Search

Your search keyword '"Rachel L Updike"' showing total 7 results
Start Over Author "Rachel L Updike"
7 results on '"Rachel L Updike"'

1. Quantifying risks and interventions that have affected the burden of lower respiratory infections among children younger than 5 years

Author

Tesfaye Dessale Kassa, Félix Carvalho, Luke D. Knibbs, Sonia Lewycka, Sonali Kochhar, Aaron Cohen, Luca Ronfani, Ebrahim M Yimer, Srinivas Murthy, Ejaz Ahmad Khan, Josip Car, Rodrigo Sarmiento-Suarez, Babak Moazen, Mostafa Qorbani, Javad Nazari, Nancy Fullman, Niranjan Kissoon, Keyghobad Ghadiri, Marissa B Reitsma, Benn Sartorius, Ashish Awasthi, Aman Yesuf Endries, Christopher Troeger, Evanson Z. Sambala, Nelson Alvis-Guzman, Alessandra C. Goulart, Erlyn Rachelle King Macarayan, Ahmad Daryani, Fakher Rahim, Fiseha Wadilo Wada, Yuming Guo, Sonia Saxena, Justin R. Ortiz, Monika Sawhney, Eyal Oren, Alaa Badawi, Tomislav Mestrovic, Sezer Kisa, Cheru Tesema Leshargie, Ai Koyanagi, Long Hoang Nguyen, Alireza Rafiei, Aziz Rezapour, Huong Lan Thi Nguyen, Abdallah M. Samy, Catrin E. Moore, André Karch, Seyyed Meysam Mousavi, Chi Linh Hoang, Katie R Nielsen, Eleonora Dubljanin, Giuseppe Gorini, Charles Shey Wiysonge, Bach Xuan Tran, Christopher J L Murray, Khanh Bao Tran, Maarten J. Postma, Mohammad Sadegh Rezai, Bartosz Miazgowski, Hagos Tasew Atalay, Aziz Sheikh, Reginald Quansah, Kirsten E. Wiens, Mika Shigematsu, Devasahayam J. Christopher, Hamid Yimam Hassen, Yasir Waheed, Robert Reiner, Smita Pakhale, Joseph Adel Mattar Banoub, Fares Alahdab, Vafa Rahimi-Movaghar, Mahesh P A, Ruth W Kimokoti, Feleke Mekonnen Demeke, Mohamad-Hani Temsah, Zakir Hussain, Naohiro Yonemoto, Noore Alam, Mu'awiyyah Babale Sufiyan, Lidia Morawska, Adane Teshome Kefale, Ali H. Mokdad, Rachel L Updike, Amir Kasaeian, Yousef Veisani, Rajesh Kumar Rai, Jeffrey D. Stanaway, Mina Anjomshoa, Corey B. Bills, Puja C Rao, Euripide Frinel G Arthur Avokpaho, Lorenzo Monasta, Zoubida Zaidi, Yousef Khader, Heather J. Zar, Ali Bijani, Tommi Vasankari, Kefyalew Addis Alene, Young-Ho Khang, Afewerki Gebremeskel Tsadik, Joseph Frostad, Ghulam Mustafa, Jalal Arabloo, Rajaa Al-Raddadi, Shanshan Li, David L. Smith, Maria Jesus Rios-Blancas, Carlos A Castañeda-Orjuela, Syed Mohamed Aljunid, Andrew T Olagunju, Suleman Atique, Abdullah T Khoja, Ibrahim A Khalil, William M. Gardner, Zikria Saleem, Addisu Melese, Stephen S Lim, Eyasu Ejeta Duken, Erkin M. Mirrakhimov, Gessessew Bugssa Hailu, Hmwe H Kyu, Seyedmojtaba Seyedmousavi, Aleksandra Barac, Spencer L. James, Salvatore Rubino, Lalit Dandona, Arya Haj-Mirzaian, Kate Causey, Nicholas J Kassebaum, Simon I. Hay, Ravi Prakash Jha, Karzan Abdulmuhsin Mohammad, Son Hoang Nguyen, Belay Tessema, Muhammad Imran Nisar, Barthelemy Kuate Defo, Alireza Ahmadi, Theo Vos, Krittika Bhattacharyya, Irfan Ullah, Molly H Biehl, Kalpana Balakrishnan, Tinuke O Olagunju, Florian Fischer, Olatunde Aremu, Brigette F. Blacker, Derrick A Bennett, Vahid Alipour, Carl Abelardo T. Antonio, Manisha Dubey, Tuomo J. Meretoja, G Anil Kumar, Varshil Mehta, Molly R Nixon, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Anselm Okoro, Zulfiqar A Bhutta, Maysaa El Sayed Zaki, Shafiu Mohammed, Nuruzzaman Khan, Jost B. Jonas, Samah Awad, Miloje Savic, Soewarta Kosen, Quique Bassat, Amha Admasie, Cuong Tat Nguyen, Chalachew Genet Akal, Milena M Santric Milicevic, Adnan Kisa, Arvin Haj-Mirzaian, Jonathan F. Mosser, Stephanie R M Zimsen, Dharmesh Kumar Lal, Birhanu Geta, Nobuyuki Horita, Gulfaraz Khan, Saeed Amini, Ziad A. Memish, Rakhi Dandona, Alyssa N. Sbarra, Dietrich Rothenbacher, Samer Hamidi, Felix Akpojene Ogbo, Helena Manguerra, Shirin Djalalinia, Degu Abate, Rakesh Lodha, Samuel B. Albertson, Seyed Sina Naghibi Irvani, Abdullah Al Mamun, Neeraj Bedi, Parvaiz A Koul, Desalegn Tadese Mengistu, Katie Welgan, Masood Ali Shaikh, Marek Majdan, Mihaela Hostiuc, Mohamed Lemine Cheikh brahim Ahmed, Public Health, GBD Lower Resp Infect, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Collaborators, GBD 2017 Lower Respiratory Infections, Clinicum, Institute for Molecular Medicine Finland, HUS Comprehensive Cancer Center, Staff Services, University of Helsinki, II kirurgian klinikka, and Department of Oncology

Subjects
Male, Psychological intervention, Global Health, Global Burden of Disease, 0302 clinical medicine, Risk Factors, Case fatality rate, Medicine, 030212 general & internal medicine, Respiratory Tract Infections, INFLUENZAE TYPE-B, education.field_of_study, NUTRITION TRANSITION, CHALLENGES, Trastornos respiratorios, Incidence (epidemiology), Mortality rate, Incidence, Enfermedades en niños, CHILDHOOD PNEUMONIA, Children younger than 5 years, 3. Good health, Infectious Diseases, Child, Preschool, Child Mortality, Female, TERRITORIES, CONJUGATE VACCINE, 030231 tropical medicine, Population, 195 COUNTRIES, Infections, Article, CHINA, 03 medical and health sciences, Age Distribution, Nutrition transition, SYSTEMATIC ANALYSIS, Humans, Risk factor, education, Lower respiratory, Models, Statistical, business.industry, AIR-POLLUTION, Verbal autopsy, Enfermedades respiratorias, Socioeconomic Factors, 3121 General medicine, internal medicine and other clinical medicine, Human medicine, business, Demography
Abstract

Background Despite large reductions in under-5 lower respiratory infection (LRI) mortality in many locations, the pace of progress for LRIs has generally lagged behind that of other childhood infectious diseases. To better inform programmes and policies focused on preventing and treating LRIs, we assessed the contributions and patterns of risk factor attribution, intervention coverage, and sociodemographic development in 195 countries and territories by drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) LRI estimates. Methods We used four strategies to model LRI burden: the mortality due to LRIs was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive ensemble modelling tool; the incidence of LRIs was modelled using population representative surveys, health-care utilisation data, and scientific literature in a compartmental meta-regression tool; the attribution of risk factors for LRI mortality was modelled in a counterfactual framework; and trends in LRI mortality were analysed applying changes in exposure to risk factors over time. In GBD, infectious disease mortality, including that due to LRI, is among HIV-negative individuals. We categorised locations based on their burden in 1990 to make comparisons in the changing burden between 1990 and 2017 and evaluate the relative percent change in mortality rate, incidence, and risk factor exposure to explain differences in the health loss associated with LRIs among children younger than 5 years. Findings In 2017, LRIs caused 808 920 deaths (95% uncertainty interval 747 286–873 591) in children younger than 5 years. Since 1990, there has been a substantial decrease in the number of deaths (from 2 337 538 to 808 920 deaths; 65·4% decrease, 61·5–68·5) and in mortality rate (from 362·7 deaths [330·1–392·0] per 100 000 children to 118·9 deaths [109·8–128·3] per 100 000 children; 67·2% decrease, 63·5–70·1). LRI incidence declined globally (32·4% decrease, 27·2–37·5). The percent change in under-5 mortality rate and incidence has varied across locations. Among the risk factors assessed in this study, those responsible for the greatest decrease in under-5 LRI mortality between 1990 and 2017 were increased coverage of vaccination against Haemophilus influenza type b (11·4% decrease, 0·0–24·5), increased pneumococcal vaccine coverage (6·3% decrease, 6·1–6·3), and reductions in household air pollution (8·4%, 6·8–9·2). Interpretation Our findings show that there have been substantial but uneven declines in LRI mortality among countries between 1990 and 2017. Although improvements in indicators of sociodemographic development could explain some of these trends, changes in exposure to modifiable risk factors are related to the rates of decline in LRI mortality. No single intervention would universally accelerate reductions in health loss associated with LRIs in all settings, but emphasising the most dominant risk factors, particularly in countries with high case fatality, can contribute to the reduction of preventable deaths. Funding Bill & Melinda Gates Foundation.

