; Umesh Kapil; Manoochehr Karami; Behzad Karami Matin; André Karch; Corine Karema; Seyed M. Karimi; Amir Kasaeian; Dessalegn H. Kassa; Getachew Mullu Kassa; Tesfaye Dessale Kassa; Zemenu Yohannes Kassa; Nicholas J. Kassebaum; Anshul Kastor; Srinivasa Vittal Katikireddi; Anil Kaul; Norito Kawakami; Ali Kazemi Karyani; Seifu Kebede; Peter Njenga Keiyoro; Grant Rodgers Kemp; Andre Pascal Kengne; Andre Keren; Maia Kereselidze; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Alireza Khajavi; Nauman Khalid; Ibrahim A. Khalil; Ejaz Ahmad Khan; Muhammad Shahzeb Khan; Young-Ho Khang; Tripti Khanna; Mona M. Khater; Alireza Khatony; Zahra Khazaeipour; Habibolah Khazaie; Abdullah T. Khoja; Ardeshir Khosravi; Mohammad Hossein Khosravi; Getiye D. Kibret; Zelalem Teklemariam Kidanemariam; Daniel N. Kiirithio; Paul Evan Kilgore; Daniel Kim; Jun Y. Kim; Young-Eun Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Sanjay Kinra; Adnan Kisa; Mika Kivimäki; Sonali Kochhar; Yoshihiro Kokubo; Tufa Kolola; Jacek A. Kopec; Margaret N. Kosek; Soewarta Kosen; Parvaiz A. Koul; Ai Koyanagi; Kewal Krishan; Sanjay Krishnaswami; Kristopher J. Krohn; Barthelemy Kuate Defo; Burcu Kucuk Bicer; G. Anil Kumar; Manasi Kumar; Pushpendra Kumar; Fekede Asefa Kumsa; Michael J. Kutz; Sheetal D. Lad; Alessandra Lafranconi; Dharmesh Kumar Lal; Ratilal Lalloo; Hilton Lam; Faris Hasan Lami; Justin J. Lang; Sonia Lansky; Van C. Lansingh; Dennis Odai Laryea; Zohra S. Lassi; Arman Latifi; Avula Laxmaiah; Jeffrey V. Lazarus; James B. Lee; Paul H. Lee; James Leigh; Cheru Tesema Leshargie; Samson Leta; Miriam Levi; Shanshan Li; Xiaohong Li; Yichong Li; Juan Liang; Xiaofeng Liang; Misgan Legesse Liben; Lee-Ling Lim; Miteku Andualem Limenih; Shai Linn; Shiwei Liu; Stefan Lorkowski; Paulo A. Lotufo; Rafael Lozano; Raimundas Lunevicius; Crispin Mabika Mabika; Erlyn Rachelle King Macarayan; Mark T. Mackay; Fabiana Madotto; Tarek Abd Elaziz Mahmood; Narayan Bahadur Mahotra; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Manzoor Ahmad Malik; Abdullah A. Mamun; Wondimu Ayele Manamo; Ana-Laura Manda; Srikanth Mangalam; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Chabila Christopher Mapoma; Dadi Marami; Joemer C. Maravilla; Wagner Marcenes; Shakhnazarova Marina; Francisco Rogerlândio Martins-Melo; Winfried März; Melvin B. Marzan; Tivani Phosa Mashamba-Thompson; Felix Masiye; Amanda J. Mason-Jones; Benjamin Ballard Massenburg; Manu Raj Mathur; Pallab K. Maulik; Mohsen Mazidi; John J. McGrath; Suresh Mehata; Sanjay Madhav Mehendale; Man Mohan Mehndiratta; Ravi Mehrotra; Saeed Mehrzadi; Kala M. Mehta; Varshil Mehta; Tefera C. Mekonnen; Hagazi Gebre Meles; Kidanu Gebremariam Meles; Addisu Melese; Mulugeta Melku; Peter T.N. Memiah; Ziad A. Memish; Walter Mendoza; Melkamu Merid Mengesha; Desalegn Tadese Mengistu; Getnet Mengistu; George A. Mensah; Seid Tiku Mereta; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Haftay Berhane Mezgebe; Yode Miangotar; Bartosz Miazgowski; Tomasz Miazgowski; Ted R. Miller; Molly Katherine Miller-Petrie; G.K. Mini; Parvaneh Mirabi; Andreea Mirica; Erkin M. Mirrakhimov; Awoke Temesgen Misganaw; Babak Moazen; Karzan Abdulmuhsin Mohammad; Moslem Mohammadi; Noushin Mohammadifard; Maryam Mohammadi-Khanaposhtani; Mohammed A. Mohammed; Shafiu Mohammed; Ali H. Mokdad; Glen Dl Mola; Mariam Molokhia; Lorenzo Monasta; Julio Cesar Montañez; Ghobad Moradi; Mahmoudreza Moradi; Maziar Moradi-Lakeh; Mehdi Moradinazar; Paula Moraga; Joana