15 research outputs found
Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017
No full textGlobal, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017
No full textData sharing:
To download the data used in these analyses, please visit the Global Health Data Exchange at https://ghdx.healthdata.org/gbd–2017 .GBD 2017 DALYs and HALE Collaborators:
Hmwe Hmwe Kyu, Degu Abate, Kalkidan Hassen Abate, Solomon M Abay, Cristiana Abbafati, Nooshin Abbasi, Hedayat Abbastabar, Foad Abd-Allah, Jemal Abdela, Ahmed Abdelalim, Ibrahim Abdollahpour, Rizwan Suliankatchi Abdulkader, Molla Abebe, Zegeye Abebe, Olifan Zewdie Abil, Victor Aboyans, Aklilu Roba Abrham, Laith Jamal Abu-Raddad, Niveen M E Abu-Rmeileh, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Pawan Acharya, Ilana N Ackerman, Abdu A Adamu, Oladimeji M Adebayo, Victor Adekanmbi, Zanfina Ademi, Olatunji O Adetokunboh, Mina G Adib, Jose C Adsuar, Kossivi Agbelenko Afanvi, Mohsen Afarideh, Ashkan Afshin, Gina Agarwal, Kareha M Agesa, Rakesh Aggarwal, Sargis Aghasi Aghayan, Anurag Agrawal, Alireza Ahmadi, Mehdi Ahmadi, Hamid Ahmadieh, Muktar Beshir Ahmed, Sayem Ahmed, Amani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Tomi Akinyemiju, Nadia Akseer, Ziyad Al-Aly, Ayman Al-Eyadhy, Hesham M Al-Mekhlafi, Rajaa M Al-Raddadi, Fares Alahdab, Khurshid Alam, Tahiya Alam, Alaa Alashi, Seyed Moayed Alavian, Kefyalew Addis Alene, Mehran Alijanzadeh, Reza Alizadeh-Navaei, Syed Mohamed Aljunid, Ala'a Alkerwi, François Alla, Peter Allebeck, Jordi Alonso, Ubai Alsharif, Khalid Altirkawi, Nelson Alvis-Guzman, Leopold N Aminde, Erfan Amini, Mohammadreza Amiresmaili, Walid Ammar, Yaw Ampem Amoako, Nahla Hamed Anber, Catalina Liliana Andrei, Sofia Androudi, Megbaru Debalkie Animut, Mina Anjomshoa, Mustafa Geleto Ansha, Carl Abelardo T Antonio, Palwasha Anwari, Jalal Arabloo, Olatunde Aremu, Johan Ärnlöv, Amit Arora, Megha Arora, Al Artaman, Krishna K Aryal, Hamid Asayesh, Zerihun Ataro, Marcel Ausloos, Leticia Avila-Burgos, Euripide F G A Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Rakesh Ayer, Peter S Azzopardi, Arefeh Babazadeh, Hamid Badali, Kalpana Balakrishnan, Ayele Geleto Bali, Maciej Banach, Joseph Adel Mattar Banoub, Aleksandra Barac, Miguel A Barboza, Suzanne Lyn Barker-Collo, Till Winfried Bärnighausen, Simon Barquera, Lope H Barrero, Shahrzad Bazargan-Hejazi, Neeraj Bedi, Ettore Beghi, Masoud Behzadifar, Meysam Behzadifar, Bayu Begashaw Bekele, Eyasu Tamru Bekru, Abate Bekele Belachew, Yihalem Abebe Belay, Michelle L Bell, Aminu K Bello, Derrick A Bennett, Isabela M Bensenor, Adugnaw Berhane, Eduardo Bernabe, Robert S Bernstein, Mircea Beuran, Tina Beyranvand, Neeraj Bhala, Samir Bhatt, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Belete Biadgo, Molly H Biehl, Ali Bijani, Boris Bikbov, Ver Bilano, Nigus Bililign, Muhammad Shahdaat Bin Sayeed, Donal Bisanzio, Tone Bjørge, Archie Bleyer, Eshetu Mulisa Bobasa, Ibrahim R Bou-Orm, Soufiane Boufous, Rupert Bourne, Oliver J Brady, Luisa C Brant, Carol Brayne, Alexandra Brazinova, Nicholas J K Breitborde, Hermann Brenner, Paul Svitil Briant, Andrey Nikolaevich Briko, Gabrielle