Published
2020
Full Text
View/download PDF

2. Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019: A systematic analysis from the Global Burden of Disease Study 2019

Author

Mohsen Naghavi, Saman Esmaeilnejad, Irena Ilic, Chhabi Lal Ranabhat, Hubert Amu, Jalil Jaafari, Walter Mendoza, Yanzhong Wang, Atta Abbas Naqvi, Mahesh P A, Afshin Maleki, Songhomitra Panda-Jonas, Akila Prashant, Jessica Y Islam, Ali H. Mokdad, Rahmatollah Moradzadeh, Roman Shrestha, Muhammad Naveed, Andre M. N. Renzaho, Santi Martini, Reza Rawassizadeh, Chisom Joyqueenet Akunna, Tudorel Andrei, Jason A. Anderson, Martin McKee, Iffat Elbarazi, Golnaz Heidari, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Davood Anvari, Randah R. Hamadeh, G. K. Mini, Emerito Jose A. Faraon, Farhad Islami, Yasir Waheed, Fahad Alanezi, Maciej Banach, Sheikh Mohammed Shariful Islam, Ismaeel Yunusa, Suresh Mehata, Tarun Gupta, Mavra A Riaz, Derrick A Bennett, Nithin Kumar, Ali Soroush, Kurt Straif, Muhammad Aziz Rahman, Hasan Yusefzadeh, Avirup Guha, Catalina Liliana Andrei, Muhammed Shahriar Zaman, Arief Hargono, Sandhya Neupane Kandel, Adam E. Berman, Giulia Carreras, Ali Bijani, Christoph Nowak, Rafael Alves Guimarães, Aziz Sheikh, Kamal Hezam, Carlo Eduardo Medina-Solís, Simon I. Hay, Deborah Carvalho Malta, Rahman Shiri, Ashok Pandey, Ramesh Holla, Gyu Ri Kim, Aidin Abedi, Sharath Burugina Nagaraja, Andem Effiong, Samad Azari, Bhaskar Thakur, Mohsen Mazidi, Vahid Yazdi-Feyzabadi, Prashant Mathur, Bay Vo, Robert Ancuceanu, Eun-Kee Park, Mehdi Fazlzadeh, Thomas Hsiao, Richard G Pestell, Sindhura Lakshmi Koulmane Laxminarayana, Doo Woong Lee, Bayew Kelkay, Erkin M. Mirrakhimov, Hualiang Lin, Mohsen Bayati, Florian Fischer, Wei Liu, Stefan Stortecky, Javad Nazari, Fatemeh Pashazadeh Kan, Virginia Núñez-Samudio, Nitish Naik, Sreenivas Narasimha Swamy, Rajat Gupta, Rakhi Dandona, Hermann Brenner, Chandrashekhar T Sreeramareddy, Mohammad Ali Mansournia, Yuichiro Yano, Pankaj Bhardwaj, Samath D Dharmaratne, Constantine I. Vardavas, Gabriela Fernanda Gil, Azeem Majeed, Akram Pourshams, Nachimuthu Senthil Kumar, Florentino Luciano Caetano dos Santos, Juan Sanabria, Iván Landires, Parkes J Kendrick, Dinh-Toi Chu, Asma Tahir Awan, Khem Narayan Pokhrel, Siddharudha Shivalli, Omid Shafaat, Shankar Prasad Nagaraju, Manu Raj Mathur, Rachel L Updike, Mohammad Ebrahimi Kalan, Ryan David Kennedy, Alessandra Lugo, Olalekan A. Uthman, Tarek Tawfik Amin, Jiregna Darega Gela, Zhi-Jiang Zhang, Yeshambel T. Nigatu, Bedanta Roy, Arielle Wilder Eagan, Jalal Arabloo, Milena Ilic, Mehdi Hosseinzadeh, Jost B. Jonas, Dian Kusuma, Shahrzad Bazargan-Hejazi, Yo Han Lee, Mohammed Shannawaz, Mohammad Ali Moni, Valery L. Feigin, Himal Kandel, Lalit Dandona, Milena Santric-Milicevic, Jasvinder A. Singh, Till Bärnighausen, Neeraj Bhala, Sara Sheikhbahaei, Alireza Ansari-Moghaddam, Borhan Mansouri, Narayana Manjunatha, Giuseppe Gorini, Saif Ullah, Sheikh M. Alif, Giang Thu Vu, Ai Koyanagi, Mahaveer Golechha, Ingan Ukur Tarigan, Sumaira Mubarik, Naohiro Yonemoto, Ahmad Ghashghaee, Yves Miel H Zuniga, Bach Xuan Tran, Sorin Hostiuc, Catherine P. Benziger, Ritesh G. Menezes, Leonardo Roever, Xiaochen Dai, Meghnath Dhimal, Medhat Farwati, Chenwen Zhong, Seyed Sina Naghibi Irvani, G Anil Kumar, Jaya Prasad Tripathy, Amirhossein Sahebkar, Simiao Chen, Zubair Kabir, Meseret Derbew Molla, Tilahun Ali, Animut Tagele Tamiru, Negussie Boti Sidemo, Monika Sawhney, Bright Opoku Ahinkorah, Ruxandra Irina Negoi, Segun Emmanuel Ibitoye, Vin Gupta, Mona Pathak, Lorenzo Monasta, Andrew T Olagunju, Nermin Ghith, Nuwan Darshana Wickramasinghe, Kazumasa Yamagishi, Virendra Singh, Takahiro Tabuchi, Gholamreza Roshandel, Andre R. Brunoni, Hayley D. Tymeson, Madhur Verma, Eyayou Girma Tadesse, Adrian Pana, Isabela M. Benseñor, Abdullah Al Mamun, Jianrong Zhang, Hai Quang Pham, Mihaela Hostiuc, Sung-In Jang, Vinay Nangia, Luca Ronfani, Rizwan Suliankatchi Abdulkader, Dhirendra N Sinha, Josip Car, Sohail Ahmad, Rekha Thapar, Salman Rawaf, Joanna L Whisnant, Sanjay Basu, Abdallah M. Samy, Michal Grivna, Zahid A Butt, Abera Getachew Obsa, Mahdi Nalini, Ted R. Miller, Sanjeev Misra, Utsav Parekh, Budi Aji, Saeed Amini, João Pedro Silva, Felix Akpojene Ogbo, Mihajlo Jakovljevic, Demosthenes B. Panagiotakos, Baye Dagnew, Yousef Khader, Atif Amin Baig, Habib Benzian, Keivan Ahmadi, Marco Vacante, Brijesh Sathian, Akshaya Srikanth Bhagavathula, Savita Lasrado, Maryam Khayamzadeh, Darshan B B, Mohammad Rifat Haider, Yonas Akalu, Irmina Maria Michalek, Simone Vidale, Getie Lake Aynalem, Rosa A. S. Couto, Yigizie Yeshaw, Syed Mohamed Aljunid, Pradhum Ram, Shrikant Pawar, Kevin Welding, Suzanne Barker-Collo, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Hiba Jawdat Barqawi, Marcos Roberto Tovani-Palone, K M Shivakumar, Gebiyaw Wudie Tsegaye, Fares Alahdab, Vafa Rahimi-Movaghar, Om P Kurmi, Nataliya Foigt, André Karch, Marina Pinheiro, Basema Saddik, Paschalis Steiropoulos, Chuanhua Yu, Graeme J. Hankey, Panniyammakal Jeemon, Abdul-Aziz Seidu, Ramaiah Itumalla, Befikadu Legesse Wubishet, Vera Marisa Costa, Shanshan Li, Ambrish Singh, Yuming Guo, Reza Malekzadeh, Nikha Bhardwaj, Mikhail Sergeevich Zastrozhin, Maryam Zamanian, Onyema greg Chido-Amajuoyi, Ibtihal Fadhil, Sabina O Nduaguba, Turki Alanzi, Eun-Cheol Park, Nicholas Arian, Salah Eddin Karimi, Parnaz Daneshpajouhnejad, Minale Tareke, Paramjit Gill, Chukwudi A Nnaji, Haroon Ahmed, Irina Filip, Juwel Rana, Aziz Rezapour, Huong Lan Thi Nguyen, Ashish Badiye, Kewal Krishan, Nima Hafezi-Nejad, Masood Ali Shaikh, Tanuj Kanchan, Shilpashree Madhava Kunjathur, Reza Ghanei Gheshlagh, Thomas R. Hird, Yousef Mohammad, Soraya Siabani, Falk Schwendicke, Ziyad Al-Aly, Desta Debalkie Atnafu, Krittika Bhattacharyya, Mika Kivimäki, Ayodipupo Sikiru Oguntade, Zabihollah Yousefi, Neeti Kapoor, Syed Mahboob Shah, Kavumpurathu Raman Thankappan, Mika Shigematsu, Ben Lacey, Ireneous N. Soyiri, Amir Radfar, Lemma Getacher, Sameer Vali Gopalani, David Laith Rawaf, Amir Masoud Rahmani, Birhan Gebresillassie Gebregiorgis, Morenike Oluwatoyin Folayan, Salime Goharinezhad, Ambuj Roy, Ruth W Kimokoti, Nuworza Kugbey, Getinet Ayano, Mohammad Hifz Ur Rahman, Benny Antony, Katrin Burkart, Christopher J L Murray, Khalid F. AlHabib, Mariam Molokhia, Mansour Ghafourifard, Abebaw Alemayehu Desta, Tariku Tesfaye Bekuma, Shailesh Advani, Kiomars Sharafi, Kurnia Dwi Artanti, E S Abhilash, Ejaz Ahmad Khan, Sana Salehi, Dan J. Stein, Pankaj Chaturvedi, Mahmoud A. Alomari, Kawkab Shishani, Dejana Braithwaite, Jung-Chen Chang, Rajeev Gupta, Giovanni Damiani, Maha El Tantawi, Maria Sofia Sofia Cattaruzza, Amir Abdoli, Narayanaswamy Venketasubramanian, Rakibul M Islam, Ibrahim Abdelmageed Ginawi, Victor Aboyans, Ganesh Kumar Saya, Silvano Gallus, João Mauricio Castaldelli-Maia, Vardhmaan Jain, Masoud Foroutan, Janni Leung, Mohammad Abdollahi, Mohammed Zewdu Yimmer, Vahid Alipour, Wondwossen Niguse Asmare, Ravi Prakash Jha, Gerhard Sulo, Brigid Unim, Sheng-Chia Chung, Sadaf G. Sepanlou, Hamed Mirzaei, Anna Aleksandrovna Skryabina, In-Hwan Oh, Rannveig Sigurvinsdottir, Oladimeji Adebayo, Farshad Farzadfar, Anasthasia Zastrozhina, Shafiu Mohammed, Johan Sundström, Ali Kabir, Paolo Lauriola, Tilahun Belete Mossie, Sadia Bibi, Bartosz Miazgowski, Erin C Mullany, Keyvan Pakshir, Srikanta Banerjee, Mowafa Househ, Mohamed M. Gad, Leila R Kalankesh, Mikk Jürisson, Ismail Tareque, Albertino Damasceno, Musliu Adetola Tolani, Andrea Werdecker, Shane D. Morrison, Inga Dora Sigfusdottir, Marcel Ausloos, Monika Arora, Marissa B Reitsma, Filippos Filippidis, Biniyam Sahiledengle Geberemariyam, Bruno Piassi Sao Jose, Leeberk Raja Inbaraj, Antonio Biondi, Mohsen Abbasi-Kangevari, Junjie Huang, Mohammad Mahdi Zamani, Jean Jacques Noubiap, Emmanuela Gakidou, Valentin Yurievich Skryabin, Mayowa O. Owolabi, Shubha Jayaram, Hiroyasu Iso, Charles Ugochukwu Ibeneme, Molly R Nixon, Rachel Feldman, Liliana G Ciobanu, Kristina Edvardsson, Claudiu Herteliu, Andreea Mirica, Kindie Mitiku Kebede, Department of Public Health, Collaborators, GBD 2019 Chewing Tobacco, and Lacey, B

