1. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015
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Haidong, Wang, Mohsen, Naghavi, Christine, Allen, Ryan M, Barber Zulfi, qar A, Bhutta, Austin, Carter, Daniel C, Casey Fiona, J Charlson, Alan Zian, Chen Matthew, M Coates, Megan, Coggeshall, Lalit, Dandona, Daniel J, Dicker Holly, E Erskine, Alize J, Ferrari, Christina, Fitzmaurice, Kyle, Foreman, Mohammad H, Forouzanfar Maya, S Fraser, Nancy, Fullman, Peter W, Gething Ellen, M Goldberg, Nicholas, Graetz, Juanita A, Haagsma Simon, I Hay, Chantal, Huynh, Catherine O, Johnson Nicholas, J Kassebaum, Yohannes, Kinfu, Xie Rachel, Kulikoff, Michael, Kutz, Hmwe H, Kyu Heidi, J Larson, Janni, Leung, Xiaofeng, Liang, Stephen S, Lim, Margaret, Lind, Rafael, Lozano, Neal, Marquez, George A, Mensah, Joe, Mikesell, Ali H, Mokdad Meghan, D Mooney, Grant, Nguyen, Elaine, Nsoesie, David M, Pigott, Christine, Pinho, Gregory A, Roth Joshua, A Salomon, Logan, Sandar, Naris, Silpakit, Amber, Sligar, Reed J, D Sorensen, Jeff rey, Stanaway, Caitlyn, Steiner, Stephanie, Teeple, Bernadette A, Thomas, Christopher, Troeger, Amelia, VanderZanden, Stein Emil, Vollset, Valentine, Wanga, Harvey A, Whiteford, Timothy, Wolock, Leo, Zoeckler, Kalkidan Hassen, Abate, Cristiana, Abbafati, Kaja M, Abbas, Foad, Abd-Allah, Semaw Ferede, Abera Daisy, M X, Abreu Laith, J Abu-Raddad, Gebre Yitayih, Abyu, Tom, Achoki, Ademola Lukman, Adelekan Zanfi, na Ademi, Arsène Kouablan, Adou José, C Adsuar, Kossivi Agbelenko, Afanvi, Ashkan, Afshin, Emilie Elisabet, Agardh, Arnav, Agarwal, Anurag, Agrawal, Aliasghar Ahmad, Kiadaliri Oluremi, N Ajala, Ali Shafqat, Akanda Rufus, Olusola Akinyemi, Tomi F, Akinyemiju, Nadia, Akseer, Faris Hasan, Al Lami, Samer, Alabed, Ziyad, Al-Aly, Khurshid, Alam, Noore K, M Alam, Deena, Alasfoor, Saleh Fahed, Aldhahri Robert, William Aldridge, Miguel Angel, Alegretti Alicia, V Aleman, Zewdie Aderaw, Alemu Lily, T Alexander, Samia, Alhabib, Raghib, Ali, Ala’a, Alkerwi, François, Alla, Peter, Allebeck, Rajaa, Al-Raddadi, Ubai, Alsharif, Khalid A, Altirkawi Elena, Alvarez Martin, Nelson, Alvis-Guzman, Azmeraw T, Amare Adeladza, Kofi Amegah, Emmanuel A, Ameh, Heresh, Amini, Walid, Ammar, Stephen Marc, Amrock Hjalte, H Andersen, Benjamin O, Anderson Gregory, M Anderson, Carl Abelardo, T Antonio, Atsede Fantahun, Aregay, Johan, Ärnlöv, Valentina S, Arsic Arsenijevic, Al, Artaman, Hamid, Asayesh, Rana Jawad, Asghar, Suleman, Atique, Euripide Frinel, G Arthur, Avokpaho, Ashish, Awasthi, Peter, Azzopardi, Umar, Bacha, Alaa, Badawi, Maria C, Bahit, Kalpana, Balakrishnan, Amitava, Banerjee, Aleksandra, Barac, Suzanne L, Barker-Collo, Till, Bärnighausen, Lars, Barregard, Lope H, Barrero, Arindam, Basu, Sanjay, Basu, Yibeltal Tebekaw, Bayou, Shahrzad, Bazargan-Hejazi, Justin, Beardsley, Neeraj, Bedi, Ettore, Beghi, Haileeyesus Adamu, Belay, Brent, Bell, Michelle L, Bell Aminu, K Bello, Derrick A, Bennett Isabela, M Bensenor, Adugnaw, Berhane, Eduardo, Bernabé, Balem Demtsu, Betsu Addisu, Shunu Beyene, Neeraj, Bhala, Ashish, Bhalla, Sibhatu, Biadgilign, Boris, Bikbov, Aref A, Bin Abdulhak, Brian J, Biroscak, Stan, Biryukov, Espen, Bjertness, Jed D, Blore Christopher, D Blosser, Megan A, Bohensky, Rohan, Borschmann, Dipan, Bose, Rupert