Browsing by Author "Vinay Srinivasan"

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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. Anil Kumar; Manasi Kumar; Pushpendra Kumar; Michael J. Kutz; Igor Kuzin; Hmwe Hmwe Kyu; Deepesh P. Lad; Sheetal D. Lad; Alessandra Lafranconi; Dharmesh Kumar Lal; Ratilal Lalloo; Tea Lallukka; Jennifer O. Lam; Faris Hasan Lami; Van C. Lansingh; Sonia Lansky; Heidi J. Larson; Arman Latifi; Kathryn Mei-Ming Lau; Jeffrey V. Lazarus; Georgy Lebedev; Paul H. Lee; James Leigh; Mostafa Leili; Cheru Tesema Leshargie; Shanshan Li; Yichong Li; Juan Liang; Lee-Ling Lim; Stephen S. Lim; Miteku Andualem Limenih; Shai Linn; Shiwei Liu; Yang Liu; Rakesh Lodha; Chris Lonsdale; Alan D. Lopez; Stefan Lorkowski; Paulo A. Lotufo; Rafael Lozano; Raimundas Lunevicius; Stefan Ma; Erlyn Rachelle King Macarayan; Mark T. Mackay; Jennifer H. MacLachlan; Emilie R. Maddison; Fabiana Madotto; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Dhaval P. Maghavani; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Deborah Carvalho Malta; Ana-Laura Manda; Luiz Garcia Mandarano-Filho; Helena Manguerra; Mohammad Ali Mansournia; Chabila Christopher Mapoma; Dadi Marami; Joemer C. Maravilla; Wagner Marcenes; Laurie Marczak; Ashley Marks; Guy B. Marks; Gabriel Martinez; Francisco Rogerlandio Martins-Melo; Ira Martopullo; Winfried Marz; Melvin B. Marzan; Joseph R. Masci; Benjamin Ballard Massenburg; Manu Raj Mathur; Prashant Mathur; Richard Matzopoulos; Pallab K. Maulik; Mohsen Mazidi; Colm McAlinden; John J. McGrath; Martin McKee; Brian J. McMahon; Suresh Mehata; Man Mohan Mehndiratta; Ravi Mehrotra; Kala M. Mehta; Varshil Mehta; Tefera C. Mekonnen; Addisu Melese; Mulugeta Melku; 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; Haftay Berhane Mezgebe; Bartosz Miazgowski; Tomasz Miazgowski; Anoushka I. Millear; Ted R. Miller; Molly Katherine Miller-Petrie; G.K. Mini; Parvaneh Mirabi; Mojde Mirarefin; Andreea Mirica; Erkin M. Mirrakhimov; Awoke Temesgen Misganaw; Habtamu Mitiku; Babak Moazen; Karzan Abdulmuhsin Mohammad; Moslem Mohammadi; Noushin Mohammadifard; Mohammed A. Mohammed; Shafiu Mohammed; Viswanathan Mohan; Ali H. Mokdad; Mariam Molokhia; Lorenzo Monasta; Ghobad Moradi; Maziar Moradi-Lakeh; Mehdi Moradinazar; Paula Moraga; Lidia Morawska; Ilais Moreno Velasquez; Joana Morgado-Da-Costa; Shane Douglas Morrison; Marilita M. Moschos; Simin Mouodi; Seyyed Meysam Mousavi; Kindie Fentahun Muchie; Ulrich Otto Mueller; Satinath Mukhopadhyay; Kate Muller; John Everett Mumford; Jonah Musa; Kamarul Imran Musa; Ghulam Mustafa; Saravanan Muthupandian; Jean B. Nachega; Gabriele Nagel; Aliya Naheed; Azin Nahvijou; Gurudatta Naik; Sanjeev Nair; 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 R.J. Newton; Frida N. Ngalesoni; Josephine W. Ngunjiri; Anh Quynh Nguyen; Grant Nguyen; Ha Thu Nguyen; Huong Thanh Nguyen; Long Hoang Nguyen; Minh Nguyen; Trang Huyen Nguyen; Emma Nichols; Dina Nur Anggraini Ningrum; Yirga Legesse Nirayo; 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; Peter S. Nyasulu; Christopher M. Odell; Richard Ofori-Asenso; Felix Akpojene Ogbo; In-Hwan Oh; Olanrewaju Oladimeji; Andrew T. Olagunju; Pedro R. Olivares; Helen Elizabeth Olsen; Bolajoko Olubukunola Olusanya; Jacob Olusegun Olusanya; Kanyin L. Ong; Sok King Sk Ong; Eyal Oren; Heather M. Orpana; Alberto Ortiz; Justin R. Ortiz; Stanislav S. Otstavnov; Simon Overland; Mayowa Ojo Owolabi; Raziye Ozdemir; P.A. Mahesh; Rosana Pacella; Smita Pakhale; Abhijit P. Pakhare; Amir H. Pakpour; Adrian Pana; Songhomitra Panda-Jonas; Jeyaraj Durai Pandian; Andrea Parisi; Eun-Kee Park; Charles D.H. Parry; Hadi Parsian; Shanti Patel; Sanghamitra Pati; George C. Patton; Vishnupriya Rao Paturi; Katherine R. Paulson; Alexandre Pereira; David M. Pereira; Norberto Perico; Konrad Pesudovs; Max Petzold; Michael R. Phillips; Frederic B. Piel; David M. Pigott; Julian David Pillay; Meghdad Pirsaheb; Farhad Pishgar; Suzanne Polinder; Maarten J. Postma; Akram Pourshams; Hossein Poustchi; Ashwini Pujar; Swayam Prakash; Narayan Prasad; Caroline A. Purcell; Mostafa Qorbani; Hedley Quintana; D.Alex Quistberg; Kirankumar Waman Rade; Amir Radfar Anwar Rafay; Fakher Rahim; Kazem Rahimi; Afarin Rahimi-Movaghar; Mahfuzar Rahman; Mohammad Hifz Ur Rahman; Muhammad Aziz Rahman; Rajesh Kumar Rai; Sasa Rajsic; Usha Ram; Chhabi Lal Ranabhat; Prabhat Ranjan; Puja C. Rao; David