Subjects
Male, Health Status, Smoking Prevention, DETERMINANTS, Global Health, 01 natural sciences, Global Burden of Disease, SMOKELESS TOBACCO, 0302 clinical medicine, Risk Factors, Global health, Prevalence, 030212 general & internal medicine, 610 Medicine & health, RISK, High prevalence, WOMEN, Public Health, Global Health, Social Medicine and Epidemiology, Articles, Middle Aged, 3142 Public health care science, environmental and occupational health, Chewing tobacco, Smokeless tobacco, Population Surveillance, A990 Medicine and Dentistry not elsewhere classified, Female, Quality-Adjusted Life Years, Burden of disease, Adult, medicine.medical_specialty, Tobacco, Smokeless, Adolescent, WHO Framework Convention on Tobacco Control, VALIDATION, 03 medical and health sciences, Young Adult, Age Distribution, SDG 3 - Good Health and Well-being, Environmental health, medicine, Humans, 0101 mathematics, Sex Distribution, Chewing tobacco, Prevalence, Global Burden, Smokeless tobacco, business.industry, Public health, Smoking Tobacco, 010102 general mathematics, Public Health, Environmental and Occupational Health, Global Burden, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, STATES, Socioeconomic Factors, Smoking Cessation, business
Abstract

Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Findings In 2019, 273 center dot 9 million (95% uncertainty interval 258 center dot 5 to 290 center dot 9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 center dot 72% (4 center dot 46 to 5 center dot 01). 228 center dot 2 million (213 center dot 6 to 244 center dot 7; 83 center dot 29% [82 center dot 15 to 84 center dot 42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global agestandardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 center dot 21% [-1 center dot 26 to -1 center dot 16]), similar progress was not observed for chewing tobacco (0 center dot 46% [0 center dot 13 to 0 center dot 79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 center dot 94% [-1 center dot 72 to -0 center dot 14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273 & middot;9 million (95% uncertainty interval 258 & middot;5 to 290 & middot;9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 & middot;72% (4 & middot;46 to 5 & middot;01). 228 & middot;2 million (213 & middot;6 to 244 & middot;7; 83 & middot;29% [82 & middot;15 to 84 & middot;42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 & middot;21% [-1 & middot;26 to -1 & middot;16]), similar progress was not observed for chewing tobacco (0 & middot;46% [0 & middot;13 to 0 & middot;79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 & middot;94% [-1 & middot;72 to -0 & middot;14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. For complete list of authors see http://dx.doi.org/10.1016/S2468-2667(21)00065-7

Published
2021
Full Text
View/download PDF

3. Quantifying risks and interventions that have affected the burden of diarrhoea among children younger than 5 years : an analysis of the Global Burden of Disease Study 2017

Author

Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Yuming Guo, Soewarta Kosen, Irfan Ullah, Khanh Bao Tran, Joan B. Soriano, Carl Abelardo T. Antonio, Teklay G E Teklu, Smita Pakhale, Dietrich Rothenbacher, Christopher Troeger, Eyasu Ejeta Duken, Erkin M. Mirrakhimov, Helena Manguerra, Cuong Tat Nguyen, Chalachew Genet Akal, Rakhi Dandona, Alaa Badawi, Barthelemy Kuate Defo, Sonali Kochhar, Javad Nazari, Evanson Z. Sambala, Nelson Alvis-Guzman, G Anil Kumar, Niranjan Kissoon, Yousef Veisani, Ai Koyanagi, Lalit Dandona, Molly R Nixon, David L. Smith, Samah Awad, Seyyed Meysam Mousavi, Rachel L Updike, Rajesh Kumar Rai, Hagos Tasew Atalay, Giuseppe Gorini, Charles Shey Wiysonge, Molly H Biehl, Zoubida Zaidi, Ahmad Daryani, Bach Xuan Tran, André Karch, Mostafa Qorbani, Zikria Saleem, Addisu Melese, Devasahayam J. Christopher, Adane Teshome Kefale, Félix Carvalho, Stephen S Lim, Birhanu Geta, Aziz Sheikh, Reginald Quansah, Andrew T Olagunju, Jalal Arabloo, Karzan Abdulmuhsin Mohammad, Fiseha Wadilo Wada, Amir Kasaeian, Maarten J. Postma, Abdullah T Khoja, Ravi Prakash Jha, Syed Mohamed Aljunid, Yousef Khader, Heather J. Zar, Ali Bijani, Ibrahim A Khalil, William M. Gardner, Marcia R. Weaver, Ebrahim M Yimer, Srinivas Murthy, Quique Bassat, Mu'awiyyah Babale Sufiyan, Kirsten E. Wiens, Saeed Amini, Ziad A. Memish, Samer Hamidi, Shanshan Li, Belay Tessema, Erlyn Rachelle King Macarayan, Tinuke O Olagunju, Alessandra C. Goulart, Seyed Sina Naghibi Irvani, Mahesh P A, Olatunde Aremu, Spencer L. James, Derrick A Bennett, Sezer Kisa, Keyghobad Ghadiri, Alireza Ahmadi, Theo Vos, Tuomo J. Meretoja, Mika Shigematsu, Naohiro Yonemoto, Shirin Djalalinia, Rakesh Lodha, Anselm Okoro, Adnan Kisa, Ali H. Mokdad, Aman Yesuf Endries, Josip Car, Fakher Rahim, Cheru Tesema Leshargie, Babak Moazen, Hamid Yimam Hassen, Lorenzo Monasta, Abdullah Al Mamun, Young-Ho Khang, Yasir Waheed, Mohamad-Hani Temsah, Zakir Hussain, Milena M Santric Milicevic, Abdallah M. Samy, Ejaz Ahmad Khan, Hmwe H Kyu, Afshin Zarghi, Monika Sawhney, Ghulam Mustafa, Samuel B. Albertson, Tomislav Mestrovic, Long Hoang Nguyen, Marek Majdan, Maysaa El Sayed Zaki, Mihaela Hostiuc, Desalegn Tadese Mengistu, Chi Linh Hoang, Christopher J L Murray, Nahla Anber, Seyedmojtaba Seyedmousavi, Maria Jesus Rios-Blancas, Mohammad Sadegh Rezai, Ashish Awasthi, Robert Reiner, Carlos A Castañeda-Orjuela, Shafiu Mohammed, Saeed Safari, Catrin E. Moore, Mina Anjomshoa, Joseph Adel Mattar Banoub, Fares Alahdab, Vafa Rahimi-Movaghar, Aniruddha Deshpande, Nicholas J Kassebaum, Kefyalew Addis Alene, Rajaa Al-Raddadi, Nancy Fullman, Benn Sartorius, Nuruzzaman Khan, Manisha Dubey, Eleonora Dubljanin, Stephanie R M Zimsen, Jost B. Jonas, Dharmesh Kumar Lal, Feleke Mekonnen Demeke, Jeffrey D. Stanaway, Euripide Frinel G Arthur Avokpaho, Tommi Vasankari, Florian Fischer, Krittika Bhattacharyya, Aleksandra Barac, Simon I. Hay, Kalpana Balakrishnan, Brigette F. Blacker, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Puja C Rao, Neeraj Bedi, Masood Ali Shaikh, Bartosz Miazgowski, Arya Haj-Mirzaian, Mohamed Lemine Cheikh brahim Ahmed, Vahid Alipour, Tesfaye Dessale Kassa, Luca Ronfani, Suleman Atique, Muhammad Imran Nisar, Alireza Rafiei, Aziz Rezapour, Ruth W Kimokoti, Noore Alam, Zulfiqar A Bhutta, Katherine Rosettie, Jonathan F. Mosser, Felix Akpojene Ogbo, Degu Abate, Clinicum, HUS Comprehensive Cancer Center, Staff Services, University of Helsinki, Department of Oncology, Public Health, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Collaborators, GBD 2017 Diarrhoeal Disease, and GBD 2017 Diarrhoeal Dis

