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1. The burden of cardiovascular disease attributable to high systolic blood pressure across China, 2005–18: a population-based study

Author

Xue Cao, Zhenping Zhao, Yuting Kang, Yixin Tian, Yuxin Song, Limin Wang, Linfeng Zhang, Xin Wang, Zuo Chen, Congyi Zheng, Lu Tian, Peng Yin, Yuehui Fang, Mei Zhang, Yuna He, Zugui Zhang, William S Weintraub, Maigeng Zhou, Zengwu Wang, X Cao, Z Zhao, Y Kang, Y Tian, Y Song, L Wang, L Zhang, X Wang, Z Chen, C Zheng, L Tian, L Chen, J Cai, Z Hu, H Zhou, R Gu, Y Huang, P Yin, Y Fang, M Zhang, Y He, Z Zhang, W S Weintraub, M Zhou, and Z Wang

Subjects
Adult, Male, China, Research, Myocardial Ischemia, Public Health, Environmental and Occupational Health, Blood Pressure, Bayes Theorem, Brain Ischemia, Stroke, Hemorrhagic Stroke, Cardiovascular Diseases, Humans, Female, Ischemic Stroke
Abstract

Temporal trends and geographical variations in cardiovascular disease attributable to high systolic blood pressure in China are not yet fully understood. The aim of this study was to quantify the cardiovascular disease burden attributable to high systolic blood pressure at national and provincial levels in China.In this population-based study, we evaluated systolic blood pressure and estimated the number of deaths, age-standardised mortality rates, and years of life lost (YLLs) due to cardiovascular disease and its subcategories (including ischaemic heart disease, ischaemic stroke, haemorrhagic stroke, and other cardiovascular diseases) attributable to high systolic blood pressure, at the national level and by 31 provincial levels, in China, from 2005 to 2018. We pooled blood pressure data of 1·30 million adults aged 25 years and older from the China Chronic Disease and Risk Factor Surveillance project, the China National Nutrition Survey, and the China Hypertension Survey. We applied a temporal-spatial Bayesian hierarchical model to estimate age-specific, sex-specific, province-specific, and year-specific average systolic blood pressure, and a comparative risk assessment method to compute the cardiovascular disease burden attributable to high systolic blood pressure by age, sex, year, and province.Nationally, age-standardised mean systolic blood pressure was 132·5 mm Hg (95% uncertainty interval [UI] 124·6-140·3) in men and 129·4 mm Hg (121·7 to 137·2) in women. 2·67 million (95% UI 2·61 to 2·72) cardiovascular disease deaths in China were attributable to high systolic blood pressure, including 1·12 million deaths (1·07 to 1·16) due to ischaemic heart disease, 0·63 million deaths (0·60 to 0·65) due to ischaemic stroke, 0·58 million deaths (0·57 to 0·60) due to haemorrhagic stroke, and 0·34 million deaths (0·32 to 0·36) due to other cardiovascular disease. The age-standardised cardiovascular disease mortality rates associated with high systolic blood pressure were 268·99 per 100 000 people (95% UI 264·11 to 273·51) in 2005 and 220·84 per 100 000 people (216·30 to 224·76) in 2018, a percentage change of -17·90%; the rate changed by an average of -1·50% (95% UI -1·55% to -1·45%) per year from 2005 to 2018 nationally. YLL rates for total cardiovascular disease caused by high systolic blood pressure varied substantially across provinces, ranging from 3078·33 (95% UI 2807·40 to 3303·57) per 100 000 people in Beijing to 7189·98 (95% UI 6817·18 to 7507·99) per 100 000 people in Heilongjiang in 2018. Age-standardised YLL rates for ischaemic heart disease and ischaemic stroke attributable to high systolic blood pressure were particularly high in northeastern provinces, including Heilongjiang, Liaoning, and Jilin.The deaths and YLLs for cardiovascular disease attributable to high systolic blood pressure in China increased between 2005 and 2018, and age-standardised cardiovascular disease mortality rates decreased in the same timeframe. Our findings could help policy makers in promoting blood pressure control measures and implementing effective and locally adapted preventive interventions to reduce the prevalence of high systolic blood pressure and reduce the burden of systolic blood pressure-related cardiovascular disease in China.China National Key Research and Development Program, China National ScienceTechnology Pillar Program, and National Health Commission of the People's Republic of China.For the Chinese translation of the abstract see Supplementary Materials section.

Published
2022

2. Mortality and Years of Life Lost in Diabetes Mellitus and Its Subcategories in China and Its Provinces, 2005–2020

Author

Feixue Wang, Wei Wang, Peng Yin, Yunning Liu, Jiangmei Liu, Lijun Wang, Jinlei Qi, Jinlin You, Lin Lin, and Maigeng Zhou

Subjects
Aged, 80 and over, Male, China, Diabetes Mellitus, Type 1, Endocrinology, Diabetes Mellitus, Type 2, Article Subject, Endocrinology, Diabetes and Metabolism, Chronic Disease, Humans, Female, Aged
Abstract

Objectives. To analyze diabetes mellitus (DM) mortality and years of life lost (YLL) in different years and different subgroups at the national and regional levels in China from 2005 to 2020. Methods. We estimated mortality and YLL of DM and its subcategories for 31 provinces in China during 2005–2020 using multisource data from the National Mortality Surveillance System (NMSS). Results. The age standardized mortality rate (ASMR) of DM increased from 12.18 per 100,000 in 2005 to 13.62 per 100,000 in 2020, which was an increase of 11.86%. The ASMR of type 2 diabetes mellitus (T2DM) was much higher than that of type 1 diabetes mellitus (T1DM). The ASMR of T1DM remained stable, but the rate of T2DM increased, and the increase in male patients was higher than that in their female counterparts. At the same time, the burden of premature death was highest in the group ≥ 80 years old, and ASMR increased from 236.02 per 100,000 in 2005 to 358.86 per 100,000 in 2020. In 2005, the eastern region had the highest ASMR of DM, but the western region’s ASMR grew faster and eventually became the highest in 2020. In addition, the YLL rate in the eastern region showed a downward trend; however, in the middle and western regions the YLL rate continued to rise, with that of the western region rapidly increasing. Conclusion. A dramatically upward trend in DM deaths can be seen in China from 2005 to 2020. DM remains a chronic disease in urgent need of prevention and control, especially in the elderly and people in less-affluent provinces. We must put forward more targeted policies to effectively allocate medical resources and focus on high-risk groups to reduce the premature-mortality burden of DM and its subcategories.

Published
2022

3. Trend of nasopharyngeal carcinoma mortality and years of life lost in China and its provinces from 2005 to 2020

Author

Zheng Long, Wei Wang, Wei Liu, Feixue Wang, Shidi Meng, Jiangmei Liu, Yunning Liu, Jinlei Qi, Lijun Wang, Maigeng Zhou, and Peng Yin

Subjects
Male, Aging, China, Cancer Research, Nasopharyngeal Carcinoma, Oncology, Humans, Female, Nasopharyngeal Neoplasms, Public Health, Mortality
Abstract

To examine the trends of nasopharyngeal carcinoma (NPC) mortality and years of life lost (YLL) in China and its provinces from 2005 to 2020, our study used data from China National Mortality Surveillance System (NMSS) to estimate the number and rate of mortality and YLL of NPC by age and sex. We calculated average annual percent change (AAPC) to describe the trend of NPC mortality and YLL over time. We also analyzed the proportion of NPC deaths in all cancer deaths and explored the drivers of change in NPC deaths by decomposition analysis. The age-standardized mortality rate (ASMR) of NPC in China had a significant downward trend from 2.0/100 000 in 2005 to 1.4/100 000 in 2020 (AAPC = -2.4, P .05). Age-standardized YLL rate also showed the similar trends (AAPC = -2.8, P .05). Southern provinces including Guangdong (163.9/100 000), Guangxi (130.5/100 000), and Hainan (105.6/100 000) had the highest YLL rate in 2020. The mortality and YLL rate increased with age and males were higher than females. From 2005 to 2020, the proportion of NPC deaths in all cancer deaths remained stable at around 1.0% in China. The total number of deaths of NPC increased by 7.3%, of which age-specific mortality, population growth, and population aging accounted for -46.2%, 8.5% and 45.0%, respectively. NPC remains a significant public health issue in China southern provinces and tailored prevention and control strategies should be strengthened to reduce the burden of premature mortality of NPC in high risk areas.

Published
2022

5. The burden of oral cancer in China, 1990–2017: an analysis for the Global Burden of Disease, Injuries, and Risk Factors Study 2017

Author

Chunxiao Wang, Yang Yang, Maigeng Zhou, and Xinying Zeng

Subjects
Burden of disease, Male, medicine.medical_specialty, China, Global Burden of Disease, 03 medical and health sciences, 0302 clinical medicine, Intervention measures, Risk Factors, medicine, Humans, Disabled Persons, 030212 general & internal medicine, Mortality, General Dentistry, Disease burden, DALY, business.industry, Public health, Incidence (epidemiology), Oral cancer, Incidence, Cancer, medicine.disease, lcsh:RK1-715, 030220 oncology & carcinogenesis, lcsh:Dentistry, Oral and maxillofacial surgery, Hong Kong, Female, Mouth Neoplasms, Quality-Adjusted Life Years, business, Demography, Research Article
Abstract

Background Oral cancer is among the most common malignant tumors worldwide, and it has become an increasingly important public health problem in China. This study systematically assesses the current state of oral cancer in China from 1990 to 2017, providing new information and perspectives for oral health researchers and public health policy makers. Methods Based on the Global Burden of Disease, Injuries, and Risk Factors Study 2017 (GBD 2017), we evaluated the incidence rates, mortality and disability-adjusted life year (DALY) rates for oral cancer in China and their changing trends between 1990 and 2017, making comparisons by gender and age. We also assessed the DALY rates associated with oral cancer at the provincial level for 33 provinces and their trends over time. Results From 1990 to 2017, the number of new cases and the age-standardized incidence rate for oral cancer in China increased by 280.0% and 79.7%, respectively; the number of deaths and the age-standardized mortality rose by 196.8% and 29.0%, respectively; and the number of DALYs and the age-standardized DALY rate increased by 149.1% and 21.0%, respectively. The incidence rates for oral cancer rose after 30 years of age and peaked at 65–69 years; the mortality for oral cancer rose after 50 years of age and peaked at 65–69 years; and the DALY rates for oral cancer rose after 45 years of age and peaked at 65–69 years. The incidence rates, mortality and DALY rates for oral cancer in males were significantly higher than those in females and showed an upward trend, while there was a decrease or no significant change in females. The DALY rates increased in 21 provinces and decreased in 12 provinces, with the largest growth in Henan Province and the largest decline in Hong Kong Province. Conclusions The burden of oral cancer in China continues to increase continuously. More prevention, control and intervention measures should be taken and increased attention paid to common risk factors is essential for the prevention of oral cancer.

Published
2021

6. Prevalence and causes of vision loss in China from 1990 to 2019: findings from the Global Burden of Disease Study 2019

Author

Rupert R A Bourne, Maigeng Zhou, Nickolas Reinig, Wenlan Dong, Bingsong Wang, Hua Liu, Theo Vos, Paul S Briant, Jianhong Li, Haidong Wang, Tingling Xu, Charlie Ashbaugh, Peng Yin, Ningli Wang, Jaimie D. Adelson, Ya Xing Wang, and Mayinuer Yusufu

Subjects
Adult, Male, Aging, China, Population ageing, medicine.medical_specialty, Refractive error, Adolescent, genetic structures, Population, Blindness, Global Health, Severity of Illness Index, 01 natural sciences, Cataract, Global Burden of Disease, Macular Degeneration, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Environmental health, Epidemiology, Prevalence, Global health, Humans, Medicine, 030212 general & internal medicine, 0101 mathematics, Child, education, Health policy, Aged, education.field_of_study, business.industry, Public health, 010102 general mathematics, Age Factors, Public Health, Environmental and Occupational Health, Middle Aged, Macular degeneration, Refractive Errors, medicine.disease, eye diseases, Child, Preschool, Female, business
Abstract

Summary Background Vision loss is an important public health issue in China, but a detailed understanding of national and regional trends in its prevalence and causes, which could inform health policy, has not been available. This study aimed to assess the prevalence, causes, and regional distribution of vision impairment and blindness in China in 1990 and 2019. Methods Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used to estimate the prevalence of moderate and severe vision impairment and blindness in China and compare with other Group of 20 (G20) countries. We used GBD methodology to systematically analyse all available demographic and epidemiological data at the provincial level in China. We compared the age-standardised prevalences across provinces, and the changes in proportion of vision loss attributable to various eye diseases in 1990 and 2019. We used two different counterfactual scenarios with respect to population structure and age-specific prevalence to assess the contribution of population growth and ageing to trends in vision loss. Findings In 2019, the age-standardised prevalence was 2·57% (uncertainty interval [UI] 2·28–2·86) for moderate vision impairment, 0·25% (0·22–0·29) for severe vision impairment, and 0·48% (0·43–0·54) for blindness in China, which were all below the global average, but the prevalence of moderate and severe vision impairment had increased more rapidly than in other G20 countries from 1990 to 2019. The prevalence of vision loss increased with age, and the main causes of vision loss varied across age groups. The leading causes of vision impairment in China were uncorrected refractive error, cataract, and macular degeneration in both 1990 and 2019 in the overall population. From 1990 to 2019, the number of people with moderate vision impairment increased by 133·67% (from 19·65 to 45·92 million), those with severe vision impairment increased by 147·14% (from 1·89 to 4·67 million), and those with blindness increased by 64·35% (from 5·29 to 8·69 million); in each case, 20·16% of the increase could be explained by population growth. The contributions to these changes by population ageing were 87·22% for moderate vision impairment, 116·06% for severe vision impairment, and 99·22% for blindness, and the contributions by age-specific prevalence were 26·29% for moderate vision impairment, 10·91% for severe vision impairment, and −55·04% for blindness. The prevalence and specific causes of vision loss differed across provinces. Interpretation Although a comprehensive national policy to prevent blindness is in place, public awareness of visual health needs improving, and reducing the prevalence of moderate and severe vision impairment should be prioritised in future work. Funding China National Key Research and Development Programme and Beijing Municipal Special Funds for Medical Research on Public Welfare Development and Reform.

Published
2020

7. The burden of ischemic heart disease and type 2 diabetes mellitus attributable to diet high in sugar‐sweetened beverages in China: An analysis for the Global Burden of Disease Study 2017

Author

Lu Zhang, Yanfang Zhao, Zhuoqun Wang, Man Li, Jing Yang, Maigeng Zhou, and Xiaojie Li

Subjects
Adult, Male, Burden of disease, China, medicine.medical_specialty, Time Factors, Dietary Sugars, Endocrinology, Diabetes and Metabolism, Myocardial Ischemia, 030209 endocrinology & metabolism, Disease, 030204 cardiovascular system & hematology, Risk Assessment, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Diabetes mellitus, medicine, Humans, Aged, Aged, 80 and over, Sugar-Sweetened Beverages, business.industry, Public health, Age Factors, Type 2 Diabetes Mellitus, Middle Aged, medicine.disease, Health Surveys, Years of potential life lost, Diabetes Mellitus, Type 2, Socioeconomic Factors, Heart Disease Risk Factors, Female, Ischemic heart, business, Demography
Abstract

The aim of this study was to estimate the burden of ischemic heart disease (IHD) and type 2 diabetes mellitus (T2DM) attributable to a diet high in sugar-sweetened beverages (SSBs) in China from 1990 to 2017.Data from the Global Burden of Disease Study 2017 were used to assess all-age and age-standardized, risk-attributable mortality, years of life lost (YLL), years of life with disability (YLD), and disability-adjusted life years (DALYs) by age, sex, year, province, and sociodemographic index (SDI).For total noncommunicable diseases (NCDs), 12 523 (95% uncertainty interval 776-27 631) deaths, 305 288 (18 611-661 847) YLL, 142 051 (64 530-257 468) YLD, and 447 339 (132 677-858 838) DALYs were attributable to diet high in SSBs in 2017, particularly among males. Age-standardized, risk-attributable mortality, YLL, YLD, and DALY rates increased distinctly by 507.3%, 410.3%, 571.0%, and 453.3% from 1990 to 2017 respectively. Age-sex-specific, risk-attributable mortality and YLL rates for IHD in older adults (over 65 years) were higher than in young (between 25 and 39 years) and middle-aged adults (between 40 and 64 years) in 2017; however, the YLD and DALY rates for T2DM were higher in young and middle-aged males than in older males. The age-standardized, risk-attributable DALY rates for total NCDs increased substantially in high-SDI and high-middle-SDI provinces during the period.China has a huge and growing burden of IHD and T2DM attributable to diet high in SSBs, particularly among young and middle-aged male adults in wealthier provinces. Evidence-based public health policies at the provincial levels to reduce the consumption of SSBs should be prioritized in China.目的: 估计中国1990年至2017年高糖饮料所导致的缺血性心脏病和2型糖尿病的疾病负担。 方法: 使用2017年全球疾病负担研究的数据; 按年龄、性别、年份、省份和社会人口指数评估归因于高糖饮料的缺血性心脏病和2型糖尿病的死亡率、早死所致寿命损失(YLL)、伤残所致寿命损失(YLD)和伤残调整寿命年(DALY)数及标化率。 结果: 2017年归因于高糖饮料的慢性病总死亡人数12523人(776-27631); 早死所致寿命损失为305288人年(18611-661847); 伤残所致寿命损失为142051人年(64530-257468); 伤残调整寿命年为447339人年(132677-858838); 以男性为主。1990年至2017年; 年龄标化的死亡率、YLL、 YLD 和DALY率分别增加了507.3%、410.3%、571.0%和453.3%。2017年; 老年人群(65岁以上)缺血性心脏病的死亡率和YLL率高于年轻人(25-39岁)和中年人(40-64岁); 然而; 对2型糖尿病来说; 青年和中年男性的YLD率和DALY率高于老年男性。1990-2017年; 在高SDI和高-中SDI的省份; 慢性病的标化DALY率大大增加。 结论: 中国归因于高糖饮料的缺血性心脏病和2型糖尿病的疾病负担呈现增长趋势; 特别是在较富裕省份的年轻和中年男性人群中。基于这些证据; 应优先考虑减少高糖饮料消费的公共卫生决策。.

Published
2020

8. Burden of colorectal cancer attributable to diet low in milk in China, 1990–2017: findings from the global burden of disease study 2017

Author

Yuhuan Gao, Man Li, Xin-na Li, J M Liu, W B Guo, Maigeng Zhou, Zhuo Qun Wang, Lantong Zhang, and Yunfeng Zhao

Subjects
Adult, Male, 0301 basic medicine, Burden of disease, China, medicine.medical_specialty, Colorectal cancer, Population, Medicine (miscellaneous), 030209 endocrinology & metabolism, Recommended Dietary Allowances, 03 medical and health sciences, Spatio-Temporal Analysis, 0302 clinical medicine, Cost of Illness, medicine, Animals, Humans, Mortality, education, Disease burden, Aged, Aged, 80 and over, education.field_of_study, 030109 nutrition & dietetics, Nutrition and Dietetics, business.industry, Public health, Disability-Adjusted Life Years, Middle Aged, medicine.disease, Diet, Weak correlation, Milk, Attributable risk, Female, Colorectal Neoplasms, business, Demography
Abstract

Background Colorectal cancer (CRC) has emerged as a major public health concern. However, little is known about the burden attributable to specific risk factors. The present study aimed to estimate the temporal trends and geographical variation of CRC burden attributable to a diet low in milk in China. Methods Following the general analytic strategy used in the 2017 Global Burden of Disease study, we assessed the age-, sex-, and province-specific mortality and disability-adjusted life-years (DALYs) of CRC caused by a diet low in milk in China from 1990 to 2017. Results In 2017, a diet low in milk contributed 32 032 [95% uncertainty interval (UI) = 11 350-53 806] deaths and 726 710 (95% UI = 256 651-1 218 153) DALYs for CRC with a population attributable fraction of 17.1%. The age-standardised mortality and DALY rates per 100 000 were 1.7 (95% UI = 0.6-2.9) and 36.8 (95% UI = 13.0-61.7), respectively. An upward trend with age in rates of mortality and DALYs was observed. Males had higher age-standardised rates than females. The number of deaths and DALYs increased significantly from 1990 to 2017, whereas the corresponding age-standardised rates showed relatively stable trends. In 2017, Hunan and Liaoning were ranked as the top two provinces in terms of disease burden. Socio-demographic index had a weak correlation with the age-standardised mortality (r = 0.348, P = 0.047). Conclusions The present study shows a substantial increase in the CRC burden attributable to a diet low in milk over the past three decades. Greater priority in CRC prevention should be given to males and the elderly population throughout China, particularly in less-developed provinces.

Published
2020

9. The effect of air pollution on deaths, disease burden, and life expectancy across China and its provinces, 1990–2017: an analysis for the Global Burden of Disease Study 2017

Author

Maigeng Zhou, Haidong Wang, Jeffrey D. Stanaway, Joseph Frostad, William W Godwin, Peng Yin, Lijun Wang, Jie Li, Samantha Leigh Larson, Aaron J Cohen, Ashley Marks, Christopher J L Murray, Richard T. Burnett, Kate Causey, and Michael Brauer

Subjects
Male, Pollution, China, Health (social science), media_common.quotation_subject, Air pollution, Medicine (miscellaneous), 010501 environmental sciences, medicine.disease_cause, 01 natural sciences, Global Burden of Disease, 03 medical and health sciences, Life Expectancy, Ozone, 0302 clinical medicine, Cost of Illness, Risk Factors, Air Pollution, Cause of Death, Environmental health, medicine, Humans, 030212 general & internal medicine, Air quality index, Disease burden, 0105 earth and related environmental sciences, media_common, Air Pollutants, Inhalation Exposure, Geography, Health Policy, Mortality rate, Public Health, Environmental and Occupational Health, Articles, Particulates, Life expectancy, Environmental science, Female, Particulate Matter, Quality-Adjusted Life Years
Abstract

Summary Background Air pollution is an important public health concern in China, with high levels of exposure to both ambient and household air pollution. To inform action at provincial levels in China, we estimated the exposure to air pollution and its effect on deaths, disease burden, and loss of life expectancy across all provinces in China from 1990 to 2017. Methods In all 33 provinces, autonomous regions, municipalities, and special administrative regions in China, we estimated exposure to air pollution, including ambient particulate matter pollution (defined as the annual gridded concentration of PM2·5), household air pollution (defined as the percentage of households using solid cooking fuels and the corresponding exposure to PM2·5), and ozone pollution (defined as average gridded ozone concentrations). We used the methods of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 to estimate deaths and disability-adjusted life-years (DALYs) attributable to air pollution, and what the life expectancy would have been if air pollution levels had been less than the minimum level causing health loss. Findings The average annual population-weighted PM2·5 exposure in China was 52·7 μg/m3 (95% uncertainty interval [UI] 41·0–62·8) in 2017, which is 9% lower than in 1990 (57·8 μg/m3, 45·0–67·0). We estimated that 1·24 million (95% UI 1·08–1·40) deaths in China were attributable to air pollution in 2017, including 851 660 (712 002–990 271) from ambient PM2·5 pollution, 271 089 (209 882–346 561) from household air pollution from solid fuels, and 178 187 (67 650–286 229) from ambient ozone pollution. The age-standardised DALY rate attributable to air pollution was 1513·1 per 100 000 in China in 2017, and was higher in males (1839·8 per 100 000) than in females (1198·3 per 100 000). The age-standardised death rate attributable to air pollution decreased by 60·6% (55·7–63·7) for China overall between 1990 and 2017, driven by an 85·4% (83·2–87·3) decline in household air pollution and a 12·0% (1·4–22·1) decline in ambient PM2·5 pollution. 40·0% of DALYs for COPD were attributable to air pollution, as were 35·6% of DALYs for lower respiratory infections, 26·1% for diabetes, 25·8% for lung cancer, 19·5% for ischaemic heart disease, and 12·8% for stroke. We estimated that if the air pollution level in China was below the minimum causing health loss, the average life expectancy would have been 1·25 years greater. The DALY rate per 100 000 attributable to air pollution varied across provinces, ranging from 482·3 (371·1–604·1) in Hong Kong to 1725·6 (720·4–2653·1) in Xinjiang for ambient pollution, and from 18·7 (9·1–34·0) in Shanghai to 1804·5 (1339·5–2270·1) in Tibet for household pollution. Although the overall mortality attributable to air pollution decreased in China between 1990 and 2017, 12 provinces showed an increasing trend during the past 27 years. Interpretation Pollution from ambient PM2·5 and household burning of solid fuels decreased markedly in recent years in China, after extensive efforts to control emissions. However, PM2·5 concentrations still exceed the WHO Air Quality Guideline for the entire population of China, with 81% living in regions exceeding the WHO Interim Target 1, and air pollution remains an important risk factor. Sustainable development policies should be implemented and enforced to reduce the impact of air pollution on long-term economic development and population health. Funding Bill & Melinda Gates Foundation; and China National Key Research and Development Program.

Published
2020

10. Measuring the completeness of death registration in 2844 Chinese counties in 2018

Author

Maigeng Zhou, Lijun Wang, Peng Yin, Alan D. Lopez, Jiangmei Liu, Tim Adair, Xinying Zeng, Jinlei Qi, and Yunning Liu

Subjects
Male, China, Population, lcsh:Medicine, 010502 geochemistry & geophysics, Logistic regression, History, 21st Century, 01 natural sciences, Death Certificates, 03 medical and health sciences, 0302 clinical medicine, Health care, Humans, Medicine, Registries, 030212 general & internal medicine, education, Socioeconomic status, County level, 0105 earth and related environmental sciences, Cause of death, education.field_of_study, business.industry, Incidence, Multilevel model, lcsh:R, Completeness of death registration, General Medicine, Female, business, Completeness (statistics), Research Article, Demography
Abstract

Background Death registration completeness has never been assessed at the county level in China. Such analyses would provide critical intelligence to monitor the performance of the vital registration system and yield adjustment factors to correct death registration data, thereby increasing their policy utility. Methods We estimated the completeness of death registration for 31 provinces and 2844 counties of China in 2018 based on death data from the China Cause of Death Reporting System (CDRS) by using the empirical completeness method. We computed the root mean square difference (RMSD) of county-level completeness compared with provincial-level completeness to study intra-provincial variations. A two-level (province and county) logistic regression model was fitted to explore the association between county-level registration completeness and a set of covariates reflecting socioeconomic status, healthcare quality, and specific strategies and regulations designed to improve registration. Results In 2018, the overall death registration completeness for the CDRS in China was 74.2% (95% uncertainty interval [UI] 66.2–80.4), with very little difference for males and females. Geographical differences in completeness were higher across counties than across provinces. The county-level completeness ranged from 2.4% (95% UI 1.0–5.0%) in Burang County, Tibet, to 100.0% (95% UI 99.9–100.0%) in Guandu District, Yunnan. The coastal provinces of Jiangsu, Guangdong, and Fujian, with higher overall completeness, contained counties with low completeness; conversely, the underdeveloped provinces of Guangxi and Guizhou, with lower overall completeness, included some counties with high completeness. GDP, education, population density, minority population, healthcare access, and registration strategies were important drivers of the geographical differences in registration completeness. Conclusions There are marked inequalities in registration completeness at the county level and within provinces in China. The socioeconomic condition, the implementation of specific registration-enhancing initiatives, and the availability and quality of medical care were the primary drivers of the observed geographical variation. A more strategic approach, with more research, is required to identify the main reasons for death under-reporting, especially in the poorer performing counties, to guide remedial action.

Published
2020

11. Burden of depression in China, 1990–2017: Findings from the global burden of disease study 2017

Author

Wenlan Dong, Maigeng Zhou, Xiaohui Xu, Peng Yin, Shicheng Yu, and Xinwen Ren

Subjects
Adult, Male, Burden of disease, China, medicine.medical_specialty, Adolescent, Population, Prevalence, Disease, Global Burden of Disease, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Epidemiology, medicine, Humans, Child, education, Depression (differential diagnoses), Aged, education.field_of_study, Depression, business.industry, Public health, Middle Aged, 030227 psychiatry, Psychiatry and Mental health, Clinical Psychology, Child, Preschool, Female, Quality-Adjusted Life Years, business, 030217 neurology & neurosurgery, Demography
Abstract

Background Depression in China has risen from the 15th leading cause of all-cause disability-adjusted life years (DALYs) in 1990 to the 10th in 2017. However, the burden of depression and the epidemiological trend in Chinese provinces remain unclear. This study aimed to estimate the prevalence and burden of depression among different sexes, ages, disease types and provincial administrative units in China. Methods Based on a general analysis of the Global Burden of Disease study (GBD) in 2017, we analyzed the age- sex- and province-specific prevalence and DALYs of depression in China from 1990 to 2017. Results From 1990 to 2017, the all-age prevalence rate of depression per 100,000 rose from 3224.6 (95% UI:2976.6–3509.1) to 3990.5 (95% UI: 3667.8–4353.0), and the DALY rate per 100,000 rose from 525.1 (95% UI: 373.5–719.0) to 607.4 (95% UI: 427.7–820.2). The prevalence rate decreased in the population aged 5–54 years, and increased in the population aged over 55 years. In 2017, the prevalence rate of females (5039.6, 95% UI: 4630.0–5502.8) was significantly higher than that of males (2984.9, 95% UI: 2736.0–3265.3). The prevalence and DALY rate increased in all provinces. However, the age-standardized prevalence and DALYs rate decreased in 31 provinces. Conclusions Depression has gradually become a major public health issue in China. The government should take measures to prevent the development of depression immediately. Women and the elderly are at high risk for depression.

Published
2020

12. Prevalence of Hyperuricemia Among Chinese Adults: Findings From Two Nationally Representative Cross-Sectional Surveys in 2015–16 and 2018–19

Author

Mei, Zhang, Xiaoxia, Zhu, Jing, Wu, Zhengjing, Huang, Zhenping, Zhao, Xiao, Zhang, Yu, Xue, Weiguo, Wan, Chun, Li, Wenrong, Zhang, Linhong, Wang, Maigeng, Zhou, Hejian, Zou, and Limin, Wang

Subjects
Adult, Male, trends, China, Chinese, Immunology, prevalence, Hyperuricemia, RC581-607, Uric Acid, hypeuricemia, Cross-Sectional Studies, gout, Humans, Immunology and Allergy, Female, Immunologic diseases. Allergy
Abstract

ObjectiveTo determine the nationwide prevalence of hyperuricemia in China and evaluate its trends and associated risk factors.MethodsUsing a multi-stage, stratified, cluster-randomized sampling design, two cross-sectional surveys (representative of national and provincial information) were conducted in 31 provinces (autonomous regions and municipalities) in mainland China, with 166, 861 Chinese adults in 2015–16 and 168, 351 in 2018–19. Serum uric acid (SUA) levels of all participants were measured after a >10-hour overnight fast. Hyperuricemia (HUA) was defined when SUA was >420 μmol/L. Prevalence estimates were weighted to represent the total population considering the complex sampling design. Multivariable logistic regression models was used to estimate factors associated with HUA.ResultsThe overall hyperuricemia prevalence in the Chinese adult population was 11.1% (95% confidence interval 10.3% to 11.8%) in 2015–16 and 14.0% (13.1% to 14.8%) in 2018–19; an alarming rise was observed in the three years. Hyperuricemia was more common in men with 19.3% (17.9% to 20.7%) in 2015–16 and 24.4% (23.0% to 25.8%) in 2018–19, although the prevalence also escalated from 2.8% (2.5% to 3.0%) in 2015–16 to 3.6% (3.2% to 4.0%) in 2018–19 in women. The hyperuricemia risk factors include the urban culture, settlement in the East, Zhuang descent, high education, heavy or frequent beer drinking, high red meat intake, physical inactivity, high body mass index, central obesity, hypertension, hyperlipidemia, and low glomerular filtration rate.ConclusionThe estimated hyperuricemia prevalence among Chinese adults was 14.0% in 2018-19; significant escalating trends were observed between 2015-16 and 2018-19.

Published
2022

13. The burden of aortic aneurysm in China from 1990 to 2019: findings from the Global Burden of Disease Study 2019

Author

Xinran Hou, Fan Zhang, Zhi Ye, Qian Xu, Lingjin Huang, Qulian Guo, Wei Liu, Lijun Wang, Maigeng Zhou, Peng Yin, and Maoen Zhu

Subjects
Male, China, Cost of Illness, Risk Factors, Public Health, Environmental and Occupational Health, Humans, Female, Quality-Adjusted Life Years, Aged, Aortic Aneurysm, Global Burden of Disease
Abstract

Background Aortic aneurysm (AA) is a global public health concern. However, little is known about the disease burden of AA in China. Methods Following the general analytic strategy used in the Global Burden of Disease Study (GBD) 2019, we analyzed the mortality and years of life lost (YLLs) due to AA, stratified by sex, age, and province-level region in China from 1990 to 2019. The temporal trend of AA burden in China was analyzed and the main attributable risk factors for AA in China were also explored. Results In China, the total AA deaths were 17,038 (95% UI: 14,392-19,980) in 2019, an increase of 136.1% compared with that in 1990, with an age-standardized death rate (ASDR) of 0.93 (95% UI: 0.79-1.08) per 100,000 person-years in 2019, a decrease of 6.8%. Meanwhile AA caused 378,578 (95% UI: 315,980-450,479) YLLs in 2019, an increase of 102.6% compared with that in 1990, with a crude YLL rate of 26.6 (95% UI: 22.2-31.7) per 100,000 person-years, an increase of 68.6%. The AA mortality and YLLs were higher in males than in females. AA caused most YLLs in the 65- to 75-year-old age group. The AA mortality and YLLs varied significantly among provinces in China, and the change in ASDR showed a negative correlation with the sociodemographic index of different provinces, namely, more decline of ASDR in developed provinces. High systolic blood pressure was shown to be the most significant attributable risk factor for AA burden in both males and females, and smoking was another major attributable risk factor, especially in males. Conclusions The disease burden of AA increased significantly from 1990 to 2019 in China, with higher mortality and YLLs in males, senior populations, and among residents of most western provinces in China. High systolic blood pressure and smoking were two major attributable risk factors for AA mortality in China.

Published
2021

14. Future injury mortality burden attributable to compound hot extremes will significantly increase in China

Author

Liying, Luo, Fangfang, Zeng, Guoxia, Bai, Weiwei, Gong, Zhoupeng, Ren, Jianxiong, Hu, Guanhao, He, Heng, Shi, Ziqiang, Lin, Tao, Liu, Peng, Yin, Mingfang, Qin, Zhulin, Hou, Ruilin, Meng, Chunliang, Zhou, Xiaomei, Dong, Zhuoma, Pingcuo, Yize, Xiao, Min, Yu, Biao, Huang, Xiaojun, Xu, Lifeng, Lin, Jianpeng, Xiao, Jieming, Zhong, Donghui, Jin, Yajie, Li, Cangjue, Gama, Peng, Xiong, Yiqing, Xu, Lingshuang, Lv, Weilin, Zeng, Xing, Li, Maigeng, Zhou, Cunrui, Huang, and Wenjun, Ma

Subjects
Male, China, Cross-Over Studies, Hot Temperature, Environmental Engineering, Climate Change, Pollution, Humans, Wounds and Injuries, Environmental Chemistry, Female, Mortality, Waste Management and Disposal, Aged, Forecasting
Abstract

As climate change, compound hot extremes (CHEs), daytime and nighttime persistent hot extremes, are projected to become much more frequent and intense, which may pose a serious threat to human health. However, evidence on the impact of CHEs on injury is rare.We collected injury death data and daily meteorological data from six Chinese provinces during 2013-2018. A time-stratified case-crossover design with two-stage analytic approach was applied to assess the associations of CHEs with injury mortality by intention, mechanism, age and gender. Using the projected daily temperatures of five General Circulation Models (GCMs), we projected the frequency of CHEs and CHEs-attributable mortality burden of injury under three Representative Concentration Pathway (RCP) scenarios.CHEs were significantly associated with increased injury mortality risk (RR = 1.14, 95%CI: 1.09-1.19), with strong effects on unintentional injuries (RR = 1.16, 95%CI:1.11,1.22) and intentional injuries (RR = 1.11, 95%CI:0.99,1.25). Female (RR = 1.21,95%CI: 1.13-1.29) and the elderly (RR = 1.30, 95%CI: 1.22-1.39) were more susceptible to CHEs. Both the frequency and injury mortality burden of CHEs showed a steep rising trend under RCP8.5 scenario, with a 7.37-fold and 8.22-fold increase respectively, by the end of the century, especially in southern, eastern, central and northwestern China.CHEs were associated with increased injury mortality risk, and the CHEs-attributable injury mortality burden was projected to aggravate substantially in the future as global warming. It is urgent to develop targeted adaptation policies to alleviate the health burden of CHEs.