Laith Rawaf; Salman Rawaf; Christian Razo-Garcia; K. Srinath Reddy; Robert C. Reiner; Marissa B. Reitsma; Giuseppe Remuzzi; Andre M.N. Renzaho; Serge Resnikoff; Satar Rezaei; Shahab Rezaeian; Mohammad Sadegh Rezai; Seyed Mohammad Riahi; Antonio Luiz P. Ribeiro; Maria Jesus Rios-Blancas; Kedir Teji Roba; Nicholas L.S. Roberts; Stephen R. Robinson; Leonardo Roever; Luca Ronfani; Gholamreza Roshandel; Ali Rostami; Dietrich Rothenbacher; Ambuj Roy; Enrico Rubagotti; Perminder S. Sachdev; Basema Saddik; Ehsan Sadeghi; Hosein Safari; Mahdi Safdarian; Sare Safi; Saeid Safiri; Rajesh Sagar; Amirhossein Sahebkar; Mohammad Ali Sahraian; Nasir Salam; Joseph S. Salama; Payman Salamati; Raphael De Freitas Saldanha; Zikria Saleem; Yahya Salimi; Sundeep Santosh Salvi; Inbal Salz; Evanson Zondani Sambala; Abdallah M. Samy; Juan Sanabria; Maria Dolores Sanchez-Nino; Damian Francesco Santomauro; Itamar S. Santos; Joao Vasco Santos; Milena M. Santric Milicevic; Bruno Piassi Sao Jose; Abdur Razzaque Sarker; Rodrigo Sarmiento-Suarez; Nizal Sarrafzadegan; Benn Sartorius; Shahabeddin Sarvi; Brijesh Sathian; Maheswar Satpathy; Arundhati R. Sawant; Monika Sawhney; Sonia Saxena; Mehdi Sayyah; Elke Schaeffner; Maria Ines Schmidt; Ione J.C. Schneider; Ben Schottker; Aletta Elisabeth Schutte; David C. Schwebel; Falk Schwendicke; James G. Scott; Mario Sekerija; Sadaf G. Sepanlou; Edson Servan-Mori; Seyedmojtaba Seyedmousavi; Hosein Shabaninejad; Katya Anne Shackelford; Azadeh Shafieesabet; Mehdi Shahbazi; Amira A. Shaheen; Masood Ali Shaikh; Mehran Shams-Beyranvand; Mohammadbagher Shamsi; Morteza Shamsizadeh; Kiomars Sharafi; Mehdi Sharif; Mahdi Sharif-Alhoseini; Rajesh Sharma; Jun She; Aziz Sheikh; Peilin Shi; Mekonnen Sisay Shiferaw; Mika Shigematsu; Rahman Shiri; Reza Shirkoohi; Ivy Shiue; Farhad Shokraneh; Mark G. Shrime; Si Si; Soraya Siabani; Tariq J. Siddiqi; Inga Dora Sigfusdottir; Rannveig Sigurvinsdottir; Donald H. Silberberg; Diego Augusto Santos Silva; Joao Pedro Silva; Natacha Torres Da Silva; Dayane Gabriele Alves Silveira; Jasvinder A. Singh; Narinder Pal Singh; Prashant Kumar Singh; Virendra Singh; Dhirendra Narain Sinha; Karen Sliwa; Mari Smith; Badr Hasan Sobaih; Soheila Sobhani; Eugene Sobngwi; Samir S. Soneji; Moslem Soofi; Reed J.D. Sorensen; Joan B. Soriano; Ireneous N. Soyiri; Luciano A. Sposato; Chandrashekhar T. Sreeramareddy; Vinay Srinivasan; Jeffrey D. Stanaway; Vladimir I. Starodubov; Vasiliki Stathopoulou; Dan J. Stein; Caitlyn Steiner; Leo G. Stewart; Mark A. Stokes; Michelle L. Subart; Agus Sudaryanto; Mu'Awiyyah Babale Sufiyan; Patrick John Sur; Ipsita Sutradhar; Bryan L. Sykes; P.N. Sylaja; Dillon O. Sylte; Cassandra E.I. Szoeke; Rafael Tabares-Seisdedos; Takahiro Tabuchi; Santosh Kumar Tadakamadla; Ken Takahashi; Nikhil Tandon; Segen Gebremeskel Tassew; Nuno Taveira; Arash Tehrani-Banihashemi; Tigist Gashaw Tekalign; Merhawi Gebremedhin Tekle; Mohamad-Hani Temsah; Omar Temsah; Abdullah Sulieman Terkawi; Manaye Yihune Teshale; Belay Tessema; Gizachew Assefa Tessema; Kavumpurathu Raman Thankappan; Sathish Thirunavukkarasu; Nihal Thomas; Amanda G. Thrift; George D. Thurston; Binyam Tilahun; Quyen G. To; Ruoyan Tobe-Gai; Marcello Tonelli; Roman Topor-Madry; Anna E. Torre; Miguel Tortajada-Girbes; Mathilde Touvier; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Khanh Bao Tran; Suryakant Tripathi; Christopher E. Troeger; Thomas Clement Truelsen; Nu Thi Truong; Afewerki Gebremeskel Tsadik; Derrick Tsoi; Lorainne Tudor Car; E. Murat Tuzcu; Stefanos Tyrovolas; Kingsley N. Ukwaja; Irfan Ullah; Eduardo A. Undurraga; Rachel L. Updike; Muhammad Shariq Usman; Olalekan A. Uthman; Selen Begum Uzun; Muthiah Vaduganathan; Afsane Vaezi; Gaurang Vaidya; Pascual R. Valdez; Elena Varavikova; Tommi Juhani Vasankari; Narayanaswamy Venketasubramanian; Santos Villafaina; Francesco S. Violante; Sergey Konstantinovitch Vladimirov; Vasily Vlassov; Stein Emil Vollset; Theo Vos; Gregory R. Wagner; Fasil Shiferaw Wagnew; Yasir Waheed; Mitchell Taylor Wallin; Judd L. Walson; Yanping Wang; Yuan-Pang Wang; Molla Mesele Wassie; Elisabete Weiderpass; Robert G. Weintraub; Fitsum Weldegebreal; Kidu Gidey Weldegwergs; Andrea Werdecker; Adhena Ayaliew Werkneh; T. Eoin West; Ronny Westerman; Harvey A. Whiteford; Justyna Widecka
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
Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 (The Lancet (2018) 392(10159) (1923–1994), (S0140673618322256), (10.1016/S0140-6736(18)32225-6))