Britton, Traolach Brugha, Rachelle Buchbinder, Reinhard Busse, Zahid A Butt, Lucero Cahuana-Hurtado, Julio Cesar Campuzano Rincon, Jorge Cano, Rosario Cárdenas, Juan J Carrero, Austin Carter, Félix Carvalho, Carlos A Castañeda-Orjuela, Jacqueline Castillo Rivas, Franz Castro, Ferrán Catalá-López, Kelly M Cercy, Ester Cerin, Yazan Chaiah, Jung-Chen Chang, Fiona J Charlson, Vijay Kumar Chattu, Peggy Pei-Chia Chiang, Abdulaal Chitheer, Jee-Young J Choi, Hanne Christensen, Devasahayam J Christopher, Sheng-Chia Chung, Flavia M Cicuttini, Massimo Cirillo, Daniel Collado-Mateo, Cyrus Cooper, Paolo Angelo Cortesi, Monica Cortinovis, Ewerton Cousin, Michael H Criqui, Elizabeth A Cromwell, Marita Cross, John A Crump, Alemneh Kabeta Daba, Berihun Assefa Dachew, Abel Fekadu Dadi, Lalit Dandona, Rakhi Dandona, Paul I Dargan, Ahmad Daryani, Rajat Das Gupta, José Das Neves, Tamirat Tesfaye Dasa, Dragos Virgil Davitoiu, Fernando Pio De La Hoz, Diego De Leo, Jan-Walter De Neve, Hans De Steur, Meaza Girma Degefa, Louisa Degenhardt, Selina Deiparine, Gebre Teklemariam Demoz, Edgar Denova-Gutiérrez, Kebede Deribe, Nikolaos Dervenis, Don C Des Jarlais, Subhojit Dey, Samath D Dharmaratne, Meghnath Dhimal, Mesfin Tadese Dinberu, M Ashworth Dirac, Shirin Djalalinia, Linh Doan, Klara Dokova, David Teye Doku, E Ray Dorsey, Kerrie E Doyle, Tim Robert Driscoll, Manisha Dubey, Eleonora Dubljanin, Eyasu Ejeta Duken, Bruce B Duncan, Andre R Duraes, Hedyeh Ebrahimi, Soheil Ebrahimpour, Michelle M Echko, Dumessa Edessa, David Edvardsson, Andem Effiong, Anne Elise Eggen, Joshua R Ehrlich, Charbel El Bcheraoui, Ziad El-Khatib, Iqbal R F Elyazar, Ahmadali Enayati, Melese Linger Endalifer, Aman Yesuf Endries, Benjamin Er, Holly E Erskine, Sharareh Eskandarieh, Alireza Esteghamati, Sadaf Esteghamati, Hamed Fakhim, Mahbobeh Faramarzi, Mohammad Fareed, Farzaneh Farhadi, Talha A Farid, Carla Sofia E sá Farinha, Andrea Farioli, Andre Faro, Farshad Farzadfar, Ali Akbar Fazaeli, Valery L Feigin, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Joao C Fernandes, Alize J Ferrari, Manuela L Ferreira, Irina Filip, Florian Fischer, Christina Fitzmaurice, Nataliya A Foigt, Kyle J Foreman, Tahvi D Frank, Takeshi Fukumoto, Nancy Fullman, Thomas Fürst, João M Furtado, Emmanuela Gakidou, Seana Gall, Silvano Gallus, Morsaleh Ganji, Alberto L Garcia-Basteiro, William M Gardner, Abadi Kahsu Gebre, Amanuel Tesfay Gebremedhin, Teklu Gebrehiwo Gebremichael, Tilayie Feto Gelano, Johanna M Geleijnse, Ricard Genova-Maleras, Yilma Chisha Dea Geramo, Peter W Gething, Kebede Embaye Gezae, Mohammad Rasoul Ghadami, Keyghobad Ghadiri, Maryam Ghasemi-Kasman, Mamata Ghimire, Aloke Gopal Ghoshal, Paramjit Singh Gill, Tiffany K Gill, Ibrahim Abdelmageed Ginawi, Giorgia Giussani, Elena V Gnedovskaya, Ellen M Goldberg, Srinivas Goli, Hector Gómez-Dantés, Philimon N Gona, Sameer Vali Gopalani, Taren M Gorman, Alessandra C Goulart, Bárbara Niegia Garcia Goulart, Ayman Grada, Giuseppe Grosso, Harish Chander Gugnani, Francis Guillemin, Yuming Guo, Prakash C Gupta, Rahul Gupta, Rajeev Gupta, Tanush Gupta, Reyna Alma Gutiérrez, Bishal Gyawali, Juanita A Haagsma, Vladimir