Subjects
Male, Diarrhea, AFRICA, 030231 tropical medicine, Developing country, Global Health, Risk Assessment, Global Burden of Disease, 03 medical and health sciences, MORBIDITY, Life Expectancy, 0302 clinical medicine, SDG 3 - Good Health and Well-being, SANITATION, NUTRITIONAL INTERVENTIONS, Environmental health, Prevalence, Global health, Humans, Medicine, 030212 general & internal medicine, Risk factor, Child, Developing Countries, Wasting, Children, Models, Statistical, business.industry, Mortality rate, MORTALITY, 1. No poverty, Infant, Verbal autopsy, 3. Good health, Infectious Diseases, Socioeconomic Factors, WATER-QUALITY, Child, Preschool, Relative risk, 3121 General medicine, internal medicine and other clinical medicine, Child Mortality, GROWTH, Female, Human medicine, medicine.symptom, business, Risk assessment, Diarrea, Infants
Abstract

Background Many countries have shown marked declines in diarrhoeal disease mortality among children younger than 5 years. With this analysis, we provide updated results on diarrhoeal disease mortality among children younger than 5 years from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) and use the study's comparative risk assessment to quantify trends and effects of risk factors, interventions, and broader sociodemographic development on mortality changes in 195 countries and territories from 1990 to 2017. Methods This analysis for GBD 2017 had three main components. Diarrhoea mortality was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive, Bayesian, ensemble modelling tool; and the attribution of risk factors and interventions for diarrhoea were modelled in a counterfactual framework that combines modelled population-level prevalence of the exposure to each risk or intervention with the relative risk of diarrhoea given exposure to that factor. We assessed the relative and absolute change in diarrhoea mortality rate between 1990 and 2017, and used the change in risk factor exposure and sociodemographic status to explain differences in the trends of diarrhoea mortality among children younger than 5 years. Findings Diarrhoea was responsible for an estimated 533 768 deaths (95% uncertainty interval 477 162–593 145) among children younger than 5 years globally in 2017, a rate of 78·4 deaths (70·1–87·1) per 100 000 children. The diarrhoea mortality rate ranged between countries by over 685 deaths per 100 000 children. Diarrhoea mortality per 100 000 globally decreased by 69·6% (63·1–74·6) between 1990 and 2017. Among the risk factors considered in this study, those responsible for the largest declines in the diarrhoea mortality rate were reduction in exposure to unsafe sanitation (13·3% decrease, 11·2–15·5), childhood wasting (9·9% decrease, 9·6–10·2), and low use of oral rehydration solution (6·9% decrease, 4·8–8·4). Interpretation Diarrhoea mortality has declined substantially since 1990, although there are variations by country. Improvements in sociodemographic indicators might explain some of these trends, but changes in exposure to risk factors—particularly unsafe sanitation, childhood growth failure, and low use of oral rehydration solution—appear to be related to the relative and absolute rates of decline in diarrhoea mortality. Although the most effective interventions might vary by country or region, identifying and scaling up the interventions aimed at preventing and protecting against diarrhoea that have already reduced diarrhoea mortality could further avert many thousands of deaths due to this illness. Funding Bill & Melinda Gates Foundation.

Published
2020
Full Text
View/download PDF

4. Mapping diphtheria-pertussis-tetanus vaccine coverage in Africa, 2000–2016: a spatial and temporal modelling study

Author

Daniel C Casey, Robert C. Reiner, William C. Gagne-Maynard, Freya M Shearer, Peter W. Gething, Daniel J. Weiss, Roy Burstein, Elizabeth A. Cromwell, Aniruddha Deshpande, Nancy Fullman, Christopher J L Murray, Aaron Osgood-Zimmerman, Lucas Earl, Nicholas Graetz, Stephen S Lim, Patrick Y Liu, Jonathan F. Mosser, Heidi J. Larson, Sarah E Ray, David M. Pigott, Samir Bhatt, Puja C Rao, Simon I. Hay, Rachel L Updike, and Laura Dwyer-Lindgren

Subjects
Vaccination Coverage, Inequality, Somalia, media_common.quotation_subject, Childhood vaccination, 030204 cardiovascular system & hematology, Health outcomes, Article, 03 medical and health sciences, Spatio-Temporal Analysis, 0302 clinical medicine, Cost of Illness, medicine, Humans, 030212 general & internal medicine, Socioeconomics, Diphtheria-Tetanus-Pertussis Vaccine, media_common, Tetanus, Immunization Programs, Diphtheria, Vaccination, Rwanda, Infant, General Medicine, Models, Theoretical, medicine.disease, Morocco, Geography, Angola, Socioeconomic Factors, Action plan, Africa, Diphtheria-Pertussis-Tetanus Vaccine, Guinea, Immunization, Ethiopia, Geographical inequalities, Delivery of Health Care
Abstract

Summary Background Routine childhood vaccination is among the most cost-effective, successful public health interventions available. Amid substantial investments to expand vaccine delivery throughout Africa and strengthen administrative reporting systems, most countries still require robust measures of local routine vaccine coverage and changes in geographical inequalities over time. Methods This analysis drew from 183 surveys done between 2000 and 2016, including data from 881 268 children in 49 African countries. We used a Bayesian geostatistical model calibrated to results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017, to produce annual estimates with high-spatial resolution (5 × 5 km) of diphtheria-pertussis-tetanus (DPT) vaccine coverage and dropout for children aged 12–23 months in 52 African countries from 2000 to 2016. Findings Estimated third-dose (DPT3) coverage increased in 72·3% (95% uncertainty interval [UI] 64·6–80·3) of second-level administrative units in Africa from 2000 to 2016, but substantial geographical inequalities in DPT coverage remained across and within African countries. In 2016, DPT3 coverage at the second administrative (ie, district) level varied by more than 25% in 29 of 52 countries, with only two (Morocco and Rwanda) of 52 countries meeting the Global Vaccine Action Plan target of 80% DPT3 coverage or higher in all second-level administrative units with high confidence (posterior probability ≥95%). Large areas of low DPT3 coverage (≤50%) were identified in the Sahel, Somalia, eastern Ethiopia, and in Angola. Low first-dose (DPT1) coverage (≤50%) and high relative dropout (≥30%) together drove low DPT3 coverage across the Sahel, Somalia, eastern Ethiopia, Guinea, and Angola. Interpretation Despite substantial progress in Africa, marked national and subnational inequalities in DPT coverage persist throughout the continent. These results can help identify areas of low coverage and vaccine delivery system vulnerabilities and can ultimately support more precise targeting of resources to improve vaccine coverage and health outcomes for African children. Funding Bill & Melinda Gates Foundation.