(Lancet Publishing Group, 2019) Jeffrey D. Stanaway; Ashkan Afshin; Emmanuela Gakidou; Stephen S. Lim; Degu Abate; Kalkidan Hassen Abate; Cristiana Abbafati; Nooshin Abbasi; Hedayat Abbastabar; Foad Abd-Allah; Jemal Abdela; Ahmed Abdelalim; Ibrahim Abdollahpour; Rizwan Suliankatchi Abdulkader; Molla Abebe; Zegeye Abebe; Semaw F. Abera; Olifan Zewdie Abil; Haftom Niguse Abraha; Aklilu Roba Abrham; Laith Jamal Abu-Raddad; Niveen M.E. Abu-Rmeileh; Manfred Mario Kokou Accrombessi; Dilaram Acharya; Pawan Acharya; Abdu A. Adamu; Akilew Awoke Adane; Oladimeji M. Adebayo; Rufus Adesoji Adedoyin; Victor Adekanmbi; Zanfina Ademi; Olatunji O. Adetokunboh; Mina G. Adib; Amha Admasie; Jose C. Adsuar; Kossivi Agbelenko Afanvi; Mohsen Afarideh; Gina Agarwal; Anju Aggarwal; Sargis Aghasi Aghayan; Anurag Agrawal; Sutapa Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Muktar Beshir Ahmed; Amani Nidhal Aichour; Ibtihel Aichour; Miloud Taki Eddine Aichour; Mohammad Esmaeil Akbari; Tomi Akinyemiju; Nadia Akseer; Ziyad Al-Aly; Ayman Al-Eyadhy; Hesham M. Al-Mekhlafi; Fares Alahdab; Khurshid Alam; Samiah Alam; Tahiya Alam; Alaa Alashi; Seyed Moayed Alavian; Kefyalew Addis Alene; Komal Ali; Syed Mustafa Ali; Mehran Alijanzadeh; Reza Alizadeh-Navaei; Syed Mohamed Aljunid; Ala’a Alkerwi; François Alla; Ubai Alsharif; Khalid Altirkawi; Nelson Alvis-Guzman; Azmeraw T. Amare; Walid Ammar; Nahla Hamed Anber; Jason A. Anderson; Catalina Liliana Andrei; Sofia Androudi; Megbaru Debalkie Animut; Mina Anjomshoa; Mustafa Geleto Ansha; Josep M. Antó; Carl Abelardo T. Antonio; Palwasha Anwari; Lambert Tetteh Appiah; Seth Christopher Yaw Appiah; Jalal Arabloo; Olatunde Aremu; Johan Ärnlöv; Al Artaman; Krishna K. Aryal; Hamid Asayesh; Zerihun Ataro; Marcel Ausloos; Euripide F.G.A. Avokpaho; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Rakesh Ayer; Tambe B. Ayuk; Peter S. Azzopardi; Arefeh Babazadeh; Hamid Badali; Alaa Badawi; Kalpana Balakrishnan; Ayele Geleto Bali; Kylie Ball; Shoshana H. Ballew; Maciej Banach; Joseph Adel Mattar Banoub; Aleksandra Barac; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Lope H. Barrero; Sanjay Basu; Bernhard T. Baune; Shahrzad Bazargan-Hejazi; Neeraj Bedi; Ettore Beghi; Masoud Behzadifar; Meysam Behzadifar; Yannick Béjot; Bayu Begashaw Bekele; Eyasu Tamru Bekru; Ezra Belay; Yihalem Abebe Belay; Michelle L. Bell; Aminu K. Bello; Derrick A. Bennett; Isabela M. Bensenor; Gilles Bergeron; Adugnaw Berhane; Eduardo Bernabe; Robert S. Bernstein; Mircea Beuran; Tina Beyranvand; Neeraj Bhala; Ashish Bhalla; Suraj Bhattarai; Zulfiqar A. Bhutta; Belete Biadgo; Ali Bijani; Boris Bikbov; Ver Bilano; Nigus Bililign; Muhammad Shahdaat Bin Sayeed; Donal Bisanzio; Tuhin Biswas; Tone Bjørge; Brigette F. Blacker; Archie Bleyer; Rohan Borschmann; Ibrahim R. Bou-Orm; Soufiane Boufous; Rupert Bourne; Oliver J. Brady; Michael Brauer; Alexandra Brazinova; Nicholas J.K. Breitborde; Hermann Brenner; Andrey Nikolaevich Briko; Gabrielle Britton; Traolach Brugha; Rachelle Buchbinder; Richard T. Burnett; Reinhard Busse; Zahid A. Butt; Leah E. Cahill; Lucero Cahuana-Hurtado; Ismael R. Campos-Nonato; Rosario Cárdenas; Giulia Carreras; Juan J. Carrero; Félix Carvalho; Carlos A. Castañeda-Orjuela; Jacqueline Castillo Rivas; Franz Castro; Ferrán Catalá-López; Kate Causey; Kelly M. Cercy; Ester Cerin; Yazan Chaiah; Hsing-Yi Chang; Jung-Chen Chang; Kai-Lan Chang; Fiona J. Charlson; Aparajita Chattopadhyay; Vijay Kumar Chattu; Miao Li Chee; Ching-Yu Cheng; Adrienne Chew; Peggy Pei-Chia Chiang; Odgerel Chimed-Ochir; Ken Lee Chin; Abdulaal Chitheer; Jee-Young J. Choi; Rajiv Chowdhury; Hanne Christensen; Devasahayam J. Christopher; Sheng-Chia Chung; Flavia M. Cicuttini; Massimo Cirillo; Aaron J. Cohen; Daniel Collado-Mateo; Cyrus Cooper; Owen R. Cooper; Josef Coresh; Leslie Cornaby; Paolo Angelo Cortesi; Monica Cortinovis; Megan Costa; Ewerton Cousin; Michael H. Criqui; Elizabeth A. Cromwell; David K. Cundiff; Alemneh Kabeta Daba; Berihun Assefa Dachew; Abel Fekadu Dadi; Albertino Antonio Moura Damasceno; Lalit Dandona; Rakhi Dandona; Sarah C. Darby; Paul I. Dargan; Ahmad Daryani; Rajat Das Gupta; José Das Neves; Tamirat Tesfaye Dasa; Aditya Prasad Dash; Dragos Virgil Davitoiu; Kairat Davletov; Vanessa De la Cruz-Góngora; Fernando Pio De La Hoz; Diego De Leo; Jan-Walter De Neve; Louisa