Published
2022

15. Cold spell and mortality in 31 Chinese capital cities: Definitions, vulnerability and implications

Author

Jinjian Chen, Chun-Quan Ou, Qiyong Liu, Xiuping Song, Jun Yang, Boguang Wang, Peng Yin, Zhao-Yue Chen, Maigeng Zhou, and Jiangmei Liu

Subjects
Adult, Male, Risk, Distributed lag, China, Percentile, Adolescent, 010504 meteorology & atmospheric sciences, Lag, Developing country, Context (language use), 010501 environmental sciences, 01 natural sciences, Young Adult, Asian People, Humans, Cities, Mortality, Child, lcsh:Environmental sciences, Aged, 0105 earth and related environmental sciences, General Environmental Science, lcsh:GE1-350, Infant, Newborn, Infant, Regression analysis, Middle Aged, Random effects model, Cold Temperature, Geography, Child, Preschool, Relative risk, Female, Demography
Abstract

Background: In the context of global warming, most researches have been conducted on health influences of heat waves, with limited understanding of health impacts of cold spells, especially for developing countries. Methods: We collected daily mortality and meteorological data for 31 capital cities across China during the maximum period of 2007–2013. A quasi-Poisson regression model combined with a distributed lag non-linear model was used to estimate the short-term effects of cold spells on mortality in cold seasons (November to March). 19 definitions of cold spell were clearly compared, including three definitions from the China Meteorological Administration (CMA) and 16 definitions by combining two temperature indicators (daily minimum and mean temperature), two temperature thresholds (3rd and 5th percentile) and four durations of at least 2–5 days. Then, a random effect meta-analysis was applied to pool the effect estimates at national level. Furthermore, a stratified analysis was constructed to identify the vulnerable subpopulations to cold spells. Results: The definition, in which daily mean temperature falls below 5th percentile for at least two consecutive days, produced the optimum model fit performance. Generally, the mortality risk increased to the maximum after 3–6 days' exposure to cold spell and then leveled off in the next 3 weeks. The pooled relative risks (RR) of non-accidental mortality for cold spells were 1.03 (95% CI: 1.01–1.05), 1.27 (1.19–1.35) and 1.55 (1.40–1.70) at lag 0, lag 0–14 and lag 0–27 days, respectively. The greatest effect estimates of cold spells were found among total respiratory diseases and COPD, with RR of 1.88 (1.65–2.11) and 1.88 (1.58–2.19), respectively. The elderly, less-educated individuals and residents in southern China were more vulnerable to cold spells. Conclusion: There are remarkable mortality effects of cold spells, with effect estimates varying with the definition of cold spell and subpopulations. Using the official definition of cold spells may fail to capture the mortality risk associated with cold spells. These findings may facilitate the development of cold alert warning system and preventive actions to the vulnerable populations. Keywords: Cold spell, Definition, Cause-specific mortality, Vulnerable population, China

Published
2019

16. Associations between ambient high temperatures and suicide mortality: a multi-city time-series study in China

Author

Guijie Luan, Peng Yin, Lijun Wang, and Maigeng Zhou

Subjects
Male, Risk, Distributed lag, China, Health, Toxicology and Mutagenesis, Poison control, 010501 environmental sciences, 01 natural sciences, Suicide prevention, Occupational safety and health, Injury prevention, medicine, Humans, Environmental Chemistry, Cities, Weather, Aged, 0105 earth and related environmental sciences, Confounding, Temperature, Humidity, General Medicine, Middle Aged, Seasonality, medicine.disease, Pollution, Suicide, Geography, Relative risk, Multivariate Analysis, Female, Public Health, Demography
Abstract

Suicide prevention has become a public health issue of great concern. Previous studies proved that ambient temperature had an impact on suicide death, but few studies focus on regional studies in large cities. We aimed to estimate the association between ambient temperature and suicide in 31 capital cities in China during 2008~2013. Distributed lag non-linear model was used to explore the relationship between ambient temperature and suicide, adjusting for long-term trend, seasonality, and humidity confounders. Multivariate meta-analysis was used to pool the city-specific estimates to explore the overall relative risk in China. High temperature had a significant impact on suicide death. The country-level relative risk of high temperature on suicide was 1.37 (95% CI, 0.96~2.57), and the RR was higher in male and age < 65-year-old group than that in female and age ≥ 65-year-old group. There has no consistent pattern of associations in city-level with sex and age. The high temperature has a greater impact on suicide in south region compared with north region. We found the positive association between ambient temperature and suicide in China.

Published
2019

17. Prevalence of Smoking and Knowledge About the Hazards of Smoking Among 170 000 Chinese Adults, 2013–2014

Author

Mei Zhang, Shiwei Liu, Ling Yang, Yong Jiang, Zhengjing Huang, Zhenping Zhao, Qian Deng, Yichong Li, Maigeng Zhou, Linhong Wang, Zhengming Chen, and Limin Wang

Subjects
Adult, Male, Rural Population, China, Health Knowledge, Attitudes, Practice, Adolescent, Cross-sectional study, Health Behavior, Population, 030204 cardiovascular system & hematology, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Prevalence, medicine, Humans, 030212 general & internal medicine, Young adult, Lung cancer, education, Stroke, education.field_of_study, business.industry, Smoking, Tobacco control, Public Health, Environmental and Occupational Health, Middle Aged, medicine.disease, Former Smoker, Cross-Sectional Studies, Life expectancy, Female, Smoking Cessation, business, Demography
Abstract

Introduction Periodic population surveys of smoking behavior can inform development of effective tobacco control strategies. We investigated smoking patterns, cessation, and knowledge about smoking hazards in China. Methods A nationally representative cross-sectional survey recruited 176 318 people aged ≥18 years across 31 provinces of China in 2013–2014, using multi-stage stratified cluster sampling methods. The smoking patterns, cessation, and knowledge about smoking hazards were analyzed, overall and in population subgroups, adjusting for sample selection weight and post-stratification factors. Results Among men, 60.7% were ever-smokers, with proportions of regular, occasional and former smokers being 46.3%, 5.5%, and 8.8% respectively. Among women, only 2.8% had ever smoked. The prevalence of ever smoking in men was higher in rural than urban areas (63.2% vs. 57.6%) and varied from 39.5% to 67.4% across 31 provinces. Among male regular smokers, the mean daily number of cigarettes smoked was 17.8, with mean age at first starting to smoke daily being 20.1 years. Among current smokers, one-third (32.6% men, 32.1% women) had tried to quit before and 36.8% (36.8% men, 35.5% women) intended to quit in the future. Of the Chinese adults, 75.9% recognized that smoking was hazardous, with the proportions believing that smoking could cause lung cancer, heart attack or stroke being 67.0%, 33.2%, and 29.5%, respectively and with 26.0% reporting that smoking could cause all these conditions. Conclusion Among Chinese adults, the smoking prevalence remained high in men but was low in women. In both men and women, knowledge about smoking hazards was poor. Implications This study showed that tobacco smoking remained highly prevalent among adult men in China in 2013–2014. Moreover, men born in recent decades were more likely to start smoking at younger ages and to smoke more cigarettes than those born in previous generations. There was a large regional variation in male smoking prevalence, with the least economically developed regions having higher prevalence. In contrast, few women in China smoked, especially among those born in recent decades. The contrasting smoking patterns in men and women is likely to result in an increasingly large gender disparity in life expectancy in the coming decades.

Published
2019

18. Disparities by province, age, and sex in site-specific cancer burden attributable to 23 potentially modifiable risk factors in China: a comparative risk assessment

Author

Maigeng Zhou, Kexin Sun, Lijun Wang, Rongshou Zheng, Zhixun Yang, Changfa Xia, Ahmedin Jemal, Hongmei Zeng, Siwei Zhang, He Li, Jie He, Freddie Bray, Chunqing Lin, Wanqing Chen, Farhad Islami, and Matthew Brown

Subjects
Adult, Dietary Fiber, Male, Mainland China, China, Epstein-Barr Virus Infections, Alcohol Drinking, 030231 tropical medicine, HIV Infections, Risk Assessment, Helicobacter Infections, Young Adult, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Risk Factors, Neoplasms, Environmental health, Diabetes Mellitus, Prevalence, medicine, Humans, 030212 general & internal medicine, Young adult, Aged, Cancer prevention, Geography, Health Policy, Papillomavirus Infections, Smoking, Cancer, Environmental Exposure, Health Status Disparities, General Medicine, Middle Aged, Overweight, Hepatitis B, medicine.disease, Hepatitis C, Diet, Fruit, Meta-analysis, Relative risk, Female, Sedentary Behavior, Risk assessment
Abstract

Summary Background Understanding disparities in the burden of cancer attributable to different risk factors is crucial to inform and improve cancer prevention and control. In this report, we estimate the site-specific population-attributable fractions (PAFs) for 23 potentially modifiable risk factors across all provinces in China. Methods In this comparative risk assessment study, we used 2014 cancer mortality data for adults from 978 county-level surveillance points in 31 provinces of mainland China. Risk-factor prevalence estimates were obtained from representative surveys. We used summary relative risks obtained from several recent large-scale pooled analyses or high-quality meta-analyses of studies in China. We calculated PAFs using multiple formulae incorporating exposure prevalence and relative risk data stratified by age, sex and province and then combined to create summary PAFs by sex, cancer site, and risk factors. Findings About 1 036 004 cancer deaths (45·2% of all cancer deaths [95% CI 44·0–46·4]) in China in 2014 in adults aged 20 years or older were attributable to 23 evaluated risk factors. The PAF was higher in men (51·2% [95% CI 50·0–52·4]) than in women (34·9% [33·6–36·2]), with the leading risk factors being active smoking in men and low fruit intake in women. By province, the PAF in both sexes combined ranged from 35·2% in Shanghai to 52·9% in Heilongjiang, while the PAF varied from 40·9% in Shanghai to 56·4% in Guangdong among men and from 26·9% in Shanghai to 48·0% in Heilongjiang among women. The highest PAF among men was smoking in all 31 provinces, whereas among women it varied among low fruit intake (14 provinces), hepatitis B virus infection (seven provinces), smoking (six provinces), excess bodyweight (three provinces), and human papilloma virus infection (one province). Interpretation The PAFs of cancers attributable to potentially modifiable risk factors vary substantially across provinces in China. Regional adoption of effective primary cancer prevention strategies has a vast potential to reduce the burden of cancer and disparities in China. Smoking, poor diet, and infection warrant particular policy attention as they contributed a large proportion to the total cancer burden. Funding National Science and Technology Basic Research Special Foundation of China.

Published
2019

19. Trends in smoking prevalence in urban and rural China, 2007 to 2018: Findings from 5 consecutive nationally representative cross-sectional surveys

Author

Mei Zhang, Ling Yang, Limin Wang, Yong Jiang, Zhengjing Huang, Zhenping Zhao, Xiao Zhang, Yichong Li, Shiwei Liu, Chun Li, Linhong Wang, Jing Wu, Xinhua Li, Zhengming Chen, and Maigeng Zhou

Subjects
Adult, Male, China, Adolescent, Smoking, General Medicine, Middle Aged, Young Adult, Cross-Sectional Studies, Chronic Disease, Prevalence, Tobacco Smoking, Humans, Female, Aged
Abstract

Background Tobacco smoking is a leading cause of premature death in China, especially among adult men. Since the implementation of the Framework Convention on Tobacco Control in 2005, nationwide tobacco control has been strengthened, but its long-term impact on smoking prevalence is unclear. Methods and findings Five nationally representative surveys of the China Chronic Disease and Risk Factor Surveillance (CCDRFS) were conducted in 2007, 2010, 2013, 2015, and 2018. A total of 624,568 adults (278,605 men and 345,963 women) aged 18 to 69 years were randomly selected from 31 provinces (or equivalent) in China. Temporal changes in smoking prevalence and patterns (e.g., percentages of those smoking manufactured cigarettes, amount smoked, and age at smoking initiation) were analyzed, overall and by sex, urban or rural residence, year of birth, education and occupation, using linear regression methods. Among men, the standardized prevalence of current smoking decreased from 58.4% (95% confidence interval [CI]: 56.1 to 60.7) to 50.8% (95% CI: 49.1 to 52.5, p < 0.001) between 2007 and 2018, with annual decrease more pronounced in urban (55.7% [95% CI: 51.2 to 60.3] to 46.3% [95% CI: 43.7 to 49.0], p < 0.001) than rural men (59.9% [95% CI: 57.5 to 62.4] to 54.6% [95% CI: 52.6 to 56.6], p = 0.05) and in those born before than after 1980. Among rural men born after 1990, however, the prevalence increased from 40.2% [95% CI: 34.0 to 46.4] to 52.1% ([95% CI: 45.7 to 58.5], p = 0.007), with the increase taking place mainly before 2015. Among women, smoking prevalence remained extremely low at around 2% during 2007 to 2018. No significant changes of current smoking prevalence (53.9% to 50.8%, p = 0.22) were observed in male patients with at least 1 of major chronic diseases (e.g., hypertension, diabetes, myocardial infarction, stroke, chronic obstructive pulmonary disease (COPD)). In 2018, 25.6% of adults aged ≥18 years smoked, translating into an estimated 282 million smokers (271 million men and 11 million women) in China. Across 31 provinces, smoking prevalence varied greatly. The 3 provinces (Yunnan, Guizhou, and Hunan) with highest per capita tobacco production had highest smoking prevalence in men (68.0%, 63.4%, and 61.5%, respectively), while lowest prevalence was observed in Shanghai (34.8%). Since the children and teenage groups were not included in the surveys, we could not assess the smoking trends among youths. Furthermore, since the smoking behavior was self-reported, the smoking prevalence could be underestimated due to reporting bias. Conclusions In this study, we observed that the smoking prevalence has decreased steadily in recent decades in China, but there were diverging trends between urban and rural areas, especially among men born after 1980. Future tobacco control strategies should target rural young men, regions with high tobacco production, and patients suffering from chronic diseases.

Published
2022

20. Burden of brain and other central nervous system cancer in China, 1990–2019: a systematic analysis of observational data from the global burden of disease study 2019

Author

Xinran Hou, Zongbin Song, Fan Zhang, Zhuoyi Liu, Wenyong Long, Zheng Long, Maigeng Zhou, E Wang, Peng Yin, and Maoen Zhu

Subjects
Central Nervous System Neoplasms, Male, China, Brain Neoplasms, Child, Preschool, Incidence, Prevalence, Humans, Female, General Medicine, Child, Aged, Global Burden of Disease
Abstract

ObjectiveTo evaluate the trends in disease burden and the epidemiological features of central nervous system (CNS) cancer in China from 1990 to 2019.DesignA population-based observational study.SettingThe incidence, prevalence, death and disability-adjusted life years (DALYs) due to CNS cancer in China, stratified by sex, age and provincial region, were collected from the Global Burden of Disease Study 2019.ParticipantsData were publicly available and individuals were not involved.ResultsIn 2019, the incident cases of CNS cancer in China were 347 992 (95% UI 262 084–388 896), and the age-standardised rate (ASR) of incidence was 5.69 (95% UI 4.36–6.78) per 100 000 person-years increased by 27.9% compared with that in 1990; meanwhile, CNS cancer caused 63 527 (95% UI 47 793–76 948) deaths in China in 2019, and the ASR of death was 3.5 (95% UI 2.62–4.21) per 100 000 person-years decreased by 9.6%. The ASRs of incidence and prevalence of CNS cancer in China increased more rapidly than the global average; meanwhile, the ASRs of DALYs owing to CNS cancer declined more rapidly. The burden of CNS cancer showed no significant differences between men and women, but was more pronounced in early childhood and old adulthood. The ASRs of incidence and prevalence were higher in high-income provinces, confirmed by the positive correlation with Sociodemographic Index (SDI), with correlation coefficient r of 0.322 and 0.767, respectively (both pConclusionsFrom a global perspective, China has been bearing a substantial burden of CNS cancer. More attention should be paid to children and elderly populations for CNS cancer. The disease burden varied significantly at the subnational level of China, which was associated with socioeconomic development.

Published
2022

21. The added effects of heatwaves on cause-specific mortality: A nationwide analysis in 272 Chinese cities

Author

Renjie Chen, Maigeng Zhou, Yue Niu, Jinlei Qi, Yunning Liu, Lijun Wang, Weidong Wang, Jiangmei Liu, Peng Yin, Haidong Kan, Jinling You, Yixuan Jiang, and Cong Liu

Subjects
Adult, Male, Distributed lag, China, Percentile, Adolescent, 010504 meteorology & atmospheric sciences, Infrared Rays, Respiratory Tract Diseases, 010501 environmental sciences, 01 natural sciences, Young Adult, Environmental health, Humans, Medicine, Mortality displacement, Cities, Child, Stroke, lcsh:Environmental sciences, Disease burden, Aged, 0105 earth and related environmental sciences, General Environmental Science, Cardiopulmonary disease, lcsh:GE1-350, Cyclonic Storms, business.industry, Generalized additive model, Cumulative effects, Middle Aged, medicine.disease, Cardiovascular Diseases, Child, Preschool, Female, business
Abstract

Background: The evidence was limited and inconclusive about the added effects of heatwaves, especially in developing countries. Objective: To evaluate the added effects of heatwaves on cause-specific mortality in China. Methods: We designed a nationwide time-series analysis based on daily data from 272 main Chinese cities to from 2013 to 2015. We adopted 12 definitions by combining 4 heat thresholds (90th, 92.5th, 95th, 97.5th percentile of city-specific daily mean temperature) and duration of ≥2, 3 and 4 days. We applied overdispersed generalized additive models with distributed lag models to estimate the city-specific cumulative effects of heatwaves over lags of 0–10 days after controlling for daily temperature. We then, used a meta-regression model to pool the effect estimates at national and regional levels. Results: Heatwaves could significantly increase risk for mortality from total and cardiopulmonary diseases, including coronary heart disease, ischemic stroke (rather than hemorrhagic stroke) and chronic obstructive pulmonary disease. The effects increased with higher thresholds, but were not appreciably influenced by the duration of heat. The risks generally occurred immediately and lasted for 3 to 5 days. The risks were much larger in the temperate continental zone and the temperate monsoon zones than in the subtropical monsoon zone where there was an evident mortality displacement. The elderly, females and less-educated people were more vulnerable. Conclusions: This analysis provided ample evidence for the added mortality risk associated with heatwaves, which had important implications for designing heatwave-warning systems and predicting the disease burden of future heatwaves. Keywords: Heat waves, Mortality, Cardiopulmonary diseases, Vulnerable subgroups, Climatic zones, China

Published
2018

22. [Burden of nutritional deficiencies of children under 5 years old in China, 1990-2015]

Author

Yuanyuan, Xu, Xinying, Zeng, Xiu, Qiu, Liwen, Fang, Zhuoqun, Wang, Maigeng, Zhou, and Linhong, Wang

Subjects
Male, China, Cost of Illness, Child, Preschool, Malnutrition, Humans, Disabled Persons, Female, Quality-Adjusted Life Years, Child
Abstract

To quantify and describe the distribution and trends of burden of nutritional deficiencies among children under 5 years old in China from 1990 to 2015.Subnational data of China on children under 5 years old in 33 provinces and autonomous regions, which including 31 mainland regions, Hong Kong and Macao Special Administrative Regions, were extracted from the result of Global Burden of Disease Study 2015(GBD 2015). Based on the method of descriptive epidemiology, we analyzed the prevalence, mortality as well as disability adjusted life year(DALY) rate of nutritional deficiencies among children under 5 years old by sex, time and locations in China, as well as its temporal trend since 1990.In 2015, the prevalence of nutritional deficiencies among children under 5 years old was 17. 26%, and the DALY rate was 776. 26 person-years per 100000. Compared to 1990, the DALY rate of nutritional deficiencies declined by 71. 42%. The DALY rate of nutritional deficiencies decreased in the past 25 years in Eastern, Central and Western China. Meanwhile, the gap in disease burden between boys and girls declined. Among diseases caused by nutritional deficiencies, burden of protein-energy malnutrition and iron deficiency anemia among children under 5 years old were relatively higher. Compared to 1990, the DALY rate of iron deficiency anemia among children under 5 years old declined by 15. 68%, which was lower than other nutritional deficiencies among children in 2015.From 1990 to 2015, the disease burden caused by nutritional deficiencies among Chinese children under 5 years old showed downtrend. There were still differences of disease burden distributions between regions and common nutritional deficiencies.

Published
2021

23. Temporal trend and attributable risk factors of stroke burden in China, 1990-2019: an analysis for the Global Burden of Disease Study 2019

Author

Miao Cai, Rui Li, Chuming Yan, Yuan Wang, Hualiang Lin, Yin Yang, Peng Yin, Mohsen Naghavi, Zhengmin Qian, Qingfeng Ma, Maigeng Zhou, Chongjian Wang, Michael G. Vaughn, Zilong Zhang, Stephen Edward McMillin, Lijun Wang, Simon I. Hay, and Yi Ren

Subjects
Male, China, Population, Prevalence, Global Burden of Disease, Cost of Illness, Risk Factors, Environmental health, medicine, Humans, Mortality, education, Stroke, Disease burden, education.field_of_study, Population Health, business.industry, Mortality rate, Incidence (epidemiology), Incidence, Public Health, Environmental and Occupational Health, Disability-Adjusted Life Years, medicine.disease, Attributable risk, Female, Risk assessment, business
Abstract

Summary Background Understanding the temporal trend of the disease burden of stroke and its attributable risk factors in China, especially at provincial levels, is important for effective prevention strategies and improvement. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) is to investigate the disease burden of stroke and its risk factors at national and provincial levels in China from 1990 to 2019. Methods Following the methodology in the GBD 2019, the incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of stroke cases in the Chinese population were estimated by sex, age, year, stroke subtypes (ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage), and across 33 provincial administrative units in China from 1990 to 2019. Attributable mortality and DALYs of underlying risk factors were calculated by a comparative risk assessment. Findings In 2019, there were 3·94 million (95% uncertainty interval 3·43–4·58) new stroke cases in China. The incidence rate of stroke increased by 86·0% (73·2–99·0) from 1990, reaching 276·7 (241·3–322·0) per 100 000 population in 2019. The age-standardised incidence rate declined by 9·3% (3·3–15·5) from 1990 to 2019. Among 28·76 million (25·60–32·21) prevalent cases of stroke in 2019, 24·18 million (20·80–27·87) were ischaemic stroke, 4·36 million (3·69–5·05) were intracerebral haemorrhage, and 1·58 million (1·32–1·91) were subarachnoid haemorrhage. The prevalence rate increased by 106·0% (93·7–118·8) and age-standardised prevalence rate increased by 13·2% (7·7–19·1) from 1990 to 2019. In 2019, there were 2·19 million (1·89–2·51) deaths and 45·9 million (39·8–52·3) DALYs due to stroke. The mortality rate increased by 32·3% (8·6–59·0) from 1990 to 2019. Over the same period, the age-standardised mortality rate decreased by 39·8% (28·6–50·7) and the DALY rate decreased by 41·6% (30·7–50·9). High systolic blood pressure, ambient particulate matter pollution exposure, smoking, and diet high in sodium were four major risk factors for stroke burden in 2019. Moreover, we found marked differences of stroke burden and attributable risk factors across provinces in China from 1990 to 2019. Interpretation The disease burden of stroke is still severe in China, although the age-standardised incidence and mortality rates have decreased since 1990. The stroke burden in China might be reduced through blood pressure management, lifestyle interventions, and air pollution control. Moreover, because substantial heterogeneity of stroke burden existed in different provinces, improved health care is needed in provinces with heavy stroke burden. Funding National Key Research and Development Program of China and Taikang Yicai Public Health and Epidemic Control Fund.

Published
2021

24. Projecting heat-related excess mortality under climate change scenarios in China

Author

Jun Yang, Boguang Wang, Zhoupeng Ren, Jinfeng Wang, Hao Wang, Maigeng Zhou, Chunlin Zhang, Shilu Tong, Jimin Sun, Qiyong Liu, Peng Yin, Mengmeng Li, De Li Liu, Chun-Quan Ou, and Yuming Guo

Subjects
Lung Diseases, Male, Hot Temperature, 010504 meteorology & atmospheric sciences, Vulnerability, General Physics and Astronomy, 010501 environmental sciences, 01 natural sciences, Environmental impact, skin and connective tissue diseases, Child, Public health, Multidisciplinary, Representative Concentration Pathways, Middle Aged, Environmental health, Geography, Cardiovascular Diseases, Child, Preschool, Educational Status, Female, Adult, China, Population ageing, medicine.medical_specialty, Adolescent, Science, Climate Change, Climate change, Article, General Biochemistry, Genetics and Molecular Biology, medicine, Humans, Computer Simulation, Socioeconomic status, Aged, 0105 earth and related environmental sciences, Models, Statistical, Global warming, Infant, Newborn, Infant, General Chemistry, Survival Analysis, Educational attainment, Risk factors, sense organs, Climate-change impacts, Demography
Abstract

Recent studies have reported a variety of health consequences of climate change. However, the vulnerability of individuals and cities to climate change remains to be evaluated. We project the excess cause-, age-, region-, and education-specific mortality attributable to future high temperatures in 161 Chinese districts/counties using 28 global climate models (GCMs) under two representative concentration pathways (RCPs). To assess the influence of population ageing on the projection of future heat-related mortality, we further project the age-specific effect estimates under five shared socioeconomic pathways (SSPs). Heat-related excess mortality is projected to increase from 1.9% (95% eCI: 0.2–3.3%) in the 2010s to 2.4% (0.4–4.1%) in the 2030 s and 5.5% (0.5–9.9%) in the 2090 s under RCP8.5, with corresponding relative changes of 0.5% (0.0–1.2%) and 3.6% (−0.5–7.5%). The projected slopes are steeper in southern, eastern, central and northern China. People with cardiorespiratory diseases, females, the elderly and those with low educational attainment could be more affected. Population ageing amplifies future heat-related excess deaths 2.3- to 5.8-fold under different SSPs, particularly for the northeast region. Our findings can help guide public health responses to ameliorate the risk of climate change., Global warming is expected to increase mortality due to heat stress in many regions. Here, the authors asses how mortality due to high temperatures changes in China changes for different demographic groups and show that heat-related excess mortality is increasing under climate change, a process that is strongly amplified by population ageing.

Published
2021

25. Body-mass index and obesity in urban and rural China: findings from consecutive nationally representative surveys during 2004-18

Author

Gangqiang Ding, Jing Wu, Mei Zhang, Zhengjing Huang, Xinhua Li, Xiao Zhang, Limin Wang, Bin Zhou, Yong Jiang, Ling Yang, Majid Ezzati, Liyun Zhao, Zhenping Zhao, Maigeng Zhou, Linhong Wang, Dongmei Yu, Zhengming Chen, Chun Li, and Yichong Li

Subjects
Adult, Male, Rural Population, medicine.medical_specialty, China, Adolescent, Urban Population, Population, 030204 cardiovascular system & hematology, Body Mass Index, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Risk Factors, medicine, Humans, 030212 general & internal medicine, Obesity, Young adult, education, Socioeconomic status, Aged, education.field_of_study, business.industry, Public health, Metabolic risk, General Medicine, Middle Aged, medicine.disease, Health Surveys, Female, business, Body mass index, Demography
Abstract

Summary Background In China, mean body-mass index (BMI) and obesity in adults have increased steadily since the early 1980s. However, to our knowledge, there has been no reliable assessment of recent trends, nationally, regionally, or in certain population subgroups. To address this evidence gap, we present detailed analyses of relevant data from six consecutive nationally representative health surveys done between 2004 and 2018. We aimed to examine the long-term and recent trends in mean BMI and prevalence of obesity among Chinese adults, with specific emphasis on changes before and after 2010 (when various national non-communicable disease prevention programmes were initiated), assess how these trends might vary by sex, age, urban–rural locality, and socioeconomic status, and estimate the number of people who were obese in 2018 compared with 2004. Methods We used data from the China Chronic Disease and Risk Factors Surveillance programme, which was established in 2004 with the aim to provide periodic nationwide data on the prevalence of major chronic diseases and the associated behavioural and metabolic risk factors in the general population. Between 2004 and 2018 six nationally representative surveys were done. 776 571 individuals were invited and 746 020 (96·1%) participated, including 33 051 in 2004, 51 050 in 2007, 98 174 in 2010, 189 115 in 2013, 189 754 in 2015, and 184 876 in 2018. After exclusions, 645 223 participants aged 18–69 years remained for the present analyses. The mean BMI and prevalence of obesity (BMI ≥30 kg/m2) were calculated and time trends compared by sex, age, urban–rural locality, geographical region, and socioeconomic status. Findings Standardised mean BMI levels rose from 22·7 kg/m2 (95% CI 22·5–22·9) in 2004 to 24·4 kg/m2 (24·3–24·6) in 2018 and obesity prevalence from 3·1% (2·5–3·7) to 8·1% (7·6–8·7). Between 2010 and 2018, mean BMI rose by 0·09 kg/m2 annually (0·06–0·11), which was half of that reported during 2004–10 (0·17 kg/m2, 95% CI 0·12–0·22). Similarly, the annual increase in obesity prevalence was somewhat smaller after 2010 than before 2010 (6·0% annual relative increase, 95% CI 4·4–7·6 vs 8·7% annual relative increase, 4·9–12·8; p=0·13). Since 2010, the rise in mean BMI and obesity prevalence has slowed down substantially in urban men and women, and moderately in rural men, but continued steadily in rural women. By 2018, mean BMI was higher in rural than urban women (24·3 kg/m2 vs 23·9 kg/m2; p=0·0045), but remained lower in rural than urban men (24·5 kg/m2 vs 25·1 kg/m2; p=0·0007). Across all six surveys, mean BMI was persistently lower in women with higher levels of education compared with women with lower levels of education, but the inverse was true among men. Overall, an estimated 85 million adults (95% CI 70 million–100 million; 48 million men [95% CI 39 million–57 million] and 37 million women [31 million–43 million]) aged 18–69 years in China were obese in 2018, which was three times as many as in 2004. Interpretation In China, the rise in mean BMI among the adult population appears to have slowed down over the past decade. However, we found divergent trends by sex, geographical area, and socioeconomic status, highlighting the need for a more targeted approach to prevent further increases in obesity in the Chinese general population. Funding China National Key Research and Development Program, China National Key Project of Public Health Program, and Youth Scientific Research Foundation of the National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention.

Published
2021

26. Premature deaths caused by smoking in Sichuan, Southwest China, 2015–2030

Author

Ying Deng, Hui Guo, Li Zhao, Kun Zou, Zhuo Wang, Yu Luo, Shujuan Yang, Maigeng Zhou, Jun He, and Rong Pei

Subjects
Adult, Male, China, Science, Population, Diseases, Population health, 030204 cardiovascular system & hematology, Article, 03 medical and health sciences, 0302 clinical medicine, Cause of Death, Environmental health, Prevalence, Humans, Medicine, 030212 general & internal medicine, Noncommunicable Diseases, education, Health policy, Aged, education.field_of_study, Multidisciplinary, Mortality, Premature, business.industry, Smoking, Tobacco control, Middle Aged, Premature death, Risk factors, Attributable risk, Life expectancy, Female, business, Forecasting
Abstract

Smoking has a substantial impact on deaths from non-communicable chronic diseases (NCDs). Quantitatively measuring the impact of tobacco control on population health is of great theoretical and practical importance, for governments to make health policy decisions. Focusing on premature deaths, we predicted the deaths by 2030 from major NCDs caused by smoking among people aged 30–69 years in Sichuan Province, Southwest China. We extracted data for 1990–2015 from the Global Burden of Disease Study 2015 and calculated the population attributable fraction, to estimate the proportion of deaths caused by smoking. Four different tobacco control standards were used to estimate 2030 projections for the prevalence of smoking and premature mortality. If smoking prevalence were reduced by 30% from 2015 levels, premature mortality could be expected to decline by 24.4% in 2030, achieving 81.3% of the World Health Organization target for reducing premature mortality by 30%. Compared with the continuation of historical trends, the strongest tobacco control policy scenario would reduce premature mortality by 6.6%, prevent 23,600 deaths, reduce mortality by 7.8%, and increase life expectancy at birth by 0.3 years. Smoking bans represent an important action toward achieving national health goals.

Published
2021

27. Short- and medium-term impacts of strict anti-contagion policies on non-COVID-19 mortality in China

Author

Jinlei, Qi, Dandan, Zhang, Xiang, Zhang, Tanakao, Takana, Yuhang, Pan, Peng, Yin, Jiangmei, Liu, Shuocen, Liu, George F, Gao, Guojun, He, and Maigeng, Zhou

Subjects
Adult, Male, China, Adolescent, Physical Distancing, Young Adult, Air Pollution, Cause of Death, Neoplasms, Humans, Registries, Mortality, Child, Respiratory Tract Infections, Aged, SARS-CoV-2, Accidents, Traffic, Infant, Newborn, Masks, COVID-19, Infant, Middle Aged, Cardiovascular Diseases, Child, Preschool, Communicable Disease Control, Wounds and Injuries, Female, Public Health
Abstract

The effects of coronavirus disease-19 (COVID-19) public health policies on non-COVID-19-related mortality are unclear. Here, using death registries based on 300 million Chinese people and a difference-in-differences design, we find that China's strict anti-contagion policies during the COVID-19 pandemic significantly reduced non-COVID-19 mortality outside Wuhan (by 4.6%). The health benefits persisted and became even greater after the measures were loosened: mortality was reduced by 12.5% in the medium term. Significant changes in people's behaviours (for example, wearing masks and practising social distancing) and reductions in air pollution and traffic accidents could have driven these results. We estimate that 54,000 lives could have been saved from non-COVID-19 causes during the 50 days of strict policies and 293,000 in the subsequent 115 days. The results suggest that virus countermeasures not only effectively controlled COVID-19 in China but also brought about unintended and substantial public health benefits.

Published
2021

28. Disease Burden and Attributable Risk Factors of Alzheimer’s Disease and Dementia in China from 1990 to 2019

Author

Hualiang Lin, Haoyan Guo, Jinlei Qi, Yinglin Wu, Yanpeng Yin, Yin Yang, Stephen Edward McMillin, Rui Li, Morgan H. LeBaige, Zhengmin Qian, and Maigeng Zhou

Subjects
Male, China, business.industry, Incidence (epidemiology), Disease, medicine.disease, Global Burden of Disease, Alzheimer Disease, Risk Factors, Environmental health, Attributable risk, Health care, medicine, Humans, Dementia, Female, Quality-Adjusted Life Years, business, High body mass index, Disease burden
Abstract

Updated information on the burden of Alzheimer's disease and other forms of dementia are of great importance for evidence-based health care planning. However, such an estimate has been lacking in Chinese populations at both national and provincial levels.To estimate the temporal trends and the attributable burdens of selected risk factors of Alzheimer's disease and other forms of dementia in China.This is an observational description of the Global Burden of Diseases Study 2019 (GBD 2019). Data on incidence, mortality, prevalence, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) of Alzheimer's disease and other forms of dementia were derived from the GBD 2019 study at both national and provincial levels in China.Six indicators were used: incidence, mortality, prevalence, DALYs, YLLs, and YLDs. Absolute numbers in detail by age, sex, region, and age-standardized rates (with 95% uncertainty intervals) were calculated.There were notable increasing trends in the number of deaths (247·9%), incidence (264·8%), prevalence (296·5%), DALYs (228·1%), YLDs (308·7%) and YLLs (201·7%) from 1990 to 2019, respectively. The corresponding age-standardized rates increased by 6·2%, 19·3%, 33·6%, 10·7%, 33·4% and 3·1%. Smoking, high body mass index, high fasting plasma glucose levels, and metabolic risks were the four leading risk factors. Higher burden was observed among females versus males and in the more developed regions.The disease burden in China were increasing substantially. Regional differences of the disease burden are accompanied by discrepancies of economic level and geographical location, as well as different levels of exposure to risk factors. Targeted prevention and control strategies are urgently needed to reduce the disease burden.