Published
2019
Full Text
View/download PDF

5. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author

Gregory A Roth, Degu Abate, Kalkidan Hassen Abate, Solomon M Abay, Cristiana Abbafati, Nooshin Abbasi, Hedayat Abbastabar, Foad Abd-Allah, Jemal Abdela, Ahmed Abdelalim, Ibrahim Abdollahpour, Rizwan Suliankatchi Abdulkader, Haftom Temesgen Abebe, Molla Abebe, Zegeye Abebe, Ayenew Negesse Abejie, Semaw F Abera, Olifan Zewdie Abil, Haftom Niguse Abraha, Aklilu Roba Abrham, Laith Jamal Abu-Raddad, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Beyene Meressa Adhena, Mina G Adib, Amha Admasie, Ashkan Afshin, Gina Agarwal, Kareha M Agesa, Anurag Agrawal, Sutapa Agrawal, Alireza Ahmadi, Mehdi Ahmadi, Muktar Beshir Ahmed, Sayem Ahmed, Amani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Mohammad Esmaeil Akbari, Rufus Olusola Akinyemi, Nadia Akseer, Ziyad Al-Aly, Ayman Al-Eyadhy, Rajaa M Al-Raddadi, Fares Alahdab, Khurshid Alam, Tahiya Alam, Animut Alebel, Kefyalew Addis Alene, Mehran Alijanzadeh, Reza Alizadeh-Navaei, Syed Mohamed Aljunid, Ala'a Alkerwi, François Alla, Peter Allebeck, Jordi Alonso, Khalid Altirkawi, Nelson Alvis-Guzman, Azmeraw T Amare, Leopold N Aminde, Erfan Amini, Walid Ammar, Yaw Ampem Amoako, Nahla Hamed Anber, Catalina Liliana Andrei, Sofia Androudi, Megbaru Debalkie Animut, Mina Anjomshoa, Hossein Ansari, Mustafa Geleto Ansha, Carl Abelardo T Antonio, Palwasha Anwari, Olatunde Aremu, Johan Ärnlöv, Amit Arora, Monika Arora, Al Artaman, Krishna K Aryal, Hamid Asayesh, Ephrem Tsegay Asfaw, Zerihun Ataro, Suleman Atique, Sachin R Atre, Marcel Ausloos, Euripide F G A Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Yohanes Ayele, Rakesh Ayer, Peter S Azzopardi, Arefeh Babazadeh, Umar Bacha, Hamid Badali, Alaa Badawi, Ayele Geleto Bali, Katherine E Ballesteros, Maciej Banach, Kajori Banerjee, Marlena S Bannick, Joseph Adel Mattar Banoub, Miguel A Barboza, Suzanne Lyn Barker-Collo, Till Winfried Bärnighausen, Simon Barquera, Lope H Barrero, Quique Bassat, Sanjay Basu, Bernhard T Baune, Habtamu Wondifraw Baynes, Shahrzad Bazargan-Hejazi, Neeraj Bedi, Ettore Beghi, Masoud Behzadifar, Meysam Behzadifar, Yannick Béjot, Bayu Begashaw Bekele, Abate Bekele Belachew, Ezra Belay, Yihalem Abebe Belay, Michelle L Bell, Aminu K Bello, Derrick A Bennett, Isabela M Bensenor, Adam E Berman, Eduardo Bernabe, Robert S Bernstein, Gregory J Bertolacci, Mircea Beuran, Tina Beyranvand, Ashish Bhalla, Suraj Bhattarai, Soumyadeeep Bhaumik, Zulfiqar A Bhutta, Belete Biadgo, Molly H Biehl, Ali Bijani, Boris Bikbov, Ver Bilano, Nigus Bililign, Muhammad Shahdaat Bin Sayeed, Donal Bisanzio, Tuhin Biswas, Brigette F Blacker, Berrak Bora Basara, Rohan Borschmann, Cristina Bosetti, Kayvan Bozorgmehr, Oliver J Brady, Luisa C Brant, Carol Brayne, Alexandra Brazinova, Nicholas J K Breitborde, Hermann Brenner, Paul Svitil Briant, Gabrielle Britton, Traolach Brugha, Reinhard Busse, Zahid A Butt, Charlton S K H Callender, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Mate Car, Rosario Cárdenas, Giulia Carreras, Juan J Carrero, Austin Carter, Félix Carvalho, Carlos A Castañeda-Orjuela, Jacqueline Castillo Rivas, Chris D Castle, Clara Castro, Franz Castro, Ferrán Catalá-López, Ester Cerin, Yazan Chaiah, Jung-Chen Chang, Fiona J Charlson, Pankaj Chaturvedi, Peggy Pei-Chia Chiang, Odgerel Chimed-Ochir, Vesper Hichilombwe Chisumpa, Abdulaal Chitheer, Rajiv Chowdhury, Hanne Christensen, Devasahayam J Christopher, Sheng-Chia Chung, Flavia M Cicuttini, Liliana G Ciobanu, Massimo Cirillo, Aaron J Cohen, Leslie Trumbull Cooper, Paolo Angelo Cortesi, Monica Cortinovis, Ewerton Cousin, Benjamin C Cowie, Michael H Criqui, Elizabeth A Cromwell, Christopher Stephen Crowe, John A Crump, Matthew Cunningham, Alemneh Kabeta Daba, Abel Fekadu Dadi, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Paul I Dargan, Ahmad Daryani, Siddharth K Das, Rajat Das Gupta, José Das Neves, Tamirat Tesfaye Dasa, Aditya Prasad Dash, Adrian C Davis, Nicole Davis Weaver, Dragos Virgil Davitoiu, Kairat Davletov, Fernando Pio De La Hoz, Jan-Walter De Neve, Meaza Girma Degefa, Louisa Degenhardt, Tizta T Degfie, Selina Deiparine, Gebre Teklemariam Demoz, Balem Betsu Demtsu, Edgar Denova-Gutiérrez, Kebede Deribe, Nikolaos Dervenis, Don C Des Jarlais, Getenet Ayalew Dessie, Subhojit Dey, Samath D Dharmaratne, Daniel Dicker, Mesfin Tadese Dinberu, Eric L Ding, M Ashworth Dirac, Shirin Djalalinia, Klara Dokova, David Teye Doku, Christl A Donnelly, E Ray Dorsey, Pratik P Doshi, Dirk Douwes-Schultz, Kerrie E Doyle, Tim R Driscoll, Manisha Dubey, Eleonora Dubljanin, Eyasu Ejeta Duken, Bruce B Duncan, Andre R Duraes, Hedyeh Ebrahimi, Soheil Ebrahimpour, Dumessa Edessa, David Edvardsson, Anne Elise Eggen, Charbel El Bcheraoui, Maysaa El Sayed Zaki, Ziad El-Khatib, Hajer Elkout, Christian Lycke Ellingsen, Matthias Endres, Aman Yesuf Endries, Benjamin Er, Holly E Erskine, Babak Eshrati, Sharareh Eskandarieh, Reza Esmaeili, Alireza Esteghamati, Mahdi Fakhar, Hamed Fakhim, Mahbobeh Faramarzi, Mohammad Fareed, Farzaneh Farhadi, Carla Sofia E sá Farinha, Andre Faro, Maryam S Farvid, Farshad Farzadfar, Mohammad Hosein Farzaei, Valery L Feigin, Andrea B Feigl, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Joao C Fernandes, Alize J Ferrari, Garumma Tolu Feyissa, Irina Filip, Samuel Finegold, Florian Fischer, Christina Fitzmaurice, Nataliya A Foigt, Kyle J Foreman, Carla Fornari, Tahvi D Frank, Takeshi Fukumoto, John E Fuller, Nancy Fullman, Thomas Fürst, João M Furtado, Neal D Futran, Silvano Gallus, Alberto L Garcia-Basteiro, Miguel A Garcia-Gordillo, William M Gardner, Abadi Kahsu Gebre, Tsegaye Tewelde Gebrehiwot, Amanuel Tesfay Gebremedhin, Bereket Gebremichael, Teklu Gebrehiwo Gebremichael, Tilayie Feto Gelano, Johanna M Geleijnse, Ricard Genova-Maleras, Yilma Chisha Dea Geramo, Peter W Gething, Kebede Embaye Gezae, Mohammad Rasoul Ghadami, Reza Ghadimi, Khalil Ghasemi Falavarjani, Maryam Ghasemi-Kasman, Mamata Ghimire, Katherine B Gibney, Paramjit Singh Gill, Tiffany K Gill, Richard F Gillum, Ibrahim Abdelmageed Ginawi, Maurice Giroud, Giorgia Giussani, Shifalika Goenka, Ellen M Goldberg, Srinivas Goli, Hector Gómez-Dantés, Philimon N Gona, Sameer Vali Gopalani, Taren M Gorman, Atsushi Goto, Alessandra C Goulart, Elena