Degenhardt; Selina Deiparine; Robert P. Dellavalle; Gebre Teklemariam Demoz; Edgar Denova-Gutiérrez; Kebede Deribe; Nikolaos Dervenis; Aniruddha Deshpande; Don C. Des Jarlais; Getenet Ayalew Dessie; Gabrielle Aline Deveber; Subhojit Dey; Samath Dhamminda Dharmaratne; Meghnath Dhimal; Mesfin Tadese Dinberu; Eric L. Ding; Helen Derara Diro; Shirin Djalalinia; Huyen Phuc Do; Klara Dokova; David Teye Doku; Kerrie E. Doyle; Tim R. Driscoll; Manisha Dubey; Eleonora Dubljanin; Eyasu Ejeta Duken; Bruce B. Duncan; Andre R. Duraes; Natalie Ebert; Hedyeh Ebrahimi; Soheil Ebrahimpour; David Edvardsson; Andem Effiong; Anne Elise Eggen; Charbel El Bcheraoui; Ziad El-Khatib; Iqbal Rf Elyazar; Ahmadali Enayati; Aman Yesuf Endries; Benjamin Er; Holly E. Erskine; Sharareh Eskandarieh; Alireza Esteghamati; Kara Estep; Hamed Fakhim; Mahbobeh Faramarzi; Mohammad Fareed; Talha A. Farid; Carla Sofia E. Sá Farinha; Andrea Farioli; Andre Faro; Maryam S. Farvid; Mohammad Hosein Farzaei; Batool Fatima; Kairsten A. Fay; Ali Akbar Fazaeli; Valery L. Feigin; Andrea B. Feigl; Seyed-Mohammad Fereshtehnejad; Eduarda Fernandes; Joao C. Fernandes; Giannina Ferrara; Alize J. Ferrari; Manuela L. Ferreira; Irina Filip; Jonas David Finger; Florian Fischer; Nataliya A. Foigt; Kyle J. Foreman; Takeshi Fukumoto; Nancy Fullman; Thomas Fürst; João M. Furtado; Neal D. Futran; Seana Gall; Silvano Gallus; Amiran Gamkrelidze; Morsaleh Ganji; Alberto L. Garcia-Basteiro; William M. Gardner; Abadi Kahsu Gebre; Amanuel Tesfay Gebremedhin; Teklu Gebrehiwo Gebremichael; Tilayie Feto Gelano; Johanna M. Geleijnse; Yilma Chisha Dea Geramo; Peter W. Gething; Kebede Embaye Gezae; Reza Ghadimi; Keyghobad Ghadiri; Khalil Ghasemi Falavarjani; Maryam Ghasemi-Kasman; Mamata Ghimire; Rakesh Ghosh; Aloke Gopal Ghoshal; Simona Giampaoli; Paramjit Singh Gill; Tiffany K. Gill; Richard F. Gillum; Ibrahim Abdelmageed Ginawi; Giorgia Giussani; Elena V. Gnedovskaya; William W. Godwin; Srinivas Goli; Hector Gómez-Dantés; Philimon N. Gona; Sameer Vali Gopalani; Alessandra C. Goulart; Ayman Grada; Morgan E. Grams; Giuseppe Grosso; Harish Chander Gugnani; Yuming Guo; Rahul Gupta; Rajeev Gupta; Tanush Gupta; Reyna Alma Gutiérrez; Daniela S. Gutiérrez-Torres; Juanita A. Haagsma; Tesfa Dejenie Habtewold; 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; Sivadasanpillai Harikrishnan; Josep Maria Haro; Hadi Hassankhani; Hamid Yimam Hassen; Rasmus Havmoeller; Caitlin N. Hawley; Simon I. Hay; Akbar Hedayatizadeh-Omran; Behzad Heibati; Behnam Heidari; Mohsen Heidari; Delia Hendrie; Andualem Henok; Ileana Heredia-Pi; Claudiu Herteliu; Fatemeh Heydarpour; Sousan Heydarpour; Desalegn T. Hibstu; Tarig B. Higazi; Esayas Haregot Hilawe; 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; Damian G. Hoy; Mohamed Hsairi; Thomas Hsiao; Guoqing Hu; Howard Hu; John J. Huang; Mamusha Aman Hussen; Chantal K. Huynh; Kim Moesgaard Iburg; Nayu Ikeda; Olayinka Stephen Ilesanmi; Usman Iqbal; Seyed Sina Naghibi Irvani; Caleb Mackay Salpeter Irvine; Sheikh Mohammed Shariful Islam; Farhad Islami; Maria D. Jackson; Kathryn H. Jacobsen; Leila Jahangiry; Nader Jahanmehr; Sudhir Kumar Jain; Mihajlo Jakovljevic; Spencer L. James; Simerjot K. Jassal; Achala Upendra Jayatilleke; Panniyammakal Jeemon; Ravi Prakash Jha; Vivekanand Jha; John S. Ji; Jost B. Jonas; Jitendra Jonnagaddala; Zahra Jorjoran Shushtari; Ankur Joshi; Jacek Jerzy Jozwiak; Mikk Jürisson; Zubair Kabir; Amaha Kahsay; Rizwan Kalani; Tanuj Kanchan; Surya Kant; Chittaranjan Kar; 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; Anil Kaul; Norito Kawakami; Zhila Kazemi; Ali Kazemi Karyani; 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; Gulfaraz Khan; Muhammad Shahzeb Khan; Muhammad Ali Khan; Young-Ho Khang; Mona M. Khater; Mohammad Khazaei; Habibolah Khazaie; Abdullah T. Khoja; Ardeshir Khosravi; Mohammad Hossein Khosravi; Aliasghar A. Kiadaliri; Daniel N. Kiirithio; Cho-Il Kim; Daniel Kim; Young-Eun Kim; Yun Jin Kim; Ruth W. Kimokoti; Yohannes Kinfu; Adnan Kisa; Katarzyna Kissimova-Skarbek; Mika Kivimäki; Luke D. Knibbs; Ann Kristin Skrindo Knudsen; Sonali Kochhar; Yoshihiro Kokubo; Tufa Kolola; Jacek A. Kopec; Soewarta Kosen; Parvaiz A. Koul; Ai Koyanagi; Michael A. Kravchenko; Kewal Krishan; Kristopher J. Krohn; Hans Kromhout; Barthelemy Kuate Defo; Burcu Kucuk Bicer; G. Anil Kumar; Manasi Kumar; Igor Kuzin; Hmwe Hmwe Kyu; Carl Lachat; Deepesh