Published
2021

29. The impact of carbon monoxide on years of life lost and modified effect by individual- and city-level characteristics: Evidence from a nationwide time-series study in China

Author

Lijun Wang, Jie Li, Yun Lin, Peng Yin, Maigeng Zhou, Yu Wang, and Shanglong Yao

Subjects
Male, medicine.medical_specialty, China, Health, Toxicology and Mutagenesis, Population, Respiratory Tract Diseases, 0211 other engineering and technologies, 02 engineering and technology, 010501 environmental sciences, 01 natural sciences, Environmental pollution, Time-series analysis, Air Pollution, medicine, Per capita, Humans, GE1-350, Cities, education, Cardiopulmonary disease, Disease burden, 0105 earth and related environmental sciences, Aged, 021110 strategic, defence & security studies, education.field_of_study, Air Pollutants, Carbon Monoxide, Public health, Public Health, Environmental and Occupational Health, General Medicine, Environmental Exposure, Random effects model, Pollution, Confidence interval, Environmental sciences, Years of potential life lost, TD172-193.5, Cardiovascular Diseases, Female, Years of life lost, Demography
Abstract

Ambient carbon monoxide (CO) has been linked with mortality and morbidity. Little evidence is available regarding the relation between CO and years of life lost (YLL). Using data from 48 major cities in China from 2013 to 2017, we applied generalized additive models and random effects meta-analyses to explore the effects of CO on YLL from various diseases. Stratified analyses and meta-regression were performed to estimate potential effect modifications of demographic factors, regions, meteorological factors, co-pollutants, urbanization rate, economic level and health service level. Additional life gains due to avoidable YLL under certain scenario were also evaluated. Results indicated that a 1-mg/m³ increase of CO concentrations (lagged over 0–3 d), was associated with 2.08% (95% confidence interval [CI], 1.35%, 2.80%), 2.35% (95% CI: 1.39%, 3.30%), 1.47% (95% CI: -0.01%, 2.93%), 2.28% (95% CI: 1.09%, 3.47%), 2.42% (95% CI: 1.31%, 3.54%), 2.09% (95% CI: 0.47%, 3.72%) increments in daily YLL from non-accidental causes, cardiovascular diseases, respiratory diseases, coronary heart disease, stroke and chronic obstructive pulmonary disease, respectively. These associations were robust to the adjustment of co-pollutants and varied substantially by geography and demographic characteristics. Associations were stronger in the elder people (≥65 years), females, population with low education attainment, and lived in south region, than younger people, males, high educated populations and those lived in north region. Moreover, the harmful impact of increasing CO concentration could be attenuated by city-level characteristics, including the growth of urbanization rate, gross domestic product (GDP), GDP per capita, number of hospital beds, doctors and hospitals. Finally, an estimated life of 0.081 (95% CI: -0.027, 0.190) years would be gained per deceased people if CO concentration could fall to 1 mg/m3. In conclusions, this nationwide analysis showed significant associations between short-term CO exposure and cause-specific YLL. The heterogeneity of both individual- and city-level characteristics should be considered for relevant intervention. These findings may have significant public health implications for the reduction of CO-attributed disease burden in China.

Published
2020

30. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author

Soufiane Boufous, Yousef Veisani, Mehran Asadi-Aliabadi, Sharath Burugina Nagaraja, Maziar Moradi-Lakeh, Getachew Mullu Kassa, Edward J Mills, Dimas Ria Angga Pribadi, William James Dangel, Mohamad-Hani Temsah, Catherine O. Johnson, Gregory A. Roth, Giuseppe Gorini, Fariborz Mansour-Ghanaei, Alberto Ortiz, Samad Azari, Assefa Ayalew Ayalew Ayalew Gebreslassie, Salime Goharinezhad, Stephanie R. M. Zimsen, Peng Zheng, Michael Assmus, Elisabetta Pupillo, Bach Xuan Tran, Lal B. Rawal, Narayanaswamy Venketasubramanian, Noushin Mohammadifard, Stephen S Lim, Ata Rafiee, Maria Inês Schmidt, Vincent C. Iannucci, Suzanne Lyn Barker-Collo, Leah E. Cahill, Tauseef Ahmad, Platon D. Lopukhov, Kazumasa Yamagishi, Abdullah Al Mamun, Iqbal R. F. Elyazar, Giovanni Damiani, Mohammad Hossein Bakhshaei, Mehdi Fazlzadeh, Virginia Núñez-Samudio, Alyssa Pennini, Dietrich Plass, Atkilt Esaiyas Etisso, Gebre Teklemariam Demoz, Alexandrea Watson, Arvin Haj-Mirzaian, Paul S Briant, Frank B. Osei, Blair R. Bumgarner, Maciej Banach, Ravensara S. Travillian, Kai-Lan Chang, Shirin Djalalinia, Hasan Yusefzadeh, Silvano Gallus, Seyyed Meysam Mousavi, Bernhard T. Baune, Aaron van Donkelaar, Azeem Majeed, Hans Kromhout, Robert Ancuceanu, Blessing J. Akombi, Pushpendra Singh, Nayu Ikeda, William M. Gardner, Zahid A Butt, Mohammad Abdollahi, Temesgen Yihunie Akalu, Rahman Shiri, Benn Sartorius, Ai-Min Wu, Bing Fang Hwang, Flavia M. Cicuttini, Hiroyasu Iso, Luis Camera, Amin Soheili, Félix Carvalho, Yun Jin Kim, Caleb Mackay Salpeter Irvine, Mehdi Mirzaei-Alavijeh, Iman Halvaei, Saqib Ali, Giulio Castelpietra, Catalina Liliana Andrei, Ali Kazemi Karyani, Parkes J Kendrick, Hamidreza Haririan, Lucas Guimarães Abreu, Mukhammad David Naimzada, Jeff T. Zhao, Samiah Alam, Sorin Hostiuc, Shaun Wen Huey Lee, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Cyrus Alinia, Takahiro Tabuchi, Manu Raj Mathur, Søren Thorgaard Skou, Thomas Khaled Dwayne Classen, Reza Heidari-Soureshjani, Massimo Cirillo, Nikita Otstavnov, Mehdi Bohluli, Ruth W. Kimokoti, Animut Tagele Tamiru, Masoumeh Sadeghi, Mohammad Ali Jahani, Itamar S. Santos, Mekdes Tigistu Yilma, Lars Johansson, Arielle Wilder Eagan, Nevine El Nahas, Silvia Schiavolin, Kevin D. Shield, Dinh-Toi Chu, Shiva Borzouei, Paul S. F. Yip, Beatrix Haddock, Gianfranco Alicandro, Vasily Vlassov, Deanna Anderlini, Giuseppe Remuzzi, Khalid A Altirkawi, Farahnaz Joukar, Aso Mohammad Darwesh, Ratilal Lalloo, Panniyammakal Jeemon, Rohollah Kalhor, Daniel Youngwhan Cho, Weijia Fu, João Pedro Silva, Rodrigo Sarmiento-Suarez, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Jacob Olusegun Olusanya, José Neves, Gaorui Guo, Tomas Y. Yeheyis, John S. Ji, Charles D. H. Parry, Maryam Ghadimi, Seyed-Mohammad Fereshtehnejad, Serge Resnikoff, Anna E. Torre, Vinod C Nayak, Jamileh Shadid, Susanne Breitner, Mohammad Khammarnia, Mathilde Touvier, Ensiyeh Jenabi, Hosna Janjani, Floriane Ausloos, Irmina Maria Michalek, Alexandra S. Boon-Dooley, Jessica A. Cruz, Syed Mohamed Aljunid, Abiodun M. Adeoye, André Faro, Bartosz Miazgowski, Jobert Richie Nansseu, Erin C Mullany, Giannina Ferrara, Martin McKee, Emmanuel Peprah, Oommen John, Reza Saeedi, Yasser Vasseghian, Dragos Virgil Davitoiu, Sarah Wulf Hanson, Yingxi Zhao, Omid Shafaat, Ali Rajabpour-Sanati, Farid Najafi, Ana Maria Mantilla Herrera, Fatemeh Rajati, Tarun Gupta, Łukasz Szumowski, Mohammed Ibrahim Mohialdeen Gubari, Peter Njenga Keiyoro, Dharmesh Kumar Lal, Zhi Jiang Zhang, Osayomwanbo Osarenotor, Tanvir M. Huda, Perminder S. Sachdev, Farhad Ghamari, Era Upadhyay, Vivek Kumar, Guoqing Hu, Vinay Nangia, Vladimir Andreevich Korshunov, Saeed Shahabi, Golnaz Heidari, Ashraf Nabhan, Robert C. Reiner, Aziz Rezapour, Justin J. Lang, Rakhi Dandona, Josephine W. Ngunjiri, Anna-Karin Danielsson, André Karch, Filippo Ariani, Ahmed Abdelalim, Masih Tajdini, Stefanos Tyrovolas, Mohamed Hsairi, Jae Il Shin, Jasvinder A. Singh, Meghan D. Mooney, Fiona B. Bennitt, Hesam Alizade, Segun Emmanuel Ibitoye, Pradhum Ram, Soraya Siabani, Evanson Z. Sambala, Reza Malekzadeh, Falk Schwendicke, Lalit Dandona, Masoud Moradi, Molly R Nixon, Roya Mirzaei, Rachel Feldman, Hosni Salem, Alberto L. García-Basteiro, Lorainne Tudor Car, Sharareh Eskandarieh, Ramesh Holla, Ritesh G. Menezes, Taraneh Yousefinezhadi, Hai Quang Pham, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Ali Bijani, Harvey Whiteford, Shanshan Li, Aleksandr Y. Aravkin, Joshua A. Salomon, Franz Castro, Lisa M. Force, Abdilahi Yousuf Yousuf, Mina Anjomshoa, Ken Takahashi, Maigeng Zhou, Telma Zahirian Moghadam, Maseer Khan, Irina Filip, Santi Martini, Randah R. Hamadeh, Somayeh Bohlouli, Joana Morgado-da-Costa, Tim Driscoll, Jingkai Wei, Hermann Brenner, Reza Rawassizadeh, Radoslaw Sierpinski, Saman Esmaeilnejad, Emmanuel Wandera Okunga, Marisa Freitas, Srikanta Banerjee, Feleke Mekonnen Demeke, Shahin Soltani, Naser Mohammad Gholi Mezerji, Reed J D Sorensen, Elena V. Gnedovskaya, Johan Ärnlöv, Ivo Rakovac, Reza Mohammadpourhodki, Hussain Jafari, Atte Meretoja, Yasir Waheed, Fahad Alanezi, Arya Haj-Mirzaian, Sezer Kisa, Jaifred Christian F. Lopez, Khalid F. Alhabib, Basema Saddik, Michael R. Phillips, Vishnu Renjith, Yafeng Wang, Kevan R. Polkinghorne, Liliana G Ciobanu, Jacek Jerzy Jozwiak, Gelin Xu, Richard C. Franklin, Junjie Wu, Thomas R. Hird, Mohammad Zamani, Diana Silva, Fotis Topouzis, Irena Ilic, Jeffrey D. Stanaway, Hadi Pourjafar, Huong Lan Thi Nguyen, Khaled Khatab, Ammas Siraj Mohammed, Ziyad Al-Aly, A. A. Fomenkov, Charlie Ashbaugh, Mowafa Househ, Paul I. Dargan, Endalkachew Worku Mengesha, Shaimaa I. El-Jaafary, Ernoiz Antriyandarti, Iffat Elbarazi, Dara K. Mohammad, Naznin Hossain, Reza Shirkoohi, João M. Furtado, Arash Ziapour, Morteza Jafarinia, M. Mofizul Islam, Anamika Pandey, Ahmed I. Hasaballah, Tanuj Kanchan, Lee Ling Lim, Muktar Omer Omer, Charles D.A. Wolfe, Ulrich O Mueller, Helen Bitew, V. Prakash, Fereshteh Mehri, Randall V. Martin, Claudiu Herteliu, Constance D. Pond, Min Jeong Shin, Morteza Oladnabi, Antonio Maria Borzì, Yousef Mohammad, Yuichiro Yano, Luke D. Knibbs, Kevin S Ikuta, Maryam Mirzaei, Andreea Mirica, Sofia Boston Redford, Siamak Sabour, Mariya Vladimirovna Titova, Davood Anvari, Ghobad Moradi, Jordi Alonso, Shiwei Liu, Theo Vos, Tuomo J. Meretoja, Ireneous N. Soyiri, Owen R. Cooper, Seyed Sina Naghibi Irvani, Kejia Hu, Hannah J. Henrikson, Sanni Yaya, Robert P. Dellavalle, Chidozie Declan Iwu, Sergey Soshnikov, Jee-Young Jasmine Choi, Satinath Mukhopadhyay, Zabihollah Yousefi, Iman El Sayed, Biresaw Wassihun Alemu, Neeti Kapoor, Ahmad Daryani, Cathleen Keller, Ibrahim Abdollahpour, Nuno Taveira, Masoud Foroutan, Fatemeh Amiri, Mariam Molokhia, Songhomitra Panda-Jonas, Amy E. Peden, Rufus Akinyemi, Ejaz Ahmad Khan, Mostafa Amini-Rarani, J. Becker, Hamidreza Pazoki Toroudi, Ben Lacey, Kidanemaryam Berhe, Simon Yadgir, Spencer L. James, Cory N. Spencer, Aletta E. Schutte, Mu'awiyyah Babale Sufiyan, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Fereshteh Ansari, Rixing Xu, Jonathan F. Mosser, Josep Maria Haro, Enrico Rubagotti, Anurag Agrawal, Zahiruddin Quazi Syed, Hoa Thi Do, Ettore Beghi, Seyed Mohammad Kazem Aghamir, Abraham Geremew, Alireza Esteghamati, Paramjit Gill, Farzad Jalilian, J. Jason West, Mikhail Sergeevich Zastrozhin, Albertino Damasceno, Bruce Bartholow Duncan, Nazir Fattahi, Daniel Cury Ribeiro, Michael Brauer, Mark A. Stokes, Veincent Christian Filipino Pepito, Lidia Morawska, Fiona J Charlson, Babak Moazen, Dejana Braithwaite, Jonathan M. Kocarnik, Sergio I. Prada, Andrea Farioli, Zahra Atafar, Heather Orpana, Daniela Balzi, Marco Vacante, Rahmatollah Moradzadeh, Jacek A. Kopec, Iván Landires, Robert G. Weintraub, Leonardo Roever, Yannick Béjot, Markus P. Schlaich, Hamed Zandian, Subramanian Senthilkumaran, Klara Dokova, Vahid Alipour, Sowmya J. Rao, Rakesh Ghosh, Omar Mukhtar Salman, Faris Lami, Marcos Roberto Tovani-Palone, Hamid Reza Tohidinik, Seyed Mohammad Riahi, Adnan Kisa, Ghasem Azarian, Caroline Stein, Zulfiqar A. Bhutta, Sinead Langan, Kunihiro Matsushita, Lauren E. Schaeffer, Kathryn H. Jacobsen, Mehdi Naderi, Mehdi Hosseinzadeh, Nizal Sarrafzadegan, Bahram Armoon, Dan J. Stein, Jessica Fanzo, Morenike Oluwatoyin Folayan, Luca Ronfani, Phetole Walter Mahasha, Nicholas J K Breitborde, Adrian Oţoiu, Arash Sarveazad, Marc L. Serre, Mostafa Hosseini, Nicolas Cherbuin, George D. Thurston, Jalal Arabloo, Mokhtar Mahdavi, Andre Rodrigues Duraes, Ana Laura Manda, Ahmed Abualhasan, Nima Rezaei, Yuan-Pang Wang, Theodore Patrick Younker, Alireza Ansari-Moghaddam, Borhan Mansouri, Adam E. Berman, Khezar Hayat, Rosario Cárdenas, Bolajoko O. Olusanya, Tommi Vasankari, Simon I. Hay, Fatemeh Ghaffarifar, Leo Stockfelt, Ai Koyanagi, Giorgia Giussani, Yuming Guo, Sonia Saxena, Deborah Carvalho Malta, Mehedi Hasan, Negar Rezaei, Maja Pasovic, Jukka Takala, Bogdan Oancea, Sare Safi, A. Werdecker, Florian Fischer, Beatriz Paulina Ayala Quintanilla, Muhammad Shahdaat Bin Sayeed, Takeshi Fukumoto, Maha Atout, Brijesh Sathian, Cristina Bosetti, Mitchell T. Wallin, Agegnehu Bante, Helen Ippolito, Anthony Masaka, Chantal Huynh, Justin Lo, Jordan Weiss, Joemer C. Maravilla, Alberto Raggi, Peter W. Gething, Cristiana Abbafati, Daniela Ribeiro, Mohammad Farahmand, Yetunde O. John-Akinola, Isabela M. Benseñor, Emilie R Maddison, John J. McGrath, Salman Khazaei, Scott B. Patten, Jean Jacques Noubiap, Emmanuela Gakidou, Celine M. Barthelemy, Ashish Badiye, George C. Patton, Obinna Onwujekwe, Peter Allebeck, Victor Aboyans, Olayinka Stephen Ilesanmi, Mousa Yaminfirooz, Neeraj Bedi, Nicholas L S Roberts, Joht Singh Chandan, Hans W. Hoek, Usman Iqbal, Nima Hafezi-Nejad, Haley Lescinsky, Naohiro Yonemoto, Ahmad Ghashghaee, Anders Larsson, David C. Schwebel, Milena Ilic, Richard T. Burnett, Yang Liu, Carlo La Vecchia, Felix Akpojene Ogbo, Morteza Naserbakht, Sangram Kishor Patel, Melanie S. Hammer, Prasanna Mithra, Mohammad Amin Bahrami, Kanyin L. Ong, Mona Pathak, Afshin Maleki, Saeid Safiri, Masood Ali Shaikh, Kate Causey, Michael R.M. Abrigo, Jost B. Jonas, Dian Kusuma, Jagadish Rao Padubidri, Mihajlo Jakovljevic, Ali S. Shalash, Abdiwahab Hashi, Ionut Negoi, Nataliya A. Foigt, Andrey Nikolaevich Briko, François Alla, Giuseppe Grosso, Houman Goudarzi, Di H. Cross, Vera Marisa Costa, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Odgerel Chimed-Ochir, Sonia Rodríguez-Ramírez, Bo Norrving, Kerem Shuval, Jacob L. Stubbs, Muhammad Ali, Shuhei Nomura, Man Mohan Mehndiratta, Chisom Joyqueenet Akunna, Abdollah Mohammadian-Hafshejani, Navid Rabiee, Dana Bryazka, Hussen Mohammed, Asadollah Gholamian, Ashley Marks, Rizwan Kalani, Molly E. Herbert, Islam Y. Elgendy, Moritz U. G. Kraemer, Chuanhua Yu, Suzanne Polinder, Pascual R. Valdez, Jennifer Rickard, Kylie Ball, Turki Alanzi, Mohsen Bayati, Hamed Mirzaei, Christopher M Odell, Amira Shaheen, Ziad A. Memish, Thirunavukkarasu Sathish, Michael A. Piradov, Hamed Kalani, Lorenzo Monasta, Christopher S Yilgwan, Desalegn Getnet Demsie, Riaz Uddin, Rizwan Suliankatchi Abdulkader, Vinay Srinivasan, Hamid Ahmadieh, Claudio Alberto Dávila-Cervantes, Raffaele Palladino, Chukwudi A Nnaji, Mika Shigematsu, Stein Emil Vollset, Abbas Sheikhtaheri, Paulo A. Lotufo, Nasir Salam, Binyam Minuye Birihane, Mohammad Ali Mansournia, Tomislav Mestrovic, Samer Hamidi, Rajesh Sagar, Mayowa O. Owolabi, Kara Estep, Ester Cerin, Michael T. Chung, Simon Øverland, Amir Taherkhani, Sheng Chia Chung, Martin Amogre Ayanore, Nikolaos Dervenis, Joan B. Soriano, Tahereh Javaheri, Victor Adekanmbi, Seid Tiku Mereta, Gbenga A. Kayode, Christopher R. Cederroth, Razique Anwer, Rajan Nikbakhsh, Kaja Abbas, Fatemeh Heydarpour, Louisa Degenhardt, Tahiya Alam, Mohammad Miri, Alibek Mereke, David Laith Rawaf, Ippazio Cosimo Antonazzo, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Desta Debalkie Atnafu, Davide Sattin, Moslem Soofi, Edris Hasanpoor, Krittika Bhattacharyya, Mika Kivimäki, Nikolay Ivanovich Briko, Joanna L Whisnant, Christopher J L Murray, Simin Mouodi, Alize J. Ferrari, Damian Santomauro, Katrin Burkart, Tudorel Andrei, Alberto Baldasseroni, Hafiz Ansar Rasul Suleria, Valery L. Feigin, Nauman Khalid, Ewerton Cousin, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Themba G.G. Ginindza, Sadaf G. Sepanlou, Sheikh Mohammed Shariful Islam, Sanjay Basu, Getinet Ayano, Paula Moraga, Soheil Hassanipour, Jason A. Anderson, Catherine Bisignano, Iyad Sultan, Deepak Kumar Pasupula, Keivan Ahmadi, Fariba Dorostkar, Rajeev Gupta, David M. Pereira, Mustafa Z. Younis, Adel Spotin, Rasmus Havmoeller, Yeshambel T. Nigatu, Barthelemy Kuate Defo, Mithila Faruque, Alan D. Lopez, Shailesh Advani, Behshad Naghshtabrizi, Shane D. Morrison, Inga Dora Sigfusdottir, Konrad Pesudovs, Anna Gershberg Hayoon, Raaj Kishore Biswas, Reshmi Bhageerathy, H. Dean Hosgood, Giulia Carreras, Sarika Chaturvedi, James L. Fisher, In-Hwan Oh, G Anil Kumar, Christoph Nowak, Vijay Kumar Chattu, Puja C Rao, Marcel Ausloos, Ali Kabir, Rannveig Sigurvinsdottir, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Rafael Tabarés-Seisdedos, Minh Nguyen, Ashkan Afshin, Payman Salamati, Colin Angus, Mona M. Khater, Ehsan Sadeghi, Mahalaqua Nazli Khatib, Antonio Biondi, Valentin Yurievich Skryabin, Mohsen Abbasi-Kangevari, Andrew T Olagunju, Amir Radfar, Laith J. Abu-Raddad, Marcello Tonelli, Hesam Ghiasvand, Hanne Christensen, Juan Jesus Carrero, Maryam Adabi, Saravanan Muthupandian, Kurt Straif, Hossein Samadi Kafil, Lope H Barrero, Harish Chander Gugnani, Mohammad Fareed, Morteza Shamsizadeh, Jemal Abdu Mohammed, Juan A Rivera, Shai Linn, Saad M.A. Dahlawi, Janni Leung, Shokofeh Maleki, Mohd Anisul Karim, Kamarul Imran Musa, Farshad Pourmalek, Dietrich Rothenbacher, Kiomars Sharafi, Alessandra C. Goulart, Leila Doshmangir, Gabriele Nagel, Helena Manguerra, Olatunji O. Adetokunboh, Srinivasa Vittal Katikireddi, Nermin Ghith, Maha El Tantawi, Awoke Misganaw, Yunquan Zhang, Carl Abelardo T. Antonio, Vahid Rashedi, Mehran Shams-Beyranvand, Bhaskaran Unnikrishnan, Holly E. Erskine, Ann Kristin Knudsen, Marissa B Reitsma, Getayeneh Antehunegn Tesema, Javad Javidnia, Ismael R. Campos-Nonato, Biniyam Sahiledengle Geberemariyam, Godfrey Mutashambara Rwegerera, Alaa Badawi, James Leigh, Morteza Arab-Zozani, Kyle E. Simpson, Muluken Bekele Sorrie, Roghiyeh Faridnia, Vivekanand Jha, Tomasz Miazgowski, Aaron J Cohen, Chukwuma David Umeokonkwo, Alessandra Lugo, Adhanom Gebreegziabher Baraki, Akshaya Srikanth Bhagavathula, Caitlyn Steiner, Gholamreza Roshandel, Cuong Tat Nguyen, Tania G Sánchez-Pimienta, Ahamarshan Jayaraman Nagarajan, Laura Kemmer, Ihoghosa Osamuyi Iyamu, Seyedeh Zahra Masoumi, Vivian Chia-Rong Hsieh, Kris J. Krohn, Phoebe Anne Rhinehart, Sarah Wozniak, Sahar Saeedi Moghaddam, Kate E. LeGrand, Christian Kieling, Vahid Yazdi-Feyzabadi, Robin Room, Zelalem Nigussie Azene, Kelly Cercy, Paul H. Lee, Stanislav S. Otstavnov, Dinesh Bhandari, Rafael Alves Guimarães, Zemenu Tadesse Tessema, Aziz Sheikh, Michellr L. Bell, Marwa Rashad Salem, Kirsten E. Wiens, Emma U.R. Smith, Hassan Abolhassani, Cristiano Piccinelli, Kedir Hussein Abegaz, G.K. Mini, Christian Razo, Manuela L. Ferreira, Diego De Leo, Francesco Saverio Violante, Aristidis Tsatsakis, Zahra Sadat Dibaji Forooshani, Tea Lallukka, Dickson A. Amugsi, Anna Poznańska, Graeme J. Hankey, Kewal Krishan, Maryam Zamanian, Eirini Skiadaresi, Jai K Das, Felix Greaves, Tessa M. Pilz, Sameer Vali Gopalani, Mansour Ghafourifard, M. DeLang, Morteza Mahmoudi, Alton Lu, Brian J. Hall, Ravi Prakash Jha, David Edvardsson, Xiu Ju George Zhao, Farshad Farzadfar, Hadi Hassankhani, Samuel M. Ostroff, Gerhard Sulo, Keyghobad Ghadiri, Neeraj Bhala, Stefan Lorkowski, Mohammad Rabiee, Sivan Yegnanarayana Iyer Saraswathy, Amirhossein Sahebkar, Rashid Abdi Guled, Abdallah M. Samy, Roman Topor-Madry, Michal Grivna, Afsaneh Arzani, Ayesha Humayun, Simin Liu, Maryam Khayamzadeh, Davoud Adham, Ahad Bakhtiari, Shafiu Mohammed, Paolo Lauriola, Abbas Mosapour, Sophia Emmons-Bell, Khurshid Alam, Rajat Das Gupta, Matilde Leonardi, Muktar Beshir Ahmed, Jeffrey V. Lazarus, Mohamed M. Gad, Kelly Compton, Leila R Kalankesh, Abdelrahman Ibrahim Abushouk, Mikk Jürisson, Catherine M. Antony, Ali A. Asadi-Pooya, Daniel Diaz, Salman Rawaf, Gina Agarwal, Ted R. Miller, Rebecca Ivers, João Vasco Santos, Savita Lasrado, Abdul Moiz Hafiz, Amir Almasi-Hashiani, Praveen Hoogar, Fares Alahdab, Om P Kurmi, Anbissa Muleta Senbeta, Tomi Akinyemiju, Boris Bikbov, Muhammad Aziz Rahman, Amin Mousavi Khaneghah, Yahya Safari, Guilherme Borges, Carlos A Castañeda-Orjuela, Kenji Shibuya, Bahman Yousefi, Berrin Serdar, Karen M. Tabb, Sonali Kochhar, Till Bärnighausen, Kala M. Mehta, Mostafa Dianatinasab, Arash Etemadi, Melissa Y. Wei, Kiana Ramezanzadeh, Lingkan Barua, Zubair Kabir, Rade Vukovic, Hesham M. Al-Mekhlafi, Shoshana H. Ballew, Miriam Levi, Zainab Samad, Florentino Luciano Caetano dos Santos, Juan Sanabria, Ramu Rawat, Chinwe Juliana Iwu, Gabrielle B. Britton, Colm McAlinden, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Jalil Jaafari, Walter Mendoza, Mahesh P A, Pallab K. Maulik, Ali H. Mokdad, Andre M. N. Renzaho, Milena Santric-Milicevic, Parvaiz A Koul, Foad Abd-Allah, Mihaela Hostiuc, Richard G. Cowden, Ronny Westerman, Meghdad Pirsaheb, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Tampere University, Tays Research Services, Health Sciences, Murray, C. J. L., Aravkin, A. Y., Zheng, P., Abbafati, C., Abbas, K. M., Abbasi-Kangevari, M., Abd-Allah, F., Abdelalim, A., Abdollahi, M., Abdollahpour, I., Abegaz, K. H., Abolhassani, H., Aboyans, V., Abreu, L. G., Abrigo, M. R. M., Abualhasan, A., Abu-Raddad, L. J., Abushouk, A. I., Adabi, M., Adekanmbi, V., Adeoye, A. M., Adetokunboh, O. O., Adham, D., Advani, S. M., Agarwal, G., Aghamir, S. M. K., Agrawal, A., Ahmad, T., Ahmadi, K., Ahmadi, M., Ahmadieh, H., Ahmed, M. B., Akalu, T. Y., Akinyemi, R. O., Akinyemiju, T., Akombi, B., Akunna, C. J., Alahdab, F., Al-Aly, Z., Alam, K., Alam, S., Alam, T., Alanezi, F. M., Alanzi, T. M., Alemu, B. W., Alhabib, K. F., Ali, M., Ali, S., Alicandro, G., Alinia, C., Alipour, V., Alizade, H., Aljunid, S. M., Alla, F., Allebeck, P., Almasi-Hashiani, A., Al-Mekhlafi, H. M., Alonso, J., Altirkawi, K. A., Amini-Rarani, M., Amiri, F., Amugsi, D. A., Ancuceanu, R., Anderlini, D., Anderson, J. A., Andrei, C. L., Andrei, T., Angus, C., Anjomshoa, M., Ansari, F., Ansari-Moghaddam, A., Antonazzo, I. C., Antonio, C. A. T., Antony, C. M., Antriyandarti, E., Anvari, D., Anwer, R., Appiah, S. C. Y., Arabloo, J., Arab-Zozani, M., Ariani, F., Armoon, B., Arnlov, J., Arzani, A., Asadi-Aliabadi, M., Asadi-Pooya, A. A., Ashbaugh, C., Assmus, M., Atafar, Z., Atnafu, D. D., Atout, M. M. W., Ausloos, F., Ausloos, M., Ayala Quintanilla, B. P., Ayano, G., Ayanore, M. A., Azari, S., Azarian, G., Azene, Z. N., Badawi, A., Badiye, A. D., Bahrami, M. A., Bakhshaei, M. H., Bakhtiari, A., Bakkannavar, S. M., Baldasseroni, A., Ball, K., Ballew, S. H., Balzi, D., Banach, M., Banerjee, S. K., Bante, A. B., Baraki, A. G., Barker-Collo, S. L., Barnighausen, T. W., Barrero, L. H., Barthelemy, C. M., Barua, L., Basu, S., Baune, B. T., Bayati, M., Becker, J. S., Bedi, N., Beghi, E., Bejot, Y., Bell, M. L., Bennitt, F. B., Bensenor, I. M., Berhe, K., Berman, A. E., Bhagavathula, A. S., Bhageerathy, R., Bhala, N., Bhandari, D., Bhattacharyya, K., Bhutta, Z. A., Bijani, A., Bikbov, B., Bin Sayeed, M. S., Biondi, A., Birihane, B. M., Bisignano, C., Biswas, R. K., Bitew, H., Bohlouli, S., Bohluli, M., Boon-Dooley, A. S., Borges, G., Borzi, A. M., Borzouei, S., Bosetti, C., Boufous, S., Braithwaite, D., Breitborde, N. J. K., Breitner, S., Brenner, H., Briant, P. S., Briko, A. N., Briko, N. I., Britton, G. B., Bryazka, D., Bumgarner, B. R., Burkart, K., Burnett, R. T., Burugina Nagaraja, S., Butt, Z. A., Caetano dos Santos, F. L., Cahill, L. E., Camera, L. L. A., Campos-Nonato, I. R., Cardenas, R., Carreras, G., Carrero, J. J., Carvalho, F., Castaldelli-Maia, J. M., Castaneda-Orjuela, C. A., Castelpietra, G., Castro, F., Causey, K., Cederroth, C. R., Cercy, K. M., Cerin, E., Chandan, J. S., Chang, K. -L., Charlson, F. J., Chattu, V. K., Chaturvedi, S., Cherbuin, N., Chimed-Ochir, O., Cho, D. Y., Choi, J. -Y. J., Christensen, H., Chu, D. -T., Chung, M. T., Chung, S. -C., Cicuttini, F. M., Ciobanu, L. G., Cirillo, M., Classen, T. K. D., Cohen, A. J., Compton, K., Cooper, O. R., Costa, V. M., Cousin, E., Cowden, R. G., Cross, D. H., Cruz, J. A., Dahlawi, S. M. A., Damasceno, A. A. M., Damiani, G., Dandona, L., Dandona, R., Dangel, W. J., Danielsson, A. -K., Dargan, P. I., Darwesh, A. M., Daryani, A., Das, J. K., Das Gupta, R., das Neves, J., Davila-Cervantes, C. A., Davitoiu, D. V., De Leo, D., Degenhardt, L., Delang, M., Dellavalle, R. P., Demeke, F. M., Demoz, G. T., Demsie, D. G., Denova-Gutierrez, E., Dervenis, N., Dhungana, G. P., Dianatinasab, M., Dias da Silva, D., Diaz, D., Dibaji Forooshani, Z. S., Djalalinia, S., Do, H. T., Dokova, K., Dorostkar, F., Doshmangir, L., Driscoll, T. R., Duncan, B. B., Duraes, A. R., Eagan, A. W., Edvardsson, D., El Nahas, N., El Sayed, I., El Tantawi, M., Elbarazi, I., Elgendy, I. Y., El-Jaafary, S. I., Elyazar, I. R., Emmons-Bell, S., Erskine, H. E., Eskandarieh, S., Esmaeilnejad, S., Esteghamati, A., Estep, K., Etemadi, A., Etisso, A. E., Fanzo, J., Farahmand, M., Fareed, M., Faridnia, R., Farioli, A., Faro, A., Faruque, M., Farzadfar, F., Fattahi, N., Fazlzadeh, M., Feigin, V. L., Feldman, R., Fereshtehnejad, S. -M., Fernandes, E., Ferrara, G., Ferrari, A. J., Ferreira, M. L., Filip, I., Fischer, F., Fisher, J. L., Flor, L. S., Foigt, N. A., Folayan, M. O., Fomenkov, A. A., Force, L. M., Foroutan, M., Franklin, R. C., Freitas, M., Fu, W., Fukumoto, T., Furtado, J. M., Gad, M. M., Gakidou, E., Gallus, S., Garcia-Basteiro, A. L., Gardner, W. M., Geberemariyam, B. S., Gebreslassie, A. A. A. A., Geremew, A., Gershberg Hayoon, A., Gething, P. W., Ghadimi, M., Ghadiri, K., Ghaffarifar, F., Ghafourifard, M., Ghamari, F., Ghashghaee, A., Ghiasvand, H., Ghith, N., Gholamian, A., Ghosh, R., Gill, P. S., Ginindza, T. G. G., Giussani, G., Gnedovskaya, E. V., Goharinezhad, S., Gopalani, S. V., Gorini, G., Goudarzi, H., Goulart, A. C., Greaves, F., Grivna, M., Grosso, G., Gubari, M. I. M., Gugnani, H. C., Guimaraes, R. A., Guled, R. A., Guo, G., Guo, Y., Gupta, R., Gupta, T., Haddock, B., Hafezi-Nejad, N., Hafiz, A., Haj-Mirzaian, A., Hall, B. J., Halvaei, I., Hamadeh, R. R., Hamidi, S., Hammer, M. S., Hankey, G. J., Haririan, H., Haro, J. M., Hasaballah, A. I., Hasan, M. M., Hasanpoor, E., Hashi, A., Hassanipour, S., Hassankhani, H., Havmoeller, R. J., Hay, S. I., Hayat, K., Heidari, G., Heidari-Soureshjani, R., Henrikson, H. J., Herbert, M. E., Herteliu, C., Heydarpour, F., Hird, T. R., Hoek, H. W., Holla, R., Hoogar, P., Hosgood, H. D., Hossain, N., Hosseini, M., Hosseinzadeh, M., Hostiuc, M., Hostiuc, S., Househ, M., Hsairi, M., Hsieh, V. C. -R., Hu, G., Hu, K., Huda, T. M., Humayun, A., Huynh, C. K., Hwang, B. -F., Iannucci, V. C., Ibitoye, S. E., Ikeda, N., Ikuta, K. S., Ilesanmi, O. S., Ilic, I. M., Ilic, M. D., Inbaraj, L. R., Ippolito, H., Iqbal, U., Irvani, S. S. N., Irvine, C. M. S., Islam, M. M., Islam, S. M. S., Iso, H., Ivers, R. Q., Iwu, C. C. D., Iwu, C. J., Iyamu, I. O., Jaafari, J., Jacobsen, K. H., Jafari, H., Jafarinia, M., Jahani, M. A., Jakovljevic, M., Jalilian, F., James, S. L., Janjani, H., Javaheri, T., Javidnia, J., Jeemon, P., Jenabi, E., Jha, R. P., Jha, V., Ji, J. S., Johansson, L., John, O., John-Akinola, Y. O., Johnson, C. O., Jonas, J. B., Joukar, F., Jozwiak, J. J., Jurisson, M., Kabir, A., Kabir, Z., Kalani, H., Kalani, R., Kalankesh, L. R., Kalhor, R., Kanchan, T., Kapoor, N., Karami Matin, B., Karch, A., Karim, M. A., Kassa, G. M., Katikireddi, S. V., Kayode, G. A., Kazemi Karyani, A., Keiyoro, P. N., Keller, C., Kemmer, L., Kendrick, P. J., Khalid, N., Khammarnia, M., Khan, E. A., Khan, M., Khatab, K., Khater, M. M., Khatib, M. N., Khayamzadeh, M., Khazaei, S., Kieling, C., Kim, Y. J., Kimokoti, R. W., Kisa, A., Kisa, S., Kivimaki, M., Knibbs, L. D., Knudsen, A. K. S., Kocarnik, J. M., Kochhar, S., Kopec, J. A., Korshunov, V. A., Koul, P. A., Koyanagi, A., Kraemer, M. U. G., Krishan, K., Krohn, K. J., Kromhout, H., Kuate Defo, B., Kumar, G. A., Kumar, V., Kurmi, O. P., Kusuma, D., La Vecchia, C., Lacey, B., Lal, D. K., Lalloo, R., Lallukka, T., Lami, F. H., Landires, I., Lang, J. J., Langan, S. M., Larsson, A. O., Lasrado, S., Lauriola, P., Lazarus, J. V., Lee, P. H., Lee, S. W. H., Legrand, K. E., Leigh, J., Leonardi, M., Lescinsky, H., Leung, J., Levi, M., Li, S., Lim, L. -L., Linn, S., Liu, S., Liu, Y., Lo, J., Lopez, A. D., Lopez, J. C. F., Lopukhov, P. D., Lorkowski, S., Lotufo, P. A., Lu, A., Lugo, A., Maddison, E. R., Mahasha, P. W., Mahdavi, M. M., Mahmoudi, M., Majeed, A., Maleki, A., Maleki, S., Malekzadeh, R., Malta, D. C., Mamun, A. A., Manda, A. L., Manguerra, H., Mansour-Ghanaei, F., Mansouri, B., Mansournia, M. A., Mantilla Herrera, A. M., Maravilla, J. C., Marks, A., Martin, R. V., Martini, S., Martins-Melo, F. R., Masaka, A., Masoumi, S. Z., Mathur, M. R., Matsushita, K., Maulik, P. K., Mcalinden, C., Mcgrath, J. J., Mckee, M., Mehndiratta, M. M., Mehri, F., Mehta, K. M., Memish, Z. A., Mendoza, W., Menezes, R. G., Mengesha, E. W., Mereke, A., Mereta, S. T., Meretoja, A., Meretoja, T. J., Mestrovic, T., Miazgowski, B., Miazgowski, T., Michalek, I. M., Miller, T. R., Mills, E. J., Mini, G. K., Miri, M., Mirica, A., Mirrakhimov, E. M., Mirzaei, H., Mirzaei, M., Mirzaei, R., Mirzaei-Alavijeh, M., Misganaw, A. T., Mithra, P., Moazen, B., Mohammad, D. K., Mohammad, Y., Mohammad Gholi Mezerji, N., Mohammadian-Hafshejani, A., Mohammadifard, N., Mohammadpourhodki, R., Mohammed, A. S., Mohammed, H., Mohammed, J. A., Mohammed, S., Mokdad, A. H., Molokhia, M., Monasta, L., Mooney, M. D., Moradi, G., Moradi, M., Moradi-Lakeh, M., Moradzadeh, R., Moraga, P., Morawska, L., Morgado-da-Costa, J., Morrison, S. D., Mosapour, A., Mosser, J. F., Mouodi, S., Mousavi, S. M., Mousavi Khaneghah, A., Mueller, U. O., Mukhopadhyay, S., Mullany, E. C., Musa, K. I., Muthupandian, S., Nabhan, A. F., Naderi, M., Nagarajan, A. J., Nagel, G., Naghavi, M., Naghshtabrizi, B., Naimzada, M. D., Najafi, F., Nangia, V., Nansseu, J. R., Naserbakht, M., Nayak, V. C., Negoi, I., Ngunjiri, J. W., Nguyen, C. T., Nguyen, H. L. T., Nguyen, M., Nigatu, Y. T., Nikbakhsh, R., Nixon, M. R., Nnaji, C. A., Nomura, S., Norrving, B., Noubiap, J. J., Nowak, C., Nunez-Samudio, V., Otoiu, A., Oancea, B., Odell, C. M., Ogbo, F. A., Oh, I. -H., Okunga, E. W., Oladnabi, M., Olagunju, A. T., Olusanya, B. O., Olusanya, J. O., Omer, M. O., Ong, K. L., Onwujekwe, O. E., Orpana, H. M., Ortiz, A., Osarenotor, O., Osei, F. B., Ostroff, S. M., Otstavnov, N., Otstavnov, S. S., Overland, S., Owolabi, M. O., P A, M., Padubidri, J. R., Palladino, R., Panda-Jonas, S., Pandey, A., Parry, C. D. H., Pasovic, M., Pasupula, D. K., Patel, S. K., Pathak, M., Patten, S. B., Patton, G. C., Pazoki Toroudi, H., Peden, A. E., Pennini, A., Pepito, V. C. F., Peprah, E. K., Pereira, D. M., Pesudovs, K., Pham, H. Q., Phillips, M. R., Piccinelli, C., Pilz, T. M., Piradov, M. A., Pirsaheb, M., Plass, D., Polinder, S., Polkinghorne, K. R., Pond, C. D., Postma, M. J., Pourjafar, H., Pourmalek, F., Poznanska, A., Prada, S. I., Prakash, V., Pribadi, D. R. A., Pupillo, E., Quazi Syed, Z., Rabiee, M., Rabiee, N., Radfar, A., Rafiee, A., Raggi, A., Rahman, M. A., Rajabpour-Sanati, A., Rajati, F., Rakovac, I., Ram, P., Ramezanzadeh, K., Ranabhat, C. L., Rao, P. C., Rao, S. J., Rashedi, V., Rathi, P., Rawaf, D. L., Rawaf, S., Rawal, L., Rawassizadeh, R., Rawat, R., Razo, C., Redford, S. B., Reiner, R. C., Reitsma, M. B., Remuzzi, G., Renjith, V., Renzaho, A. M. N., Resnikoff, S., Rezaei, N., Rezapour, A., Rhinehart, P. -A., Riahi, S. M., Ribeiro, D. C., Ribeiro, D., Rickard, J., Rivera, J. A., Roberts, N. L. S., Rodriguez-Ramirez, S., Roever, L., Ronfani, L., Room, R., Roshandel, G., Roth, G. A., Rothenbacher, D., Rubagotti, E., Rwegerera, G. M., Sabour, S., Sachdev, P. S., Saddik, B., Sadeghi, E., Sadeghi, M., Saeedi, R., Saeedi Moghaddam, S., Safari, Y., Safi, S., Safiri, S., Sagar, R., Sahebkar, A., Sajadi, S. M., Salam, N., Salamati, P., Salem, H., Salem, M. R. R., Salimzadeh, H., Salman, O. M., Salomon, J. A., Samad, Z., Samadi Kafil, H., Sambala, E. Z., Samy, A. M., Sanabria, J., Sanchez-Pimienta, T. G., Santomauro, D. F., Santos, I. S., Santos, J. V., Santric-Milicevic, M. M., Saraswathy, S. Y. I., Sarmiento-Suarez, R., Sarrafzadegan, N., Sartorius, B., Sarveazad, A., Sathian, B., Sathish, T., Sattin, D., Saxena, S., Schaeffer, L. E., Schiavolin, S., Schlaich, M. P., Schmidt, M. I., Schutte, A. E., Schwebel, D. C., Schwendicke, F., Senbeta, A. M., Senthilkumaran, S., Sepanlou, S. G., Serdar, B., Serre, M. L., Shadid, J., Shafaat, O., Shahabi, S., Shaheen, A. A., Shaikh, M. A., Shalash, A. S., Shams-Beyranvand, M., Shamsizadeh, M., Sharafi, K., Sheikh, A., Sheikhtaheri, A., Shibuya, K., Shield, K. D., Shigematsu, M., Shin, J. I., Shin, M. -J., Shiri, R., Shirkoohi, R., Shuval, K., Siabani, S., Sierpinski, R., Sigfusdottir, I. D., Sigurvinsdottir, R., Silva, J. P., Simpson, K. E., Singh, J. A., Singh, P., Skiadaresi, E., Skou, S. T. S., Skryabin, V. Y., Smith, E. U. R., Soheili, A., Soltani, S., Soofi, M., Sorensen, R. J. D., Soriano, J. B., Sorrie, M. B., Soshnikov, S., Soyiri, I. N., Spencer, C. N., Spotin, A., Sreeramareddy, C. T., Srinivasan, V., Stanaway, J. D., Stein, C., Stein, D. J., Steiner, C., Stockfelt, L., Stokes, M. A., Straif, K., Stubbs, J. L., Sufiyan, M. B., Suleria, H. A. R., Suliankatchi Abdulkader, R., Sulo, G., Sultan, I., Szumowski, Tabares-Seisdedos, R., Tabb, K. M., Tabuchi, T., Taherkhani, A., Tajdini, M., Takahashi, K., Takala, J. S., Tamiru, A. T., Taveira, N., Tehrani-Banihashemi, A., Temsah, M. -H., Tesema, G. A., Tessema, Z. T., Thurston, G. D., Titova, M. V., Tohidinik, H. R., Tonelli, M., Topor-Madry, R., Topouzis, F., Torre, A. E., Touvier, M., Tovani-Palone, M. R. R., Tran, B. X., Travillian, R., Tsatsakis, A., Tudor Car, L., Tyrovolas, S., Uddin, R., Umeokonkwo, C. D., Unnikrishnan, B., Upadhyay, E., Vacante, M., Valdez, P. R., van Donkelaar, A., Vasankari, T. J., Vasseghian, Y., Veisani, Y., Venketasubramanian, N., Violante, F. S., Vlassov, V., Vollset, S. E., Vos, T., Vukovic, R., Waheed, Y., Wallin, M. T., Wang, Y., Wang, Y. -P., Watson, A., Wei, J., Wei, M. Y. W., Weintraub, R. G., Weiss, J., Werdecker, A., West, J. J., Westerman, R., Whisnant, J. L., Whiteford, H. A., Wiens, K. E., Wolfe, C. D. A., Wozniak, S. S., Wu, A. -M., Wu, J., Wulf Hanson, S., Xu, G., Xu, R., Yadgir, S., Yahyazadeh Jabbari, S. H., Yamagishi, K., Yaminfirooz, M., Yano, Y., Yaya, S., Yazdi-Feyzabadi, V., Yeheyis, T. Y., Yilgwan, C. S., Yilma, M. T., Yip, P., Yonemoto, N., Younis, M. Z., Younker, T. P., Yousefi, B., Yousefi, Z., Yousefinezhadi, T., Yousuf, A. Y., Yu, C., Yusefzadeh, H., Zahirian Moghadam, T., Zamani, M., Zamanian, M., Zandian, H., Zastrozhin, M. S., Zhang, Y., Zhang, Z. -J., Zhao, J. T., Zhao, X. -J. G., Zhao, Y., Zhou, M., Ziapour, A., Zimsen, S. R. M., Brauer, M., Afshin, A., Lim, S. S., Lacey, B, Sartorius, B, Abbafati, C, Abbas, K, Abbasi-Kangevari, M, Abd-Allah, F, Abdelalim, A, Abdollahi, M, Abdollahpour, I, Abegaz, K, Abolhassani, H, Aboyans, V, Abreu, L, Abrigo, M, Abualhasan, A, Abu-Raddad, L, Abushouk, A, Adabi, M, Adekanmbi, V, Adeoye, A, Adetokunboh, O, Adham, D, Advani, S, Afshin, A, Agarwal, G, Aghamir, S, Agrawal, A, Ahmad, T, Ahmadi, K, Ahmadi, M, Ahmadieh, H, Ahmed, M, Akalu, T, Akinyemi, R, Akinyemiju, T, Akombi, B, Akunna, C, Alahdab, F, Al-Aly, Z, Alam, K, Alam, S, Alam, T, Alanezi, F, Alanzi, T, Alemu, B, Alhabib, K, Ali, M, Ali, S, Alicandro, G, Alinia, C, Alipour, V, Alizade, H, Aljunid, S, Alla, F, Allebeck, P, Almasi-Hashiani, A, Al-Mekhlafi, H, Alonso, J, Altirkawi, K, Amini-Rarani, M, Amiri, F, Amugsi, D, Ancuceanu, R, Anderlini, D, Anderson, J, Andrei, C, Andrei, T, Angus, C, Anjomshoa, M, Ansari, F, Ansari-Moghaddam, A, Antonazzo, I, Antonio, C, Antony, C, Antriyandarti, E, Anvari, D, Anwer, R, Appiah, S, Arabloo, J, Arab-Zozani, M, Aravkin, A, Ariani, F, Armoon, B, Arnlov, J, Arzani, A, Asadi-Aliabadi, M, Asadi-Pooya, A, Ashbaugh, C, Assmus, M, Atafar, Z, Atnafu, D, Atout, M, Ausloos, F, Ausloos, M, Ayala Quintanilla, B, Ayano, G, Ayanore, M, Azari, S, Azarian, G, Azene, Z, Badawi, A, Badiye, A, Bahrami, M, Bakhshaei, M, Bakhtiari, A, Bakkannavar, S, Baldasseroni, A, Ball, K, Ballew, S, Balzi, D, Banach, M, Banerjee, S, Bante, A, Baraki, A, Barker-Collo, S, Barnighausen, T, Barrero, L, Barthelemy, C, Barua, L, Basu, S, Baune, B, Bayati, M, Becker, J, Bedi, N, Beghi, E, Bejot, Y, Bell, M, Bennitt, F, Bensenor, I, Berhe, K, Berman, A, Bhagavathula, A, Bhageerathy, R, Bhala, N, Bhandari, D, Bhattacharyya, K, Bhutta, Z, Bijani, A, Bikbov, B, Bin Sayeed, M, Biondi, A, Birihane, B, Bisignano, C, Biswas, R, Bitew, H, Bohlouli, S, Bohluli, M, Boon-Dooley, A, Borges, G, Borzi, A, Borzouei, S, Bosetti, C, Boufous, S, Braithwaite, D, Brauer, M, Breitborde, N, Breitner, S, Brenner, H, Briant, P, Briko, A, Briko, N, Britton, G, Bryazka, D, Bumgarner, B, Burkart, K, Burnett, R, Burugina Nagaraja, S, Butt, Z, Caetano Dos Santos, F, Cahill, L, Camera, L, Campos-Nonato, I, Cardenas, R, Carreras, G, Carrero, J, Carvalho, F, Castaldelli-Maia, J, Castaneda-Orjuela, C, Castelpietra, G, Castro, F, Causey, K, Cederroth, C, Cercy, K, Cerin, E, Chandan, J, Chang, K, Charlson, F, Chattu, V, Chaturvedi, S, Cherbuin, N, Chimed-Ochir, O, Cho, D, Choi, J, Christensen, H, Chu, D, Chung, M, Chung, S, Cicuttini, F, Ciobanu, L, Cirillo, M, Classen, T, Cohen, A, Compton, K, Cooper, O, Costa, V, Cousin, E, Cowden, R, Cross, D, Cruz, J, Dahlawi, S, Damasceno, A, Damiani, G, Dandona, L, Dandona, R, Dangel, W, Danielsson, A, Dargan, P, Darwesh, A, Daryani, A, Das, J, Das Gupta, R, das Neves, J, Davila-Cervantes, C, Davitoiu, D, De Leo, D, Degenhardt, L, Delang, M, Dellavalle, R, Demeke, F, Demoz, G, Demsie, D, Denova-Gutierrez, E, Dervenis, N, Dhungana, G, Dianatinasab, M, Dias da Silva, D, Diaz, D, Dibaji Forooshani, Z, Djalalinia, S, Do, H, Dokova, K, Dorostkar, F, Doshmangir, L, Driscoll, T, Duncan, B, Duraes, A, Eagan, A, Edvardsson, D, El Nahas, N, El Sayed, I, El Tantawi, M, Elbarazi, I, Elgendy, I, El-Jaafary, S, Elyazar, I, Emmons-Bell, S, Erskine, H, Eskandarieh, S, Esmaeilnejad, S, Esteghamati, A, Estep, K, Etemadi, A, Etisso, A, Fanzo, J, Farahmand, M, Fareed, M, Faridnia, R, Farioli, A, Faro, A, Faruque, M, Farzadfar, F, Fattahi, N, Fazlzadeh, M, Feigin, V, Feldman, R, Fereshtehnejad, S, Fernandes, E, Ferrara, G, Ferrari, A, Ferreira, M, Filip, I, Fischer, F, Fisher, J, Flor, L, Foigt, N, Folayan, M, Fomenkov, A, Force, L, Foroutan, M, Franklin, R, Freitas, M, Fu, W, Fukumoto, T, Furtado, J, Gad, M, Gakidou, E, Gallus, S, Garcia-Basteiro, A, Gardner, W, Geberemariyam, B, Ayalew Gebreslassie, A, Geremew, A, Gershberg Hayoon, A, Gething, P, Ghadimi, M, Ghadiri, K, Ghaffarifar, F, Ghafourifard, M, Ghamari, F, Ghashghaee, A, Ghiasvand, H, Ghith, N, Gholamian, A, Ghosh, R, Gill, P, Ginindza, T, Giussani, G, Gnedovskaya, E, Goharinezhad, S, Gopalani, S, Gorini, G, Goudarzi, H, Goulart, A, Greaves, F, Grivna, M, Grosso, G, Gubari, M, Gugnani, H, Guimaraes, R, Guled, R, Guo, G, Guo, Y, Gupta, R, Gupta, T, Haddock, B, Hafezi-Nejad, N, Hafiz, A, Haj-Mirzaian, A, Hall, B, Halvaei, I, Hamadeh, R, Hamidi, S, Hammer, M, Hankey, G, Haririan, H, Haro, J, Hasaballah, A, Hasan, M, Hasanpoor, E, Hashi, A, Hassanipour, S, Hassankhani, H, Havmoeller, R, Hay, S, Hayat, K, Heidari, G, Heidari-Soureshjani, R, Henrikson, H, Herbert, M, Herteliu, C, Heydarpour, F, Hird, T, Hoek, H, Holla, R, Hoogar, P, Hosgood, H, Hossain, N, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Hsairi, M, Hsieh, V, Hu, G, Hu, K, Huda, T, Humayun, A, Huynh, C, Hwang, B, Iannucci, V, Ibitoye, S, Ikeda, N, Ikuta, K, Ilesanmi, O, Ilic, I, Ilic, M, Inbaraj, L, Ippolito, H, Iqbal, U, Irvani, S, Irvine, C, Islam, M, Islam, S, Iso, H, Ivers, R, Iwu, C, Iyamu, I, Jaafari, J, Jacobsen, K, Jafari, H, Jafarinia, M, Jahani, M, Jakovljevic, M, Jalilian, F, James, S, Janjani, H, Javaheri, T, Javidnia, J, Jeemon, P, Jenabi, E, Jha, R, Jha, V, Ji, J, Johansson, L, John, O, John-Akinola, Y, Johnson, C, Jonas, J, Joukar, F, Jozwiak, J, Jurisson, M, Kabir, A, Kabir, Z, Kalani, H, Kalani, R, Kalankesh, L, Kalhor, R, Kanchan, T, Kapoor, N, Matin, B, Karch, A, Karim, M, Kassa, G, Katikireddi, S, Kayode, G, Kazemi Karyani, A, Keiyoro, P, Keller, C, Kemmer, L, Kendrick, P, Khalid, N, Khammarnia, M, Khan, E, Khan, M, Khatab, K, Khater, M, Khatib, M, Khayamzadeh, M, Khazaei, S, Kieling, C, Kim, Y, Kimokoti, R, Kisa, A, Kisa, S, Kivimaki, M, Knibbs, L, Knudsen, A, Kocarnik, J, Kochhar, S, Kopec, J, Korshunov, V, Koul, P, Koyanagi, A, Kraemer, M, Krishan, K, Krohn, K, Kromhout, H, Kuate Defo, B, Kumar, G, Kumar, V, Kurmi, O, Kusuma, D, La Vecchia, C, Lal, D, Lalloo, R, Lallukka, T, Lami, F, Landires, I, Lang, J, Langan, S, Larsson, A, Lasrado, S, Lauriola, P, Lazarus, J, Lee, P, Lee, S, Legrand, K, Leigh, J, Leonardi, M, Lescinsky, H, Leung, J, Levi, M, Li, S, Lim, L, Linn, S, Liu, S, Liu, Y, Lo, J, Lopez, A, Lopez, J, Lopukhov, P, Lorkowski, S, Lotufo, P, Lu, A, Lugo, A, Maddison, E, Mahasha, P, Mahdavi, M, Mahmoudi, M, Majeed, A, Maleki, A, Maleki, S, Malekzadeh, R, Malta, D, Mamun, A, Manda, A, Manguerra, H, Mansour-Ghanaei, F, Mansouri, B, Mansournia, M, Mantilla Herrera, A, Maravilla, J, Marks, A, Martin, R, Martini, S, Martins-Melo, F, Masaka, A, Masoumi, S, Mathur, M, Matsushita, K, Maulik, P, Mcalinden, C, Mcgrath, J, Mckee, M, Mehndiratta, M, Mehri, F, Mehta, K, Memish, Z, Mendoza, W, Menezes, R, Mengesha, E, Mereke, A, Mereta, S, Meretoja, A, Meretoja, T, Mestrovic, T, Miazgowski, B, Miazgowski, T, Michalek, I, Miller, T, Mills, E, Mini, G, Miri, M, Mirica, A, Mirrakhimov, E, Mirzaei, H, Mirzaei, M, Mirzaei, R, Mirzaei-Alavijeh, M, Misganaw, A, Mithra, P, Moazen, B, Mohammad, D, Mohammad, Y, Mohammad Gholi Mezerji, N, Mohammadian-Hafshejani, A, Mohammadifard, N, Mohammadpourhodki, R, Mohammed, A, Mohammed, H, Mohammed, J, Mohammed, S, Mokdad, A, Molokhia, M, Monasta, L, Mooney, M, Moradi, G, Moradi, M, Moradi-Lakeh, M, Moradzadeh, R, Moraga, P, Morawska, L, Morgado-Da-Costa, J, Morrison, S, Mosapour, A, Mosser, J, Mouodi, S, Mousavi, S, Khaneghah, A, Mueller, U, Mukhopadhyay, S, Mullany, E, Musa, K, Muthupandian, S, Nabhan, A, Naderi, M, Nagarajan, A, Nagel, G, Naghavi, M, Naghshtabrizi, B, Naimzada, M, Najafi, F, Nangia, V, Nansseu, J, Naserbakht, M, Nayak, V, Negoi, I, Ngunjiri, J, Nguyen, C, Nguyen, H, Nguyen, M, Nigatu, Y, Nikbakhsh, R, Nixon, M, Nnaji, C, Nomura, S, Norrving, B, Noubiap, J, Nowak, C, Nunez-Samudio, V, Oancea, B, Odell, C, Ogbo, F, Oh, I, Okunga, E, Oladnabi, M, Olagunju, A, Olusanya, B, Olusanya, J, Omer, M, Ong, K, Onwujekwe, O, Orpana, H, Ortiz, A, Osarenotor, O, Osei, F, Ostroff, S, Otoiu, A, Otstavnov, N, Otstavnov, S, Overland, S, Owolabi, M, Mahesh, P, Padubidri, J, Palladino, R, Panda-Jonas, S, Pandey, A, Parry, C, Pasovic, M, Pasupula, D, Patel, S, Pathak, M, Patten, S, Patton, G, Toroudi, H, Peden, A, Pennini, A, Pepito, V, Peprah, E, Pereira, D, Pesudovs, K, Pham, H, Phillips, M, Piccinelli, C, Pilz, T, Piradov, M, Pirsaheb, M, Plass, D, Polinder, S, Polkinghorne, K, Pond, C, Postma, M, Pourjafar, H, Pourmalek, F, Poznanska, A, Prada, S, Prakash, V, Pribadi, D, Pupillo, E, Syed, Z, Rabiee, M, Rabiee, N, Radfar, A, Rafiee, A, Raggi, A, Rahman, M, Rajabpour-Sanati, A, Rajati, F, Rakovac, I, Ram, P, Ramezanzadeh, K, Ranabhat, C, Rao, P, Rao, S, Rashedi, V, Rathi, P, Rawaf, D, Rawaf, S, Rawal, L, Rawassizadeh, R, Rawat, R, Razo, C, Redford, S, Reiner, R, Reitsma, M, Remuzzi, G, Renjith, V, Renzaho, A, Resnikoff, S, Rezaei, N, Rezapour, A, Rhinehart, P, Riahi, S, Ribeiro, D, Rickard, J, Rivera, J, Roberts, N, Rodriguez-Ramirez, S, Roever, L, Ronfani, L, Room, R, Roshandel, G, Roth, G, Rothenbacher, D, Rubagotti, E, Rwegerera, G, Sabour, S, Sachdev, P, Saddik, B, Sadeghi, E, Sadeghi, M, Saeedi, R, Saeedi Moghaddam, S, Safari, Y, Safi, S, Safiri, S, Sagar, R, Sahebkar, A, Sajadi, S, Salam, N, Salamati, P, Salem, H, Salem, M, Salimzadeh, H, Salman, O, Salomon, J, Samad, Z, Samadi Kafil, H, Sambala, E, Samy, A, Sanabria, J, Sanchez-Pimienta, T, Santomauro, D, Santos, I, Santos, J, Santric-Milicevic, M, Saraswathy, S, Sarmiento-Suarez, R, Sarrafzadegan, N, Sarveazad, A, Sathian, B, Sathish, T, Sattin, D, Saxena, S, Schaeffer, L, Schiavolin, S, Schlaich, M, Schmidt, M, Schutte, A, Schwebel, D, Schwendicke, F, Senbeta, A, Senthilkumaran, S, Sepanlou, S, Serdar, B, Serre, M, Shadid, J, Shafaat, O, Shahabi, S, Shaheen, A, Shaikh, M, Shalash, A, Shams-Beyranvand, M, Shamsizadeh, M, Sharafi, K, Sheikh, A, Sheikhtaheri, A, Shibuya, K, Shield, K, Shigematsu, M, Shin, J, Shin, M, Shiri, R, Shirkoohi, R, Shuval, K, Siabani, S, Sierpinski, R, Sigfusdottir, I, Sigurvinsdottir, R, Silva, J, Simpson, K, Singh, J, Singh, P, Skiadaresi, E, Skou, S, Skryabin, V, Smith, E, Soheili, A, Soltani, S, Soofi, M, Sorensen, R, Soriano, J, Sorrie, M, Soshnikov, S, Soyiri, I, Spencer, C, Spotin, A, Sreeramareddy, C, Srinivasan, V, Stanaway, J, Stein, C, Stein, D, Steiner, C, Stockfelt, L, Stokes, M, Straif, K, Stubbs, J, Sufiyan, M, Suleria, H, Suliankatchi Abdulkader, R, Sulo, G, Sultan, I, Tabares-Seisdedos, R, Tabb, K, Tabuchi, T, Taherkhani, A, Tajdini, M, Takahashi, K, Takala, J, Tamiru, A, Taveira, N, Tehrani-Banihashemi, A, Temsah, M, Tesema, G, Tessema, Z, Thurston, G, Titova, M, Tohidinik, H, Tonelli, M, Topor-Madry, R, Topouzis, F, Torre, A, Touvier, M, Tovani-Palone, M, Tran, B, Travillian, R, Tsatsakis, A, Tudor Car, L, Tyrovolas, S, Uddin, R, Umeokonkwo, C, Unnikrishnan, B, Upadhyay, E, Vacante, M, Valdez, P, van Donkelaar, A, Vasankari, T, Vasseghian, Y, Veisani, Y, Venketasubramanian, N, Violante, F, Vlassov, V, Vollset, S, Vos, T, Vukovic, R, Waheed, Y, Wallin, M, Wang, Y, Watson, A, Wei, J, Wei, M, Weintraub, R, Weiss, J, Werdecker, A, West, J, Westerman, R, Whisnant, J, Whiteford, H, Wiens, K, Wolfe, C, Wozniak, S, Wu, A, Wu, J, Wulf Hanson, S, Xu, G, Xu, R, Yadgir, S, Yahyazadeh Jabbari, S, Yamagishi, K, Yaminfirooz, M, Yano, Y, Yaya, S, Yazdi-Feyzabadi, V, Yeheyis, T, Yilgwan, C, Yilma, M, Yip, P, Yonemoto, N, Younis, M, Younker, T, Yousefi, B, Yousefi, Z, Yousefinezhadi, T, Yousuf, A, Yu, C, Yusefzadeh, H, Moghadam, T, Zamani, M, Zamanian, M, Zandian, H, Zastrozhin, M, Zhang, Y, Zhang, Z, Zhao, J, Zhao, X, Zhao, Y, Zheng, P, Zhou, M, Ziapour, A, Zimsen, S, Lim, S, Murray, C, GBD 2019 Risk Factors Collaborator, Violante FS, Biosciences, Department of Public Health, Clinicum, Department of Neurosciences, HUS Comprehensive Cancer Center, Environmental Sciences, Sub Foundations&PhilosophyofNaturSc begr, IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Public Health, Bin Sayeed, M. S. B., Caetano Dos Santos, F. L., Camera, L. A., Elyazar, I. R. F., Ayalew Gebreslassie, A. A. A., Ginindza, T. G., Matin, B. K., Morgado-Da-Costa, J., Khaneghah, A. M., Mahesh, P. A., Toroudi, H. P., Syed, Z. Q., Salem, M. R., Skou, S. T., Tovani-Palone, M. R., Tudor Car, L. T., and Moghadam, T. Z.