Morgado-Da-Costa; Rintaro Mori; Shane Douglas Morrison; Abbas Mosapour; Marilita M. Moschos; Seyyed Meysam Mousavi; Achenef Asmamaw Muche; Kindie Fentahun Muchie; Ulrich Otto Mueller; Satinath Mukhopadhyay; Tasha B. Murphy; Kate Muller; G.V.S. Murthy; Jonah Musa; Kamarul Imran Musa; Ghulam Mustafa; Saravanan Muthupandian; Jean B. Nachega; Gabriele Nagel; Mohsen Naghavi; Aliya Naheed; Azin Nahvijou; Gurudatta Naik; Paulami Naik; Farid Najafi; Luigi Naldi; Vinay Nangia; Jobert Richie Nansseu; Bruno Ramos Nascimento; Haseeb Nawaz; Busisiwe P. Ncama; Nahid Neamati; Ionut Negoi; Ruxandra Irina Negoi; Subas Neupane; Charles Richard James Newton; Frida N. Ngalesoni; Josephine W. Ngunjiri; Grant Nguyen; Long Hoang Nguyen; Trang Huyen Nguyen; Dina Nur Anggraini Ningrum; Yirga Legesse Nirayo; Muhammad Imran Nisar; Molly R. Nixon; Shuhei Nomura; Mehdi Noroozi; Jean Jacques Noubiap; Hamid Reza Nouri; Malihe Nourollahpour Shiadeh; Mohammad Reza Nowroozi; Alypio Nyandwi; Peter S. Nyasulu; Christopher M. Odell; Richard Ofori-Asenso; Okechukwu Samuel Ogah; Felix Akpojene Ogbo; In-Hwan Oh; Anselm Okoro; Olanrewaju Oladimeji; Andrew T. Olagunju; Tinuke O. Olagunju; Pedro R. Olivares; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Sok King Ong; Alberto Ortiz; Aaron Osgood-Zimmerman; Erika Ota; Brenda Achieng Otieno; Stanislav S. Otstavnov; Mayowa Ojo Owolabi; Abayomi Samuel Oyekale; P.A. Mahesh; Smita Pakhale; Abhijit P. Pakhare; Adrian Pana; Basant Kumar Panda; Songhomitra Panda-Jonas; Achyut Raj Pandey; Eun-Kee Park; Hadi Parsian; Shanti Patel; Snehal T. Patil; Ajay Patle; George C. Patton; Vishnupriya Rao Paturi; Deepak Paudel; Marcel Moraes Pedroso; Emmanuel K. Peprah; David M. Pereira; Norberto Perico; Konrad Pesudovs; William A. Petri; Max Petzold; Maxwell Pierce; David M. Pigott; Julian David Pillay; Meghdad Pirsaheb; Guilherme V. Polanczyk; Maarten J. Postma; Farshad Pourmalek; Akram Pourshams; Hossein Poustchi; Swayam Prakash; Narayan Prasad; Caroline A. Purcell; Manorama B. Purwar; Mostafa Qorbani; Reginald Quansah; Amir Radfar; Anwar Rafay; Alireza Rafiei; Fakher Rahim; Afarin Rahimi-Movaghar; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Md Shafiur Rahman; Mohammad Hifz Ur Rahman; Muhammad Aziz Rahman; Sajjad Ur Rahman; Rajesh Kumar Rai; Fatemeh Rajati; Sasa Rajsic; Usha Ram; Chhabi Lal Ranabhat; Prabhat Ranjan; David Laith Rawaf; Salman Rawaf; Sarah E. Ray; Christian Razo-García; Robert C. Reiner; Cesar Reis; Giuseppe Remuzzi; Andre M.N. Renzaho; Serge Resnikoff; Satar Rezaei; Shahab Rezaeian; Mohammad Sadegh Rezai; Seyed Mohammad Riahi; Maria Jesus Rios-Blancas; Kedir Teji Roba; Nicholas L.S. Roberts; Leonardo Roever; Luca Ronfani; Gholamreza Roshandel; Ali Rostami; Enrico Rubagotti; George Mugambage Ruhago; Yogesh Damodar Sabde; Perminder S. Sachdev; Basema Saddik; Sahar Saeedi Moghaddam; Hosein Safari; Yahya Safari; Roya Safari-Faramani; Mahdi Safdarian; Sare Safi; Saeid Safiri; Rajesh Sagar; Amirhossein Sahebkar; Mohammad Ali Sahraian; Haniye Sadat Sajadi; Mohamadreza Salahshoor; Nasir Salam; Joseph S. Salama; Payman Salamati; Raphael De Freitas Saldanha; Zikria Saleem; Yahya Salimi; Hamideh Salimzadeh; Joshua A. Salomon; Sundeep Santosh Salvi; Inbal Salz; Evanson Zondani Sambala; Abdallah M. Samy; Juan Sanabria; Maria Dolores Sanchez-Niño; Itamar S. Santos; Milena M. Santric Milicevic; Bruno Piassi Sao Jose; Mayank Sardana; Abdur Razzaque Sarker; Rodrigo Sarmiento-Suárez; Satish Saroshe; Nizal Sarrafzadegan; Benn