P. Lad; Sheetal D. Lad; Alessandra Lafranconi; Ratilal Lalloo; Tea Lallukka; Faris Hasan Lami; Justin J. Lang; Van C. Lansingh; Samantha Leigh Larson; Arman Latifi; Jeffrey V. Lazarus; Paul H. Lee; James Leigh; Mostafa Leili; Cheru Tesema Leshargie; Janni Leung; Miriam Levi; Sonia Lewycka; Shanshan Li; Yichong Li; Juan Liang; Xiaofeng Liang; Yu Liao; Misgan Legesse Liben; Lee-Ling Lim; Shai Linn; Shiwei Liu; Rakesh Lodha; Giancarlo Logroscino; Alan D. Lopez; Stefan Lorkowski; Paulo A. Lotufo; Rafael Lozano; Tim C.D. Lucas; Raimundas Lunevicius; Stefan Ma; Erlyn Rachelle King Macarayan; Ísis Eloah Machado; Fabiana Madotto; Hue Thi Mai; Marek Majdan; Reza Majdzadeh; Azeem Majeed; Reza Malekzadeh; Deborah Carvalho Malta; Abdullah A. Mamun; Ana-Laura Manda; Helena Manguerra; Mohammad Ali Mansournia; Lorenzo Giovanni Mantovani; Joemer C. Maravilla; Wagner Marcenes; Ashley Marks; Randall V. Martin; Sheila C.O. Martins; Francisco Rogerlândio Martins-Melo; Winfried März; Melvin B. Marzan; Benjamin Ballard Massenburg; Manu Raj Mathur; Prashant Mathur; Kunihiro Matsushita; Pallab K. Maulik; Mohsen Mazidi; Colm McAlinden; John J. McGrath; Martin McKee; Ravi Mehrotra; Kala M. Mehta; Varshil Mehta; Toni Meier; Fantahun Ayenew Mekonnen; Yohannes A. Melaku; Addisu Melese; Mulugeta Melku; Peter T.N. Memiah; Ziad A. Memish; Walter Mendoza; Desalegn Tadese Mengistu; George A. Mensah; Gert B.M. Mensink; Seid Tiku Mereta; Atte Meretoja; Tuomo J. Meretoja; Tomislav Mestrovic; Haftay Berhane Mezgebe; Bartosz Miazgowski; Tomasz Miazgowski; Anoushka I. Millear; Ted R. Miller; Molly Katherine Miller-Petrie; G.K. Mini; Mojde Mirarefin; Andreea Mirica; Erkin M. 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Smith; Mari Smith; Badr Hasan Sobaih; Soheila Sobhani; Ranjani Somayaji; Moslem Soofi; Reed J.D. Sorensen; Joan B. Soriano; Ireneous N. Soyiri; Angela Spinelli; Luciano A. Sposato; Chandrashekhar T. Sreeramareddy; Vinay Srinivasan; Vladimir I. Starodubov; Nadine Steckling; Dan J. Stein; Murray B. Stein; Goran Stevanovic; Leo Stockfelt; Mark A. Stokes; Lela Sturua; Michelle L. Subart; Agus Sudaryanto; Mu’awiyyah Babale Sufiyan; Gerhard Sulo; Bruno F. Sunguya; Patrick John Sur; Bryan L. Sykes; Cassandra E.I. Szoeke; Rafael Tabarés-Seisdedos; Takahiro Tabuchi; Santosh Kumar Tadakamadla; Ken Takahashi; Nikhil Tandon; Segen Gebremeskel Tassew; Mohammad Tavakkoli; Nuno Taveira; Arash Tehrani-Banihashemi; Tigist Gashaw Tekalign; Shishay Wahdey Tekelemedhin; Merhawi Gebremedhin Tekle; Habtamu Temesgen; Mohamad-Hani Temsah; Omar Temsah; Abdullah Sulieman Terkawi; Belay Tessema; Mebrahtu Teweldemedhin; Kavumpurathu Raman Thankappan; Andrew Theis; Sathish Thirunavukkarasu; Hannah J. 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Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followed by smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million [2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
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Background: Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods: GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk–outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk–outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk–outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings: The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95% uncertainty interval [UI] 9·51–12·1) deaths (19·2% [16·9–21·3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12–9·31) deaths (15·4% [14·6–16·2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253–350) DALYs (11·6% [10·3–13·1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0–9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10–24 years, alcohol use for those aged 25–49 years, and high systolic blood pressure for those aged 50–74 years and 75 years and older. Interpretation: Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global, 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