Subjects
Male, Nutritional Sciences, Specific risk, Contaminación del Aire Interior, 030204 cardiovascular system & hematology, Socioeconomic Factor, systematic analysis, Global Health, Body Mass Index, Global Burden of Disease, Health Risk Behavior, Health Risk Behaviors, Disease studies, 0302 clinical medicine, Risk Factors, METABOLIC RISKS, 030212 general & internal medicine, 11 Medical and Health Sciences, Factores de Riesgo, 2. Zero hunger, education.field_of_study, Public health, Injuries, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, GBD, risck factors, attributable burden of disease, 3142 Public health care science, environmental and occupational health, 3. Good health, Relative risk, Environmental health, Health, Hypertension, Global Burden of Diseases, Injuries, Risk Factors, A990 Medicine and Dentistry not elsewhere classified, Female, Leading risk factors, Global Health Metrics, Cohort study, Human, medicine.medical_specialty, Substance-Related Disorders, Population, UNITED-STATES, Risk Assessment, DIET, ITC-HYBRID, 03 medical and health sciences, Life Expectancy, MORTALITY, DISABILITY, POLLUTION, CLUSTERS, SDG 3 - Good Health and Well-being, General & Internal Medicine, medicine, Humans, Global Burden of Disease Study, Risk factor, education, Global burden, business.industry, Risk Factor, Malnutrition, Klinisk medicin, Global Burden of Diseases, Environmental Exposure, medicine.disease, Enfermedades, purl.org/pe-repo/ocde/ford#3.02.00 [https], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Years of potential life lost, Socioeconomic Factors, Risk factors, Disease study, Hyperglycemia, ITC-ISI-JOURNAL-ARTICLE, NA, Clinical Medicine, business, RA
Abstract

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. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.

Published
2020

31. Life loss of cardiovascular diseases per death attributable to ambient temperature: A national time series analysis based on 364 locations in China

Author

Maigeng Zhou, Jianpeng Xiao, Ruying Hu, Weiwei Gong, Siqi Chen, Guanhao He, Lifeng Lin, Biao Huang, Lingchuan Guo, Zhulin Hou, Mingfang Qin, Tao Liu, Yize Xiao, Weilin Zeng, Xiaojun Xu, Wenjun Ma, Chunliang Zhou, Xing Li, Qinglong Zhao, Jianxiong Hu, Donghui Jin, Cunrui Huang, Yanjun Xu, Yiqing Xu, Junhua Li, Min Yu, and Peng Yin

Subjects
Male, China, Environmental Engineering, Hot Temperature, 010504 meteorology & atmospheric sciences, Population, Central china, 010501 environmental sciences, Temperature a, 01 natural sciences, medicine, Environmental Chemistry, Humans, education, Waste Management and Disposal, Stroke, 0105 earth and related environmental sciences, education.field_of_study, business.industry, Temperature, medicine.disease, Pollution, Cold Temperature, Premature death, Years of potential life lost, Cardiovascular Diseases, Nonlinear model, business, Demography
Abstract

Background Although the effect of ambient temperature on cardiovascular disease (CVDs) has been well explored, studies using years of life lost (YLLs) as the outcome especially evaluating the average life loss per death attributable to temperatures were rare. We examine the associations between ambient temperature and YLLs of CVDs, and further quantify temperature-related life loss per death. Methods Daily YLL rates were calculated using death data from 364 locations across China during 2006–2017, and meteorological data were collected for the same period. A distributed-lag nonlinear model and meta-regression were applied to examine the relationships between temperature and YLL rates of CVDs. Subgroup analyses by age, gender, region, and cause-specific CVDs were investigated. The total YLLs and average YLLs per death attributable to temperature were further quantified to assess life loss caused by non-optimal temperature. Results Both high and low temperatures significantly increased YLL rates of CVDs, with greater effects for cold than heat. Cerebrovascular diseases (CEDs) account for the largest proportion (47.17%) of total YLLs of CVDs attributable to non-optimal temperature. On average, life loss per CVD death attributable to non-optimal temperatures was 1.51 (95% eCI: 1.33, 1.69) years, with 1.07 (95% eCI: 1.00, 1.15) years from moderate cold. Average life losses per death were observed higher for males (1.71, 95% eCI: 1.43, 1.99), younger population (3.82, 95% eCI: 2.86, 4.75), central China (1.62; 95% eCI: 1.41, 1.83) and hemorrhagic stroke (2.86, 95% eCI: 2.63, 3.10) than their correspondents. Conclusions We found that non-optimal temperature significantly aggravated premature death of CVD, with CEDs being the most affected, and most of temperature-related life loss of CVD was attributed to moderate cold. Our findings imply that peoples with CEDs in moderate cold days are vulnerable populations, which may contribute to a better understanding the adverse effects and pathogenesis of temperature on CVDs.

Published
2020

32. Physical behaviors of 12-15 year-old adolescents in 54 low- and middle-income countries: Results from the Global School-based Student Health Survey

Author

Guodong Xu, Maigeng Zhou, Wanfu Qi, Ning Sun, Liyuan Han, Changwei Li, Zhu Chen, and Lian Li

Subjects
Male, Adolescent, 030231 tropical medicine, Poison control, Global Health, Occupational safety and health, 03 medical and health sciences, 0302 clinical medicine, Injury prevention, Medicine, Humans, 030212 general & internal medicine, Child, Students, Developing Countries, Exercise, Schools, business.industry, Health Policy, Public Health, Environmental and Occupational Health, Articles, Health Surveys, Confidence interval, Eastern mediterranean, Low and middle income countries, Adolescent Behavior, Health survey, School based, Female, business, Demography
Abstract

Background To describe and compare the separate and combined prevalence of physical activity, active transportation, physical education, and sedentary behavior among adolescents 12-15 year-olds in low- and middle-income countries (LMICs). Methods We used the latest data from the Global School-based Student Health Survey (GSHS), which collect data on the physical behaviors of young adolescents in LMICs. The weighted prevalence and 95% confidence intervals of separate, combined and all of the qualifying physical behaviors were calculated. Pooled overall and regional estimates were calculated using a random effects model. Results In total, 154 559 young adolescents (45.90% boys) aged 12-15 from 54 countries covered in the GSHS were included in our analysis. Only 0.7% (95% confidence interval (CI) = 0.5%-1.0%) of the adolescents, comprising 0.9% (95% CI = 0.6%-1.3%) of the boys and 0.5% (95% CI = 0.3%-0.7%) of the girls, displayed all of the qualifying physical behaviors. The overall prevalence of physical activity, active transportation, physical education, and sedentary behavior was 15.2% (95% CI = 13.7%-16.7%), 39.5% (95% CI = 34.9%-44.0%), 18.8% (95% CI = 16.1%-21.5%), and 34.6% (95% CI = 28.4%-40.7%), respectively. The overall prevalence of high levels of combined physical behaviors was 6.6% (95% CI = 5.4%-7.8%), with lowest in the Eastern Mediterranean region (4.9%, 95% CI = 3.5%-6.2%) and highest in Southeast Asia (8.6%, 95% CI = 4.9%-12.3%). Conclusion The prevalence of the separate physical behaviors and high levels of the combined physical behaviors was consistently low among young adolescents in LMICs, and that of all qualifying physical behaviors was even lower.