Hachinski, Nima Hafezi-Nejad, Hassan Haghparast Bidgoli, Tekleberhan B Hagos, Tewodros Tesfa Hailegiyorgis, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Alexis J Handal, Graeme J Hankey, Yuantao Hao, Hilda L Harb, Sivadasanpillai Harikrishnan, Hamidreza Haririan, Josep Maria Haro, Hadi Hassankhani, Hamid Yimam Hassen, Rasmus Havmoeller, Roderick J Hay, Simon I Hay, Akbar Hedayatizadeh-Omran, Behzad Heibati, Delia Hendrie, Andualem Henok, Ileana Heredia-Pi, Claudiu Herteliu, Fatemeh Heydarpour, Pouria Heydarpour, Desalegn Tsegaw Hibstu, Hans W Hoek, Howard J Hoffman, Michael K Hole, Enayatollah Homaie Rad, Praveen Hoogar, H Dean Hosgood, Seyed Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Peter J Hotez, Damian G Hoy, Mohamed Hsairi, Aung Soe Htet, John J Huang, Kim Moesgaard Iburg, Chad Thomas Ikeda, Olayinka Stephen Ilesanmi, Seyed Sina Naghibi Irvani, Caleb Mackay Salpeter Irvine, Sheikh Mohammed Shariful Islam, Farhad Islami, Kathryn H Jacobsen, Leila Jahangiry, Nader Jahanmehr, Sudhir Kumar Jain, Mihajlo Jakovljevic, Spencer L James, Achala Upendra Jayatilleke, Panniyammakal Jeemon, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Catherine O Johnson, Jost B Jonas, Jitendra Jonnagaddala, Zahra Jorjoran Shushtari, Ankur Joshi, Jacek Jerzy Jozwiak, Suresh Banayya Jungari, Mikk Jürisson, Zubair Kabir, Rajendra Kadel, Amaha Kahsay, Rizwan Kalani, Tanuj Kanchan, Chittaranjan Kar, Manoochehr Karami, Behzad Karami Matin, André Karch, Corine Karema, Narges Karimi, Seyed M Karimi, Amir Kasaeian, Dessalegn H Kassa, Getachew Mullu Kassa, Tesfaye Dessale Kassa, Nicholas J Kassebaum, Srinivasa Vittal Katikireddi, Anil Kaul, Norito Kawakami, Zhila Kazemi, Ali Kazemi Karyani, Masoud Masoud Keighobadi, Peter Njenga Keiyoro, Laura Kemmer, Grant Rodgers Kemp, Andre Pascal Kengne, Andre Keren, Yousef Saleh Khader, Behzad Khafaei, Morteza Abdullatif Khafaie, Alireza Khajavi, Nauman Khalid, Ibrahim A Khalil, Ejaz Ahmad Khan, Muhammad Shahzeb Khan, Muhammad Ali Khan, Young-Ho Khang, Mona M Khater, Mohammad Khazaei, Abdullah T Khoja, Ardeshir Khosravi, Mohammad Hossein Khosravi, Aliasghar A Kiadaliri, Zelalem Teklemariam Kidanemariam, Daniel N Kiirithio, Cho-Il Kim, Daniel Kim, Young-Eun Kim, Yun Jin Kim, Ruth W Kimokoti, Yohannes Kinfu, Adnan Kisa, Katarzyna Kissimova-Skarbek, Ann Kristin Skrindo Knudsen, Jonathan M Kocarnik, Sonali Kochhar, Yoshihiro Kokubo, Tufa Kolola, Jacek A Kopec, Soewarta Kosen, Georgios A Kotsakis, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, Sanjay Krishnaswami, Kristopher J Krohn, Barthelemy Kuate Defo, Burcu Kucuk Bicer, G Anil Kumar, Manasi Kumar, Igor Kuzin, Deepesh P Lad, Sheetal D Lad, Alessandra Lafranconi, Ratilal Lalloo, Tea Lallukka, Faris Hasan Lami, Justin J Lang, Sinéad M Langan, Van C Lansingh, Arman Latifi, Kathryn Mei-Ming Lau, Jeffrey V Lazarus, Janet L Leasher, Jorge R Ledesma, Paul H Lee, James Leigh, Mostafa Leili, Cheru Tesema Leshargie, Janni Leung, Miriam Levi, Sonia Lewycka, Shanshan Li, Yichong Li, Xiaofeng Liang, Yu Liao, Misgan Legesse Liben, Lee-Ling Lim, Stephen S Lim, Miteku Andualem Limenih, Shai Linn, Shiwei Liu, Katharine J