R, A Bourne, Michael, Brainin, Carol E, G Brayne, Alexandra, Brazinova, Nicholas J, K Breitborde, Hermann, Brenner, Jerry D, Brewer, Alexandria, Brown, Jonathan, Brown, Traolach S, Brugha Geoff, rey Colin, Buckle Zahid, A Butt, Bianca, Calabria, Ismael Ricardo, Campos-Nonato Julio, Cesar Campuzano, Jonathan R, Carapetis, Rosario, Cárdenas, David O, Carpenter Juan, Jesus Carrero, Carlos A, Castañeda-Orjuela Jacqueline, Castillo Rivas, Ferrán, Catalá-López, Fiorella, Cavalleri, Kelly, Cercy, Jorge, Cerda, Wanqing, Chen, Adrienne, Chew, Peggy Pei-Chia, Chiang, Mirriam, Chibalabala, Chioma Ezinne, Chibueze, Odgerel, Chimed-Ochir, Vesper Hichilombwe, Chisumpa Jee-Young, Jasmine Choi, Rajiv, Chowdhury, Hanne, Christensen, Devasahayam Jesudas, Christopher Liliana, G Ciobanu, Cirillo Massimo, Aaron J, Cohen, Valentina, Colistro, Mercedes, Colomar, Samantha M, Colquhoun, Cyrus, Cooper, Leslie Trumbull, Cooper, Monica, Cortinovis, Benjamin C, Cowie John, A Crump, James, Damsere-Derry, Hadi, Danawi, Rakhi, Dandona, Farah, Daoud, Sarah C, Darby Paul, I Dargan, José das, Neves, Gail, Davey, Adrian C, Davis Dragos, V Davitoiu, E Filipa, de Castro, Pieter de, Jager Diego, De Leo, Louisa, Degenhardt, Robert P, Dellavalle, Kebede, Deribe, Amare, Deribew, Samath D, Dharmaratne Preet, K Dhillon, Cesar, Diaz-Torné, Eric L, Ding Kadine, Priscila Bender, dos Santos, Edem, Dossou, Tim R, Driscoll, Leilei, Duan, Manisha, Dubey, Bruce Bartholow, Duncan Richard, G Ellenbogen, Christian Lycke, Ellingsen, Iqbal, Elyazar, Aman Yesuf, Endries Sergey, Petrovich Ermakov, Babak, Eshrati, Alireza, Esteghamati, Kara, Estep, Imad D, A Faghmous, Saman, Fahimi, Emerito Jose, Aquino Faraon, Talha A, Farid Carla, Sofi a, e Sa, Farinha, André, Faro, Maryam S, Farvid, Farshad, Farzadfar, Valery L, Feigin, Seyed-Mohammad, Fereshtehnejad, Jeff erson, G Fernandes, Joao C, Fernandes, Florian, Fischer, Joseph R, A Fitchett, Abraham, Flaxman, Nataliya, Foigt, F Gerry, R Fowkes, Elisabeth Barboza, Franca Richard, C Franklin, Joseph, Friedman, Joseph, Frostad, Thomas, Fürst, Neal D, Futran Seana, L Gall, Ketevan, Gambashidze, Amiran, Gamkrelidze, Parthasarathi, Ganguly, Fortuné Gbètoho, Gankpé, Teshome, Gebre, Tsegaye Tsewelde, Gebrehiwot Amanuel, Tesfay Gebremedhin, Alemseged Aregay, Gebru Johanna, M Geleijnse, Bradford D, Gessner Aloke, Gopal Ghoshal, Katherine B, Gibney Richard, F Gillum, Stuart, Gilmour, Ababi Zergaw, Giref, Maurice, Giroud, Melkamu Dedefo, Gishu, Giorgia, Giussani, Elizabeth, Glaser, William W, Godwin, Hector, Gomez-Dantes, Philimon, Gona, Amador, Goodridge, Sameer Vali, Gopalani Richard, A Gosselin, Carolyn C, Gotay, Atsushi, Goto, Hebe N, Gouda, Felix, Greaves, Harish Chander, Gugnani, Rahul, Gupta, Rajeev, Gupta, Vipin, Gupta, Reyna A, Gutiérrez, Nima, Hafezi-Nejad, Demewoz, Haile, Alemayehu Desalegne, Hailu Gessessew, Bugssa Hailu, Yara A, Halasa Randah, Ribhi Hamadeh, Samer, Hamidi, Jamie, Hancock, Alexis J, Handal Graeme, J Hankey, Yuantao, Hao, Hilda L, Harb, Sivadasanpillai, Harikrishnan, Josep Maria, Haro, Rasmus, Havmoeller, Susan R, Heckbert Ileana, Beatriz Heredia-Pi, Pouria, Heydarpour, Henk B, M Hilderink, Hans W, Hoek Robert, S Hogg, Masako, Horino, Nobuyuki, Horita, H Dean, Hosgood Peter, J