V Gnedovskaya, Ayman Grada, Giuseppe Grosso, Harish Chander Gugnani, Andre Luiz Sena Guimaraes, Yuming Guo, Prakash C Gupta, Rahul Gupta, Rajeev Gupta, Tanush Gupta, Reyna Alma Gutiérrez, Bishal Gyawali, Juanita A Haagsma, Nima Hafezi-Nejad, Tekleberhan B Hagos, Tewodros Tesfa Hailegiyorgis, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Alexis J Handal, Graeme J Hankey, Hilda L Harb, Sivadasanpillai Harikrishnan, Josep Maria Haro, Mehedi Hasan, Hadi Hassankhani, Hamid Yimam Hassen, Rasmus Havmoeller, Roderick J Hay, Simon I Hay, Yihua He, Akbar Hedayatizadeh-Omran, Mohamed I Hegazy, Behzad Heibati, Mohsen Heidari, Delia Hendrie, Andualem Henok, Nathaniel J Henry, Claudiu Herteliu, Fatemeh Heydarpour, Pouria Heydarpour, Sousan Heydarpour, Desalegn Tsegaw Hibstu, Hans W Hoek, Michael K Hole, Enayatollah Homaie Rad, Praveen Hoogar, H Dean Hosgood, Seyed Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Peter J Hotez, Damian G Hoy, Thomas Hsiao, Guoqing Hu, John J Huang, Abdullatif Husseini, Mohammedaman Mama Hussen, Susan Hutfless, Bulat Idrisov, Olayinka Stephen Ilesanmi, Usman Iqbal, Seyed Sina Naghibi Irvani, Caleb Mackay Salpeter Irvine, Nazrul Islam, Sheikh Mohammed Shariful Islam, Farhad Islami, Kathryn H Jacobsen, Leila Jahangiry, Nader Jahanmehr, Sudhir Kumar Jain, Mihajlo Jakovljevic, Moti Tolera Jalu, Spencer L James, Mehdi Javanbakht, Achala Upendra Jayatilleke, Panniyammakal Jeemon, Kathy J Jenkins, Ravi Prakash Jha, Vivekanand Jha, Catherine O Johnson, Sarah C Johnson, Jost B Jonas, Ankur Joshi, Jacek Jerzy Jozwiak, Suresh Banayya Jungari, Mikk Jürisson, Zubair Kabir, Rajendra Kadel, Amaha Kahsay, Rizwan Kalani, Manoochehr Karami, Behzad Karami Matin, André Karch, Corine Karema, Hamidreza Karimi-Sari, Amir Kasaeian, Dessalegn H Kassa, Getachew Mullu Kassa, Tesfaye Dessale Kassa, Nicholas J Kassebaum, Srinivasa Vittal Katikireddi, Anil Kaul, Zhila Kazemi, Ali Kazemi Karyani, Dhruv Satish Kazi, Adane Teshome Kefale, Peter Njenga Keiyoro, Grant Rodgers Kemp, Andre Pascal Kengne, Andre Keren, Chandrasekharan Nair Kesavachandran, Yousef Saleh Khader, Behzad Khafaei, Morteza Abdullatif Khafaie, Alireza Khajavi, Nauman Khalid, Ibrahim A Khalil, Ejaz Ahmad Khan, Muhammad Shahzeb Khan, Muhammad Ali Khan, Young-Ho Khang, Mona M Khater, Abdullah T Khoja, Ardeshir Khosravi, Mohammad Hossein Khosravi, Jagdish Khubchandani, Aliasghar A Kiadaliri, Getiye D Kibret, Zelalem Teklemariam Kidanemariam, Daniel N Kiirithio, Daniel Kim, Young-Eun Kim, Yun Jin Kim, Ruth W Kimokoti, Yohannes Kinfu, Adnan Kisa, Katarzyna Kissimova-Skarbek, Mika Kivimäki, Ann Kristin Skrindo Knudsen, Jonathan M Kocarnik, Sonali Kochhar, Yoshihiro Kokubo, Tufa Kolola, Jacek A Kopec, Parvaiz A Koul, Ai Koyanagi, Michael A Kravchenko, Kewal Krishan, Barthelemy Kuate Defo, Burcu Kucuk Bicer, G Anil Kumar, Manasi Kumar, Pushpendra Kumar, Michael J Kutz, Igor Kuzin, Hmwe Hmwe Kyu, Deepesh P Lad, Sheetal D Lad, Alessandra Lafranconi, Dharmesh Kumar Lal, Ratilal Lalloo, Tea Lallukka, Jennifer O Lam, Faris Hasan Lami, Van C Lansingh, Sonia Lansky, Heidi J Larson, Arman Latifi, Kathryn Mei-Ming Lau, Jeffrey V Lazarus, Georgy Lebedev, Paul H Lee, James Leigh, Mostafa Leili, Cheru Tesema Leshargie, Shanshan Li, Yichong Li, Juan Liang, Lee-Ling Lim, Stephen S Lim, Miteku Andualem Limenih, Shai Linn, Shiwei Liu, Yang Liu, Rakesh Lodha, Chris Lonsdale, Alan D Lopez, Stefan Lorkowski, Paulo A Lotufo, Rafael Lozano, Raimundas Lunevicius, Stefan Ma, Erlyn Rachelle King Macarayan, Mark T Mackay, Jennifer H MacLachlan, Emilie R Maddison, Fabiana Madotto, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Dhaval P Maghavani, Marek Majdan, Reza Majdzadeh, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Ana-Laura Manda, Luiz Garcia Mandarano-Filho, Helena Manguerra, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Dadi Marami, Joemer C Maravilla, Wagner Marcenes, Laurie Marczak, Ashley Marks, Guy B Marks, Gabriel Martinez, Francisco Rogerlândio Martins-Melo, Ira Martopullo, Winfried März, Melvin B Marzan, Joseph R Masci, Benjamin Ballard Massenburg, Manu Raj Mathur, Prashant Mathur, Richard Matzopoulos, Pallab K Maulik, Mohsen Mazidi, Colm McAlinden, John J McGrath, Martin McKee, Brian J McMahon, Suresh Mehata, Man Mohan Mehndiratta, Ravi Mehrotra, Kala M Mehta, Varshil Mehta, Tefera C Mekonnen, Addisu Melese, Mulugeta Melku, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Desalegn Tadese Mengistu, Getnet Mengistu, George A Mensah, Seid Tiku Mereta, Atte Meretoja, Tuomo J Meretoja, Tomislav Mestrovic, Haftay Berhane Mezgebe, Bartosz Miazgowski, Tomasz Miazgowski, Anoushka I Millear, Ted R Miller, Molly Katherine Miller-Petrie, G K Mini, Parvaneh Mirabi, Mojde Mirarefin, Andreea Mirica, Erkin M Mirrakhimov, Awoke Temesgen Misganaw, Habtamu Mitiku, Babak Moazen, Karzan Abdulmuhsin Mohammad, Moslem Mohammadi, Noushin Mohammadifard, Mohammed A Mohammed, Shafiu Mohammed, Viswanathan Mohan, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Ghobad Moradi, Maziar Moradi-Lakeh, Mehdi Moradinazar, Paula Moraga, Lidia Morawska, Ilais Moreno Velásquez, Joana Morgado-Da-Costa, Shane Douglas Morrison, Marilita M Moschos, Simin Mouodi, Seyyed Meysam Mousavi, Kindie Fentahun Muchie, Ulrich Otto Mueller, Satinath Mukhopadhyay, Kate Muller, John Everett Mumford, Jonah Musa, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Jean B Nachega, Gabriele Nagel, Aliya Naheed, Azin Nahvijou, Gurudatta Naik, Sanjeev Nair, Farid Najafi, Luigi Naldi, Hae Sung Nam, Vinay Nangia, Jobert Richie Nansseu, Bruno Ramos Nascimento, Gopalakrishnan Natarajan, Nahid Neamati, Ionut Negoi, Ruxandra Irina Negoi, Subas Neupane, Charles R J Newton, Frida N Ngalesoni, Josephine W Ngunjiri, Anh Quynh Nguyen, Grant Nguyen, Ha Thu Nguyen, Huong Thanh Nguyen, Long Hoang Nguyen, Minh Nguyen, Trang Huyen Nguyen, Emma Nichols, Dina Nur Anggraini Ningrum, Yirga Legesse Nirayo, Molly R Nixon, Nomonde Nolutshungu, Shuhei Nomura, Ole F Norheim, Mehdi Noroozi, Bo Norrving, Jean Jacques Noubiap, Hamid Reza Nouri, Malihe Nourollahpour Shiadeh, Mohammad Reza Nowroozi, Peter S Nyasulu, Christopher M Odell, Richard Ofori-Asenso, Felix Akpojene Ogbo, In-Hwan Oh, Olanrewaju Oladimeji, Andrew T Olagunju, Pedro R Olivares, Helen Elizabeth Olsen, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Kanyin