Looker, Alan D Lopez, Stefan Lorkowski, Paulo A Lotufo, Rafael Lozano, Tim C D Lucas, Raimundas Lunevicius, Ronan A Lyons, Stefan Ma, Erlyn Rachelle King Macarayan, Mark T Mackay, Emilie R Maddison, Fabiana Madotto, Dhaval P Maghavani, Hue Thi Mai, Marek Majdan, Reza Majdzadeh, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Abdullah A Mamun, Ana-Laura Manda, Helena Manguerra, Mohammad Ali Mansournia, Ana Maria Mantilla Herrera, Lorenzo Giovanni Mantovani, Joemer C Maravilla, Wagner Marcenes, Ashley Marks, Francisco Rogerlândio Martins-Melo, Ira Martopullo, Winfried März, Melvin B Marzan, João Massano, Benjamin Ballard Massenburg, Manu Raj Mathur, Pallab K Maulik, Mohsen Mazidi, Colm McAlinden, John J McGrath, Martin McKee, Brian J McMahon, Suresh Mehata, Ravi Mehrotra, Kala M Mehta, Varshil Mehta, Fabiola Mejia-Rodriguez, Tesfa Mekonen, Addisu Melese, Mulugeta Melku, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Getnet Mengistu, George A Mensah, Seid Tiku Mereta, Atte Meretoja, Tuomo J Meretoja, Tomislav Mestrovic, Bartosz Miazgowski, Tomasz Miazgowski, Anoushka I Millear, Ted R Miller, G K Mini, Mojde Mirarefin, Andreea Mirica, Erkin M Mirrakhimov, Awoke Temesgen Misganaw, Philip B Mitchell, Habtamu Mitiku, Babak Moazen, Bahram Mohajer, Karzan Abdulmuhsin Mohammad, Moslem Mohammadi, Noushin Mohammadifard, Mousa Mohammadnia-Afrouzi, Mohammed A Mohammed, Shafiu Mohammed, Farnam Mohebi, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Julio Cesar Montañez, Mahmood Moosazadeh, Ghobad Moradi, Mahmoudreza Moradi, Maziar Moradi-Lakeh, Mehdi Moradinazar, Paula Moraga, Lidia Morawska, Ilais Moreno Velásquez, Joana Morgado-Da-Costa, Shane Douglas Morrison, Marilita M Moschos, Seyyed Meysam Mousavi, Kalayu Brhane Mruts, Achenef Asmamaw Muche, Kindie Fentahun Muchie, Ulrich Otto Mueller, Oumer Sada Muhammed, Satinath Mukhopadhyay, Kate Muller, John Everett Mumford, G V S Murthy, Kamarul Imran Musa, Ghulam Mustafa, Ashraf F Nabhan, Chie Nagata, Gabriele Nagel, Mohsen Naghavi, Aliya Naheed, Azin Nahvijou, Gurudatta Naik, Farid Najafi, Hae Sung Nam, Vinay Nangia, Jobert Richie Nansseu, Nahid Neamati, Ionut Negoi, Ruxandra Irina Negoi, Subas Neupane, Charles Richard James Newton, Josephine W Ngunjiri, Anh Quynh Nguyen, Grant Nguyen, Ha Thu Nguyen, Huong Lan Thi Nguyen, Huong Thanh Nguyen, Long Hoang Nguyen, Minh Nguyen, Nam Ba Nguyen, Son Hoang Nguyen, Emma Nichols, Dina Nur Anggraini Ningrum, Molly R Nixon, Shuhei Nomura, Mehdi Noroozi, Bo Norrving, Jean Jacques Noubiap, Hamid Reza Nouri, Malihe Nourollahpour Shiadeh, Mohammad Reza Nowroozi, Elaine O Nsoesie, Peter S Nyasulu, Christopher M Odell, Richard Ofori-Asenso, Felix Akpojene Ogbo, In-Hwan Oh, Olanrewaju Oladimeji, Andrew T Olagunju, Tinuke O Olagunju, Pedro R Olivares, Helen Elizabeth Olsen, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Kanyin L Ong, Sok King Ong, Eyal Oren, Alberto Ortiz, Erika Ota, Stanislav S Otstavnov, Simon Øverland, Mayowa Ojo Owolabi, Mahesh P A, Rosana Pacella, Abhijit P Pakhare, Amir H Pakpour, Adrian Pana, Songhomitra Panda-Jonas, Eun-Kee Park, James Park, Charles D H Parry, Hadi Parsian, Yahya Pasdar, Shanti