Published
2020

33. Global, regional, and national burden of lung cancer and its attributable risk factors, 1990 to 2017

Author

Shilu Tong, Kerrie Mengersen, Ning Wang, Michael G. Kimlin, Wenbiao Hu, and Maigeng Zhou

Subjects
Burden of disease, Male, Cancer Research, Lung Neoplasms, Population, History, 21st Century, Global Burden of Disease, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Medicine, Humans, 030212 general & internal medicine, Lung cancer, education, education.field_of_study, business.industry, Mortality rate, History, 20th Century, medicine.disease, 3. Good health, Years of potential life lost, Oncology, 030220 oncology & carcinogenesis, Attributable risk, Female, business, Demography
Abstract

Background: China's lung cancer (LC) burden plays a pivotal role in the global cancer epidemic. Comparing LC burden and population attributable fractions (PAFs) of risk factors between China and other countries/regions is essential to inform effective intervention. The Global Burden of Disease (GBD) study provides a unique opportunity for such comparisons. Methods: We extracted the number of LC deaths, age-standardized death rates (ASDRs), age-standardized disability-adjusted life-year (DALY) rates, and PAFs of risk factors for LC deaths between 1990 and 2017 from GBD 2017. The annual percentage change (APC) was used to quantify the trends of LC ASDRs and age-standardized DALY rates. The relationship between the APC of LC ASDR and Socio-demographic Index was assessed among China and other countries. Results: Globally, the ASDR for LC decreased in men (APC, −0.66% [95% CI, −0.69 to −0.62]) but increased in women (APC, 0.31% [95% CI, 0.26 to 0.36]) from 1990 to 2017. The ASDRs in China increased both for men (APC, 1.12% [95% CI, 1.03 to 1.20]) and women (APC, 0.80% [95% CI, 0.70 to 0.89]). The increased LC death numbers among men (312,798) and women (139,115) in China accounted for 59.39% and 43.01% of global increases. LC years of life lost accounted for the majority of LC DALYs globally and in China. The risk factors with the highest PAFs of LC death in China were smoking and ambient particulate matter. The ASDRs for LC associated with ambient particulate matter in China ranked second globally. Conclusions: The trends of LC ASDRs and age-standardized DALY rates and the PAFs of risk factors vary markedly by region, indicating a need for tailored measures to reduce LC burden and improve health equality. China's LC ASDRs are among the highest in the world, and the primary intervention priorities in China should be control of ambient particulate matter and tobacco usage.

Published
2020

34. County-level variation in the long-term association between PM

Author

Ning, Wang, Kerrie, Mengersen, Shilu, Tong, Michael, Kimlin, Maigeng, Zhou, Yang, Liu, and Wenbiao, Hu

Subjects
Male, China, Lung Neoplasms, Smoking, Humans, Female, Particulate Matter, Spatial Regression, Aged
Abstract

The relative risk (RR) of long-term exposure to PMWe obtained annual LCM in the elderly between 2013 and 2015 from the National Death Surveillance. We linked annual mean concentrations of PMThe magnitude of the association between long-term exposure to PMThe relative importance of long-term exposure to PM

Published
2020

35. Traumatic spinal cord injury mortality from 2006 to 2016 in China

Author

Xinying Zeng, Peng Yin, Peixia Cheng, Guoqing Hu, Jianzhong Hu, Maigeng Zhou, Jiangmei Liu, Jinlei Qi, Lijun Wang, Yunning Liu, and Bin Li

Subjects
Adult, Male, medicine.medical_specialty, China, Traumatic spinal cord injury, Adolescent, Population, Poison control, Suicide prevention, Occupational safety and health, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Injury prevention, Medicine, Humans, 030212 general & internal medicine, Longitudinal Studies, education, Child, Spinal Cord Injuries, education.field_of_study, business.industry, Mortality rate, Incidence, Brief Report, Accidents, Traffic, Infant, Newborn, Human factors and ergonomics, Infant, Child, Preschool, Emergency medicine, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Purpose: To report on the national traumatic spinal cord injury (TSCI) mortality of China population, and assess sex-, age-, location-, and cause-specific mortality rates, respectively. Methods: A population-based longitudinal study based on mortality data from the Disease Surveillance Points system of China, 2006–2016. TSCI was defined according to the 10th International Classification of Disease. Negative binomial regression was used to test the significance of the change in overall and subgroup mortality rate. Results: Age-adjusted TSCI mortality rate increased by 64% from 2006 to 2016, ranging from 0.19 to 0.34 per 100,000 population. The crude mortality was 0.31 per 100,000 population in 2016. Males and rural residents had higher TSCI mortality rates than females and urban residents. The age-adjusted TSCI mortality rate increased 53% for males, 107% for females, 75% in an urban area, and 59% in a rural area. In comparison with insignificant change in the age group of 0–44 years, TSCI mortality increased 56% and 147% in age groups of 45–64 years and 65 years. Falls accounted for 45.4% of total mortality. Conclusions: TSCI mortality rates were higher in males and in rural residents than in females and in urban residents during the study time period. TSCI mortality increased quickly as age increased; adults aged 65 years and older had the highest mortality rate. Falls and motor vehicle crashes were the two most common causes of TSCI mortality. More prevention efforts are needed to reduce a number of deaths from TSCI injury considering a substantial increase in TSCI mortality.