L Ong, Sok King Sk Ong, Eyal Oren, Heather M Orpana, Alberto Ortiz, Justin R Ortiz, Stanislav S Otstavnov, Simon Øverland, Mayowa Ojo Owolabi, Raziye Özdemir, Mahesh P A, Rosana Pacella, Smita Pakhale, Abhijit P Pakhare, Amir H Pakpour, Adrian Pana, Songhomitra Panda-Jonas, Jeyaraj Durai Pandian, Andrea Parisi, Eun-Kee Park, Charles D H Parry, Hadi Parsian, Shanti Patel, Sanghamitra Pati, George C Patton, Vishnupriya Rao Paturi, Katherine R Paulson, Alexandre Pereira, David M Pereira, Norberto Perico, Konrad Pesudovs, Max Petzold, Michael R Phillips, Frédéric B Piel, David M Pigott, Julian David Pillay, Meghdad Pirsaheb, Farhad Pishgar, Suzanne Polinder, Maarten J Postma, Akram Pourshams, Hossein Poustchi, Ashwini Pujar, Swayam Prakash, Narayan Prasad, Caroline A Purcell, Mostafa Qorbani, Hedley Quintana, D Alex Quistberg, Kirankumar Waman Rade, Amir Radfar, Anwar Rafay, Alireza Rafiei, Fakher Rahim, Kazem Rahimi, Afarin Rahimi-Movaghar, Mahfuzar Rahman, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Rajesh Kumar Rai, Sasa Rajsic, Usha Ram, Chhabi Lal Ranabhat, Prabhat Ranjan, Puja C Rao, David Laith Rawaf, Salman Rawaf, Christian Razo-García, K Srinath Reddy, Robert C Reiner, Marissa B Reitsma, Giuseppe Remuzzi, Andre M N Renzaho, Serge Resnikoff, Satar Rezaei, Shahab Rezaeian, Mohammad Sadegh Rezai, Seyed Mohammad Riahi, Antonio Luiz P Ribeiro, Maria Jesus Rios-Blancas, Kedir Teji Roba, Nicholas L S Roberts, Stephen R Robinson, Leonardo Roever, Luca Ronfani, Gholamreza Roshandel, Ali Rostami, Dietrich Rothenbacher, Ambuj Roy, Enrico Rubagotti, Perminder S Sachdev, Basema Saddik, Ehsan Sadeghi, Hosein Safari, Mahdi Safdarian, Sare Safi, Saeid Safiri, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, Nasir Salam, Joseph S Salama, Payman Salamati, Raphael De Freitas Saldanha, Zikria Saleem, Yahya Salimi, Sundeep Santosh Salvi, Inbal Salz, Evanson Zondani Sambala, Abdallah M Samy, Juan Sanabria, Maria Dolores Sanchez-Niño, Damian Francesco Santomauro, Itamar S Santos, João Vasco Santos, Milena M Santric Milicevic, Bruno Piassi Sao Jose, Abdur Razzaque Sarker, Rodrigo Sarmiento-Suárez, Nizal Sarrafzadegan, Benn Sartorius, Shahabeddin Sarvi, Brijesh Sathian, Maheswar Satpathy, Arundhati R Sawant, Monika Sawhney, Sonia Saxena, Mehdi Sayyah, Elke Schaeffner, Maria Inês Schmidt, Ione J C Schneider, Ben Schöttker, Aletta Elisabeth Schutte, David C Schwebel, Falk Schwendicke, James G Scott, Mario Sekerija, Sadaf G Sepanlou, Edson Serván-Mori, Seyedmojtaba Seyedmousavi, Hosein Shabaninejad, Katya Anne Shackelford, Azadeh Shafieesabet, Mehdi Shahbazi, Amira A Shaheen, Masood Ali Shaikh, Mehran Shams-Beyranvand, Mohammadbagher Shamsi, Morteza Shamsizadeh, Kiomars Sharafi, Mehdi Sharif, Mahdi Sharif-Alhoseini, Rajesh Sharma, Jun She, Aziz Sheikh, Peilin Shi, Mekonnen Sisay Shiferaw, Mika Shigematsu, Rahman Shiri, Reza Shirkoohi, Ivy Shiue, Farhad Shokraneh, Mark G Shrime, Si Si, Soraya Siabani, Tariq J Siddiqi, Inga Dora Sigfusdottir, Rannveig Sigurvinsdottir, Donald H Silberberg, Diego Augusto Santos Silva, João Pedro Silva, Natacha Torres Da Silva, Dayane Gabriele Alves Silveira, Jasvinder A Singh, Narinder Pal Singh, Prashant Kumar Singh, Virendra Singh, Dhirendra Narain Sinha, Karen Sliwa, Mari Smith, Badr Hasan Sobaih, Soheila Sobhani, Eugène Sobngwi, Samir S Soneji, Moslem Soofi, Reed J D Sorensen, Joan B Soriano, Ireneous N Soyiri, Luciano A Sposato, Chandrashekhar T Sreeramareddy, Vinay Srinivasan, Jeffrey D Stanaway, Vladimir I Starodubov, Vasiliki Stathopoulou, Dan J Stein, Caitlyn Steiner, Leo G Stewart, Mark A Stokes, Michelle L Subart, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Patrick John Sur, Ipsita Sutradhar, Bryan L Sykes, P N Sylaja, Dillon O Sylte, Cassandra E I Szoeke, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Santosh Kumar Tadakamadla, Ken Takahashi, Nikhil Tandon, Segen Gebremeskel Tassew, Nuno Taveira, Arash Tehrani-Banihashemi, Tigist Gashaw Tekalign, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Omar Temsah, Abdullah Sulieman Terkawi, Manaye Yihune Teshale, Belay Tessema, Gizachew Assefa Tessema, Kavumpurathu Raman Thankappan, Sathish Thirunavukkarasu, Nihal Thomas, Amanda G Thrift, George D Thurston, Binyam Tilahun, Quyen G To, Ruoyan Tobe-Gai, Marcello Tonelli, Roman Topor-Madry, Anna E Torre, Miguel Tortajada-Girbés, Mathilde Touvier, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Khanh Bao Tran, Suryakant Tripathi, Christopher E Troeger, Thomas Clement Truelsen, Nu Thi Truong, Afewerki Gebremeskel Tsadik, Derrick Tsoi, Lorainne Tudor Car, E Murat Tuzcu, Stefanos Tyrovolas, Kingsley N Ukwaja, Irfan Ullah, Eduardo A Undurraga, Rachel L Updike, Muhammad Shariq Usman, Olalekan A Uthman, Selen Begüm Uzun, Muthiah Vaduganathan, Afsane Vaezi, Gaurang Vaidya, Pascual R Valdez, Elena Varavikova, Tommi Juhani Vasankari, Narayanaswamy Venketasubramanian, Santos Villafaina, Francesco S Violante, Sergey Konstantinovitch Vladimirov, Vasily Vlassov, Stein Emil Vollset, Theo Vos, Gregory R Wagner, Fasil Shiferaw Wagnew, Yasir Waheed, Mitchell Taylor Wallin, Judd L Walson, Yanping Wang, Yuan-Pang Wang, Molla Mesele Wassie, Elisabete Weiderpass, Robert G Weintraub, Fitsum Weldegebreal, Kidu Gidey Weldegwergs, Andrea Werdecker, Adhena Ayaliew Werkneh, T Eoin West, Ronny Westerman, Harvey A Whiteford, Justyna Widecka, Lauren B Wilner, Shadrach Wilson, Andrea Sylvia Winkler, Charles Shey Wiysonge, Charles D A Wolfe, Shouling Wu, Yun-Chun Wu, Grant M A Wyper, Denis Xavier, Gelin Xu, Simon Yadgir, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Bereket Yakob, Lijing L Yan, Yuichiro Yano, Mehdi Yaseri, Yasin Jemal Yasin, Gökalp Kadri Yentür, Alex Yeshaneh, Ebrahim M Yimer, Paul Yip, Biruck Desalegn Yirsaw, Engida Yisma, Naohiro Yonemoto, Gerald Yonga, Seok-Jun Yoon, Marcel Yotebieng, Mustafa Z Younis, Mahmoud Yousefifard, Chuanhua Yu, Vesna Zadnik, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Zohreh Zare, Ayalew Jejaw Zeleke, Zerihun Menlkalew Zenebe, Anthony Lin Zhang, Kai Zhang, Maigeng Zhou, Sanjay Zodpey, Liesl Joanna Zuhlke, Mohsen Naghavi, and Christopher J L Murray., Rubagotti, Enrico, Abay, Solomon M., Roth, Gregory, Abd Allah, Foad, Abdela, Jemal, Abbastabar, Hedayat, and Abbasi, Nooshin