Patel, Snehal T Patil, Ajay Patle, George C Patton, Vishnupriya Rao Paturi, Deepak Paudel, Katherine R Paulson, Neil Pearce, Alexandre Pereira, David M Pereira, Norberto Perico, Konrad Pesudovs, Max Petzold, Hai Quang Pham, Michael R Phillips, David M Pigott, Julian David Pillay, Michael A Piradov, Meghdad Pirsaheb, Farhad Pishgar, Oleguer Plana-Ripoll, Suzanne Polinder, Svetlana Popova, Maarten J Postma, Akram Pourshams, Hossein Poustchi, Dorairaj Prabhakaran, Swayam Prakash, V Prakash, Narayan Prasad, Caroline A Purcell, Mostafa Qorbani, D Alex Quistberg, Amir Radfar, Anwar Rafay, Alireza Rafiei, Fakher Rahim, Kazem Rahimi, Zohreh Rahimi, Afarin Rahimi-Movaghar, Vafa Rahimi-Movaghar, Mahfuzar Rahman, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Sajjad Ur Rahman, Rajesh Kumar Rai, Fatemeh Rajati, Prabhat Ranjan, Puja C Rao, Davide Rasella, David Laith Rawaf, Salman Rawaf, K Srinath Reddy, Robert C Reiner, Marissa Bettay Reitsma, Giuseppe Remuzzi, Andre M N Renzaho, Serge Resnikoff, Satar Rezaei, Mohammad Sadegh Rezai, Antonio Luiz P Ribeiro, Nicholas L S Roberts, Stephen R Robinson, Leonardo Roever, Luca Ronfani, Gholamreza Roshandel, Ali Rostami, Gregory A Roth, Dietrich Rothenbacher, Enrico Rubagotti, Perminder S Sachdev, Nafis Sadat, Ehsan Sadeghi, Sahar Saeedi Moghaddam, Hosein Safari, Yahya Safari, Roya Safari-Faramani, Mahdi Safdarian, Sare Safi, Saeid Safiri, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, Haniye Sadat Sajadi, Nasir Salam, Joseph S Salama, Payman Salamati, Zikria Saleem, Yahya Salimi, Hamideh Salimzadeh, Joshua A Salomon, Sundeep Santosh Salvi, Inbal Salz, 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, Mayank Sardana, Abdur Razzaque Sarker, Rodrigo Sarmiento-Suárez, Nizal Sarrafzadegan, Benn Sartorius, Shahabeddin Sarvi, Brijesh Sathian, Maheswar Satpathy, Arundhati R Sawant, Monika Sawhney, Sonia Saxena, Elke Schaeffner, Maria Inês Schmidt, Ione J C Schneider, Aletta Elisabeth Schutte, David C Schwebel, Falk Schwendicke, James G Scott, Mario Sekerija, Sadaf G Sepanlou, Edson Serván-Mori, Seyedmojtaba Seyedmousavi, Hosein Shabaninejad, Azadeh Shafieesabet, Mehdi Shahbazi, Amira A Shaheen, Masood Ali Shaikh, Mehran Shams-Beyranvand, Mohammadbagher Shamsi, Heidar Sharafi, Kiomars Sharafi, Mehdi Sharif, Mahdi Sharif-Alhoseini, Jayendra Sharma, Rajesh Sharma, Jun She, Aziz Sheikh, Peilin Shi, Kenji Shibuya, Mekonnen Sisay Shiferaw, Mika Shigematsu, Rahman Shiri, Reza Shirkoohi, Ivy Shiue, Yalda Shokoohinia, Farhad Shokraneh, Haitham Shoman, Mark G Shrime, Si Si, Soraya Siabani, Abla Mehio Sibai, Tariq J Siddiqi, Inga Dora Sigfusdottir, Rannveig Sigurvinsdottir, Diego Augusto Santos Silva, João Pedro Silva, Dayane Gabriele Alves Silveira, Narayana Sarma Venkata Singam, Jasvinder A Singh, Narinder Pal Singh, Virendra Singh, Dhirendra Narain Sinha, Eirini Skiadaresi, Vegard Skirbekk, Karen Sliwa, David L Smith, Mari Smith, Adauto Martins Soares Filho, Badr Hasan Sobaih, Soheila Sobhani, Moslem Soofi, Reed J D Sorensen, Joan B Soriano, Ireneous N Soyiri, Luciano A Sposato, Chandrashekhar T Sreeramareddy, Vinay Srinivasan, Jeffrey D Stanaway, Vladimir