Published
2020

36. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author

Sorin Hostiuc, Shaun Wen Huey Lee, Jorge R. Ledesma, Carsten Flohr, Masoumeh Sadeghi, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Cyrus Alinia, Mehdi Bohluli, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Seyyed Meysam Mousavi, Bernhard T. Baune, Ehsan Ahmadpour, Dinh-Toi Chu, Beatrix Haddock, Gianfranco Alicandro, Vasily Vlassov, Mohammad Taghi Khodayari, Gianna Gayle Herrera Amul, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Fereshteh Ansari, Michael K. Hole, Azeem Majeed, Iman Halvaei, Saqib Ali, Arianna Maever L. Amit, Tomas Y. Yeheyis, John S. Ji, Martin McKee, Jamileh Shadid, Leonardo Roever, Peng Jia, Ettore Beghi, Pablo M. Lavados, Young Eun Kim, Vahid Alipour, Sowmya J. Rao, Ahmad Daryani, Cathleen Keller, Ibrahim Abdollahpour, Nicole K. DeCleene, Ebrahim Babaee, Saman Esmaeilnejad, Boris Bikbov, William M. Gardner, Lydia M. Haile, Luca Ronfani, Azalea M. Thomson, Irena Ilic, Ruth W. Kimokoti, Yingxi Zhao, Guoqing Hu, Mehran Shams-Beyranvand, Ilais Moreno Velásquez, Nathaniel J. Henry, Brijesh Sathian, Daniel Kim, Peter Memiah, Mohammad Hadi Abbasi, Andrea Farioli, Zahra Kamiab, Bolajoko O. Olusanya, Matthew C. Doxey, Tommi Vasankari, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Shanshan Li, Tanvir M. Huda, Dillon O Sylte, Rosario Cárdenas, Agegnehu Bante, Helen Ippolito, Alyssa Acebedo, Jeffrey D. Stanaway, Anwar Faraj, João Pedro Silva, Amin Mousavi Khaneghah, Pushpendra Kumar, Sangram Kishor Patel, Josephine W. Ngunjiri, Holly E. Erskine, Eugene Sobngwi, Filippo Ariani, Shane D. Morrison, Mohammad Aghaali, Meghan D. Mooney, Vera Marisa Costa, Palash Chandra Banik, Rupak Desai, Ken Takahashi, Maigeng Zhou, Morteza Oladnabi, Bogdan Oancea, Daniela Ribeiro, Mohammad Farahmand, Irmina Maria Michalek, Yetunde O. John-Akinola, Khem Narayan Pokhrel, Emilie R Maddison, Syed Mohamed Aljunid, Damian G. Hoy, Hosni Salem, V. Prakash, Shuhei Nomura, Inga Dora Sigfusdottir, Anders Larsson, Sharareh Eskandarieh, Abdollah Mohammadian-Hafshejani, Somayeh Bohlouli, Joana Morgado-da-Costa, Siamak Sabour, Theo Vos, Han Yong Wunrow, Khaled Khatab, Alireza Zangeneh, Ann Kristin Knudsen, Marissa B Reitsma, Hannah J. Henrikson, Randah R. Hamadeh, Tuomo J. Meretoja, Ireneous N. Soyiri, Giuseppe Grosso, Ziyad Al-Aly, Taraneh Yousefinezhadi, Joseph L Ward, Roba Khundkar, Ricardo Santiago Gomez, Reza Malekzadeh, John J. McGrath, Sandra B. Munro, Shahin Soltani, Amy E. Peden, Rufus Akinyemi, Marcel Ausloos, Naohiro Yonemoto, Bogdan Wojtyniak, Ahmad Ghashghaee, Guilherme Borges, Sadia Bibi, Farhad Islami, Hamed Mirzaei, Mohammad Ali Sahraian, M. Ashworth Dirac, Hosna Janjani, Kairat Davletov, Hermann Brenner, Yuichiro Yano, Elissa M. Abrams, Ana Vukovic, Bartosz Miazgowski, Jobert Richie Nansseu, Jennifer O Lam, Mona Pathak, Leeberk Raja Inbaraj, Thirunavukkarasu Sathish, Asadollah Gholamian, Carlos A Castañeda-Orjuela, Babak Eshrati, Edgar Denova-Gutiérrez, Atte Meretoja, Lorenzo Monasta, Ronan A. Lyons, Neda Kianipour, Desalegn Getnet Demsie, Yasir Waheed, Desta Debalkie Atnafu, Davide Sattin, Kevin S Ikuta, Ghobad Moradi, Srinivas Goli, Krittika Bhattacharyya, Mika Kivimäki, Christopher Troeger, Jordi Alonso, Alireza Ahmadi, Navid Manafi, Caroline Stein, Songhomitra Panda-Jonas, Jason Nguyen, Moses K. Muriithi, Aziz Rezapour, Ismael R. Campos-Nonato, Adrian Pana, H. Dean Hosgood, Noore Alam, James L. Fisher, Mariam Molokhia, Susan F. Rumisha, Ernoiz Antriyandarti, Ayman Grada, Emma Nichols, Babak Asghari, André Luiz Sena Guimarães, Ferrán Catalá-López, Aletta E. Schutte, Fiona B. Bennitt, Maciej Banach, Antonio Biondi, Donal Bisanzio, Josip Car, Ronny Westerman, Shafiu Mohammed, Biniyam Sahiledengle Geberemariyam, Kenji Shibuya, Meghdad Pirsaheb, Milena Santric-Milicevic, Karen M. Tabb, Paula Moraga, Soheil Hassanipour, Hasan Yusefzadeh, Avina Vongpradith, Dara K. Mohammad, Ralph Maddison, Babak Moazen, Getachew Mullu Kassa, Rahman Shiri, Fernando Neves Hugo, Hmwe H Kyu, Zachary V Dingels, Florian Fischer, Valentin Yurievich Skryabin, Rafael Tabarés-Seisdedos, Massimo Cirillo, Nikita Otstavnov, Robert C. Reiner, Van C. Lansingh, Rodrigo Sarmiento-Suarez, Ashkan Afshin, Benjamin A Stark, Mohsen Abbasi-Kangevari, Natalie C. Galles, Behnam Heidari, Eun-Kee Park, Mohammad Ali Jahani, Suzanne Polinder, Mahalaqua Nazli Khatib, Farhad Jadidi-Niaragh, Amir Radfar, Mowafa Househ, Derrick A Bennett, Gaorui Guo, Hesam Ghiasvand, Taweewat Wiangkham, Tamás Joó, Cristiana Abbafati, Kathryn Mei Ming Lau, Anita K. Nandi, Miklós Szócska, Manasi Kumar, Eduardo A. Undurraga, Oladimeji M. Adebayo, Simon Yadgir, Victor Aboyans, Justin J. Lang, Catherine O. Johnson, Soewarta Kosen, Carla Sofia e.Sá Farinha, Marcos Roberto Tovani-Palone, Kamarul Imran Musa, Farshad Pourmalek, Kiomars Sharafi, Heather Orpana, Samuel B. Albertson, Mahdi Afshari, Nicholas J K Breitborde, Nelson J. Alvis-Zakzuk, Adrian Oţoiu, Iván Landires, Robert G. Weintraub, Kidanemaryam Berhe, André Faro, Sophia Emmons-Bell, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Yordanos Gizachew Yeshitila, Mehdi Hosseinzadeh, Arash Etemadi, Oleguer Plana-Ripoll, Theodore Patrick Younker, Joemer C. Maravilla, Alireza Ansari-Moghaddam, Borhan Mansouri, Narayanaswamy Venketasubramanian, Seyed Mohammad Kazem Aghamir, Linda Morales, Amanda Deen, Noushin Mohammadifard, Obinna Onwujekwe, Ai Koyanagi, Michele Nguyen, Chieh Han, Kiana Ramezanzadeh, Mika Shigematsu, Mohammed Shannawaz, Khurshid Alam, Javad Nazari, Bryan L. Sykes, Rajat Das Gupta, Stephen S Lim, Lingkan Barua, Zubair Kabir, Michael Brauer, Afarin Rahimi-Movaghar, Deepa Jahagirdar, Kaja Abbas, Gholamreza Bazmandegan, Mark A. Stokes, Rajaa Al-Raddadi, Kanyin L. Ong, Kate Causey, Ahmed Omar Bali, Matilde Leonardi, Jeffrey V. Lazarus, Wondimeneh Shibabaw Shiferaw, André Karch, Blair R. Bumgarner, Nelson Alvis-Guzman, Jennifer H MacLachlan, Saeed Amini, Parvaiz A Koul, Blessing J. Akombi, Ro Ting Lin, Dabere Nigatu, Alaa Badawi, Flavia M. Cicuttini, Deanna Anderlini, Claudio Alberto Dávila-Cervantes, Rupert R A Bourne, Tanuj Kanchan, Catherine P. Benziger, Tahiya Alam, M. Mofizul Islam, Muktar Omer Omer, Leila Zaki, Mehdi Mirzaei-Alavijeh, Inbal Salz, Katharine J Looker, Shiwei Liu, Fatemeh Amiri, Christopher R. Cederroth, Mitra Abbasifard, Hamidreza Pazoki Toroudi, Gbenga A. Kayode, Antonio Luiz Pinho Ribeiro, Krishna Kumar Aryal, Mu'awiyyah Babale Sufiyan, Mohamed M. Gad, Assefa Desalew, Lidia Morawska, Davood Anvari, Mohammad Reza Salahshoor, Hadi Pourjafar, Abdu A. Adamu, Maryam Adabi, Zulfiqar A. Bhutta, Jessica A. Cruz, Foad Abd-Allah, Amir Hasanzadeh, Jordan Weiss, Maryam Ghadimi, Seyed-Mohammad Fereshtehnejad, Serge Resnikoff, Joanna L Whisnant, Kelly Compton, Priya Parmar, Sanjay Basu, Leila R Kalankesh, Nickolas Reinig, Ana Maria Mantilla Herrera, Fatemeh Rajati, Damian Santomauro, Mojisola Oluwasanu, Sheikh Mohammed Shariful Islam, David M. Pereira, Joht Singh Chandan, Deepak Kumar Pasupula, Aristidis Tsatsakis, Hoa Thi Do, Whitney L. Teagle, Hans W. Hoek, James Leigh, Morteza Arab-Zozani, Yasser Vasseghian, Stephanie R M Zimsen, Charlie Ashbaugh, Fariba Dorostkar, Abdelrahman Ibrahim Abushouk, Mikk Jürisson, Golnaz Heidari, Kala M. Mehta, Saeed Shahabi, Sarah Wulf Hanson, Nizal Sarrafzadegan, Dharmesh Kumar Lal, Hai Quang Pham, Aleksandr Y. Aravkin, Joshua A. Salomon, David C. Schwebel, Milena Ilic, Kareha M Agesa, Jost B. Jonas, Dian Kusuma, Benjamin B. Massenburg, Santosh Varughese, Yousef Mohammad, Beatriz Paulina Ayala Quintanilla, Mihaela Hostiuc, Richard G. Cowden, Morteza Shamsizadeh, Thomas Pilgrim, Alessandra C. Goulart, Leila Doshmangir, Gabriele Nagel, Saravanan Muthupandian, Zahra Sadat Dibaji Forooshani, Maryam Mirzaei, Zabihollah Yousefi, Shadrach Wilson, Iman El Sayed, Juanita A. Haagsma, Segun Emmanuel Ibitoye, Eirini Skiadaresi, Reza Shirkoohi, Tim Driscoll, Morteza Jafarinia, Maha El Tantawi, Telma Zahirian Moghadam, Katarzyna Kissimova-Skarbek, Abdilahi Yousuf Yousuf, Dickson A. Amugsi, Awoke Misganaw, Maseer Khan, Norito Kawakami, Jingkai Wei, Jai K Das, Vishnu Renjith, Tessa M. Pilz, Sameer Vali Gopalani, Roghiyeh Faridnia, Islam Y. Elgendy, Prateek Rastogi, Lauren B. Wilner, Josep Maria Haro, Zahiruddin Quazi Syed, Ben Lacey, Ketema Bizuwork Gebremedhin, Sam Rolfe, Iffat Elbarazi, Yannick Béjot, Raimundas Lunevicius, Sezer Kisa, Harish Chander Gugnani, Basema Saddik, Manu Raj Mathur, Mansour Ghafourifard, Riaz Uddin, Anna Poznańska, Faris Lami, Niguse Meles Alema, Michael T. Chung, Arya Aminorroaya, Arash Sarveazad, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, João M. Furtado, Hamid Ahmadieh, Sara Conti, Yunquan Zhang, Manthan D Janodia, Aislyn U. Orji, S. Mohammad Sajadi, Jalal Arabloo, Gabrielle B. Britton, Colm McAlinden, Francisco Rogerlândio Martins-Melo, Simona Cătălina Ştefan, Ester Cerin, Nuno Taveira, Lars Jacob Stovner, Amir Taherkhani, Masoud Foroutan, Tomasz Miazgowski, Amir Manafi, Yeshambel T. Nigatu, Barthelemy Kuate Defo, Mithila Faruque, Alan D. Lopez, Man Mohan Mehndiratta, Graeme J. Hankey, Mojgan Gitimoghaddam, Chantal Huynh, G Anil Kumar, Martin Amogre Ayanore, Abbas Sheikhtaheri, Turki Alanzi, Simon Øverland, David Laith Rawaf, Brian J. Hall, Edward J Mills, Ali Kabir, Ravi Prakash Jha, Akbar Barzegar, Simin Mouodi, Alize J. Ferrari, Chirag P. Doshi, Saleh Salehi Zahabi, Mohsen Naghavi, Mohammad Hassan Emamian, Amir Jalali, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Maarten J. Postma, David Edvardsson, Chhabi Lal Ranabhat, Catherine M. Antony, Hannah Han, Ken Lee Chin, Getinet Ayano, Kewal Krishan, Maryam Zamanian, Farshad Farzadfar, Ali A. Asadi-Pooya, Daniel Diaz, Oliver J. Brady, Mohsen Bayati, Christopher M Odell, Jalil Jaafari, Walter Mendoza, Susanna Dunachie, Raffaele Palladino, Raaj Kishore Biswas, Alessandra Lugo, Reshmi Bhageerathy, Paulo A. Lotufo, Maia Kereselidze, Salman Rawaf, Olayinka Stephen Ilesanmi, Mousa Yaminfirooz, Neeraj Bedi, Mahesh P A, Harvey Whiteford, Gina Agarwal, Pallab K. Maulik, Ranjitha S Shetty, Adhanom Gebreegziabher Baraki, Prasanna Mithra, Binyam Minuye Birihane, Mohammad Ali Mansournia, Tomislav Mestrovic, Razique Anwer, Marcello Tonelli, Hanne Christensen, Juan Jesus Carrero, Ali H. Mokdad, Alberto Ortiz, Samad Azari, Ted R. Miller, Rebecca Ivers, Stephen R. Robinson, Saeid Safiri, Masood Ali Shaikh, Rajesh Sagar, Kelly Cercy, Mehran Asadi-Aliabadi, João Vasco Santos, Maziar Moradi-Lakeh, Sarah Lewington, Dimas Ria Angga Pribadi, Savita Lasrado, Abdul Moiz Hafiz, Amir Almasi-Hashiani, Burcu Kucuk Bicer, Praveen Hoogar, Fatemeh Heydarpour, Hala Rashad Elhabashy, Peng Zheng, Senthilkumar Balakrishnan, Paul H. Lee, Cameron J. Kneib, Srinivasa Rao Bolla, Harrison Chase Gottlich, Andrew M. Briggs, Alibek Mereke, Om P Kurmi, Kavumpurathu Raman Thankappan, Nikolay Ivanovich Briko, Shahram Saeidi, Anbissa Muleta Senbeta, Assefa Ayalew Ayalew Ayalew Gebreslassie, Aminu K. Bello, Tomi Akinyemiju, Ambrish Singh, Anamika Pandey, Matthew Cunningham, Endalkachew Worku Mengesha, Christine Linehan, Ata Rafiee, Maria Inês Schmidt, Vincent C. Iannucci, Stanislav S. Otstavnov, Andre M. N. Renzaho, Dinesh Bhandari, Masoud Moghadaszadeh, Atkilt Esaiyas Etisso, Valery L. Feigin, Christopher J L Murray, James D. Harvey, Daniel Cury Ribeiro, Girikumar Kumaresh, Javad Yoosefi Lebni, Elisabetta Pupillo, Shaimaa I. El-Jaafary, Marlena S Bannick, Caitlyn Steiner, Agus Sudaryanto, Eduardo Bernabé, Fereshteh Mehri, Rafael Alves Guimarães, Zemenu Tadesse Tessema, Shaun Roberts, Rajeev Gupta, Jamal A. Yearwood, Nima Rezaei, Muhammad Shahdaat Bin Sayeed, David M. Pigott, Hadi Hassankhani, Samuel M. Ostroff, Gerhard Sulo, Keyghobad Ghadiri, Pankaj Bhardwaj, Suzanne Lyn Barker-Collo, Fiona J Charlson, Norberto Perico, Jonathan M. Kocarnik, Sergio I. Prada, Mohammad Sadegh Rezai, Mustafa Z. Younis, Neeraj Bhala, Mahmoud Yousefifard, Hue Thi Mai, Marwa Rashad Salem, Reza Pourmirza Kalhori, Carl Abelardo T. Antonio, Stefan Lorkowski, Farzad Jalilian, Nicholas J Kassebaum, Haley Lescinsky, Gholamreza Roshandel, Reza Heidari-Soureshjani, Kirsten E. Wiens, Ionut Negoi, Bhaskaran Unnikrishnan, Daniel J. Weiss, Sare Safi, Hamid Reza Tohidinik, Fablina Sharara, François Alla, Mohammad Rabiee, Sivan Yegnanarayana Iyer Saraswathy, Jack T Fox, Amirhossein Sahebkar, Ratilal Lalloo, Panniyammakal Jeemon, Rohollah Kalhor, Firooz Esmaeilzadeh, Brittney S. Sheena, Kyle E. Simpson, Muluken Bekele Sorrie, Vivekanand Jha, Morteza Abdullatif Khafaie, Seyed Mohammad Riahi, Nader Jahanmehr, Yuming Guo, George C. Patton, Rashid Abdi Guled, Tim C.D. Lucas, Alberto Raggi, Peter W. Gething, Mohaimenul Islam, Abdallah M. Samy, Cuong Tat Nguyen, Kaleab Alemayehu Zewdie, Ahamarshan Jayaraman Nagarajan, Roman Topor-Madry, C. E. G. Brayne, Phoebe Anne Rhinehart, Isabela M. Benseñor, Michal Grivna, Taren M. Gorman, Natalie C. Momen, Afsaneh Arzani, Tufa Kolola, Maryam Khayamzadeh, Alexandra S. Boon-Dooley, Ihoghosa Osamuyi Iyamu, Nima Hafezi-Nejad, Hassan Abolhassani, Perminder S. Sachdev, Vivek Kumar, Anton Sokhan, Mahmood Moosazadeh, Davoud Adham, Ahad Bakhtiari, Nataliya A. Foigt, Venkatesh Maled, Henok Biresaw Netsere, Seyedeh Zahra Masoumi, Ashley Marks, Rizwan Kalani, Soraya Siabani, Jiayu Wang, Samath Dhamminda Dharmaratne, Lucas Guimarães Abreu, Vivian Chia-Rong Hsieh, Kris J. Krohn, Falk Schwendicke, Alex R. Chang, Muhammad Ali, Christine Lin, Rose G Bender, Arielle Wilder Eagan, Tissa Wijeratne, Chris D Castle, Saif Ullah, Nikolaos Dervenis, Joan B. Soriano, Syed Amir Gilani, Jianing Ma, Giuseppe Remuzzi, Dana Bryazka, Christian Razo, Manuela L. Ferreira, Ankur Joshi, Alireza Rafiei, Vinay Nangia, Victor Adekanmbi, Frances E. Dean, Chuanhua Yu, Elizabeth A. Cromwell, Pascual R. Valdez, Jennifer Rickard, Daniel Youngwhan Cho, Ashish Pathak, Angel Paternina-Caicedo, Mehdi Ahmadi, Zichen Liu, Achala Upendra Jayatilleke, Diego De Leo, Sarah Charlotte Johnson, Getenet Dessie, Zhi Jiang Zhang, Christopher S. Crowe, Farhad Ghamari, Behshad Naghshtabrizi, Francesco Saverio Violante, Muhammad Aziz Rahman, Ramesh Holla, Kate E. LeGrand, Christian Kieling, Vahid Yazdi-Feyzabadi, Shivanthi Balalla, Molly H Biehl, Mostafa Dianatinasab, Mina Anjomshoa, Abdel Douiri, Laith J. Abu-Raddad, Rade Vukovic, Amiran Gamkrelidze, Michael R. Phillips, Yafeng Wang, Sachin R Atre, Miriam Levi, Zelalem Nigussie Azene, Kevan R. Polkinghorne, Deepak Paudel, Hung Chun Liu, Zainab Samad, Robert P. Dellavalle, Florentino Luciano Caetano dos Santos, Juan Sanabria, Mohammad Fareed, Enrico Rubagotti, Samantha Leigh Larson, Anurag Agrawal, Shai Linn, Saad M.A. Dahlawi, Janni Leung, Shokofeh Maleki, Michael R.M. Abrigo, Michael Kravchenko, Mohd Anisul Karim, Alyssa N. Sbarra, Jacob L. Stubbs, Timothy J. Steiner, Helena Manguerra, Olatunji O. Adetokunboh, Amira Shaheen, Stein Emil Vollset, Yared Asmare Aynalem, Rajan Nikbakhsh, Ilana N. Ackerman, Srinivasa Vittal Katikireddi, Davide Rasella, Hedayat Abbastabar, Floriane Ausloos, Nauman Khalid, Ewerton Cousin, Nermin Ghith, Nebiyu Dereje Dereje, Rakhi Dandona, Mojtaba Bagherzadeh, Ahmed Abdelalim, Benn Sartorius, Giulio Castelpietra, Masih Tajdini, Stefanos Tyrovolas, Akram Pourshams, Ritesh G. Menezes, Eve E. Wool, Mohamed Hsairi, Alberto L. García-Basteiro, Lorainne Tudor Car, Rachelle Buchbinder, Franz Castro, Samiah Alam, Iman Ansari, Ahmed I. Hasaballah, Sanni Yaya, Silvia Schiavolin, Reza Mohammadpourhodki, Khalid A Altirkawi, Marco Vacante, Jacek A. Kopec, Archith Boloor, Simon I. Hay, Mathilde Touvier, Ensiyeh Jenabi, Deborah Carvalho Malta, Scott B. Patten, Arash Ziapour, Carlo La Vecchia, Seyed Sina Naghibi Irvani, Thomas Truelsen, Houman Goudarzi, Ryan Fitzgerald, Di H. Cross, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Odgerel Chimed-Ochir, Iqbal R. F. Elyazar, Alexandrea Watson, Bo Norrving, Kerem Shuval, Chidozie Declan Iwu, Jasvinder A. Singh, Bárbara Niegia Garcia Goulart, Shirin Djalalinia, Marisa Freitas, Feleke Mekonnen Demeke, Hiroyasu Iso, Hussain Jafari, Lee Ling Lim, Roman V. Polibin, Charles D.A. Wolfe, Ulrich O Mueller, Luis Camera, Fabiana Madotto, Gregory A. Roth, Nevine El Nahas, Paul S. F. Yip, Miguel A Barboza, Anna E. Torre, Ali Rajabpour-Sanati, Hailey Hagins, Tauseef Ahmad, Platon D. Lopukhov, Giovanni Damiani, Mohammad Hossein Bakhshaei, Hirut Teame, Silvano Gallus, Tudorel Andrei, Suzanne H. Keddie, Madgalene K. Walters, Mohammad Abdollahi, Temesgen Yihunie Akalu, Catherine Bisignano, Iyad Sultan, Ira Martopullo, Emma L. Collins, Spencer L. James, Rasmus Havmoeller, Alireza Esteghamati, Seok Jun Yoon, Paramjit Gill, Maryam Hashemian, Klara Dokova, Weijia Fu, Anna Gershberg Hayoon, Kathryn H. Jacobsen, Zohra S Lassi, Morenike Oluwatoyin Folayan, Sanjeev Nair, Phetole Walter Mahasha, Shelly Balassyano, Giulia Carreras, Ruxandra Irina Negoi, Reinhard Busse, Takeshi Fukumoto, Abdullah Al Mamun, Sarika Chaturvedi, Stefania Mondello, Christoph Nowak, Vijay Kumar Chattu, Efat Mohamadi, Mohammad Ebrahimi Kalan, Paul S Briant, M Alijanzadeh, Giuseppe Gorini, Berhane Fseha Teklehaimanot, Jacqueline Elizabeth Alcalde-Rabanal, Katya Anne Shackelford, Mehdi Fazlzadeh, Virginia Núñez-Samudio, Minh Nguyen, Payman Salamati, Itamar S. Santos, Bach Xuan Tran, Lal B. Rawal, Louisa Degenhardt, Dietrich Plass, Jacob Olusegun Olusanya, José Neves, Kazumasa Yamagishi, Mona M. Khater, Alyssa Pennini, Ehsan Sadeghi, Salah Eddin Karimi, Ravensara S. Travillian, Alexander C. Tsai, Emilie E. Agardh, Rahmatollah Moradzadeh, Hamed Zandian, Zahid A Butt, Subramanian Senthilkumaran, Ai-Min Wu, Bing Fang Hwang, Sadaf G. Sepanlou, Jeff T. Zhao, Paolo Cortesi, Giorgia Giussani, Gregory J. Bertolacci, Andrew T Olagunju, Søren Thorgaard Skou, Peter Allebeck, Benjamin C Cowie, Aso Mohammad Darwesh, In-Hwan Oh, Erin B. Hamilton, Puja C Rao, Vinod C Nayak, Carla Fornari, Khezar Hayat, Rannveig Sigurvinsdottir, Emmanuel Peprah, Oommen John, Sonyah Terrason, Mohammed Ibrahim Mohialdeen Gubari, Sojib Bin Zaman, Jean Jacques Noubiap, Emmanuela Gakidou, Abiyu Mekonnen Gebrehiwot, Celine M. Barthelemy, Nicholas L S Roberts, Jagadish Rao Padubidri, Navid Rabiee, Alireza Ghajar, Mark G. Shrime, Hamed Kalani, Mayowa O. Owolabi, Lisa M. Force, Irina Filip, Jacek Jerzy Jozwiak, Gelin Xu, Thomas R. Hird, Kara Estep, Mohammad Zamani, Lalit Dandona, João Massano, Antonio Maria Borzì, Masoud Moradi, Molly R Nixon, Delia Hendrie, Mostafa Amini-Rarani, Mikhail Sergeevich Zastrozhin, Rachel Feldman, Emmanuel Wandera Okunga, Bruce Bartholow Duncan, Nazir Fattahi, Joshua R. Ehrlich, Adnan Kisa, Ghasem Azarian, Naser Mohammad Gholi Mezerji, Reed J D Sorensen, Roderick J. Hay, Johan Ärnlöv, Liliana G Ciobanu, Claudiu Herteliu, Andreea Mirica, Sofia Boston Redford, Wahengbam Bigyananda Meitei, Jae Il Shin, Kanaan Hamagharib Abdullah, Abhijit Pakhare, Santosh Kumar Tadakamadla, Rixing Xu, Jonathan F. Mosser, Meresa Berwo Mengesha, Veincent Christian Filipino Pepito, Andre Rodrigues Duraes, Yuan-Pang Wang, Jaimie D. Adelson, Felix Akpojene Ogbo, Alireza Vakilian, Mihajlo Jakovljevic, Ali S. Shalash, Vos, T, Lim, S, Abbafati, C, Abbas, K, Abbasi, M, Abbasifard, M, Abbasi-Kangevari, M, Abbastabar, H, Abd-Allah, F, Abdelalim, A, Abdollahi, M, Abdollahpour, I, Abolhassani, H, Aboyans, V, Abrams, E, Abreu, L, Abrigo, M, Abu-Raddad, L, Abushouk, A, Acebedo, A, Ackerman, I, Adabi, M, Adamu, A, Adebayo, O, Adekanmbi, V, Adelson, J, Adetokunboh, O, Adham, D, Afshari, M, Afshin, A, Agardh, E, Agarwal, G, Agesa, K, Aghaali, M, Aghamir, S, Agrawal, A, Ahmad, T, Ahmadi, A, Ahmadi, M, Ahmadieh, H, Ahmadpour, E, Akalu, T, Akinyemi, R, Akinyemiju, T, Akombi, B, Al-Aly, Z, Alam, K, Alam, N, Alam, S, Alam, T, Alanzi, T, Albertson, S, Alcalde-Rabanal, J, Alema, N, Ali, M, Ali, S, Alicandro, G, Alijanzadeh, M, Alinia, C, Alipour, V, Aljunid, S, Alla, F, Allebeck, P, Almasi-Hashiani, A, Alonso, J, Al-Raddadi, R, Altirkawi, K, Alvis-Guzman, N, Alvis-Zakzuk, N, Amini, S, Amini-Rarani, M, Aminorroaya, A, Amiri, F, Amit, A, Amugsi, D, Amul, G, Anderlini, D, Andrei, C, Andrei, T, Anjomshoa, M, Ansari, F, Ansari, I, Ansari-Moghaddam, A, Antonio, C, Antony, C, Antriyandarti, E, Anvari, D, Anwer, R, Arabloo, J, Arab-Zozani, M, Aravkin, A, Ariani, F, Arnlov, J, Aryal, K, Arzani, A, Asadi-Aliabadi, M, Asadi-Pooya, A, Asghari, B, Ashbaugh, C, Atnafu, D, Atre, S, Ausloos, F, Ausloos, M, Ayala Quintanilla, B, Ayano, G, Ayanore, M, Aynalem, Y, Azari, S, Azarian, G, Azene, Z, Babaee, E, Badawi, A, Bagherzadeh, M, Bakhshaei, M, Bakhtiari, A, Balakrishnan, S, Balalla, S, Balassyano, S, Banach, M, Banik, P, Bannick, M, Bante, A, Baraki, A, Barboza, M, Barker-Collo, S, Barthelemy, C, Barua, L, Barzegar, A, Basu, S, Baune, B, Bayati, M, Bazmandegan, G, Bedi, N, Beghi, E, Bejot, Y, Bello, A, Bender, R, Bennett, D, Bennitt, F, Bensenor, I, Benziger, C, Berhe, K, Bernabe, E, Bertolacci, G, Bhageerathy, R, Bhala, N, Bhandari, D, Bhardwaj, P, Bhattacharyya, K, Bhutta, Z, Bibi, S, Biehl, M, Bikbov, B, Bin Sayeed, M, Biondi, A, Birihane, B, Bisanzio, D, Bisignano, C, Biswas, R, Bohlouli, S, Bohluli, M, Bolla, S, Boloor, A, Boon-Dooley, A, Borges, G, Borzi, A, Bourne, R, Brady, O, Brauer, M, Brayne, C, Breitborde, N, Brenner, H, Briant, P, Briggs, A, Briko, N, Britton, G, Bryazka, D, Buchbinder, R, Bumgarner, B, Busse, R, Butt, Z, Caetano dos Santos, F, Camera, L, Campos-Nonato, I, Car, J, Cardenas, R, Carreras, G, Carrero, J, Carvalho, F, Castaldelli-Maia, J, Castaneda-Orjuela, C, Castelpietra, G, Castle, C, Castro, F, Catala-Lopez, F, Causey, K, Cederroth, C, Cercy, K, Cerin, E, Chandan, J, Chang, A, Charlson, F, Chattu, V, Chaturvedi, S, Chimed-Ochir, O, Chin, K, Cho, D, Christensen, H, Chu, D, Chung, M, Cicuttini, F, Ciobanu, L, Cirillo, M, Collins, E, Compton, K, Conti, S, Cortesi, P, Costa, V, Cousin, E, Cowden, R, Cowie, B, Cromwell, E, Cross, D, Crowe, C, Cruz, J, Cunningham, M, Dahlawi, S, Damiani, G, Dandona, L, Dandona, R, Darwesh, A, Daryani, A, Das, J, Das Gupta, R, das Neves, J, Davila-Cervantes, C, Davletov, K, De Leo, D, Dean, F, Decleene, N, Deen, A, Degenhardt, L, Dellavalle, R, Demeke, F, Demsie, D, Denova-Gutierrez, E, Dereje, N, Dervenis, N, Desai, R, Desalew, A, Dessie, G, Dharmaratne, S, Dhungana, G, Dianatinasab, M, Diaz, D, Dibaji Forooshani, Z, Dingels, Z, Dirac, M, Djalalinia, S, Do, H, Dokova, K, Dorostkar, F, Doshi, C, Doshmangir, L, Douiri, A, Doxey, M, Driscoll, T, Dunachie, S, Duncan, B, Duraes, A, Eagan, A, Ebrahimi Kalan, M, Edvardsson, D, Ehrlich, J, El Nahas, N, El Sayed, I, El Tantawi, M, Elbarazi, I, Elgendy, I, Elhabashy, H, El-Jaafary, S, Elyazar, I, Emamian, M, Emmons-Bell, S, Erskine, H, Eshrati, B, Eskandarieh, S, Esmaeilnejad, S, Esmaeilzadeh, F, Esteghamati, A, Estep, K, Etemadi, A, Etisso, A, Farahmand, M, Faraj, A, Fareed, M, Faridnia, R, Farinha, C, Farioli, A, Faro, A, Faruque, M, Farzadfar, F, Fattahi, N, Fazlzadeh, M, Feigin, V, Feldman, R, Fereshtehnejad, S, Fernandes, E, Ferrari, A, Ferreira, M, Filip, I, Fischer, F, Fisher, J, Fitzgerald, R, Flohr, C, Flor, L, Foigt, N, Folayan, M, Force, L, Fornari, C, Foroutan, M, Fox, J, Freitas, M, Fu, W, Fukumoto, T, Furtado, J, Gad, M, Gakidou, E, Galles, N, Gallus, S, Gamkrelidze, A, Garcia-Basteiro, A, Gardner, W, Geberemariyam, B, Gebrehiwot, A, Gebremedhin, K, Gebreslassie, A, Gershberg Hayoon, A, Gething, P, Ghadimi, M, Ghadiri, K, Ghafourifard, M, Ghajar, A, Ghamari, F, Ghashghaee, A, Ghiasvand, H, Ghith, N, Gholamian, A, Gilani, S, Gill, P, Gitimoghaddam, M, Giussani, G, Goli, S, Gomez, R, Gopalani, S, Gorini, G, Gorman, T, Gottlich, H, Goudarzi, H, Goulart, A, Goulart, B, Grada, A, Grivna, M, Grosso, G, Gubari, M, Gugnani, H, Guimaraes, A, Guimaraes, R, Guled, R, Guo, G, Guo, Y, Gupta, R, Haagsma, J, Haddock, B, Hafezi-Nejad, N, Hafiz, A, Hagins, H, Haile, L, Hall, B, Halvaei, I, Hamadeh, R, Hamagharib Abdullah, K, Hamilton, E, Han, C, Han, H, Hankey, G, Haro, J, Harvey, J, Hasaballah, A, Hasanzadeh, A, Hashemian, M, Hassanipour, S, Hassankhani, H, Havmoeller, R, Hay, R, Hay, S, Hayat, K, Heidari, B, Heidari, G, Heidari-Soureshjani, R, Hendrie, D, Henrikson, H, Henry, N, Herteliu, C, Heydarpour, F, Hird, T, Hoek, H, Hole, M, Holla, R, Hoogar, P, Hosgood, H, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Hoy, D, Hsairi, M, Hsieh, V, Hu, G, Huda, T, Hugo, F, Huynh, C, Hwang, B, Iannucci, V, Ibitoye, S, Ikuta, K, Ilesanmi, O, Ilic, I, Ilic, M, Inbaraj, L, Ippolito, H, Irvani, S, Islam, M, Islam, S, Islami, F, Iso, H, Ivers, R, Iwu, C, Iyamu, I, Jaafari, J, Jacobsen, K, Jadidi-Niaragh, F, Jafari, H, Jafarinia, M, Jahagirdar, D, Jahani, M, Jahanmehr, N, Jakovljevic, M, Jalali, A, Jalilian, F, James, S, Janjani, H, Janodia, M, Jayatilleke, A, Jeemon, P, Jenabi, E, Jha, R, Jha, V, Ji, J, Jia, P, John, O, John-Akinola, Y, Johnson, C, Johnson, S, Jonas, J, Joo, T, Joshi, A, Jozwiak, J, Jurisson, M, Kabir, A, Kabir, Z, Kalani, H, Kalani, R, Kalankesh, L, Kalhor, R, Kamiab, Z, Kanchan, T, Karami Matin, B, Karch, A, Karim, M, Karimi, S, Kassa, G, Kassebaum, N, Katikireddi, S, Kawakami, N, Kayode, G, Keddie, S, Keller, C, Kereselidze, M, Khafaie, M, Khalid, N, Khan, M, Khatab, K, Khater, M, Khatib, M, Khayamzadeh, M, Khodayari, M, Khundkar, R, Kianipour, N, Kieling, C, Kim, D, Kim, Y, Kimokoti, R, Kisa, A, Kisa, S, Kissimova-Skarbek, K, Kivimaki, M, Kneib, C, Knudsen, A, Kocarnik, J, Kolola, T, Kopec, J, Kosen, S, Koul, P, Koyanagi, A, Kravchenko, M, Krishan, K, Krohn, K, Kuate Defo, B, Kucuk Bicer, B, Kumar, G, Kumar, M, Kumar, P, Kumar, V, Kumaresh, G, Kurmi, O, Kusuma, D, Kyu, H, La Vecchia, C, Lacey, B, Lal, D, Lalloo, R, Lam, J, Lami, F, Landires, I, Lang, J, Lansingh, V, Larson, S, Larsson, A, Lasrado, S, Lassi, Z, Lau, K, Lavados, P, Lazarus, J, Ledesma, J, Lee, P, Lee, S, Legrand, K, Leigh, J, Leonardi, M, Lescinsky, H, Leung, J, Levi, M, Lewington, S, Li, S, Lim, L, Lin, C, Lin, R, Linehan, C, Linn, S, Liu, H, Liu, S, Liu, Z, Looker, K, Lopez, A, Lopukhov, P, Lorkowski, S, Lotufo, P, Lucas, T, Lugo, A, Lunevicius, R, Lyons, R, Ma, J, Maclachlan, J, Maddison, E, Maddison, R, Madotto, F, Mahasha, P, Mai, H, Majeed, A, Maled, V, Maleki, S, Malekzadeh, R, Malta, D, Mamun, A, Manafi, A, Manafi, N, Manguerra, H, Mansouri, B, Mansournia, M, Mantilla Herrera, A, Maravilla, J, Marks, A, Martins-Melo, F, Martopullo, I, Masoumi, S, Massano, J, Massenburg, B, Mathur, M, Maulik, P, Mcalinden, C, Mcgrath, J, Mckee, M, Mehndiratta, M, Mehri, F, Mehta, K, Meitei, W, Memiah, P, Mendoza, W, Menezes, R, Mengesha, E, Mengesha, M, Mereke, A, Meretoja, A, Meretoja, T, Mestrovic, T, Miazgowski, B, Miazgowski, T, Michalek, I, Mihretie, K, Miller, T, Mills, E, Mirica, A, Mirrakhimov, E, Mirzaei, H, Mirzaei, M, Mirzaei-Alavijeh, M, Misganaw, A, Mithra, P, Moazen, B, Moghadaszadeh, M, Mohamadi, E, Mohammad, D, Mohammad, Y, Mohammad Gholi Mezerji, N, Mohammadian-Hafshejani, A, Mohammadifard, N, Mohammadpourhodki, R, Mohammed, S, Mokdad, A, Molokhia, M, Momen, N, Monasta, L, Mondello, S, Mooney, M, Moosazadeh, M, Moradi, G, Moradi, M, Moradi-Lakeh, M, Moradzadeh, R, Moraga, P, Morales, L, Morawska, L, Moreno Velasquez, I, Morgado-da-Costa, J, Morrison, S, Mosser, J, Mouodi, S, Mousavi, S, Mousavi Khaneghah, A, Mueller, U, Munro, S, Muriithi, M, Musa, K, Muthupandian, S, Naderi, M, Nagarajan, A, Nagel, G, Naghshtabrizi, B, Nair, S, Nandi, A, Nangia, V, Nansseu, J, Nayak, V, Nazari, J, Negoi, I, Negoi, R, Netsere, H, Ngunjiri, J, Nguyen, C, Nguyen, J, Nguyen, M, Nichols, E, Nigatu, D, Nigatu, Y, Nikbakhsh, R, Nixon, M, Nnaji, C, Nomura, S, Norrving, B, Noubiap, J, Nowak, C, Nunez-Samudio, V, Otoiu, A, Oancea, B, Odell, C, Ogbo, F, Oh, I, Okunga, E, Oladnabi, M, Olagunju, A, Olusanya, B, Olusanya, J, Oluwasanu, M, Omar Bali, A, Omer, M, Ong, K, Onwujekwe, O, Orji, A, Orpana, H, Ortiz, A, Ostroff, S, Otstavnov, N, Otstavnov, S, Overland, S, Owolabi, M, P A, M, Padubidri, J, Pakhare, A, Palladino, R, Pana, A, Panda-Jonas, S, Pandey, A, Park, E, Parmar, P, Pasupula, D, Patel, S, Paternina-Caicedo, A, Pathak, A, Pathak, M, Patten, S, Patton, G, Paudel, D, Pazoki Toroudi, H, Peden, A, Pennini, A, Pepito, V, Peprah, E, Pereira, A, Pereira, D, Perico, N, Pham, H, Phillips, M, Pigott, D, Pilgrim, T, Pilz, T, Pirsaheb, M, Plana-Ripoll, O, Plass, D, Pokhrel, K, Polibin, R, Polinder, S, Polkinghorne, K, Postma, M, Pourjafar, H, Pourmalek, F, Pourmirza Kalhori, R, Pourshams, A, Poznanska, A, Prada, S, Prakash, V, Pribadi, D, Pupillo, E, Quazi Syed, Z, Rabiee, M, Rabiee, N, Radfar, A, Rafiee, A, Rafiei, A, Raggi, A, Rahimi-Movaghar, A, Rahman, M, Rajabpour-Sanati, A, Rajati, F, Ramezanzadeh, K, Ranabhat, C, Rao, P, Rao, S, Rasella, D, Rastogi, P, Rathi, P, Rawaf, D, Rawaf, S, Rawal, L, Razo, C, Redford, S, Reiner, R, Reinig, N, Reitsma, M, Remuzzi, G, Renjith, V, Renzaho, A, Resnikoff, S, Rezaei, N, Rezai, M, Rezapour, A, Rhinehart, P, Riahi, S, Ribeiro, A, Ribeiro, D, Rickard, J, Roberts, N, Roberts, S, Robinson, S, Roever, L, Rolfe, S, Ronfani, L, Roshandel, G, Roth, G, Rubagotti, E, Rumisha, S, Sabour, S, Sachdev, P, Saddik, B, Sadeghi, E, Sadeghi, M, Saeidi, S, Safi, S, Safiri, S, Sagar, R, Sahebkar, A, Sahraian, M, Sajadi, S, Salahshoor, M, Salamati, P, Salehi Zahabi, S, Salem, H, Salem, M, Salimzadeh, H, Salomon, J, Salz, I, Samad, Z, Samy, A, Sanabria, J, Santomauro, D, Santos, I, Santos, J, Santric-Milicevic, M, Saraswathy, S, Sarmiento-Suarez, R, Sarrafzadegan, N, Sartorius, B, Sarveazad, A, Sathian, B, Sathish, T, Sattin, D, Sbarra, A, Schaeffer, L, Schiavolin, S, Schmidt, M, Schutte, A, Schwebel, D, Schwendicke, F, Senbeta, A, Senthilkumaran, S, Sepanlou, S, Shackelford, K, Shadid, J, Shahabi, S, Shaheen, A, Shaikh, M, Shalash, A, Shams-Beyranvand, M, Shamsizadeh, M, Shannawaz, M, Sharafi, K, Sharara, F, Sheena, B, Sheikhtaheri, A, Shetty, R, Shibuya, K, Shiferaw, W, Shigematsu, M, Shin, J, Shiri, R, Shirkoohi, R, Shrime, M, Shuval, K, Siabani, S, Sigfusdottir, I, Sigurvinsdottir, R, Silva, J, Simpson, K, Singh, A, Singh, J, Skiadaresi, E, Skou, S, Skryabin, V, Sobngwi, E, Sokhan, A, Soltani, S, Sorensen, R, Soriano, J, Sorrie, M, Soyiri, I, Sreeramareddy, C, Stanaway, J, Stark, B, Stefan, S, Stein, C, Steiner, C, Steiner, T, Stokes, M, Stovner, L, Stubbs, J, Sudaryanto, A, Sufiyan, M, Sulo, G, Sultan, I, Sykes, B, Sylte, D, Szocska, M, Tabares-Seisdedos, R, Tabb, K, Tadakamadla, S, Taherkhani, A, Tajdini, M, Takahashi, K, Taveira, N, Teagle, W, Teame, H, Tehrani-Banihashemi, A, Teklehaimanot, B, Terrason, S, Tessema, Z, Thankappan, K, Thomson, A, Tohidinik, H, Tonelli, M, Topor-Madry, R, Torre, A, Touvier, M, Tovani-Palone, M, Tran, B, Travillian, R, Troeger, C, Truelsen, T, Tsai, A, Tsatsakis, A, Tudor Car, L, Tyrovolas, S, Uddin, R, Ullah, S, Undurraga, E, Unnikrishnan, B, Vacante, M, Vakilian, A, Valdez, P, Varughese, S, Vasankari, T, Vasseghian, Y, Venketasubramanian, N, Violante, F, Vlassov, V, Vollset, S, Vongpradith, A, Vukovic, A, Vukovic, R, Waheed, Y, Walters, M, Wang, J, Wang, Y, Ward, J, Watson, A, Wei, J, Weintraub, R, Weiss, D, Weiss, J, Westerman, R, Whisnant, J, Whiteford, H, Wiangkham, T, Wiens, K, Wijeratne, T, Wilner, L, Wilson, S, Wojtyniak, B, Wolfe, C, Wool, E, Wu, A, Wulf Hanson, S, Wunrow, H, Xu, G, Xu, R, Yadgir, S, Yahyazadeh Jabbari, S, Yamagishi, K, Yaminfirooz, M, Yano, Y, Yaya, S, Yazdi-Feyzabadi, V, Yearwood, J, Yeheyis, T, Yeshitila, Y, Yip, P, Yonemoto, N, Yoon, S, Yoosefi Lebni, J, Younis, M, Younker, T, Yousefi, Z, Yousefifard, M, Yousefinezhadi, T, Yousuf, A, Yu, C, Yusefzadeh, H, Zahirian Moghadam, T, Zaki, L, Zaman, S, Zamani, M, Zamanian, M, Zandian, H, Zangeneh, A, Zastrozhin, M, Zewdie, K, Zhang, Y, Zhang, Z, Zhao, J, Zhao, Y, Zheng, P, Zhou, M, Ziapour, A, Zimsen, S, Naghavi, M, Murray, C, Vos, Theo, S Lim, Stephen, Abbafati, Cristiana, M Abbas, Kaja, Abbasi, Mohammad, Abbasifard, Mitra, Abbasi-Kangevari, Mohsen, Abbastabar, Hedayat, Abd-Allah, Foad, Abdelalim, Ahmed, Abdollahi, Mohammad, Abdollahpour, Ibrahim, Abolhassani, Hassan, Aboyans, Victor, M Abrams, Elissa, Guimarães Abreu, Luca, M Abrigo, Michael R, Jamal Abu-Raddad, Laith, I Abushouk, Abdelrahman, Acebedo, Alyssa, N Ackerman, Ilana, Adabi, Maryam, A Adamu, Abdu, M Adebayo, Oladimeji, Adekanmbi, Victor, D Adelson, Jaimie, O Adetokunboh, Olatunji, Adham, Davoud, Afshari, Mahdi, Afshin, Ashkan, E Agardh, Emilie, Agarwal, Gina, M Agesa, Kareha, Aghaali, Mohammad, Mohammad Kazem Aghamir, Seyed, Agrawal, Anurag, Ahmad, Tauseef, Ahmadi, Alireza, Ahmadi, Mehdi, Ahmadieh, Hamid, Ahmadpour, Ehsan, Yihunie Akalu, Temesgen, Olusola Akinyemi, Rufu, Akinyemiju, Tomi, Akombi, Blessing, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore, Alam, Samiah, Alam, Tahiya, M Alanzi, Turki, B Albertson, Samuel, Elizabeth Alcalde-Rabanal, Jacqueline, Meles Alema, Niguse, Ali, Muhammad, Ali, Saqib, Alicandro, Gianfranco, Alijanzadeh, Mehran, Alinia, Cyru, Alipour, Vahid, Mohamed Aljunid, Syed, Alla, Françoi, Allebeck, Peter, Almasi-Hashiani, Amir, Alonso, Jordi, M Al-Raddadi, Rajaa, A Altirkawi, Khalid, Alvis-Guzman, Nelson, J Alvis-Zakzuk, Nelson, Amini, Saeed, Amini-Rarani, Mostafa, Aminorroaya, Arya, Amiri, Fatemeh, L Amit, Arianna Maever, A Amugsi, Dickson, Gayle Herrera Amul, Gianna, Anderlini, Deanna, Liliana Andrei, Catalina, Andrei, Tudorel, Anjomshoa, Mina, Ansari, Fereshteh, Ansari, Iman, Ansari-Moghaddam, Alireza, T Antonio, Carl Abelardo, M Antony, Catherine, Antriyandarti, Ernoiz, Anvari, Davood, Anwer, Razique, Arabloo, Jalal, Arab-Zozani, Morteza, Y Aravkin, Aleksandr, Ariani, Filippo, Ärnlöv, Johan, K Aryal, Krishna, Arzani, Afsaneh, Asadi-Aliabadi, Mehran, A Asadi-Pooya, Ali, Asghari, Babak, Ashbaugh, Charlie, Debalkie Atnafu, Desta, R Atre, Sachin, Ausloos, Floriane, Ausloos, Marcel, Paulina Ayala Quintanilla, Beatriz, Ayano, Getinet, Amogre Ayanore, Martin, Asmare Aynalem, Yared, Azari, Samad, Azarian, Ghasem, Nigussie Azene, Zelalem, Babaee, Ebrahim, Badawi, Alaa, Bagherzadeh, Mojtaba, Hossein Bakhshaei, Mohammad, Bakhtiari, Ahad, Balakrishnan, Senthilkumar, Balalla, Shivanthi, Balassyano, Shelly, Banach, Maciej, Chandra Banik, Palash, S Bannick, Marlena, Bante Bante, Agegnehu, Gebreegziabher Baraki, Adhanom, A Barboza, Miguel, Lyn Barker-Collo, Suzanne, M Barthelemy, Celine, Barua, Lingkan, Barzegar, Akbar, Basu, Sanjay, T Baune, Bernhard, Bayati, Mohsen, Bazmandegan, Gholamreza, Bedi, Neeraj, Beghi, Ettore, Béjot, Yannick, K Bello, Aminu, G Bender, Rose, A Bennett, Derrick, B Bennitt, Fiona, M Bensenor, Isabela, P Benziger, Catherine, Berhe, Kidanemaryam, Bernabe, Eduardo, J Bertolacci, Gregory, Bhageerathy, Reshmi, Bhala, Neeraj, Bhandari, Dinesh, Bhardwaj, Pankaj, Bhattacharyya, Krittika, A Bhutta, Zulfiqar, Bibi, Sadia, H Biehl, Molly, Bikbov, Bori, Shahdaat Bin Sayeed, Muhammad, Biondi, Antonio, Minuye Birihane, Binyam, Bisanzio, Donal, Bisignano, Catherine, Kishore Biswas, Raaj, Bohlouli, Somayeh, Bohluli, Mehdi, Rao Rao Bolla, Srinivasa, Boloor, Archith, S Boon-Dooley, Alexandra, Borges, Guilherme, Maria Borzì, Antonio, Bourne, Rupert, J Brady, Oliver, Brauer, Michael, Brayne, Carol, K Breitborde, Nicholas J, Brenner, Hermann, Svitil Briant, Paul, M Briggs, Andrew, Ivanovich Briko, Nikolay, B Britton, Gabrielle, Bryazka, Dana, Buchbinder, Rachelle, R Bumgarner, Blair, Busse, Reinhard, A Butt, Zahid, Luciano Caetano Dos Santos, Florentino, LA Alberto Cámera, Lui, R Campos-Nonato, Ismael, Car, Josip, Cárdenas, Rosario, Carreras, Giulia, J Carrero, Juan, Carvalho, Felix, Mauricio Castaldelli-Maia, Joao, A Castañeda-Orjuela, Carlo, Castelpietra, Giulio, D Castle, Chri, Castro, Franz, Catalá-López, Ferrán, Causey, Kate, R Cederroth, Christopher, M Cercy, Kelly, Cerin, Ester, Singh Chandan, Joht, R Chang, Alex, J Charlson, Fiona, Kumar Chattu, Vijay, Chaturvedi, Sarika, Chimed-Ochir, Odgerel, Lee Chin, Ken, Youngwhan Cho, Daniel, Christensen, Hanne, Chu, Dinh-Toi, T Chung, Michael, M Cicuttini, Flavia, G Ciobanu, Liliana, Cirillo, Massimo, L Collins, Emma, Compton, Kelly, Conti, Sara, Angelo Cortesi, Paolo, Marisa Costa, Vera, Cousin, Ewerton, G Cowden, Richard, C Cowie, Benjamin, A Cromwell, Elizabeth, H Cross, Di, Stephen Crowe, Christopher, A Cruz, Jessica, Cunningham, Matthew, A Dahlawi, Saad M, Damiani, Giovanni, Dandona, Lalit, Dandona, Rakhi, Mohammad Darwesh, Aso, Daryani, Ahmad, K Das, Jai, Das Gupta, Rajat, das Neves, José, Alberto Dávila-Cervantes, Claudio, Davletov, Kairat, De Leo, Diego, E Dean, France, K DeCleene, Nicole, Deen, Amanda, Degenhardt, Louisa, Paul Dellavalle, Robert, Mekonnen Demeke, Feleke, Getnet Demsie, Desalegn, Denova-Gutiérrez, Edgar, Dereje Dereje, Nebiyu, Dervenis, Nikolao, Desai, Rupak, Desalew, Assefa, Ayalew Dessie, Getenet, Dhamminda Dharmaratne, Samath, Prasad Dhungana, Govinda, Dianatinasab, Mostafa, Diaz, Daniel, Sadat Dibaji Forooshani, Zahra, V Dingels, Zachary, Ashworth Dirac, M, Djalalinia, Shirin, Thi Do, Hoa, Dokova, Klara, Dorostkar, Fariba, P Doshi, Chirag, Doshmangir, Leila, Douiri, Abdel, C Doxey, Matthew, Robert Driscoll, Tim, J Dunachie, Susanna, B Duncan, Bruce, Rodrigues Duraes, Andre, Wilder Eagan, Arielle, Ebrahimi Kalan, Mohammad, Edvardsson, David, R Ehrlich, Joshua, El Nahas, Nevine, El Sayed, Iman, El Tantawi, Maha, Elbarazi, Iffat, Y Elgendy, Islam, Rashad Elhabashy, Hala, I El-Jaafary, Shaimaa, Rf Elyazar, Iqbal, Hassan Emamian, Mohammad, Emmons-Bell, Sophia, E Erskine, Holly, Eshrati, Babak, Eskandarieh, Sharareh, Esmaeilnejad, Saman, Esmaeilzadeh, Firooz, Esteghamati, Alireza, Estep, Kara, Etemadi, Arash, Esaiyas Etisso, Atkilt, Farahmand, Mohammad, Faraj, Anwar, Fareed, Mohammad, Faridnia, Roghiyeh, E Sá Farinha, Carla Sofia, Farioli, Andrea, Faro, Andre, Faruque, Mithila, Farzadfar, Farshad, Fattahi, Nazir, Fazlzadeh, Mehdi, L Feigin, Valery, Feldman, Rachel, Fereshtehnejad, Seyed-Mohammad, Fernandes, Eduarda, J Ferrari, Alize, L Ferreira, Manuela, Filip, Irina, Fischer, Florian, L Fisher, Jame, Fitzgerald, Ryan, Flohr, Carsten, Sorio Flor, Luisa, A Foigt, Nataliya, Oluwatoyin Folayan, Morenike, M Force, Lisa, Fornari, Carla, Foroutan, Masoud, T Fox, Jack, Freitas, Marisa, Fu, Weijia, Fukumoto, Takeshi, M Furtado, João, M Gad, Mohamed, Gakidou, Emmanuela, C Galles, Natalie, Gallus, Silvano, Gamkrelidze, Amiran, L Garcia-Basteiro, Alberto, M Gardner, William, Sahiledengle Geberemariyam, Biniyam, Mekonnen Gebrehiwot, Abiyu, Bizuwork Gebremedhin, Ketema, Ayalew Ayalew Ayalew Gebreslassie, Assefa, Gershberg Hayoon, Anna, W Gething, Peter, Ghadimi, Maryam, Ghadiri, Keyghobad, Ghafourifard, Mansour, Ghajar, Alireza, Ghamari, Farhad, Ghashghaee, Ahmad, Ghiasvand, Hesam, Ghith, Nermin, Gholamian, Asadollah, Amir Gilani, Syed, Singh Gill, Paramjit, Gitimoghaddam, Mojgan, Giussani, Giorgia, Goli, Sriniva, Santiago Gomez, Ricardo, Vali Gopalani, Sameer, Gorini, Giuseppe, M Gorman, Taren, Chase Gottlich, Harrison, Goudarzi, Houman, C Goulart, Alessandra, Niegia Garcia Goulart, Bárbara, Grada, Ayman, Grivna, Michal, Grosso, Giuseppe, Ibrahim Mohialdeen Gubari, Mohammed, Chander Gugnani, Harish, Luiz Sena Guimaraes, Andre, Alves Guimarães, Rafael, Abdi Guled, Rashid, Guo, Gaorui, Guo, Yuming, Gupta, Rajeev, A Haagsma, Juanita, Haddock, Beatrix, Hafezi-Nejad, Nima, Hafiz, Abdul, Hagins, Hailey, M Haile, Lydia, J Hall, Brian, Halvaei, Iman, R Hamadeh, Randah, Hamagharib Abdullah, Kanaan, B Hamilton, Erin, Han, Chieh, Han, Hannah, J Hankey, Graeme, Maria Haro, Josep, D Harvey, Jame, I Hasaballah, Ahmed, Hasanzadeh, Amir, Hashemian, Maryam, Hassanipour, Soheil, Hassankhani, Hadi, J Havmoeller, Rasmu, J Hay, Roderick, I Hay, Simon, Hayat, Khezar, Heidari, Behnam, Heidari, Golnaz, Heidari-Soureshjani, Reza, Hendrie, Delia, J Henrikson, Hannah, J Henry, Nathaniel, Herteliu, Claudiu, Heydarpour, Fatemeh, R Hird, Thoma, W Hoek, Han, K Hole, Michael, Holla, Ramesh, Hoogar, Praveen, Dean Hosgood, H, Hosseinzadeh, Mehdi, Hostiuc, Mihaela, Hostiuc, Sorin, Househ, Mowafa, G Hoy, Damian, Hsairi, Mohamed, Chia-Rong Hsieh, Vivian, Hu, Guoqing, M Huda, Tanvir, N Hugo, Fernando, K Huynh, Chantal, Hwang, Bing-Fang, C Iannucci, Vincent, Emmanuel Ibitoye, Segun, S Ikuta, Kevin, Stephen Ilesanmi, Olayinka, M Ilic, Irena, D Ilic, Milena, Raja Inbaraj, Leeberk, Ippolito, Helen, Sina Naghibi Irvani, Seyed, Mofizul Islam, M, Islam, Mdmohaimenul, Mohammed Shariful Islam, Sheikh, Islami, Farhad, Iso, Hiroyasu, Q Ivers, Rebecca, D Iwu, Chidozie C, Osamuyi Iyamu, Ihoghosa, Jaafari, Jalil, H Jacobsen, Kathryn, Jadidi-Niaragh, Farhad, Jafari, Hussain, Jafarinia, Morteza, Jahagirdar, Deepa, Ali Jahani, Mohammad, Jahanmehr, Nader, Jakovljevic, Mihajlo, Jalali, Amir, Jalilian, Farzad, L James, Spencer, Janjani, Hosna, Dilipkumar Janodia, Manthan, Upendra Jayatilleke, Achala, Jeemon, Panniyammakal, Jenabi, Ensiyeh, Prakash Jha, Ravi, Jha, Vivekanand, S Ji, John, Jia, Peng, John, Oommen, O John-Akinola, Yetunde, Owens Johnson, Catherine, Charlotte Johnson, Sarah, B Jonas, Jost, Joo, Tama, Joshi, Ankur, Jerzy Jozwiak, Jacek, Jürisson, Mikk, Kabir, Ali, Kabir, Zubair, Kalani, Hamed, Kalani, Rizwan, R Kalankesh, Leila, Kalhor, Rohollah, Kamiab, Zahra, Kanchan, Tanuj, Karami Matin, Behzad, Karch, André, Anisul Karim, Mohd, Eddin Karimi, Salah, Mullu Kassa, Getachew, J Kassebaum, Nichola, Vittal Katikireddi, Srinivasa, Kawakami, Norito, A Kayode, Gbenga, H Keddie, Suzanne, Keller, Cathleen, Kereselidze, Maia, Abdullatif Khafaie, Morteza, Khalid, Nauman, Khan, Maseer, Khatab, Khaled, M Khater, Mona, Nazli Khatib, Mahalaqua, Khayamzadeh, Maryam, Taghi Khodayari, Mohammad, Khundkar, Roba, Kianipour, Neda, Kieling, Christian, Kim, Daniel, Kim, Young-Eun, Jin Kim, Yun, W Kimokoti, Ruth, Kisa, Adnan, Kisa, Sezer, Kissimova-Skarbek, Katarzyna, Kivimäki, Mika, J Kneib, Cameron, Kristin Skrindo Knudsen, Ann, M Kocarnik, Jonathan, Kolola, Tufa, A Kopec, Jacek, Kosen, Soewarta, A Koul, Parvaiz, Koyanagi, Ai, A Kravchenko, Michael, Krishan, Kewal, J Krohn, Kri, Kuate Defo, Barthelemy, Kucuk Bicer, Burcu, Anil Kumar, G, Kumar, Manasi, Kumar, Pushpendra, Kumar, Vivek, Kumaresh, Girikumar, P Kurmi, Om, Kusuma, Dian, Hmwe Kyu, Hmwe, La Vecchia, Carlo, Lacey, Ben, Kumar Lal, Dharmesh, Lalloo, Ratilal, O Lam, Jennifer, Hasan Lami, Fari, Landires, Iván, J Lang, Justin, Charles Lansingh, Van, Leigh Larson, Samantha, O Larsson, Ander, Lasrado, Savita, S Lassi, Zohra, Mei-Ming Lau, Kathryn, M Lavados, Pablo, V Lazarus, Jeffrey, R Ledesma, Jorge, H Lee, Paul, Wen Huey Lee, Shaun, E LeGrand, Kate, Leigh, Jame, Leonardi, Matilde, Lescinsky, Haley, Leung, Janni, Levi, Miriam, Lewington, Sarah, Li, Shanshan, Lim, Lee-Ling, Lin, Christine, Lin, Ro-Ting, Linehan, Christine, Linn, Shai, Liu, Hung-Chun, Liu, Shiwei, Liu, Zichen, J Looker, Katharine, D Lopez, Alan, D Lopukhov, Platon, Lorkowski, Stefan, A Lotufo, Paulo, D Lucas, Tim C, Lugo, Alessandra, Lunevicius, Raimunda, A Lyons, Ronan, Ma, Jianing, H MacLachlan, Jennifer, R Maddison, Emilie, Maddison, Ralph, Madotto, Fabiana, Walter Mahasha, Phetole, Thi Mai, Hue, Majeed, Azeem, Maled, Venkatesh, Maleki, Shokofeh, Malekzadeh, Reza, Carvalho Malta, Deborah, A Mamun, Abdullah, Manafi, Amir, Manafi, Navid, Manguerra, Helena, Mansouri, Borhan, Ali Mansournia, Mohammad, M Mantilla Herrera, Ana, C Maravilla, Joemer, Marks, Ashley, Rogerlândio Martins-Melo, Francisco, Martopullo, Ira, Zahra Masoumi, Seyedeh, Massano, João, Ballard Massenburg, Benjamin, Raj Mathur, Manu, K Maulik, Pallab, Mcalinden, Colm, J McGrath, John, Mckee, Martin, Mohan Mehndiratta, Man, Mehri, Fereshteh, M Mehta, Kala, Bigyananda Meitei, Wahengbam, N Memiah, Peter T, Mendoza, Walter, G Menezes, Ritesh, Worku Mengesha, Endalkachew, Berwo Mengesha, Meresa, Mereke, Alibek, Meretoja, Atte, J Meretoja, Tuomo, Mestrovic, Tomislav, Miazgowski, Bartosz, Miazgowski, Tomasz, Maria Michalek, Irmina, Mulatu Mihretie, Kebadnew, R Miller, Ted, J Mills, Edward, Mirica, Andreea, M Mirrakhimov, Erkin, Mirzaei, Hamed, Mirzaei, Maryam, Mirzaei-Alavijeh, Mehdi, Temesgen Misganaw, Awoke, Mithra, Prasanna, Moazen, Babak, Moghadaszadeh, Masoud, Mohamadi, Efat, K Mohammad, Dara, Mohammad, Yousef, Mohammad Gholi Mezerji, Naser, Mohammadian-Hafshejani, Abdollah, Mohammadifard, Noushin, Mohammadpourhodki, Reza, Mohammed, Shafiu, H Mokdad, Ali, Molokhia, Mariam, C Momen, Natalie, Monasta, Lorenzo, Mondello, Stefania, D Mooney, Meghan, Moosazadeh, Mahmood, Moradi, Ghobad, Moradi, Masoud, Moradi-Lakeh, Maziar, Moradzadeh, Rahmatollah, Moraga, Paula, Morales, Linda, Morawska, Lidia, Moreno Velásquez, Ilai, Morgado-da-Costa, Joana, Douglas Morrison, Shane, F Mosser, Jonathan, Mouodi, Simin, Meysam Mousavi, Seyyed, Mousavi Khaneghah, Amin, Otto Mueller, Ulrich, B Munro, Sandra, K Muriithi, Mose, Imran Musa, Kamarul, Muthupandian, Saravanan, Naderi, Mehdi, Jayaraman Nagarajan, Ahamarshan, Nagel, Gabriele, Naghshtabrizi, Behshad, Nair, Sanjeev, K Nandi, Anita, Nangia, Vinay, Richie Nansseu, Jobert, C Nayak, Vinod, Nazari, Javad, Negoi, Ionut, Irina Negoi, Ruxandra, Biresaw Netsere Netsere, Henok, W Ngunjiri, Josephine, Tat Nguyen, Cuong, Nguyen, Jason, Nguyen, Michele, Nguyen, Minh, Nichols, Emma, Nigatu, Dabere, T Nigatu, Yeshambel, Nikbakhsh, Rajan, R Nixon, Molly, A Nnaji, Chukwudi, Nomura, Shuhei, Norrving, Bo, Jacques Noubiap, Jean, Nowak, Christoph, Nunez-Samudio, Virginia, Oţoiu, Adrian, Oancea, Bogdan, M Odell, Christopher, Akpojene Ogbo, Felix, Oh, In-Hwan, Wandera Okunga, Emmanuel, Oladnabi, Morteza, T Olagunju, Andrew, Olubukunola Olusanya, Bolajoko, Olusegun Olusanya, Jacob, Morenike Oluwasanu, Mojisola, Omar Bali, Ahmed, Omer Omer, Muktar, L Ong, Kanyin, E Onwujekwe, Obinna, U Orji, Aislyn, M Orpana, Heather, Ortiz, Alberto, M Ostroff, Samuel, Otstavnov, Nikita, S Otstavnov, Stanislav, Øverland, Simon, O Owolabi, Mayowa, P A, Mahesh, Rao Padubidri, Jagadish, P Pakhare, Abhijit, Palladino, Raffaele, Pana, Adrian, Panda-Jonas, Songhomitra, Pandey, Anamika, Park, Eun-Kee, G Kumari Parmar, Priya, Kumar Pasupula, Deepak, Kishor Patel, Sangram, J Paternina-Caicedo, Angel, Pathak, Ashish, Pathak, Mona, B Patten, Scott, C Patton, George, Paudel, Deepak, Pazoki Toroudi, Hamidreza, E Peden, Amy, Pennini, Alyssa, Christian Filipino Pepito, Veincent, K Peprah, Emmanuel, Pereira, Alexandre, M Pereira, David, Perico, Norberto, Quang Pham, Hai, R Phillips, Michael, M Pigott, David, Pilgrim, Thoma, M Pilz, Tessa, Pirsaheb, Meghdad, Plana-Ripoll, Oleguer, Plass, Dietrich, Narayan Pokhrel, Khem, V Polibin, Roman, Polinder, Suzanne, R Polkinghorne, Kevan, J Postma, Maarten, Pourjafar, Hadi, Pourmalek, Farshad, Pourmirza Kalhori, Reza, Pourshams, Akram, Poznańska, Anna, I Prada, Sergio, Ria Angga Pribadi, Dima, Pupillo, Elisabetta, Quazi Syed, Zahiruddin, Rabiee, Mohammad, Rabiee, Navid, Radfar, Amir, Rafiee, Ata, Rafiei, Alireza, Raggi, Alberto, Rahimi-Movaghar, Afarin, Aziz Rahman, Muhammad, Rajabpour-Sanati, Ali, Rajati, Fatemeh, Ramezanzadeh, Kiana, Lal Ranabhat, Chhabi, C Rao, Puja, J Rao, Sowmya, Rasella, Davide, Rastogi, Prateek, Rathi, Priya, Laith Rawaf, David, Rawaf, Salman, Rawal, Lal, Razo, Christian, Boston Redford, Sofia, C Reiner Jr, Robert, Reinig, Nickola, Bettay Reitsma, Marissa, Remuzzi, Giuseppe, Renjith, Vishnu, N Renzaho, Andre M, Resnikoff, Serge, Rezaei, Nima, Sadegh Rezai, Mohammad, Rezapour, Aziz, Rhinehart, Phoebe-Anne, Mohammad Riahi, Seyed, P Ribeiro, Antonio Luiz, Cury Ribeiro, Daniel, Ribeiro, Daniela, Rickard, Jennifer, S Roberts, Nicholas L, Roberts, Shaun, R Robinson, Stephen, Roever, Leonardo, Rolfe, Sam, Ronfani, Luca, Roshandel, Gholamreza, A Roth, Gregory, Rubagotti, Enrico, Fred Rumisha, Susan, Sabour, Siamak, S Sachdev, Perminder, Saddik, Basema, Sadeghi, Ehsan, Sadeghi, Masoumeh, Saeidi, Shahram, Safi, Sare, Safiri, Saeid, Sagar, Rajesh, Sahebkar, Amirhossein, Ali Sahraian, Mohammad, Mohammad Sajadi, S, Reza Salahshoor, Mohammad, Salamati, Payman, Salehi Zahabi, Saleh, Salem, Hosni, R Rashad Salem, Marwa, Salimzadeh, Hamideh, A Salomon, Joshua, Salz, Inbal, Samad, Zainab, M Samy, Abdallah, Sanabria, Juan, Francesco Santomauro, Damian, S Santos, Itamar, Vasco Santos, João, M Santric-Milicevic, Milena, Yegnanarayana Iyer Saraswathy, Sivan, Sarmiento-Suárez, Rodrigo, Sarrafzadegan, Nizal, Sartorius, Benn, Sarveazad, Arash, Sathian, Brijesh, Sathish, Thirunavukkarasu, Sattin, Davide, N Sbarra, Alyssa, E Schaeffer, Lauren, Schiavolin, Silvia, Inês Schmidt, Maria, Elisabeth Schutte, Aletta, C Schwebel, David, Schwendicke, Falk, Muleta Senbeta, Anbissa, Senthilkumaran, Subramanian, G Sepanlou, Sadaf, Anne Shackelford, Katya, Shadid, Jamileh, Shahabi, Saeed, A Shaheen, Amira, Ali Shaikh, Masood, S Shalash, Ali, Shams-Beyranvand, Mehran, Shamsizadeh, Morteza, Shannawaz, Mohammed, Sharafi, Kiomar, Sharara, Fablina, S Sheena, Brittney, Sheikhtaheri, Abba, S Shetty, Ranjitha, Shibuya, Kenji, Shibabaw Shiferaw, Wondimeneh, Shigematsu, Mika, Il Shin, Jae, Shiri, Rahman, Shirkoohi, Reza, G Shrime, Mark, Shuval, Kerem, Siabani, Soraya, Dora Sigfusdottir, Inga, Sigurvinsdottir, Rannveig, Pedro Silva, João, E Simpson, Kyle, Singh, Ambrish, A Singh, Jasvinder, Skiadaresi, Eirini, T Skou Skou, Søren, Yurievich Skryabin, Valentin, Sobngwi, Eugene, Sokhan, Anton, Soltani, Shahin, D Sorensen, Reed J, B Soriano, Joan, Bekele Sorrie, Muluken, N Soyiri, Ireneou, T Sreeramareddy, Chandrashekhar, D Stanaway, Jeffrey, A Stark, Benjamin, Cătălina Ştefan, Simona, Stein, Caroline, Steiner, Caitlyn, J Steiner, Timothy, A Stokes, Mark, Jacob Stovner, Lar, L Stubbs, Jacob, Sudaryanto, Agu, Babale Sufiyan, Mu'Awiyyah, Sulo, Gerhard, Sultan, Iyad, L Sykes, Bryan, O Sylte, Dillon, Szócska, Mikló, Tabarés-Seisdedos, Rafael, M Tabb, Karen, Kumar Tadakamadla, Santosh, Taherkhani, Amir, Tajdini, Masih, Takahashi, Ken, Taveira, Nuno, L Teagle, Whitney, Teame, Hirut, Tehrani-Banihashemi, Arash, Fseha Teklehaimanot, Berhane, Terrason, Sonyah, Tadesse Tessema, Zemenu, Raman Thankappan, Kavumpurathu, M Thomson, Azalea, Reza Tohidinik, Hamid, Tonelli, Marcello, Topor-Madry, Roman, E Torre, Anna, Touvier, Mathilde, Roberto Roberto Tovani-Palone, Marco, Xuan Tran, Bach, Travillian, Ravensara, E Troeger, Christopher, Clement Truelsen, Thoma, C Tsai, Alexander, Tsatsakis, Aristidi, Tudor Car, Lorainne, Tyrovolas, Stefano, Uddin, Riaz, Ullah, Saif, A Undurraga, Eduardo, Unnikrishnan, Bhaskaran, Vacante, Marco, Vakilian, Alireza, R Valdez, Pascual, Varughese, Santosh, Juhani Vasankari, Tommi, Vasseghian, Yasser, Venketasubramanian, Narayanaswamy, S Violante, Francesco, Vlassov, Vasily, Emil Vollset, Stein, Vongpradith, Avina, Vukovic, Ana, Vukovic, Rade, Waheed, Yasir, K Walters, Madgalene, Wang, Jiayu, Wang, Yafeng, Wang, Yuan-Pang, L Ward, Joseph, Watson, Alexandrea, Wei, Jingkai, G Weintraub, Robert, J Weiss, Daniel, Weiss, Jordan, Westerman, Ronny, L Whisnant, Joanna, A Whiteford, Harvey, Wiangkham, Taweewat, E Wiens, Kirsten, Wijeratne, Tissa, B Wilner, Lauren, Wilson, Shadrach, Wojtyniak, Bogdan, A Wolfe, Charles D, E Wool, Eve, Wu, Ai-Min, Wulf Hanson, Sarah, Yong Wunrow, Han, Xu, Gelin, Xu, Rixing, Yadgir, Simon, Hossein Yahyazadeh Jabbari, Seyed, Yamagishi, Kazumasa, Yaminfirooz, Mousa, Yano, Yuichiro, Yaya, Sanni, Yazdi-Feyzabadi, Vahid, A Yearwood, Jamal, Y Yeheyis, Toma, Gizachew Yeshitila, Yordano, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Yoosefi Lebni, Javad, Z Younis, Mustafa, Patrick Younker, Theodore, Yousefi, Zabihollah, Yousefifard, Mahmoud, Yousefinezhadi, Taraneh, Yousuf Yousuf, Abdilahi, Yu, Chuanhua, Yusefzadeh, Hasan, Zahirian Moghadam, Telma, Zaki, Leila, Bin Zaman, Sojib, Zamani, Mohammad, Zamanian, Maryam, Zandian, Hamed, Zangeneh, Alireza, Sergeevich Zastrozhin, Mikhail, Alemayehu Zewdie, Kaleab, Zhang, Yunquan, Zhang, Zhi-Jiang, T Zhao, Jeff, Zhao, Yingxi, Zheng, Peng, Zhou, Maigeng, Ziapour, Arash, M Zimsen, Stephanie R, Naghavi, Mohsen, L Murray, Christopher J, Tampere University, Tays Research Services, Health Sciences, Vos, T., Lim, S. S., Abbafati, C., Abbas, K. M., Abbasi, M., Abbasifard, M., Abbasi-Kangevari, M., Abbastabar, H., Abd-Allah, F., Abdelalim, A., Abdollahi, M., Abdollahpour, I., Abolhassani, H., Aboyans, V., Abrams, E. M., Abreu, L. G., Abrigo, M. R. M., Abu-Raddad, L. J., Abushouk, A. I., Acebedo, A., Ackerman, I. N., Adabi, M., Adamu, A. A., Adebayo, O. M., Adekanmbi, V., Adelson, J. D., Adetokunboh, O. O., Adham, D., Afshari, M., Afshin, A., Agardh, E. E., Agarwal, G., Agesa, K. M., Aghaali, M., Aghamir, S. M. K., Agrawal, A., Ahmad, T., Ahmadi, A., Ahmadi, M., Ahmadieh, H., Ahmadpour, E., Akalu, T. Y., Akinyemi, R. O., Akinyemiju, T., Akombi, B., Al-Aly, Z., Alam, K., Alam, N., Alam, S., Alam, T., Alanzi, T. M., Albertson, S. B., Alcalde-Rabanal, J. E., Alema, N. M., Ali, M., Ali, S., Alicandro, G., Alijanzadeh, M., Alinia, C., Alipour, V., Aljunid, S. M., Alla, F., Allebeck, P., Almasi-Hashiani, A., Alonso, J., Al-Raddadi, R. M., Altirkawi, K. A., Alvis-Guzman, N., Alvis-Zakzuk, N. J., Amini, S., Amini-Rarani, M., Aminorroaya, A., Amiri, F., Amit, A. M. L., Amugsi, D. A., Amul, G. G. H., Anderlini, D., Andrei, C. L., Andrei, T., Anjomshoa, M., Ansari, F., Ansari, I., Ansari-Moghaddam, A., Antonio, C. A. T., Antony, C. M., Antriyandarti, E., Anvari, D., Anwer, R., Arabloo, J., Arab-Zozani, M., Aravkin, A. Y., Ariani, F., Arnlov, J., Aryal, K. K., Arzani, A., Asadi-Aliabadi, M., Asadi-Pooya, A. A., Asghari, B., Ashbaugh, C., Atnafu, D. D., Atre, S. R., Ausloos, F., Ausloos, M., Ayala Quintanilla, B. P., Ayano, G., Ayanore, M. A., Aynalem, Y. A., Azari, S., Azarian, G., Azene, Z. N., Babaee, E., Badawi, A., Bagherzadeh, M., Bakhshaei, M. H., Bakhtiari, A., Balakrishnan, S., Balalla, S., Balassyano, S., Banach, M., Banik, P. C., Bannick, M. S., Bante, A. B., Baraki, A. G., Barboza, M. A., Barker-Collo, S. L., Barthelemy, C. M., Barua, L., Barzegar, A., Basu, S., Baune, B. T., Bayati, M., Bazmandegan, G., Bedi, N., Beghi, E., Bejot, Y., Bello, A. K., Bender, R. G., Bennett, D. A., Bennitt, F. B., Bensenor, I. M., Benziger, C. P., Berhe, K., Bernabe, E., Bertolacci, G. J., Bhageerathy, R., Bhala, N., Bhandari, D., Bhardwaj, P., Bhattacharyya, K., Bhutta, Z. A., Bibi, S., Biehl, M. H., Bikbov, B., Bin Sayeed, M. S., Biondi, A., Birihane, B. M., Bisanzio, D., Bisignano, C., Biswas, R. K., Bohlouli, S., Bohluli, M., Bolla, S. R. R., Boloor, A., Boon-Dooley, A. S., Borges, G., Borzi, A. M., Bourne, R., Brady, O. J., Brauer, M., Brayne, C., Breitborde, N. J. K., Brenner, H., Briant, P. S., Briggs, A. M., Briko, N. I., Britton, G. B., Bryazka, D., Buchbinder, R., Bumgarner, B. R., Busse, R., Butt, Z. A., Caetano dos Santos, F. L., Camera, L. L. A., Campos-Nonato, I. R., Car, J., Cardenas, R., Carreras, G., Carrero, J. J., Carvalho, F., Castaldelli-Maia, J. M., Castaneda-Orjuela, C. A., Castelpietra, G., Castle, C. D., Castro, F., Catala-Lopez, F., Causey, K., Cederroth, C. R., Cercy, K. M., Cerin, E., Chandan, J. S., Chang, A. R., Charlson, F. J., Chattu, V. K., Chaturvedi, S., Chimed-Ochir, O., Chin, K. L., Cho, D. Y., Christensen, H., Chu, D. -T., Chung, M. T., Cicuttini, F. M., Ciobanu, L. G., Cirillo, M., Collins, E. L., Compton, K., Conti, S., Cortesi, P. A., Costa, V. M., Cousin, E., Cowden, R. G., Cowie, B. C., Cromwell, E. A., Cross, D. H., Crowe, C. S., Cruz, J. A., Cunningham, M., Dahlawi, S. M. A., Damiani, G., Dandona, L., Dandona, R., Darwesh, A. M., Daryani, A., Das, J. K., Das Gupta, R., das Neves, J., Davila-Cervantes, C. A., Davletov, K., De Leo, D., Dean, F. E., Decleene, N. K., Deen, A., Degenhardt, L., Dellavalle, R. P., Demeke, F. M., Demsie, D. G., Denova-Gutierrez, E., Dereje, N. D., Dervenis, N., Desai, R., Desalew, A., Dessie, G. A., Dharmaratne, S. D., Dhungana, G. P., Dianatinasab, M., Diaz, D., Dibaji Forooshani, Z. S., Dingels, Z. V., Dirac, M. A., Djalalinia, S., Do, H. T., Dokova, K., Dorostkar, F., Doshi, C. P., Doshmangir, L., Douiri, A., Doxey, M. C., Driscoll, T. R., Dunachie, S. J., Duncan, B. B., Duraes, A. R., Eagan, A. W., Ebrahimi Kalan, M., Edvardsson, D., Ehrlich, J. R., El Nahas, N., El Sayed, I., El Tantawi, M., Elbarazi, I., Elgendy, I. Y., Elhabashy, H. R., El-Jaafary, S. I., Elyazar, I. R., Emamian, M. H., Emmons-Bell, S., Erskine, H. E., Eshrati, B., Eskandarieh, S., Esmaeilnejad, S., Esmaeilzadeh, F., Esteghamati, A., Estep, K., Etemadi, A., Etisso, A. E., Farahmand, M., Faraj, A., Fareed, M., Faridnia, R., Farinha, C. S. E. S., Farioli, A., Faro, A., Faruque, M., Farzadfar, F., Fattahi, N., Fazlzadeh, M., Feigin, V. L., Feldman, R., Fereshtehnejad, S. -M., Fernandes, E., Ferrari, A. J., Ferreira, M. L., Filip, I., Fischer, F., Fisher, J. L., Fitzgerald, R., Flohr, C., Flor, L. S., Foigt, N. A., Folayan, M. O., Force, L. M., Fornari, C., Foroutan, M., Fox, J. T., Freitas, M., Fu, W., Fukumoto, T., Furtado, J. M., Gad, M. M., Gakidou, E., Galles, N. C., Gallus, S., Gamkrelidze, A., Garcia-Basteiro, A. L., Gardner, W. M., Geberemariyam, B. S., Gebrehiwot, A. M., Gebremedhin, K. B., Gebreslassie, A. A. A. A., Gershberg Hayoon, A., Gething, P. W., Ghadimi, M., Ghadiri, K., Ghafourifard, M., Ghajar, A., Ghamari, F., Ghashghaee, A., Ghiasvand, H., Ghith, N., Gholamian, A., Gilani, S. A., Gill, P. S., Gitimoghaddam, M., Giussani, G., Goli, S., Gomez, R. S., Gopalani, S. V., Gorini, G., Gorman, T. M., Gottlich, H. C., Goudarzi, H., Goulart, A. C., Goulart, B. N. G., Grada, A., Grivna, M., Grosso, G., Gubari, M. I. M., Gugnani, H. C., Guimaraes, A. L. S., Guimaraes, R. A., Guled, R. A., Guo, G., Guo, Y., Gupta, R., Haagsma, J. A., Haddock, B., Hafezi-Nejad, N., Hafiz, A., Hagins, H., Haile, L. M., Hall, B. J., Halvaei, I., Hamadeh, R. R., Hamagharib Abdullah, K., Hamilton, E. B., Han, C., Han, H., Hankey, G. J., Haro, J. M., Harvey, J. D., Hasaballah, A. I., Hasanzadeh, A., Hashemian, M., Hassanipour, S., Hassankhani, H., Havmoeller, R. J., Hay, R. J., Hay, S. I., Hayat, K., Heidari, B., Heidari, G., Heidari-Soureshjani, R., Hendrie, D., Henrikson, H. J., Henry, N. J., Herteliu, C., Heydarpour, F., Hird, T. R., Hoek, H. W., Hole, M. K., Holla, R., Hoogar, P., Hosgood, H. D., Hosseinzadeh, M., Hostiuc, M., Hostiuc, S., Househ, M., Hoy, D. G., Hsairi, M., Hsieh, V. C. -R., Hu, G., Huda, T. M., Hugo, F. N., Huynh, C. K., Hwang, B. -F., Iannucci, V. C., Ibitoye, S. E., Ikuta, K. S., Ilesanmi, O. S., Ilic, I. M., Ilic, M. D., Inbaraj, L. R., Ippolito, H., Irvani, S. S. N., Islam, M. M., Islam, M., Islam, S. M. S., Islami, F., Iso, H., Ivers, R. Q., Iwu, C. C. D., Iyamu, I. O., Jaafari, J., Jacobsen, K. H., Jadidi-Niaragh, F., Jafari, H., Jafarinia, M., Jahagirdar, D., Jahani, M. A., Jahanmehr, N., Jakovljevic, M., Jalali, A., Jalilian, F., James, S. L., Janjani, H., Janodia, M. D., Jayatilleke, A. U., Jeemon, P., Jenabi, E., Jha, R. P., Jha, V., Ji, J. S., Jia, P., John, O., John-Akinola, Y. O., Johnson, C. O., Johnson, S. C., Jonas, J. B., Joo, T., Joshi, A., Jozwiak, J. J., Jurisson, M., Kabir, A., Kabir, Z., Kalani, H., Kalani, R., Kalankesh, L. R., Kalhor, R., Kamiab, Z., Kanchan, T., Karami Matin, B., Karch, A., Karim, M. A., Karimi, S. E., Kassa, G. M., Kassebaum, N. J., Katikireddi, S. V., Kawakami, N., Kayode, G. A., Keddie, S. H., Keller, C., Kereselidze, M., Khafaie, M. A., Khalid, N., Khan, M., Khatab, K., Khater, M. M., Khatib, M. N., Khayamzadeh, M., Khodayari, M. T., Khundkar, R., Kianipour, N., Kieling, C., Kim, D., Kim, Y. -E., Kim, Y. J., Kimokoti, R. W., Kisa, A., Kisa, S., Kissimova-Skarbek, K., Kivimaki, M., Kneib, C. J., Knudsen, A. K. S., Kocarnik, J. M., Kolola, T., Kopec, J. A., Kosen, S., Koul, P. A., Koyanagi, A., Kravchenko, M. A., Krishan, K., Krohn, K. J., Kuate Defo, B., Kucuk Bicer, B., Kumar, G. A., Kumar, M., Kumar, P., Kumar, V., Kumaresh, G., Kurmi, O. P., Kusuma, D., Kyu, H. H., La Vecchia, C., Lacey, B., Lal, D. K., Lalloo, R., Lam, J. O., Lami, F. H., Landires, I., Lang, J. J., Lansingh, V. C., Larson, S. L., Larsson, A. O., Lasrado, S., Lassi, Z. S., Lau, K. M. -M., Lavados, P. M., Lazarus, J. V., Ledesma, J. R., Lee, P. H., Lee, S. W. H., Legrand, K. E., Leigh, J., Leonardi, M., Lescinsky, H., Leung, J., Levi, M., Lewington, S., Li, S., Lim, L. -L., Lin, C., Lin, R. -T., Linehan, C., Linn, S., Liu, H. -C., Liu, S., Liu, Z., Looker, K. J., Lopez, A. D., Lopukhov, P. D., Lorkowski, S., Lotufo, P. A., Lucas, T. C. D., Lugo, A., Lunevicius, R., Lyons, R. A., Ma, J., Maclachlan, J. H., Maddison, E. R., Maddison, R., Madotto, F., Mahasha, P. W., Mai, H. T., Majeed, A., Maled, V., Maleki, S., Malekzadeh, R., Malta, D. C., Mamun, A. A., Manafi, A., Manafi, N., Manguerra, H., Mansouri, B., Mansournia, M. A., Mantilla Herrera, A. M., Maravilla, J. C., Marks, A., Martins-Melo, F. R., Martopullo, I., Masoumi, S. Z., Massano, J., Massenburg, B. B., Mathur, M. R., Maulik, P. K., Mcalinden, C., Mcgrath, J. J., Mckee, M., Mehndiratta, M. M., Mehri, F., Mehta, K. M., Meitei, W. B., Memiah, P. T. N., Mendoza, W., Menezes, R. G., Mengesha, E. W., Mengesha, M. B., Mereke, A., Meretoja, A., Meretoja, T. J., Mestrovic, T., Miazgowski, B., Miazgowski, T., Michalek, I. M., Mihretie, K. M., Miller, T. R., Mills, E. J., Mirica, A., Mirrakhimov, E. M., Mirzaei, H., Mirzaei, M., Mirzaei-Alavijeh, M., Misganaw, A. T., Mithra, P., Moazen, B., Moghadaszadeh, M., Mohamadi, E., Mohammad, D. K., Mohammad, Y., Mohammad Gholi Mezerji, N., Mohammadian-Hafshejani, A., Mohammadifard, N., Mohammadpourhodki, R., Mohammed, S., Mokdad, A. H., Molokhia, M., Momen, N. C., Monasta, L., Mondello, S., Mooney, M. D., Moosazadeh, M., Moradi, G., Moradi, M., Moradi-Lakeh, M., Moradzadeh, R., Moraga, P., Morales, L., Morawska, L., Moreno Velasquez, I., Morgado-da-Costa, J., Morrison, S. D., Mosser, J. F., Mouodi, S., Mousavi, S. M., Mousavi Khaneghah, A., Mueller, U. O., Munro, S. B., Muriithi, M. K., Musa, K. I., Muthupandian, S., Naderi, M., Nagarajan, A. J., Nagel, G., Naghshtabrizi, B., Nair, S., Nandi, A. K., Nangia, V., Nansseu, J. R., Nayak, V. C., Nazari, J., Negoi, I., Negoi, R. I., Netsere, H. B. N., Ngunjiri, J. W., Nguyen, C. T., Nguyen, J., Nguyen, M., Nichols, E., Nigatu, D., Nigatu, Y. T., Nikbakhsh, R., Nixon, M. R., Nnaji, C. A., Nomura, S., Norrving, B., Noubiap, J. J., Nowak, C., Nunez-Samudio, V., Otoiu, A., Oancea, B., Odell, C. M., Ogbo, F. A., Oh, I. -H., Okunga, E. W., Oladnabi, M., Olagunju, A. T., Olusanya, B. O., Olusanya, J. O., Oluwasanu, M. M., Omar Bali, A., Omer, M. O., Ong, K. L., Onwujekwe, O. E., Orji, A. U., Orpana, H. M., Ortiz, A., Ostroff, S. M., Otstavnov, N., Otstavnov, S. S., Overland, S., Owolabi, M. O., P A, M., Padubidri, J. R., Pakhare, A. P., Palladino, R., Pana, A., Panda-Jonas, S., Pandey, A., Park, E. -K., Parmar, P. G. K., Pasupula, D. K., Patel, S. K., Paternina-Caicedo, A. J., Pathak, A., Pathak, M., Patten, S. B., Patton, G. C., Paudel, D., Pazoki Toroudi, H., Peden, A. E., Pennini, A., Pepito, V. C. F., Peprah, E. K., Pereira, A., Pereira, D. M., Perico, N., Pham, H. Q., Phillips, M. R., Pigott, D. M., Pilgrim, T., Pilz, T. M., Pirsaheb, M., Plana-Ripoll, O., Plass, D., Pokhrel, K. N., Polibin, R. V., Polinder, S., Polkinghorne, K. R., Postma, M. J., Pourjafar, H., Pourmalek, F., Pourmirza Kalhori, R., Pourshams, A., Poznanska, A., Prada, S. I., Prakash, V., Pribadi, D. R. A., Pupillo, E., Quazi Syed, Z., Rabiee, M., Rabiee, N., Radfar, A., Rafiee, A., Rafiei, A., Raggi, A., Rahimi-Movaghar, A., Rahman, M. A., Rajabpour-Sanati, A., Rajati, F., Ramezanzadeh, K., Ranabhat, C. L., Rao, P. C., Rao, S. J., Rasella, D., Rastogi, P., Rathi, P., Rawaf, D. L., Rawaf, S., Rawal, L., Razo, C., Redford, S. B., Reiner, R. C., Reinig, N., Reitsma, M. B., Remuzzi, G., Renjith, V., Renzaho, A. M. N., Resnikoff, S., Rezaei, N., Rezai, M. S., Rezapour, A., Rhinehart, P. -A., Riahi, S. M., Ribeiro, A. L. P., Ribeiro, D. C., Ribeiro, D., Rickard, J., Roberts, N. L. S., Roberts, S., Robinson, S. R., Roever, L., Rolfe, S., Ronfani, L., Roshandel, G., Roth, G. A., Rubagotti, E., Rumisha, S. F., Sabour, S., Sachdev, P. S., Saddik, B., Sadeghi, E., Sadeghi, M., Saeidi, S., Safi, S., Safiri, S., Sagar, R., Sahebkar, A., Sahraian, M. A., Sajadi, S. M., Salahshoor, M. R., Salamati, P., Salehi Zahabi, S., Salem, H., Salem, M. R. R., Salimzadeh, H., Salomon, J. A., Salz, I., Samad, Z., Samy, A. M., Sanabria, J., Santomauro, D. F., Santos, I. S., Santos, J. V., Santric-Milicevic, M. M., Saraswathy, S. Y. I., Sarmiento-Suarez, R., Sarrafzadegan, N., Sartorius, B., Sarveazad, A., Sathian, B., Sathish, T., Sattin, D., Sbarra, A. N., Schaeffer, L. E., Schiavolin, S., Schmidt, M. I., Schutte, A. E., Schwebel, D. C., Schwendicke, F., Senbeta, A. M., Senthilkumaran, S., Sepanlou, S. G., Shackelford, K. A., Shadid, J., Shahabi, S., Shaheen, A. A., Shaikh, M. A., Shalash, A. S., Shams-Beyranvand, M., Shamsizadeh, M., Shannawaz, M., Sharafi, K., Sharara, F., Sheena, B. S., Sheikhtaheri, A., Shetty, R. S., Shibuya, K., Shiferaw, W. S., Shigematsu, M., Shin, J. I., Shiri, R., Shirkoohi, R., Shrime, M. G., Shuval, K., Siabani, S., Sigfusdottir, I. D., Sigurvinsdottir, R., Silva, J. P., Simpson, K. E., Singh, A., Singh, J. A., Skiadaresi, E., Skou, S. T. S., Skryabin, V. Y., Sobngwi, E., Sokhan, A., Soltani, S., Sorensen, R. J. D., Soriano, J. B., Sorrie, M. B., Soyiri, I. N., Sreeramareddy, C. T., Stanaway, J. D., Stark, B. A., Stefan, S. C., Stein, C., Steiner, C., Steiner, T. J., Stokes, M. A., Stovner, L. J., Stubbs, J. L., Sudaryanto, A., Sufiyan, M. B., Sulo, G., Sultan, I., Sykes, B. L., Sylte, D. O., Szocska, M., Tabares-Seisdedos, R., Tabb, K. M., Tadakamadla, S. K., Taherkhani, A., Tajdini, M., Takahashi, K., Taveira, N., Teagle, W. L., Teame, H., Tehrani-Banihashemi, A., Teklehaimanot, B. F., Terrason, S., Tessema, Z. T., Thankappan, K. R., Thomson, A. M., Tohidinik, H. R., Tonelli, M., Topor-Madry, R., Torre, A. E., Touvier, M., Tovani-Palone, M. R. R., Tran, B. X., Travillian, R., Troeger, C. E., Truelsen, T. C., Tsai, A. C., Tsatsakis, A., Tudor Car, L., Tyrovolas, S., Uddin, R., Ullah, S., Undurraga, E. A., Unnikrishnan, B., Vacante, M., Vakilian, A., Valdez, P. R., Varughese, S., Vasankari, T. J., Vasseghian, Y., Venketasubramanian, N., Violante, F. S., Vlassov, V., Vollset, S. E., Vongpradith, A., Vukovic, A., Vukovic, R., Waheed, Y., Walters, M. K., Wang, J., Wang, Y., Wang, Y. -P., Ward, J. L., Watson, A., Wei, J., Weintraub, R. G., Weiss, D. J., Weiss, J., Westerman, R., Whisnant, J. L., Whiteford, H. A., Wiangkham, T., Wiens, K. E., Wijeratne, T., Wilner, L. B., Wilson, S., Wojtyniak, B., Wolfe, C. D. A., Wool, E. E., Wu, A. -M., Wulf Hanson, S., Wunrow, H. Y., Xu, G., Xu, R., Yadgir, S., Yahyazadeh Jabbari, S. H., Yamagishi, K., Yaminfirooz, M., Yano, Y., Yaya, S., Yazdi-Feyzabadi, V., Yearwood, J. A., Yeheyis, T. Y., Yeshitila, Y. G., Yip, P., Yonemoto, N., Yoon, S. -J., Yoosefi Lebni, J., Younis, M. Z., Younker, T. P., Yousefi, Z., Yousefifard, M., Yousefinezhadi, T., Yousuf, A. Y., Yu, C., Yusefzadeh, H., Zahirian Moghadam, T., Zaki, L., Zaman, S. B., Zamani, M., Zamanian, M., Zandian, H., Zangeneh, A., Zastrozhin, M. S., Zewdie, K. A., Zhang, Y., Zhang, Z. -J., Zhao, J. T., Zhao, Y., Zheng, P., Zhou, M., Ziapour, A., Zimsen, S. R. M., Naghavi, M., Murray, C. J. L., Department of Public Health, Clinicum, Department of Neurosciences, HUS Comprehensive Cancer Center, Environmental Sciences, Public Health, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Sálfræðideild (HR), Department of Psychology (RU), Samfélagssvið (HR), School of Social Sciences (RU), Háskólinn í Reykjavík, Reykjavik University, GBD 2019 Diseases and Injuries Collaborator, Violante FS, Department of Earth Observation Science, Faculty of Geo-Information Science and Earth Observation, and UT-I-ITC-ACQUAL