Hotez, Damian G, Hoy, Mohamed, Hsairi, Aung Soe, Htet Maung, Maung Than, Htike, Guoqing, Hu, Cheng, Huang, Hsiang, Huang, Laetitia, Huiart, Abdullatif, Husseini, Inge, Huybrechts, Grace, Huynh, Kim Moesgaard, Iburg, Kaire, Innos, Manami, Inoue, Veena J, Iyer Troy, A Jacobs, Kathryn H, Jacobsen, Nader, Jahanmehr, Mihajlo B, Jakovljevic, Peter, James, Mehdi, Javanbakht, Sudha P, Jayaraman Achala, Upendra Jayatilleke, Panniyammakal, Jeemon, Paul N, Jensen, Vivekanand, Jha, Guohong, Jiang, Ying, Jiang, Tariku, Jibat, Aida, Jimenez-Corona, Jost B, Jonas Tushar, Kant Joshi, Zubair, Kabir, Ritul, Kamal, Haidong, Kan, Surya, Kant, André, Karch, Corine Kakizi, Karema, Chante, Karimkhani, Dimitris, Karletsos, Ganesan, Karthikeyan, Amir, Kasaeian, Marzieh, Katibeh, Anil, Kaul, Norito, Kawakami, Jeanne Françoise, Kayibanda Peter, Njenga Keiyoro, Laura, Kemmer, Andrew Haddon, Kemp Andre, Pascal Kengne, Andre, Keren, Maia, Kereselidze, Chandrasekharan Nair, Kesavachandran Yousef, Saleh Khader, Ibrahim A, Khalil Abdur, Rahman Khan, Ejaz Ahmad, Khan, Young-Ho, Khang, Sahil, Khera, Tawfi k, Ahmed Muthafer, Khoja, Christian, Kieling, Daniel, Kim, Yun Jin, Kim Brett, M Kissela, Niranjan, Kissoon, Luke D, Knibbs Ann, Kristin Knudsen, Yoshihiro, Kokubo, Dhaval, Kolte, Jacek A, Kopec, Soewarta, Kosen, Parvaiz A, Koul, Ai, Koyanagi, Norun Hjertager, Krog Barthelemy, Kuate Defo, Burcu Kucuk, Bicer Andreas, A Kudom, Ernst J, Kuipers Veena, S Kulkarni, G Anil, Kumar Gene, F Kwan, Aparna, Lal, Dharmesh Kumar, Lal, Ratilal, Lalloo, Hilton, Lam, Jennifer O, Lam Sinead, M 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VITAL-STATISTICS ,INTEGRATED APPROACH ,ECONOMIC-DEVELOPMENT ,DEVELOPMENT ASSISTANCE ,UNITED-STATES ,Global Health ,Communicable Disease ,Communicable Diseases ,cause of death ,Medicine, General & Internal ,Life Expectancy ,General & Internal Medicine ,Humans ,Mortality ,Medicine(all) ,Science & Technology ,Mortality, Premature ,Medicine (all) ,EPIDEMIOLOGIC TRANSITION ,GBD 2015 Mortality and Causes of Death Collaborators ,CIVIL REGISTRATION ,Public Health, Global Health, Social Medicine and Epidemiology ,Articles ,11 Medical And Health Sciences ,ROAD TRAFFIC INJURIES ,ALZHEIMERS-DISEASE ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,VERBAL AUTOPSY ,Life Sciences & Biomedicine ,Human - Abstract
Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61.7 years (95% uncertainty interval 61.4-61.9) in 1980 to 71.8 years (71.5-72.2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11.3 years (3.7-17.4), to 62.6 years (56.5-70.2). Total deaths increased by 4.1% (2.6-5.6) from 2005 to 2015, rising to 55.8 million (54.9 million to 56.6 million) in 2015, but age-standardised death rates fell by 17.0% (15.8-18.1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14.1% (12.6-16.0) to 39.8 million (39.2 million to 40.5 million) in 2015, whereas age-standardised rates decreased by 13.1% (11.9-14.3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42.1%, 39.1-44.6), malaria (43.1%, 34.7-51.8), neonatal preterm birth complications (29.8%, 24.8-34.9), and maternal disorders (29.1%, 19.3-37.1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Copyright (C) The Author(s). Published by Elsevier Ltd.
- Published
- 2016