I Starodubov, Dan J Stein, Caitlyn Steiner, Timothy J Steiner, Mark A Stokes, Lars Jacob Stovner, Michelle L Subart, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Gerhard Sulo, Bruno F Sunguya, Patrick John Sur, Bryan L Sykes, P N Sylaja, Dillon O Sylte, Cassandra E I Szoeke, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Santosh Kumar Tadakamadla, Nikhil Tandon, Segen Gebremeskel Tassew, Mohammad Tavakkoli, Nuno Taveira, Hugh R Taylor, Arash Tehrani-Banihashemi, Tigist Gashaw Tekalign, Shishay Wahdey Tekelemedhin, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Omar Temsah, Abdullah Sulieman Terkawi, Belay Tessema, Mebrahtu Teweldemedhin, Kavumpurathu Raman Thankappan, Andrew Theis, Sathish Thirunavukkarasu, Nihal Thomas, Binyam Tilahun, Quyen G To, Marcello Tonelli, Roman Topor-Madry, Anna E Torre, Miguel Tortajada-Girbés, Mathilde Touvier, Marcos Roberto Tovani-Palone, Jeffrey A Towbin, Bach Xuan Tran, Khanh Bao Tran, Christopher E Troeger, Afewerki Gebremeskel Tsadik, Derrick Tsoi, Lorainne Tudor Car, Stefanos Tyrovolas, Kingsley Nnanna Ukwaja, Irfan Ullah, Eduardo A Undurraga, Rachel L Updike, Muhammad Shariq Usman, Olalekan A Uthman, Muthiah Vaduganathan, Afsane Vaezi, Pascual R Valdez, Elena Varavikova, Santosh Varughese, Tommi Juhani Vasankari, Narayanaswamy Venketasubramanian, Santos Villafaina, Francesco S Violante, Sergey Konstantinovitch Vladimirov, Vasily Vlassov, Stein Emil Vollset, Theo Vos, Kia Vosoughi, Isidora S Vujcic, Fasil Shiferaw Wagnew, Yasir Waheed, Yafeng Wang, Yuan-Pang Wang, Elisabete Weiderpass, Robert G Weintraub, Daniel J Weiss, Fitsum Weldegebreal, Kidu Gidey Weldegwergs, Andrea Werdecker, T Eoin West, Ronny Westerman, Harvey A Whiteford, Justyna Widecka, Tissa Wijeratne, Hywel C Williams, Lauren B Wilner, Shadrach Wilson, Andrea Sylvia Winkler, Alison B Wiyeh, Charles Shey Wiysonge, Charles D A Wolfe, Anthony D Woolf, Grant M A Wyper, Denis Xavier, Gelin Xu, Simon Yadgir, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Lijing L Yan, Yuichiro Yano, Mehdi Yaseri, Yasin Jemal Yasin, Alex Yeshaneh, Ebrahim M Yimer, Paul Yip, Engida Yisma, Naohiro Yonemoto, Seok-Jun Yoon, Marcel Yotebieng, Mustafa Z Younis, Mahmoud Yousefifard, Chuanhua Yu, Vesna Zadnik, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Heather J Zar, Zerihun Menlkalew Zenebe, Ben Zipkin, Maigeng Zhou, Sanjay Zodpey, Inbar Zucker, Liesl Joanna Zuhlke, Christopher J L Murray.Correction: Errata, June 20, 2019. Volume 393, Issue 10190e44June 22, 2019. GBD 2017 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1859–922—In this Global Health Metrics paper, Joan B Soriano has been added to the collaborators list; affiliation details have been amended for Joseph Adel Mattar Banoub, Tanuj Kanchan, and Yasin Jemal Yasin; and the declaration of interests statement has been amended for Boris Bikbov. These corrections have been made to the online version as of June 20, 2019.Background:
How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted life-years (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severity of ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years.