Sartorius; Shahabeddin Sarvi; Brijesh Sathian; Maheswar Satpathy; Arundhati R. Sawant; Monika Sawhney; Sonia Saxena; Elke Schaeffner; Kathryn Schelonka; Ione J.C. Schneider; David C. Schwebel; Falk Schwendicke; Soraya Seedat; Mario Sekerija; Sadaf G. Sepanlou; Edson Serván-Mori; Hosein Shabaninejad; Katya Anne Shackelford; Azadeh Shafieesabet; Amira A. Shaheen; Masood Ali Shaikh; Raad A. Shakir; Mehran Shams-Beyranvand; Mohammadbagher Shamsi; Morteza Shamsizadeh; Heidar Sharafi; Kiomars Sharafi; Mehdi Sharif; Mahdi Sharif-Alhoseini; Jayendra Sharma; Rajesh Sharma; Jun She; Aziz Sheikh; Peilin Shi; Kenji Shibuya; Mika Shigematsu; Rahman Shiri; Reza Shirkoohi; Ivy Shiue; Farhad Shokraneh; Sharvari Rahul Shukla; Si Si; Soraya Siabani; Abla Mehio Sibai; Tariq J. Siddiqi; Inga Dora Sigfusdottir; Rannveig Sigurvinsdottir; Naris Silpakit; Diego Augusto Santos Silva; João Pedro Silva; Dayane Gabriele Alves Silveira; Narayana Sarma Venkata Singam; Jasvinder A. Singh; Narinder Pal Singh; Virendra Singh; Dhirendra Narain Sinha; Karen Sliwa; Adauto Martins Soares Filho; Badr Hasan Sobaih; Soheila Sobhani; Moslem Soofi; Joan B. Soriano; Ireneous N. Soyiri; Chandrashekhar T. Sreeramareddy; Vladimir I. Starodubov; Caitlyn Steiner; Leo G. Stewart; Mark A. Stokes; Mark Strong; Michelle L. Subart; Mu'awiyyah Babale Sufiyan; Gerhard Sulo; Bruno F. Sunguya; Patrick John Sur; Ipsita Sutradhar; Bryan L. Sykes; P.N. Sylaja; Dillon O. Sylte; Cassandra E.I. Szoeke; Rafael Tabarés-Seisdedos; Karen M. Tabb; Santosh Kumar Tadakamadla; Nikhil Tandon; Aberash Abay Tassew; Segen Gebremeskel Tassew; Nuno Taveira; Nega Yimer Tawye; Arash Tehrani-Banihashemi; Tigist Gashaw Tekalign; Merhawi Gebremedhin Tekle; Mohamad-Hani Temsah; Abdullah Sulieman Terkawi; Manaye Yihune Teshale; Belay Tessema; Mebrahtu Teweldemedhin; Jarnail Singh Thakur; Kavumpurathu Raman Thankappan; Sathish Thirunavukkarasu; Nihal Thomas; Alan J. Thomson; Binyam Tilahun; Quyen G. To; Marcello Tonelli; Roman Topor-Madry; Anna E. Torre; Miguel Tortajada-Girbés; Marcos Roberto Tovani-Palone; Hideaki Toyoshima; Bach Xuan Tran; Khanh Bao Tran; Srikanth Prasad Tripathy; Thomas Clement Truelsen; Nu Thi Truong; Afewerki Gebremeskel Tsadik; Amanuel Tsegay; Nikolaos Tsilimparis; Lorainne Tudor Car; Kingsley N. Ukwaja; Irfan Ullah; Muhammad Shariq Usman; Olalekan A. Uthman; Selen Begüm Uzun; Muthiah Vaduganathan; Afsane Vaezi; Gaurang Vaidya; Pascual R. Valdez; Elena Varavikova; Santosh Varughese; Tommi Juhani Vasankari; Ana Maria Nogales Vasconcelos; Narayanaswamy Venketasubramanian; Santos Villafaina; Francesco S. Violante; Sergey Konstantinovitch Vladimirov; Vasily Vlassov; Stein Emil Vollset; Theo Vos; Kia Vosoughi; Isidora S. Vujcic; Fasil Shiferaw Wagnew; Yasir Waheed; Judd L. Walson; Yanping Wang; Yuan-Pang Wang; Elisabete Weiderpass; Robert G. Weintraub; Kidu Gidey Weldegwergs; Andrea Werdecker; Ronny Westerman; Harvey Whiteford; Justyna Widecka; Katarzyna Widecka; Tissa Wijeratne; Andrea Sylvia Winkler; Charles Shey Wiysonge; Charles D.A. Wolfe; Shouling Wu; Grant M.A. Wyper; Gelin Xu; Tomohide Yamada; Yuichiro Yano; Mehdi Yaseri; Yasin Jemal Yasin; Pengpeng Ye; Gökalp Kadri Yentür; Alex Yeshaneh; Ebrahim M. Yimer; Paul Yip; Engida Yisma; Naohiro Yonemoto; Seok-Jun Yoon; Marcel Yotebieng; Mustafa Z. Younis; Mahmoud Yousefifard; Chuanhua Yu; Vesna Zadnik
Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation. © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license