Subjects
Male, Life expectancy, Disability-Adjusted Life Year, Diseases, Disease, communicable disease, systematic analysis, Global Burden of Disease, 0302 clinical medicine, 80 and over, Medicine, 10. No inequality, Child, 11 Medical and Health Sciences, injuries, Aged, 80 and over, education.field_of_study, Sjúkdómar, DEMENTIA, FALLS, General Medicine, Forvarnir, 3. Good health, Child, Preschool, Human, GBD, Population health, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Humans, Global Burden of Disease Study, education, Aged, Spatial Analysis, Global burden, Disability, Prevention, DISABILITY, Infant, Spatial Analysi, Mortality rate, Global Burden of Disease, Diseases, Injuries, Systematic analysis, PREVENTION, Years of potential life lost, Risk factors, Disease study, ITC-ISI-JOURNAL-ARTICLE, RISK-FACTORS, Clinical Medicine, RA, Demography, Fötlun, Dánartíðni, Áhættuþættir, 030204 cardiovascular system & hematology, Risk Factors, Cause of Death, Global health, 030212 general & internal medicine, 1. No poverty, Disability-Adjusted Life Years, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, 3142 Public health care science, environmental and occupational health, Adolescent, Adult, Age Distribution, Female, Infant, Newborn, Young Adult, Lýðheilsa, CLINICAL-TRIALS, Population, Settore MED/01 - Statistica Medica, diseases, ITC-HYBRID, Heilbrigðisvísindi, General & Internal Medicine, Mortality, Preschool, Disease burden, business.industry, Risk Factor, Klinisk medicin, Newborn, purl.org/pe-repo/ocde/ford#3.02.00 [https], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Áverkar, Systematic analysis, NA, business
Abstract