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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. 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Shaheen; Masood Ali Shaikh; Mehran Shams-Beyranvand; Mohammadbagher Shamsi; Morteza Shamsizadeh; Kiomars Sharafi; Mehdi Sharif; Mahdi Sharif-Alhoseini; Rajesh Sharma; Jun She; Aziz Sheikh; Peilin Shi; Mekonnen Sisay Shiferaw; Mika Shigematsu; Rahman Shiri; Reza Shirkoohi; Ivy Shiue; Farhad Shokraneh; Mark G. Shrime; Si Si; Soraya Siabani; Tariq J. Siddiqi; Inga Dora Sigfusdottir; Rannveig Sigurvinsdottir; Donald H. Silberberg; Diego Augusto Santos Silva; Joao Pedro Silva; Natacha Torres Da Silva; Dayane Gabriele Alves Silveira; Jasvinder A. Singh; Narinder Pal Singh; Prashant Kumar Singh; Virendra Singh; Dhirendra Narain Sinha; Karen Sliwa; Mari Smith; Badr Hasan Sobaih; Soheila Sobhani; Eugene Sobngwi; Samir S. Soneji; Moslem Soofi; Reed J.D. Sorensen; Joan B. Soriano; Ireneous N. Soyiri; Luciano A. Sposato; Chandrashekhar T. Sreeramareddy; Vinay Srinivasan; Jeffrey D. Stanaway; Vladimir I. Starodubov; Vasiliki Stathopoulou; Dan J. Stein; Caitlyn Steiner; Leo G. Stewart; Mark A. Stokes; Michelle L. Subart; Agus Sudaryanto; Mu'Awiyyah Babale Sufiyan; Patrick John Sur; Ipsita Sutradhar; Bryan L. Sykes; P.N. Sylaja; Dillon O. Sylte; Cassandra E.I. Szoeke; Rafael Tabares-Seisdedos; Takahiro Tabuchi; Santosh Kumar Tadakamadla; Ken Takahashi; Nikhil Tandon; Segen Gebremeskel Tassew; Nuno Taveira; Arash Tehrani-Banihashemi; Tigist Gashaw Tekalign; Merhawi Gebremedhin Tekle; Mohamad-Hani Temsah; Omar Temsah; Abdullah Sulieman Terkawi; Manaye Yihune Teshale; Belay Tessema; Gizachew Assefa Tessema; Kavumpurathu Raman Thankappan; Sathish Thirunavukkarasu; Nihal Thomas; Amanda G. Thrift; George D. Thurston; Binyam Tilahun; Quyen G. To; Ruoyan Tobe-Gai; Marcello Tonelli; Roman Topor-Madry; Anna E. Torre; Miguel Tortajada-Girbes; Mathilde Touvier; Marcos Roberto Tovani-Palone; Bach Xuan Tran; Khanh Bao Tran; Suryakant Tripathi; Christopher E. Troeger; Thomas Clement Truelsen; Nu Thi Truong; Afewerki Gebremeskel Tsadik; Derrick Tsoi; Lorainne Tudor Car; E. Murat Tuzcu; Stefanos Tyrovolas; Kingsley N. Ukwaja; Irfan Ullah; Eduardo A. Undurraga; Rachel L. Updike; Muhammad Shariq Usman; Olalekan A. Uthman; Selen Begum Uzun; Muthiah Vaduganathan; Afsane Vaezi; Gaurang Vaidya; Pascual R. Valdez; Elena Varavikova; Tommi Juhani Vasankari; Narayanaswamy Venketasubramanian; Santos Villafaina; Francesco S. Violante; Sergey Konstantinovitch Vladimirov; Vasily Vlassov; Stein Emil Vollset; Theo Vos; Gregory R. Wagner; Fasil Shiferaw Wagnew; Yasir Waheed; Mitchell Taylor Wallin; Judd L. Walson; Yanping Wang; Yuan-Pang Wang; Molla Mesele Wassie; Elisabete Weiderpass; Robert G. Weintraub; Fitsum Weldegebreal; Kidu Gidey Weldegwergs; Andrea Werdecker; Adhena Ayaliew Werkneh; T. Eoin West; Ronny Westerman; Harvey A. Whiteford; Justyna Widecka
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 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016
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Background: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). Methods: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE difered from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. Findings: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs ofset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the fve lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. Interpretation: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs ofset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention eforts, and development assistance for health, including fnancial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. © 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
(Lancet Publishing Group, 2018) Hmwe Hmwe Kyu; 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; Molla Abebe; Zegeye Abebe; Olifan Zewdie Abil; Victor Aboyans; Aklilu Roba Abrham; 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; Zanfina Ademi; 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; Anurag Agrawal; Alireza Ahmadi; Mehdi Ahmadi; Hamid Ahmadieh; Muktar Beshir Ahmed; Sayem 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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Shaheen; Masood Ali Shaikh; Mehran Shams-Beyranvand; Mohammadbagher Shamsi; Heidar Sharafi; Kiomars Sharafi; Mehdi Sharif; Mahdi Sharif-Alhoseini; Jayendra Sharma; Rajesh Sharma; Jun She; Aziz Sheikh; Peilin Shi; Kenji Shibuya; Mekonnen Sisay Shiferaw; Mika Shigematsu; Rahman Shiri; Reza Shirkoohi; Ivy Shiue; Yalda Shokoohinia; Farhad Shokraneh; Haitham Shoman; Mark G. Shrime; Si Si; Soraya Siabani; Abla Mehio Sibai; Tariq J. Siddiqi; Inga Dora Sigfusdottir; Rannveig Sigurvinsdottir; Diego Augusto Santos Silva; Joao Pedro Silva; Dayane Gabriele Alves Silveira; Narayana Sarma Venkata Singam; Jasvinder A. Singh; Narinder Pal Singh; Virendra Singh; Dhirendra Narain Sinha; Eirini Skiadaresi; Vegard Skirbekk; Karen Sliwa; David L. Smith; Mari Smith; Adauto Martins Soares Filho; Badr Hasan Sobaih; Soheila Sobhani; Moslem Soofi; Reed J.D. Sorensen; Ireneous N. Soyiri; Luciano A. Sposato; Chandrashekhar T. Sreeramareddy; Vinay Srinivasan; Jeffrey D. Stanaway; Vladimir I. Starodubov; Dan J. 