Subjects
Overview, Disease, Territory, Causes of death, humanities
Abstract

Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. The Lancet Publishing Group

Published
2019

6. Measuring human capital: a systematic analysis of 195 countries and territories, 1990-2016

Author

Stephen S, Lim, Rachel L, Updike, Alexander S, Kaldjian, Ryan M, Barber, Krycia, Cowling, Hunter, York, Joseph, Friedman, R, Xu, Joanna L, Whisnant, Heather J, Taylor, Andrew T, Leever, Yesenia, Roman, Miranda F, Bryant, Joseph, Dieleman, Emmanuela, Gakidou, and Christopher J L, Murray

Subjects
Adult, Male, United Nations, Health Status, Articles, Middle Aged, Global Health, Survival Analysis, Young Adult, Life Expectancy, Educational Status, Humans, Learning, Female, Economic Development
Abstract

Background Human capital is recognised as the level of education and health in a population and is considered an important determinant of economic growth. The World Bank has called for measurement and annual reporting of human capital to track and motivate investments in health and education and enhance productivity. We aim to provide a new comprehensive measure of human capital across countries globally. Methods We generated a period measure of expected human capital, defined for each birth cohort as the expected years lived from age 20 to 64 years and adjusted for educational attainment, learning or education quality, and functional health status using rates specific to each time period, age, and sex for 195 countries from 1990 to 2016. We estimated educational attainment using 2522 censuses and household surveys; we based learning estimates on 1894 tests among school-aged children; and we based functional health status on the prevalence of seven health conditions, which were taken from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016). Mortality rates specific to location, age, and sex were also taken from GBD 2016. Findings In 2016, Finland had the highest level of expected human capital of 28·4 health, education, and learning-adjusted expected years lived between age 20 and 64 years (95% uncertainty interval 27·5–29·2); Niger had the lowest expected human capital of less than 1·6 years (0·98–2·6). In 2016, 44 countries had already achieved more than 20 years of expected human capital; 68 countries had expected human capital of less than 10 years. Of 195 countries, the ten most populous countries in 2016 for expected human capital were ranked: China at 44, India at 158, USA at 27, Indonesia at 131, Brazil at 71, Pakistan at 164, Nigeria at 171, Bangladesh at 161, Russia at 49, and Mexico at 104. Assessment of change in expected human capital from 1990 to 2016 shows marked variation from less than 2 years of progress in 18 countries to more than 5 years of progress in 35 countries. Larger improvements in expected human capital appear to be associated with faster economic growth. The top quartile of countries in terms of absolute change in human capital from 1990 to 2016 had a median annualised growth in gross domestic product of 2·60% (IQR 1·85–3·69) compared with 1·45% (0·18–2·19) for countries in the bottom quartile. Interpretation Countries vary widely in the rate of human capital formation. Monitoring the production of human capital can facilitate a mechanism to hold governments and donors accountable for investments in health and education. Funding Institute for Health Metrics and Evaluation.

Published
2018

7. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories

Author

Kyle J, Foreman, Neal, Marquez, Andrew, Dolgert, Kai, Fukutaki, Nancy, Fullman, Madeline, McGaughey, Martin A, Pletcher, Amanda E, Smith, Kendrick, Tang, Chun-Wei, Yuan, Jonathan C, Brown, Joseph, Friedman, Jiawei, He, Kyle R, Heuton, Mollie, Holmberg, Disha J, Patel, Patrick, Reidy, Austin, Carter, Kelly, Cercy, Abigail, Chapin, Dirk, Douwes-Schultz, Tahvi, Frank, Falko, Goettsch, Patrick Y, Liu, Vishnu, Nandakumar, Marissa B, Reitsma, Vince, Reuter, Nafis, Sadat, Reed J D, Sorensen, Vinay, Srinivasan, Rachel L, Updike, Hunter, York, Alan D, Lopez, Rafael, Lozano, Stephen S, Lim, Ali H, Mokdad, Stein Emil, Vollset, and Christopher J L, Murray

Subjects
Male, Mortality, Premature, Decision Making, HIV Infections, Global Health, Child Nutrition Disorders, Communicable Diseases, Global Burden of Disease, Nutrition Disorders, Life Expectancy, Risk Factors, Cause of Death, Humans, Wounds and Injuries, Female, Guideline Adherence, Birth Rate, Child, Poverty, Forecasting
Abstract

Understanding potential trajectories in health and drivers of health is crucial to guiding long-term investments and policy implementation. Past work on forecasting has provided an incomplete landscape of future health scenarios, highlighting a need for a more robust modelling platform from which policy options and potential health trajectories can be assessed. This study provides a novel approach to modelling life expectancy, all-cause mortality and cause of death forecasts -and alternative future scenarios-for 250 causes of death from 2016 to 2040 in 195 countries and territories.We modelled 250 causes and cause groups organised by the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) hierarchical cause structure, using GBD 2016 estimates from 1990-2016, to generate predictions for 2017-40. Our modelling framework used data from the GBD 2016 study to systematically account for the relationships between risk factors and health outcomes for 79 independent drivers of health. We developed a three-component model of cause-specific mortality: a component due to changes in risk factors and select interventions; the underlying mortality rate for each cause that is a function of income per capita, educational attainment, and total fertility rate under 25 years and time; and an autoregressive integrated moving average model for unexplained changes correlated with time. We assessed the performance by fitting models with data from 1990-2006 and using these to forecast for 2007-16. Our final model used for generating forecasts and alternative scenarios was fitted to data from 1990-2016. We used this model for 195 countries and territories to generate a reference scenario or forecast through 2040 for each measure by location. Additionally, we generated better health and worse health scenarios based on the 85th and 15th percentiles, respectively, of annualised rates of change across location-years for all the GBD risk factors, income per person, educational attainment, select intervention coverage, and total fertility rate under 25 years in the past. We used the model to generate all-cause age-sex specific mortality, life expectancy, and years of life lost (YLLs) for 250 causes. Scenarios for fertility were also generated and used in a cohort component model to generate population scenarios. For each reference forecast, better health, and worse health scenarios, we generated estimates of mortality and YLLs attributable to each risk factor in the future.Globally, most independent drivers of health were forecast to improve by 2040, but 36 were forecast to worsen. As shown by the better health scenarios, greater progress might be possible, yet for some drivers such as high body-mass index (BMI), their toll will rise in the absence of intervention. We forecasted global life expectancy to increase by 4·4 years (95% UI 2·2 to 6·4) for men and 4·4 years (2·1 to 6·4) for women by 2040, but based on better and worse health scenarios, trajectories could range from a gain of 7·8 years (5·9 to 9·8) to a non-significant loss of 0·4 years (-2·8 to 2·2) for men, and an increase of 7·2 years (5·3 to 9·1) to essentially no change (0·1 years [-2·7 to 2·5]) for women. In 2040, Japan, Singapore, Spain, and Switzerland had a forecasted life expectancy exceeding 85 years for both sexes, and 59 countries including China were projected to surpass a life expectancy of 80 years by 2040. At the same time, Central African Republic, Lesotho, Somalia, and Zimbabwe had projected life expectancies below 65 years in 2040, indicating global disparities in survival are likely to persist if current trends hold. Forecasted YLLs showed a rising toll from several non-communicable diseases (NCDs), partly driven by population growth and ageing. Differences between the reference forecast and alternative scenarios were most striking for HIV/AIDS, for which a potential increase of 120·2% (95% UI 67·2-190·3) in YLLs (nearly 118 million) was projected globally from 2016-40 under the worse health scenario. Compared with 2016, NCDs were forecast to account for a greater proportion of YLLs in all GBD regions by 2040 (67·3% of YLLs [95% UI 61·9-72·3] globally); nonetheless, in many lower-income countries, communicable, maternal, neonatal, and nutritional (CMNN) diseases still accounted for a large share of YLLs in 2040 (eg, 53·5% of YLLs [95% UI 48·3-58·5] in Sub-Saharan Africa). There were large gaps for many health risks between the reference forecast and better health scenario for attributable YLLs. In most countries, metabolic risks amenable to health care (eg, high blood pressure and high plasma fasting glucose) and risks best targeted by population-level or intersectoral interventions (eg, tobacco, high BMI, and ambient particulate matter pollution) had some of the largest differences between reference and better health scenarios. The main exception was sub-Saharan Africa, where many risks associated with poverty and lower levels of development (eg, unsafe water and sanitation, household air pollution, and child malnutrition) were projected to still account for substantive disparities between reference and better health scenarios in 2040.With the present study, we provide a robust, flexible forecasting platform from which reference forecasts and alternative health scenarios can be explored in relation to a wide range of independent drivers of health. Our reference forecast points to overall improvements through 2040 in most countries, yet the range found across better and worse health scenarios renders a precarious vision of the future-a world with accelerating progress from technical innovation but with the potential for worsening health outcomes in the absence of deliberate policy action. For some causes of YLLs, large differences between the reference forecast and alternative scenarios reflect the opportunity to accelerate gains if countries move their trajectories toward better health scenarios-or alarming challenges if countries fall behind their reference forecasts. Generally, decision makers should plan for the likely continued shift toward NCDs and target resources toward the modifiable risks that drive substantial premature mortality. If such modifiable risks are prioritised today, there is opportunity to reduce avoidable mortality in the future. However, CMNN causes and related risks will remain the predominant health priority among lower-income countries. Based on our 2040 worse health scenario, there is a real risk of HIV mortality rebounding if countries lose momentum against the HIV epidemic, jeopardising decades of progress against the disease. Continued technical innovation and increased health spending, including development assistance for health targeted to the world's poorest people, are likely to remain vital components to charting a future where all populations can live full, healthy lives.BillMelinda Gates Foundation.

Published
2018

Catalog

Books, media, physical & digital resources
See catalog results