Publisher's version (útgefin grein), Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd., Research reported in this publication was supported by the Bill & Melinda Gates Foundation; the University of Melbourne; Queensland Department of Health, Australia; the National Health and Medical Research Council, Australia; Public Health England; the Norwegian Institute of Public Health; St Jude Children's Research Hospital; the Cardiovascular Medical Research and Education Fund; the National Institute on Ageing of the National Institutes of Health (award P30AG047845); and the National Institute of Mental Health of the National Institutes of Health (award R01MH110163). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. The authors alone are responsible for the views expressed in this Article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated, the National Health Service (NHS), the National Institute for Health Research (NIHR), the UK Department of Health and Social Care, or Public Health England; the United States Agency for International Development (USAID), the US Government, or MEASURE Evaluation; or the European Centre for Disease Prevention and Control (ECDC). This research used data from the Chile National Health Survey 2003, 2009-10, and 2016-17. The authors are grateful to the Ministry of Health, the survey copyright owner, for allowing them to have the database. All results of the study are those of the authors and in no way committed to the Ministry. The Costa Rican Longevity and Healthy Aging Study project is a longitudinal study by the University of Costa Rica's Centro Centroamericano de Poblacion and Instituto de Investigaciones en Salud, in collaboration with the University of California at Berkeley. The original pre-1945 cohort was funded by the Wellcome Trust (grant 072406), and the 1945-55 Retirement Cohort was funded by the US National Institute on Aging (grant R01AG031716). The principal investigators are Luis Rosero-Bixby and William H Dow and co-principal investigators are Xinia Fernandez and Gilbert Brenes. The accuracy of the authors' statistical analysis and the findings they report are not the responsibility of ECDC. ECDC is not responsible for conclusions or opinions drawn from the data provided. ECDC is not responsible for the correctness of the data and for data management, data merging and data collation after provision of the data. ECDC shall not be held liable for improper or incorrect use of the data. The Health Behaviour in School-Aged Children (HBSC) study is an international study carried out in collaboration with WHO/EURO. The international coordinator of the 1997-98, 2001-02, 2005-06, and 2009-10 surveys was Candace Currie and the databank manager for the 1997-98 survey was Bente Wold, whereas for the following surveys Oddrun Samdal was the databank manager. A list of principal investigators in each country can be found on the HBSC website. Data used in this paper come from the 2009-10 Ghana Socioeconomic Panel Study Survey, which is a nationally representative survey of more than 5000 households in Ghana. The survey is a joint effort undertaken by the Institute of Statistical, Social and Economic Research (ISSER) at the University of Ghana and the Economic Growth Centre (EGC) at Yale University. It was funded by EGC. ISSER and the EGC are not responsible for the estimations reported by the analysts. The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with license number SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law, 2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data. Data for this research was provided by MEASURE Evaluation, funded by USAID. The authors thank the Russia Longitudinal Monitoring Survey, conducted by the National Research University Higher School of Economics and ZAO Demoscope together with Carolina Population Center, University of North Carolina at Chapel Hill and the Institute of Sociology, Russia Academy of Sciences for making data available. This paper uses data from the Bhutan 2014 STEPS survey, implemented by the Ministry of Health with the support of WHO; the Kuwait 2006 and 2014 STEPS surveys, implemented by the Ministry of Health with the support of WHO; the Libya 2009 STEPS survey, implemented by the Secretariat of Health and Environment with the support of WHO; the Malawi 2009 STEPS survey, implemented by Ministry of Health with the support of WHO; and the Moldova 2013 STEPS survey, implemented by the Ministry of Health, the National Bureau of Statistics, and the National Center of Public Health with the support of WHO. This paper uses data from Survey of Health, Ageing and Retirement in Europe (SHARE) Waves 1 (DOI:10.6103/SHARE. w1.700), 2 (10.6103/SHARE.w2.700), 3 (10.6103/SHARE.w3.700), 4 (10.6103/SHARE.w4.700), 5 (10.6103/SHARE.w5.700), 6 (10.6103/SHARE.w6.700), and 7 (10.6103/SHARE.w7.700); see Borsch-Supan and colleagues (2013) for methodological details. The SHARE data collection has been funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N degrees 211909, SHARE-LEAP: GA N degrees 227822, SHARE M4: GA N degrees 261982) and Horizon 2020 (SHARE-DEV3: GA N degrees 676536, SERISS: GA N degrees 654221) and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the US National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C), and from various national funding sources is gratefully acknowledged. This study has been realised using the data collected by the Swiss Household Panel, which is based at the Swiss Centre of Expertise in the Social Sciences. The project is financed by the Swiss National Science Foundation. The United States Aging, Demographics, and Memory Study is a supplement to the Health and Retirement Study (HRS), which is sponsored by the National Institute of Aging (grant number NIA U01AG009740). It was conducted jointly by Duke University and the University of Michigan. The HRS is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan. This paper uses data from Add Health, a program project designed by J Richard Udry, Peter S Bearman, and Kathleen Mullan Harris, and funded by a grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies. Special acknowledgment is due to Ronald R Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website. No direct support was received from grant P01-HD31921 for this analysis. The data reported here have been supplied by the United States Renal Data System. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the US Government. Collection of data for the Mozambique National Survey on the Causes of Death 2007-08 was made possible by USAID under the terms of cooperative agreement GPO-A-00-08-000_D3-00. This manuscript is based on data collected and shared by the International Vaccine Institute (IVI) from an original study IVI conducted. L G Abreu acknowledges support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (Brazil; finance code 001) and Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, a Brazilian funding agency). I N Ackerman was supported by a Victorian Health and Medical Research Fellowship awarded by the Victorian Government. O O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. A Agrawal acknowledges the Wellcome Trust DBT India Alliance Senior Fellowship. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. M Ausloos, C Herteliu, and A Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. A Badawi is supported by the Public Health Agency of Canada. D A Bennett was supported by the NIHR Oxford Biomedical Research Centre. R Bourne acknowledges the Brien Holden Vision Institute, University of Heidelberg, Sightsavers, Fred Hollows Foundation, and Thea Foundation. G B Britton and I Moreno Velasquez were supported by the Sistema Nacional de Investigacion, SNI-SENACYT, Panama. R Buchbinder was supported by an Australian National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship. J J Carrero was supported by the Swedish Research Council (2019-01059). F Carvalho acknowledges UID/MULTI/04378/2019 and UID/QUI/50006/2019 support with funding from FCT/MCTES through national funds. A R Chang was supported by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases grant K23 DK106515. V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundacao para a Ciencia e Tecnologia, IP, under the Norma Transitaria DL57/2016/CP1334/CT0006. A Douiri acknowledges support and funding from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South London at King's College Hospital NHS Foundation Trust and the Royal College of Physicians, and support from the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. B B Duncan acknowledges grants from the Foundation for the Support of Research of the State of Rio Grande do Sul (IATS and PrInt) and the Brazilian Ministry of Health. H E Erskine is the recipient of an Australian NHMRC Early Career Fellowship grant (APP1137969). A J Ferrari was supported by a NHMRC Early Career Fellowship grant (APP1121516). H E Erskine and A J Ferrari are employed by and A M Mantilla-Herrera and D F Santomauro affiliated with the Queensland Centre for Mental Health Research, which receives core funding from the Queensland Department of Health. M L Ferreira holds an NHMRC Research Fellowship. C Flohr was supported by the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust. M Freitas acknowledges financial support from the EU (European Regional Development Fund [FEDER] funds through COMPETE POCI-01-0145-FEDER-029248) and National Funds (Fundacao para a Ciencia e Tecnologia) through project PTDC/NAN-MAT/29248/2017. A L S Guimaraes acknowledges support from CNPq. C Herteliu was partially supported by a grant co-funded by FEDER through Operational Competitiveness Program (project ID P_40_382). P Hoogar acknowledges Centre for Bio Cultural Studies, Directorate of Research, Manipal Academy of Higher Education and Centre for Holistic Development and Research, Kalaghatagi. F N Hugo acknowledges the Visiting Professorship, PRINT Program, CAPES Foundation, Brazil. B-F Hwang was supported by China Medical University (CMU107-Z-04), Taichung, Taiwan. S M S Islam was funded by a National Heart Foundation Senior Research Fellowship and supported by Deakin University. R Q Ivers was supported by a research fellowship from the National Health and Medical Research Council of Australia. M Jakovljevic acknowledges the Serbian part of this GBD-related contribution was co-funded through Grant OI175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. P Jeemon was supported by a Clinical and Public Health intermediate fellowship (grant number IA/CPHI/14/1/501497) from the Wellcome Trust-Department of Biotechnology, India Alliance (2015-20). O John is a recipient of UIPA scholarship from University of New South Wales, Sydney. S V Katikireddi acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13, MC_UU_12017/15), and the Scottish Government Chief Scientist Office (SPHSU13, SPHSU15). C Kieling is a CNPq researcher and a UK Academy of Medical Sciences Newton Advanced Fellow. Y J Kim was supported by Research Management Office, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/00010). K Krishan is supported by UGC Centre of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar was supported by K43 TW 010716 FIC/NIMH. B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. J V Lazarus was supported by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III [ISCIII]/ESF, the EU [CP18/00074]). K J Looker thanks the NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, in partnership with Public Health England, for research support. S Lorkowski was funded by the German Federal Ministry of Education and Research (nutriCARD, grant agreement number 01EA1808A). R A Lyons is supported by Health Data Research UK (HDR-9006), which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, NIHR (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and Wellcome Trust. J J McGrath is supported by the Danish National Research Foundation (Niels Bohr Professorship), and the Queensland Health Department (via West Moreton HHS). P T N Memiah acknowledges support from CODESRIA. U O Mueller gratefully acknowledges funding by the German National Cohort Study BMBF grant number 01ER1801D. S Nomura acknowledges the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). A Ortiz was supported by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. S B Patten was supported by the Cuthbertson & Fischer Chair in Pediatric Mental Health at the University of Calgary. G C Patton was supported by an aNHMRC Senior Principal Research Fellowship. M R Phillips was supported in part by the National Natural Science Foundation of China (NSFC, number 81371502 and 81761128031). A Raggi, D Sattin, and S Schiavolin were supported by grants from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4-Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). P Rathi and B Unnikrishnan acknowledge Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. A L P Ribeiro was supported by Brazilian National Research Council, CNPq, and the Minas Gerais State Research Agency, FAPEMIG. D C Ribeiro was supported by The Sir Charles Hercus Health Research Fellowship (#18/111) Health Research Council of New Zealand. D Ribeiro acknowledges financial support from the EU (FEDER funds through the Operational Competitiveness Program; POCI-01-0145-FEDER-029253). P S Sachdev acknowledges funding from the NHMRC of Australia Program Grant. A M Samy was supported by a fellowship from the Egyptian Fulbright Mission Program. M M Santric-Milicevic acknowledges the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). R Sarmiento-Suarez received institutional support from Applied and Environmental Sciences University (Bogota, Colombia) and ISCIII (Madrid, Spain). A E Schutte received support from the South African National Research Foundation SARChI Initiative (GUN 86895) and Medical Research Council. S T S Skou is currently funded by a grant from Region Zealand (Exercise First) and a grant from the European Research Council under the EU's Horizon 2020 research and innovation program (grant agreement number 801790). J B Soriano is funded by Centro de Investigacion en Red de Enfermedades Respiratorias, ISCIII. R Tabares-Seisdedos was supported in part by the national grant PI17/00719 from ISCIII-FEDER. N Taveira was partially supported by the European & Developing Countries Clinical Trials Partnership, the EU (LIFE project, reference RIA2016MC-1615). S Tyrovolas was supported by the Foundation for Education and European Culture, the Sara Borrell postdoctoral programme (reference number CD15/00019 from ISCIII-FEDER). S B Zaman received a scholarship from the Australian Government research training programme in support of his academic career., "Peer Reviewed"

Published
2020

37. Age-Period-Cohort Analysis of Type 2 Diabetes Mortality Attributable to Particulate Matter Pollution in China and the U.S

Author

Zhi-Jiang Zhang, Maigeng Zhou, Xiaoxue Liu, and Chuanhua Yu

Subjects
Adult, Male, Pollution, China, Article Subject, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Type 2 diabetes, Diseases of the endocrine glands. Clinical endocrinology, Cohort Studies, Endocrinology, Pollution in China, Air Pollution, Humans, Medicine, Mortality, Aged, media_common, Aged, 80 and over, business.industry, Mortality rate, Age Factors, Middle Aged, Particulates, RC648-665, medicine.disease, United States, Diabetes Mellitus, Type 2, Cohort effect, Cohort, Female, Particulate Matter, business, Research Article, Demography, Cohort study
Abstract

Aim. We aimed to assess and compare secular trends in type 2 diabetes mortality attributable to particulate matter pollution in China and U.S. Methods. We performed an age-period-cohort (APC) analysis to estimate the independent effects of age, period, and cohort on mortality of type 2 diabetes attributable to particulate matter pollution. We collected age-standardized and age-specific mortality rates (1990-2017) from the Global Burden of Disease 2017 Study for China and the U.S. Results. During the period 1990-2017, the age-standardized mortality rates of type 2 diabetes attributable to particulate matter pollution in China showed a general increasing trend, while that in U.S. showed an increase before 2002 and subsequently a decrease. The age effect increased markedly in China compared with the U.S. The period effect showed a substantially increase in China while that in the U.S. increased during 1990-2007 and tended to be stable during 2007-2017. The cohort effect peaked in birth cohort born in 1902–1906 in both China and U.S. and declined consistently in the cohort born in 1992-1996. Conclusions. The age-standardized mortality rates of type 2 diabetes attributable to particulate matter pollution, the age, and period effect in China have been increasing in both sexes from 1990 to 2017. The overall mortality in the U.S. began to decrease since 2003, and the period effect showed a tendency to stabilize. Consequently, it is necessary to educate the nation with the correct knowledge and adopting policies on pollutant emission and techniques to reduce air pollution in China.

Published
2020
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38. Provincial-level cancer burden attributable to active and second-hand smoking in China

Author

Mark Parascandola, Hongmei Zeng, Changfa Xia, Siwei Zhang, Zhixun Yang, He Li, Wanqing Chen, Rongshou Zheng, Farhad Islami, Maigeng Zhou, Kexin Sun, Xiaonong Zou, and Lijun Wang

Subjects
Adult, Male, Mainland China, China, Health (social science), Population, 03 medical and health sciences, 0302 clinical medicine, Beijing, Neoplasms, Surveys and Questionnaires, Humans, Medicine, Prospective Studies, 030212 general & internal medicine, Sex Distribution, education, Prospective cohort study, Aged, Aged, 80 and over, education.field_of_study, 030505 public health, business.industry, Smoking, Tobacco control, Public Health, Environmental and Occupational Health, Middle Aged, Relative risk, Attributable risk, Female, Tobacco Smoke Pollution, 0305 other medical science, business, Demography
Abstract

BackgroundUnderstanding disparities in the burden of cancer attributable to smoking is crucial to inform and improve tobacco control measures. In this report, we estimate the population attributable fraction (PAF) of cancers deaths attributable to smoking at the national and provincial levels in China.MethodsUsing cancer mortality data from 978 counties, smoking data from a nationwide survey and relative risks from a prospective study of 0.5 million adults in China, we calculated the absolute (non-standardised) and standardised numbers and proportions of cancer deaths among adults 30 years and older attributable to active and second-hand smoking in 2014 across all 31 provinces in Mainland China.ResultsThe estimated number of cancer deaths attributable to smoking in China in 2014 was 342 854 among men and 40 313 among women, of which second-hand smoking accounted for 1.8% and 50.0%, respectively. Among men, the absolute PAF in China was 23.8%, ranging from 14.6% in Xinjiang to 26.8% in Tianjin; the overall standardised PAF was 22.2%, ranging from 15.7% in Xinjiang to 26.0% in Guizhou. Among women, the overall absolute and standardised PAFs were 4.8% and 4.0%, ranging from 1.8% and 1.6% in Jiangxi to 14.9% and 9.6% in Heilongjiang, respectively. Overall, provinces with the highest standardised PAFs among men were located in Southwest China and among women in the Northeast.ConclusionsComprehensive smoke-free policies in China should expand to all provinces, notably those with a higher burden of cancer attributable to smoking, instead of being mostly limited to Beijing and some other metropolitan areas.

Published
2018

39. Association between ambient temperature and chronic obstructive pulmonary disease: a population-based study of the years of life lost

Author

Guijie Luan, Maigeng Zhou, Lijun Wang, and Peng Yin

Subjects
Male, Distributed lag, China, Health, Toxicology and Mutagenesis, Pulmonary disease, 010501 environmental sciences, 01 natural sciences, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, Life Expectancy, 0302 clinical medicine, medicine, Humans, 030212 general & internal medicine, Cities, Disease burden, Aged, 0105 earth and related environmental sciences, COPD, Heat effect, business.industry, Temperature, Public Health, Environmental and Occupational Health, General Medicine, medicine.disease, Pollution, Population based study, Years of potential life lost, Nonlinear Dynamics, Attributable risk, Female, business, Demography
Abstract

Limited evidence on the burden of chronic obstructive pulmonary disease (COPD) attributable to ambient temperature. We aim to explore the association between ambient temperature and years of life lost (YLL), and to get a more intuitive understanding of the dangers of COPD in China. Death and meteorological data of 31 Chinese provincial capital cities during 2008–2013 was analyzed in this study. Distributed Lag Non-linear Model (DLNM) was used to estimate the association between ambient temperature and mortality. The attributable fraction (AF) to cold effect ranged from 8.19 (95%CI: -8.52,19.38) to 28.98 (95%CI: -64.78,67.59), while the AF to heat effect varied from 0.02 (95%CI: -0.13,0.05) to 5.73 (95%CI: 0.31,10.22). Cold effect was higher than heat effect on COPD in women and elderly, heat effect was higher in men and younger. Low temperature can cause more serious disease burden of COPD than high temperature.

Published
2018

40. Diabetes mortality burden attributable to short-term effect of PM

Author

Jun, Yang, Maigeng, Zhou, Fengying, Zhang, Peng, Yin, Boguang, Wang, Yuming, Guo, Shilu, Tong, Hao, Wang, Chunlin, Zhang, Qinghua, Sun, Xiuping, Song, and Qiyong, Liu

Subjects
Adult, Male, Air Pollutants, China, Adolescent, Infant, Newborn, Infant, Environmental Exposure, Middle Aged, Young Adult, Air Pollution, Child, Preschool, Diabetes Mellitus, Humans, Female, Particulate Matter, Cities, Mortality, Child, Aged
Abstract

Ambient air pollution may be associated with diabetes mellitus. However, evidence from developing countries is limited although the concentrations of air pollution are disproportionably higher in these countries. We collected daily data on diabetes mortality, air pollution, and weather conditions from 16 Chinese provincial cities during 2007-2013. A quasi-Poisson regression combined with a distributed lag model was used to quantify the city-specific mortality risk of PM

Published
2019

41. Associations between short-term exposure to ambient sulfur dioxide and increased cause-specific mortality in 272 Chinese cities

Author

Lap Ah Tse, Lijun Wang, Jinlei Qi, Renjie Chen, Jinling You, Haidong Kan, Jianmin Chen, Zhijing Lin, Maigeng Zhou, Yunning Liu, Yue Niu, Jiangmei Liu, Xia Meng, Peng Yin, and Cong Liu

Subjects
Adult, Male, China, medicine.medical_specialty, Adolescent, Heart Diseases, Urban Population, 010504 meteorology & atmospheric sciences, Respiratory Tract Diseases, Air pollution, Disease, 010501 environmental sciences, medicine.disease_cause, 01 natural sciences, Young Adult, chemistry.chemical_compound, Air Pollution, Environmental health, Epidemiology, medicine, Humans, Sulfur Dioxide, Nitrogen dioxide, Young adult, Child, lcsh:Environmental sciences, Aged, 0105 earth and related environmental sciences, General Environmental Science, lcsh:GE1-350, Pollutant, Air Pollutants, business.industry, Cardiorespiratory fitness, Environmental Exposure, Environmental exposure, Middle Aged, chemistry, Child, Preschool, Female, business
Abstract

Background: Ambient sulfur dioxide (SO2) remains a major air pollutant in developing countries, but epidemiological evidence about its health effects was not abundant and inconsistent. Objectives: To evaluate the associations between short-term exposure to SO2 and cause-specific mortality in China. Methods: We conducted a nationwide time-series analysis in 272 major Chinese cities (2013–2015). We used the over-dispersed generalized linear model together with the Bayesian hierarchical model to analyze the data. Two-pollutant models were fitted to test the robustness of the associations. We conducted stratification analyses to examine potential effect modifications by age, sex and educational level. Results: On average, the annual-mean SO2 concentrations was 29.8 μg/m3 in 272 cities. We observed positive and associations of SO2 with total and cardiorespiratory mortality. A 10 μg/m3 increase in two-day average concentrations of SO2 was associated with increments of 0.59% in mortality from total non-accidental causes, 0.70% from total cardiovascular diseases, 0.55% from total respiratory diseases, 0.64% from hypertension disease, 0.65% from coronary heart disease, 0.58% from stroke, and 0.69% from chronic obstructive pulmonary disease. In two-pollutant models, there were no significant differences between single-pollutant model and two-pollutant model estimates with fine particulate matter, carbon monoxide and ozone, but the estimates decreased substantially after adjusting for nitrogen dioxide, especially in South China. The associations were stronger in warmer cities, in older people and in less-educated subgroups. Conclusions: This nationwide study demonstrated associations of daily SO2 concentrations with increased total and cardiorespiratory mortality, but the associations might not be independent from NO2. Keywords: Sulfur dioxide, Air pollution, Cause-specific mortality, Time-series analysis, China

Published
2018

42. Associations Between Ambient Nitrogen Dioxide and Daily Cause-specific Mortality

Author

Cong Liu, Peng Yin, Yunning Liu, Xia Meng, Renjie Chen, Jinlei Qi, Jiangmei Liu, Lijun Wang, Jinling You, Yue Niu, Maigeng Zhou, Haidong Kan, and Zhijing Lin

Subjects
Adult, Male, China, Adolescent, Epidemiology, Nitrogen Dioxide, 010501 environmental sciences, complex mixtures, 01 natural sciences, Young Adult, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Environmental health, Humans, Medicine, Nitrogen dioxide, 030212 general & internal medicine, Cities, Mortality, Young adult, Child, Mortality trends, Aged, 0105 earth and related environmental sciences, Air Pollutants, business.industry, Cause specific mortality, Bayes Theorem, Environmental Exposure, Middle Aged, respiratory system, chemistry, Child, Preschool, Linear Models, Female, business
Abstract

There has been a long history of debate regarding whether ambient nitrogen dioxide (NO2) directly affects human health.We conducted a nationwide time-series analysis in 272 major Chinese cities (2013-2015) to evaluate the associations between short-term exposure to NO2 and cause-specific mortality. We used the overdispersed generalized linear model together with the Bayesian hierarchical model to estimate the associations between NO2 and mortality at the national and regional levels. We examined two-pollutant models with adjustment of fine particles, sulfur dioxide, carbon monoxide, and ozone to evaluate robustness for the effects of NO2.At the national-average level, we observed linear and positive associations between NO2 and mortality from all causes and main cardiorespiratory diseases. A 10 μg/m increase in 2-day average concentrations of NO2 would lead to increments of 0.9% (95% posterial interval [PI], 0.7%, 1.1%) in mortality from total nonaccidental causes, 0.9% (95% PI, 0.7%, 1.2%) from total cardiovascular disease, 1.4% (95% PI, 0.8%, 2.0%) from hypertension, 0.9% (95% PI, 0.6%, 1.2%) from coronary heart disease, 0.9% (95% PI, 0.5%, 1.2%) from stroke, 1.2% (95% PI, 0.9%, 1.5%) from total respiratory diseases, and 1.6% (95% PI, 1.1%, 2.0%) from chronic obstructive pulmonary disease. There were no appreciable differences in estimates from single-pollutant and two-pollutant models. The associations were stronger in the south of China, in the elderly, and in females.The present study provided robust epidemiologic evidence of associations between day-to-day NO2 and mortality from total natural causes and main cardiorespiratory diseases that might be independent of other criteria air pollutants.

Published
2018

43. Construction of China cardiovascular health index

Author

Maigeng Zhou, Yong Jiang, Dong Zhao, Jing Liu, Stephen Nicholas, Yichong Li, Linhong Wang, Weiwei Chen, Yan Zhang, Yingying Jiang, Fan Mao, Junbo Ge, and Yong Huo

Subjects
Adult, Male, medicine.medical_specialty, China, Delphi Technique, Population, Index system, Delphi method, China cardiovascular health index (CHI), Disease, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Environmental health, Surveys and Questionnaires, Epidemiology, medicine, Prevalence, Health Status Indicators, Humans, 030212 general & internal medicine, education, Disease burden, Cause of death, education.field_of_study, Analytical hierarchy process (AHP) model, business.industry, Public health, lcsh:Public aspects of medicine, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Monitor, Weight, Technical Advance, Cardiovascular Diseases, Population Surveillance, Female, Biostatistics, business
Abstract

Background Cardiovascular disease (CVD) is not only the primary cause of death in developed western countries, but also its disease burden is increasing in China. The purpose of constructing population cardiovascular health index is to monitor, compare and evaluate disease burden, influencing factors and prevention and control levels of Chinese population cardiovascular disease in order to provide evidence to improve population cardiovascular health. Methods This study collected multi-source data and constructed China Cardiovascular Health Index (CHI) using literature review, questionnaire surveys, Delphi method and Analytical Hierarchy Process (AHP) model. Results China CHI system included 52 indices of 5 dimensions, which were prevalence status of CVD, exposure of risk factors, prevention and control of risk factors, treatment situation and public health policy and service ability. The weights of 5 dimensions from high to low were successively prevention and control of risk factors 0.3656, prevalence status of CVD 0.2070, treatment situation 0.1812, public health policy and service ability 0.1458, and exposure of risk factors 0.1004. Conclusion China CHI is a comprehensive evaluation system raised to effectively control the prevalence of CVD. In the future, we should strengthen and improve CVD monitoring and big data usage, to ensure these indices to reflect the practical situations and to become utility of controlling CVD.

Published
2018

44. Unintentional drowning mortality in China, 2006–2013

Author

Jinlei Qi, Guoqing Hu, Peng Yin, Maigeng Zhou, Jiangmei Liu, Lijun Wang, Xunjie Cheng, Peixia Cheng, Yunning Liu, and David C. Schwebel

Subjects
Adult, Male, medicine.medical_specialty, Resuscitation, China, Adolescent, characteristics, mechanism, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Accident Prevention, Age Distribution, Environmental health, Epidemiology, Medicine, Humans, National level, 030212 general & internal medicine, Sex Distribution, Child, Policy Making, health care economics and organizations, Swimming, Disease surveillance, Drowning, business.industry, WATER HAZARDS, Natural water, Mortality rate, Public Health, Environmental and Occupational Health, Infant, 030229 sport sciences, social sciences, Middle Aged, Health Surveys, trend, Child, Preschool, Population Surveillance, population characteristics, Original Article, Accidental Falls, Female, Public Health, business, human activities
Abstract

BackgroundEpidemiological characteristics and recent trends in unintentional drowning at the national level in China are unreported.MethodsUsing data from the Disease Surveillance Points system, the overall, sex-, location-, age- and cause-specific age-standardised mortality from unintentional drowning in China were calculated and compared. Linear regression was used to examine the significance of mortality trend changes over time.ResultsThe average mortality was 4.05 per 100 000 persons between 2006 and 2013. Men and rural residents had much higher drowning mortality rates than women and urban residents at all time points. Drowning following a fall into natural water was the most common mechanism (46% of all drowning deaths). The overall drowning mortality rate remained stable for all subgroups except for distinct decreases in urban residents, children aged 5–9 years, and other specified and unspecified drowning (−10%, −36% and −25%, respectively).ConclusionsThe overall drowning mortality rate remained high and stable in China between 2006 and 2013. Effective prevention measures like removing or covering water hazards, wearing personal floatation devices, supervision of children, and teaching survival swimming and resuscitation skills should be implemented nationwide.

Published
2018

45. Burden of Ischaemic heart disease and attributable risk factors in China from 1990 to 2015: findings from the global burden of disease 2015 study

Author

Yunquan Zhang, Chuanhua Yu, Maigeng Zhou, Ganshen Zhang, Lisha Luo, and Lu Wang

Subjects
Male, China, lcsh:Diseases of the circulatory (Cardiovascular) system, Time Factors, Psychological intervention, Myocardial Ischemia, 030204 cardiovascular system & hematology, Risk Assessment, Disability-adjusted life years, 03 medical and health sciences, Disability Evaluation, 0302 clinical medicine, Age Distribution, Cost of Illness, Environmental health, Cause of Death, Prevalence, Population growth, Medicine, Humans, 030212 general & internal medicine, Mortality, Population Growth, Life Style, Cause of death, Aged, Ischaemic heart disease, business.industry, Mortality rate, Incidence, Bayes Theorem, Health Status Disparities, Risk factors, lcsh:RC666-701, Attributable risk, Quality of Life, Female, Quality-Adjusted Life Years, Cardiology and Cardiovascular Medicine, business, Risk assessment, Research Article
Abstract

Background Ischaemic heart disease (IHD) is a major barrier to sustainable human development, but its health burden and geographic distribution among provinces of China remain unclear. This study aimed to estimate IHD burden in provinces of China, and attributable to risk factors from 1990 to 2015. Methods Data were collected from the Global Burden of Disease 2015 Study, which evaluated IHD burden and attributable risk factors using deaths and disability-adjusted life years (DALYs). Statistical models including cause of death ensemble modelling, Bayesian meta-regression analysis, and comparative risk assessment approaches were applied to reduce bias and produce comprehensive results of IHD deaths, DALYs and attributable risks. The 95% uncertainty intervals (UIs) were calculated and reported for mortality and DALYs. Results The age-standardised death rate per 100,000 people increased by 13.3% from 101.3 (95%UI: 95.3–107.5) to 114.8 (95%UI: 109.8–120.1) from 1990 to 2015 in China, whereas the age-standardised DALY rate declined 3.9% to 1760.2 per 100,000 people (95%UI: 1671.6–1864.3). In 2015, the age-standardised death rate per 100,000 people was the highest in Heilongjiang (187.4, 95%UI: 161.6–217.5) and the lowest in Shanghai (44.2, 95%UI: 37.0–53.1), and the age-standardised DALY rate per 100,000 people was the highest in Xinjiang (3040.8, 95%UI: 2488.8–3735.4) and the lowest in Shanghai (524.4, 95%UI: 434.7–638.4). Geographically, the age-standardised death and DALY rates for southern provinces were lower than northern provinces, especially in southeastern coastal provinces. 95.3% of the IHD burden in China was attributable to environmental, behavioural and metabolic risk factors. The five leading IHD risks in 2015 were high systolic blood pressure, high total cholesterol, diet high in sodium, diet low in whole grains, and smoking. Conclusions Population growth and ageing has led to a steady increase in the IHD burden. Regional disparities in IHD burden were observed in provinces of China. The distribution characteristics of IHD burden provide guidance for decision makers to formulate targeted preventive policies and interventions. Electronic supplementary material The online version of this article (10.1186/s12872-018-0761-0) contains supplementary material, which is available to authorized users.

Published
2018

46. Geographical variations in hypertension prevalence, awareness, treatment and control in China

Author

Mei Zhang, Xiaoqi Feng, Thomas Astell-Burt, Maigeng Zhou, Linhong Wang, Zhengjing Huang, Qian Deng, Yichong Li, and Limin Wang

Subjects
Adult, Male, China, Health Knowledge, Attitudes, Practice, Physiology, Cross-sectional study, MEDLINE, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Urbanization, Environmental health, Prevalence, Internal Medicine, Humans, Medicine, 030212 general & internal medicine, Geography, Medical, Risk factor, Choropleth map, Disease burden, Aged, business.industry, Body Weight, Multilevel model, Middle Aged, Hypertension, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Hypertension has been the most important risk factor for disease burden in China. We aimed to conduct the first national spatial analysis of hypertension status, awareness, treatment and control in China.Choropleth maps were used to examine the spatial patterning of hypertension, awareness, treatment and control in a nationally and provincially representative sample of 174 389 adults from the 2013 to 2014 China Chronic Disease and Risk Factors Surveillance. Multilevel regressions were used to analyze each outcome across provinces, counties, towns and villages/residential committees and to test the proportion of area-level variances explained by known risk factors.Hypertension prevalence was highest in the north (e.g. Liaoning = 37.7%) and lowest in the south (e.g. Hainan = 17.9%). Among participants found to have hypertension, awareness was generally low, especially in the south (e.g. Guizhou = 18.0%). Receipt of treatment among those who were aware of their hypertension status was above 70% in all provinces except for Tibet (37.7%) and Guizhou (54.5%). Control of hypertension among those receiving treatment (SBP 140 and DBP 90 mmHg) was generally low, especially in northeastern and southwestern provinces. Adjustment for demographic, socioeconomic and behavioral factors, weight status, healthcare use and urbanization of residence accounted for 57.7% of variation between provinces in hypertension status, 48.5% in awareness, 47.6% in treatment and 18.0% in control.Hypertension is spatially patterned in China and there is an unmet need at each step from diagnosis to receiving treatment and achieving controlled hypertension. Geographically targeted strategies are required to enhance hypertension prevention and management in China.

Published
2018

47. The years of life lost on cardiovascular disease attributable to ambient temperature in China

Author

Guijie Luan, Lijun Wang, Tiantian Li, Maigeng Zhou, and Peng Yin

Subjects
Gerontology, Burden of disease, Male, China, lcsh:Medicine, Disease, 010501 environmental sciences, 01 natural sciences, Article, 03 medical and health sciences, 0302 clinical medicine, Age groups, Medicine, Humans, 030212 general & internal medicine, Cities, lcsh:Science, health care economics and organizations, 0105 earth and related environmental sciences, Aged, Heat effect, Multidisciplinary, business.industry, lcsh:R, Temperature, Middle Aged, Quality-adjusted life year, Years of potential life lost, Cardiovascular Diseases, Attributable risk, Female, lcsh:Q, Quality-Adjusted Life Years, business, Demography
Abstract

Few studies have examined the association between ambient temperature and years of life lost (YLL). We aim to explore the burden of cardiovascular disease attributed to non-optimum temperature in China. YLL provides a complementary measure for examining the burden of disease due to ambient temperature. Non-optimal temperature leads to the increase of YLL. The mortality of fourteen cities in China during 2008–2013 was included in this study. We used the Distributed Lag Non-linear Model (DLNM) to estimate the association between daily mean temperature and YLL, controlling for long term trends, day of the week, seasonality and relative humidity. The daily YLL varied from 807 in Changchun to 2751 in Chengdu, with males higher than females. Extreme high and low temperatures were associated with higher YLL. The attributable fraction (AF) to cold effect is from 2.67 (95%CI: −1.63, 6.70) to 8.55 (95%CI: 5.05, 11.90), while the AF to heat effect is from 0.16 (95%CI: 0.06, 0.26) to 2.29 (95%CI: 1.29, 3.19). Cold effect was significantly higher than heat effect on cardiovascular disease in both men and women and for different age groups.

Published
2017

48. Lifting the lid on geographic complexity in the relationship between body mass index and education in China

Author

Wenhua Zhao, Jiang Yong, Maigeng Zhou, Yichong Li, Xiaoqi Feng, Thomas Astell-Burt, Mei Zhang, and Andrew Page

Subjects
Adult, Male, China, Health (social science), Geography, Planning and Development, 030209 endocrinology & metabolism, Geographic variation, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, Statistics, medicine, Humans, Obesity, 030212 general & internal medicine, Models, Statistical, Geography, Multilevel modelling, Multilevel model, Public Health, Environmental and Occupational Health, Contrast (statistics), Middle Aged, medicine.disease, Data Interpretation, Statistical, Ordinary least squares, Educational Status, Female, Body mass index, Demography
Abstract

In China, rising obesity has coincided with increasing affluence. Few studies have properly accounted for geographic variation, however, which may influence prior results. Using large data with biomarkers in China, we show body mass index (BMI) to be positively correlated with higher person-level education if estimated using ordinary least squares. In stark contrast, fitting the same data within a multilevel model gives the complete opposite result. We go on to show that the relationship between BMI and person-level education in China is dependent upon geography, underlining why multilevel modelling is crucial for revealing these types of people-place contingencies.

Published
2017

49. Can China achieve a one-third reduction in premature mortality from non-communicable diseases by 2030?

Author

Jinlei Qi, Shiwei Liu, Xinying Zeng, Linhong Wang, Peng Yin, Guangxue He, Jiangmei Liu, Zhenping Zhao, Yichong Li, Alan D. Lopez, George F. Gao, Yunning Liu, Maigeng Zhou, Yuehua Hu, and Shicheng Yu

Subjects
Adult, Male, China, medicine.medical_specialty, Population, lcsh:Medicine, Disease, 030204 cardiovascular system & hematology, Patient Care Planning, Chronic disease, 03 medical and health sciences, 0302 clinical medicine, Neoplasms, Diabetes mellitus, Environmental health, Diabetes Mellitus, medicine, Humans, 030212 general & internal medicine, Risk factor, education, Aged, education.field_of_study, business.industry, Mortality, Premature, Mortality rate, Smoking, Tobacco control, lcsh:R, General Medicine, Middle Aged, medicine.disease, Obesity, Surgery, Risk factors, Cardiovascular Diseases, Female, business, Risk Reduction Behavior, Research Article, Forecasting
Abstract

Background The United Nation’s Sustainable Development Goals for 2030 include reducing premature mortality from non-communicable diseases (NCDs) by one third. To assess the feasibility of this goal in China, we projected premature mortality in 2030 of NCDs under different risk factor reduction scenarios. Methods We used China results from the Global Burden of Disease Study 2013 as empirical data for projections. Deaths between 1990 and 2013 for cardiovascular disease (CVD), diabetes, chronic respiratory disease, cancer, and other NCDs were extracted, along with population numbers. We disaggregated deaths into parts attributable and unattributable to high systolic blood pressure (SBP), smoking, high body mass index (BMI), high total cholesterol, physical inactivity, and high fasting glucose. Risk factor exposure and deaths by NCD category were projected to 2030. Eight simulated scenarios were also constructed to explore how premature mortality will be affected if the World Health Organization’s targets for risk factors reduction are achieved by 2030. Results If current trends for each risk factor continued to 2030, the total premature deaths from NCDs would increase from 3.11 million to 3.52 million, but the premature mortality rate would decrease by 13.1%. In the combined scenario in which all risk factor reduction targets are achieved, nearly one million deaths among persons 30 to 70 years old due to NCDs would be avoided, and the one-third reduction goal would be achieved for all NCDs combined. More specifically, the goal would be achieved for CVD and chronic respiratory diseases, but not for cancer and diabetes. Reduction in the prevalence of high SBP, smoking, and high BMI played an important role in achieving the goals. Conclusions Reaching the goal of a one-third reduction in premature mortality from NCDs is possible by 2030 if certain targets for risk factor intervention are reached, but more efforts are required to achieve risk factor reduction. Electronic supplementary material The online version of this article (doi:10.1186/s12916-017-0894-5) contains supplementary material, which is available to authorized users.

Published
2017

50. Death burden of high systolic blood pressure in Sichuan Southwest China 1990-2030

Author

Maigeng Zhou, Jun He, Yin Deng, Shujuan Yang, Yu Luo, Mingliang Zuo, Rong Pei, Hui Guo, Kun Zou, Zhuo Wang, and Li Zhao

Subjects
Adult, Male, medicine.medical_specialty, China, High systolic blood pressure, Population, Disease, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Environmental health, Epidemiology, medicine, Humans, 030212 general & internal medicine, Risk factor, Renal Insufficiency, Chronic, education, Noncommunicable Diseases, Aged, education.field_of_study, business.industry, Mortality, Premature, Public health, Mortality rate, lcsh:Public aspects of medicine, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Middle Aged, medicine.disease, Cardiovascular Diseases, Chronic diseases, Attributable risk, Hypertension, Death burden, Female, business, Kidney disease, Forecasting, Research Article
Abstract

Background Hypertension is highly prevalent and is the primary risk factor for cardiovascular disease (CVD) and chronic kidney disease (CKD). While declining in some developed countries, it is increasing rapidly in some developing countries. Sichuan province is the largest and underdeveloped region in southwest China, with 486 thousand square kilometers, more than 80 million residents, unbalanced economic development, and high prevalence, low awareness, low treatment and low control rate of hypertension. We forecasted the death burden due to high systolic blood pressure (SBP) in Sichuan from 1990 to 2030, to raise the awareness of public and government of the importance and benefits of hypertension control. Methods We conducted secondary analysis based on data of Global Burden of Disease (GBD) 1990–2015, and predicted the population SBP level, population attributable fraction, and death burden for people aged 30–69 under different scenarios in 2030. Results Comparing with natural trend, if the prevalence of high SBP can be reduced relatively by 25% by 2030, the deaths of non-communicable chronic diseases (NCDs), CVD and CKD would be reduced by 27.1 thousand, 26.2 thousand and 0.8 thousand for people aged 30–69; the mortality would be reduced by 10.8, 32.8 and 16.0%; and the premature mortality would be reduced by 9.9, 32.0 and 16.0%, respectively. Conclusions Controlling or decreasing the prevalence of high SBP can significantly reduce the deaths, death rate and premature mortality of NCDs, CVD and CKD for the 30–69 years old population in Sichuan. There would be huge benefits for the governments to take cost-effective measures to control or reduce the prevalence of hypertension.

Published
2019

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