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Troeger; Afewerki Gebremeskel Tsadik; Derrick Tsoi; Lorainne Tudor Car; Stefanos Tyrovolas; Kingsley Nnanna Ukwaja; Irfan Ullah; Eduardo A. Undurraga; Rachel L. Updike; Muhammad Shariq Usman; Olalekan A. Uthman; Muthiah Vaduganathan; Afsane Vaezi; Pascual R. Valdez; Elena Varavikova; Santosh Varughese; Tommi Juhani Vasankari; 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; Yafeng Wang; Yuan-Pang Wang; Elisabete Weiderpass; Robert G. Weintraub; Daniel J. Weiss; Fitsum Weldegebreal; Kidu Gidey Weldegwergs; Andrea Werdecker; T. Eoin West; Ronny Westerman; Harvey A. Whiteford; Justyna Widecka; Tissa Wijeratne; Hywel C. Williams; Lauren B. Wilner; Shadrach Wilson; Andrea Sylvia Winkler; Alison B. Wiyeh; Charles Shey Wiysonge; Charles D.A. Wolfe; Anthony D. Woolf; Grant M.A. Wyper; Denis Xavier; Gelin Xu; Simon Yadgir; Seyed Hossein Yahyazadeh Jabbari; Tomohide Yamada; Lijing L. Yan; Yuichiro Yano; Mehdi Yaseri; Yasin Jemal Yasin; 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; Zoubida Zaidi; Sojib Bin Zaman; Mohammad Zamani; Hamed Zandian; Heather J. Zar; Zerihun Menlkalew Zenebe; Ben Zipkin; Maigeng Zhou; Sanjay Zodpey; Inbar Zucker; Liesl Joanna Zuhlke; Christopher J.L. Murray
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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Prakash; Caroline A. Purcell; Manorama B. Purwar; Mostafa Qorbani; D. Alex Quistberg; Amir Radfar; Anwar Rafay; Alireza Rafiei; Fakher Rahim; Kazem Rahimi; Afarin Rahimi-Movaghar; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Mohammad Hifz Ur Rahman; Muhammad Aziz Rahman; Sajjad Ur Rahman; Rajesh Kumar Rai; Fatemeh Rajati; Usha Ram; Prabhat Ranjan; Anna Ranta; Puja C. Rao; David Laith Rawaf; Salman Rawaf; K. Srinath Reddy; Robert C. Reiner; Nickolas Reinig; Marissa Bettay Reitsma; Giuseppe Remuzzi; Andre M.N. Renzaho; Serge Resnikoff; Satar Rezaei; Mohammad Sadegh Rezai; Antonio Luiz P. Ribeiro; Stephen R. Robinson; Leonardo Roever; Luca Ronfani; Gholamreza Roshandel; Ali Rostami; Gregory A. Roth; Ambuj Roy; Enrico Rubagotti; Perminder S. Sachdev; Nafis Sadat; Basema Saddik; Ehsan Sadeghi; 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; Nasir Salam; Joseph S. Salama; Payman Salamati; Komal Saleem; Zikria Saleem; Yahya Salimi; Joshua A. Salomon; Sundeep Santosh Salvi; Inbal Salz; Abdallah M. Samy; Juan Sanabria; Yingying Sang; Damian Francesco Santomauro; Itamar S. Santos; João Vasco Santos; Milena M. Santric Milicevic; Bruno Piassi Sao Jose; Mayank Sardana; Abdur Razzaque Sarker; Nizal Sarrafzadegan; Benn Sartorius; Shahabeddin Sarvi; Brijesh Sathian; Maheswar Satpathy; Arundhati R. Sawant; Monika Sawhney; Sonia Saxena; Mete Saylan; Elke Schaeffner; Maria Inês Schmidt; Ione J.C. Schneider; Ben Schöttker; David C. Schwebel; Falk Schwendicke; James G. Scott; Mario Sekerija; Sadaf G. Sepanlou; Edson Serván-Mori; Seyedmojtaba Seyedmousavi; Hosein Shabaninejad; Azadeh Shafieesabet; Mehdi Shahbazi; Amira A. Shaheen; Masood Ali Shaikh; Mehran Shams-Beyranvand; Mohammadbagher Shamsi; Morteza Shamsizadeh; Heidar Sharafi; Kiomars Sharafi; Mehdi Sharif; Mahdi Sharif-Alhoseini; Meenakshi Sharma; Rajesh Sharma; Jun She; Aziz Sheikh; Peilin Shi; Kenji Shibuya; Mika Shigematsu; Rahman Shiri; Reza Shirkoohi; Kawkab Shishani; Ivy Shiue; Farhad Shokraneh; Haitham Shoman; Mark G. Shrime; Si Si; Soraya Siabani; Tariq J. Siddiqi; Inga Dora Sigfusdottir; Rannveig Sigurvinsdottir; João Pedro Silva; Dayane Gabriele Alves Silveira; Narayana Sarma Venkata Singam; Jasvinder A. Singh; Narinder Pal Singh; Virendra Singh; Dhirendra Narain Sinha; Eirini Skiadaresi; Erica Leigh N. Slepak; Karen Sliwa; David L. Smith; Mari Smith; Adauto Martins Soares Filho; Badr Hasan Sobaih; Soheila Sobhani; Eugène Sobngwi; Samir S. Soneji; Moslem Soofi; Masoud Soosaraei; Reed J.D. Sorensen; Joan B. Soriano; Ireneous N. Soyiri; Luciano A. Sposato; Chandrashekhar T. Sreeramareddy; Vinay Srinivasan; Jeffrey D. Stanaway; Dan J. Stein; Caitlyn Steiner; Timothy J. Steiner; Mark A. Stokes; Lars Jacob Stovner; Michelle L. Subart; Agus Sudaryanto; Mu'awiyyah Babale Sufiyan; Bruno F. Sunguya; Patrick John Sur; Ipsita Sutradhar; Bryan L. Sykes; Dillon O. Sylte; Rafael Tabarés-Seisdedos; Santosh Kumar Tadakamadla; Birkneh Tilahun Tadesse; Nikhil Tandon; Segen Gebremeskel Tassew; Mohammad Tavakkoli; Nuno Taveira; Hugh R. Taylor; Arash Tehrani-Banihashemi; Tigist Gashaw Tekalign; Shishay Wahdey Tekelemedhin; Merhawi Gebremedhin Tekle; Habtamu Temesgen; Mohamad-Hani Temsah; Omar Temsah; Abdullah Sulieman Terkawi; Mebrahtu Teweldemedhin; Kavumpurathu Raman Thankappan; Nihal Thomas; Binyam Tilahun; Quyen G. To; Marcello Tonelli; Roman Topor-Madry; Fotis Topouzis; Anna E. Torre; Miguel Tortajada-Girbés; Mathilde Touvier; Marcos Roberto Tovani-Palone; Jeffrey A. Towbin; Bach Xuan Tran; Khanh Bao Tran; Christopher E. Troeger; Thomas Clement Truelsen; Miltiadis K. Tsilimbaris; Derrick Tsoi; Lorainne Tudor Car; E. Murat Tuzcu; Kingsley N. Ukwaja; Irfan Ullah; Eduardo A. Undurraga; Jurgen Unutzer; Rachel L. Updike; Muhammad Shariq Usman; Olalekan A. Uthman; Muthiah Vaduganathan; Afsane Vaezi; Pascual R. Valdez; Santosh Varughese; Tommi Juhani Vasankari; Narayanaswamy Venketasubramanian; Santos Villafaina; Francesco S. Violante; Sergey Konstantinovitch Vladimirov; Vasily Vlassov; Stein Emil Vollset; Kia Vosoughi; Isidora S. Vujcic; Fasil Shiferaw Wagnew; Yasir Waheed; Stephen G. Waller; Yafeng Wang; Yuan-Pang Wang; Elisabete Weiderpass; Robert G. Weintraub; Daniel J. Weiss; Fitsum Weldegebreal; Kidu Gidey Weldegwergs; Andrea Werdecker; T. Eoin West; Harvey A. Whiteford; Justyna Widecka; Tissa Wijeratne; Lauren B. Wilner; Shadrach Wilson; Andrea Sylvia Winkler; Alison B. Wiyeh; Charles Shey Wiysonge; Charles D.A. Wolfe; Anthony D. Woolf; Shouling Wu; Yun-Chun Wu; Grant M.A. Wyper; Denis Xavier; Gelin Xu; Simon Yadgir; Ali Yadollahpour; Seyed Hossein Yahyazadeh Jabbari; Tomohide Yamada; Lijing L. Yan; Yuichiro Yano; Mehdi Yaseri; Yasin Jemal Yasin; 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; Zoubida Zaidi; Sojib Bin Zaman; Mohammad Zamani; Zohreh Zare; Ayalew Jejaw Zeleke
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. 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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. 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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. Santric Milicevic; Abdur Razzaque Sarker; Nizal Sarrafzadegan; Benn Sartorius; Maheswar Satpathy; Miloje Savic; Monika Sawhney; Sonia Saxena; Mete I. Saylan; Elke Schaeffner; Josef Schmidhuber; Maria Inês Schmidt; Ione J.C. Schneider; Austin E. Schumacher; Aletta E. Schutte; David C. Schwebel; Falk Schwendicke; Mario Sekerija; Sadaf G. Sepanlou; Edson E. Servan-Mori; Azadeh Shafieesabet; Masood Ali Shaikh; Marina Shakh-Nazarova; Mehran Shams-Beyranvand; Heidar Sharafi; Mahdi Sharif-Alhoseini; Sheikh Mohammed Shariful Islam; Meenakshi Sharma; Rajesh Sharma; Jun She; Aziz Sheikh; Mebrahtu Teweldemedhin Shfare; Peilin Shi; Chloe Shields; Mika Shigematsu; Yukito Shinohara; Rahman Shiri; Reza Shirkoohi; Ivy Shiue; Mark G. Shrime; Sharvari Rahul Shukla; Soraya Siabani; Inga Dora Sigfusdottir; Donald H. Silberberg; Diego Augusto Santos Silva; João Pedro Silva; Dayane Gabriele Alves Silveira; Jasvinder A. 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. Whiteford; Justyna Widecka; Andrea Sylvia Winkler; Charles Shey Wiysonge; Charles D.A. Wolfe; Yohanes Ayele Wondimkun; Abdulhalik Workicho; Grant M.A. Wyper; Denis Xavier; Gelin Xu; Lijing L. Yan; Yuichiro Yano; Mehdi Yaseri; Nigus Bililign Yimer; Peng Yin; Paul Yip; Biruck Desalegn Yirsaw; Naohiro Yonemoto; Gerald Yonga; Seok-Jun Yoon; Marcel Yotebieng; Mustafa Z. Younis; Chuanhua Yu; Vesna Zadnik; Zoubida Zaidi; Maysaa El Sayed Zaki; Sojib Bin Zaman; Mohammad Zamani; Zerihun Menlkalew Zenebe; Maigeng Zhou; Jun Zhu; Stephanie R.M. Zimsen; Ben Zipkin; Sanjay Zodpey; Liesl Joanna Zuhlke; Christopher J.L. Murray; Rafael Lozano
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.
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. 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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. 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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