Methods:
We used data for age-specific mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Socio-demographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males.
Findings:
Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1–7·8), from 65·6 years (65·3–65·8) in 1990 to 73·0 years (72·7–73·3) in 2017. The increase in years of life varied from 5·1 years (5·0–5·3) in high SDI countries to 12·0 years (11·3–12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1–33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8–15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9–6·7), from 57·0 years (54·6–59·1) in 1990 to 63·3 years (60·5–65·7) in 2017. The increase varied from 3·8 years (3·4–4·1) in high SDI countries to 10·5 years (9·8–11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4–1·7) in Saint Vincent and the Grenadines (62·4 years [59·9–64·7] in 1990 to 63·5 years [60·9–65·8] in 2017) to 23·7 years (21·9–25·6) in Eritrea (30·7 years [28·9–32·2] in 1990 to 54·4 years [51·5–57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6–2·3) in Algeria to 11·9 years (10·9–12·9) in Ukraine. Of the extra years gained, the proportion spent in poor
Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017
No full textInterpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning.Stanaway, Jeffrey D-2520fbe1e553ab7130a3e14d339cc29e-0Afshin, Ashkan-4062fbc2d605ce12060facaec6d95b23-0Gakidou, Emmanuela-f92c7e1014d29cebdcab875927db3eac-0Lim, Stephen S-2dfacd56ccc922d1b607c443c3aed8b3-0Abate, Degu-4c9c9907f2717c0bf18a360b4adc23fa-0Abate, Kalkidan Hassen-c29aa366a14f60e18d131235548e6764-0Abbafati, Cristiana-f12d1252183d734ef769098209e59c75-0Abbasi, Nooshin-fe10e2a9e12733c5a369e08cac0cc626-0Abbastabar, Hedayat-db4b6e4e6a8f2f22ec5b2ef0001c80f7-0Abd-Allah, Foad-315bbcdbb313ea1850a4c83707cf22e4-0Abdela, Jemal-ea18b0db074176a0a8843cf7b6f4b574-0Abdelalim, Ahmed-729ff719b4f2e616be01aca670300fc6-0Abdollahpour, Ibrahim-01b160c436c07eb954f4720675e6bd23-0Abdulkader, Rizwan Suliankatchi-82f3def17146f3217d67e5d420a09d2f-0Abebe, Molla-f069369cc88f0ff20184f65022e52404-0Abebe, Zegeye-dc8063f4c2383f9646ee0c6014901e04-0Abera, Semaw Ferede-28fd674f722c27f0a3d66100a57fce74-0Abil, Olifan Zewdie-62e69e9e8589dc80140e0c9c76b2a743-0Abraha, Haftom Niguse-6f45c1da5e4fdda97c3adc3da2d477a6-0Roba, Aklilu Abrham-f97be0b52463568f84c9fa9affff2463-0Abu Raddad, Laith J-87179b55a3abe08d15357d22d77b0c9f-0Abun Rmeileh, Niveen M.E-e394ad81f593042412c8643ab8a7a4f9-0Accrombessi, Manfred Mario Kokou-1b088b3416d0f6ec3a7e9c864680942d-0Acharya, Dilaram-240b7a14aa142c99753566d79c7f3b22-0Acharya, Pawan-01cb4a54739afb677b91e0c05c7bface-0Adamu, Abdu Abdullahi-e39e3857e02d33a997368b54498ac2c0-0Adane, Akilew Awoke-15c0422bbf6693d459926fee9fc4d9c1-0Adebayo, Oladimeji-4c0a9d75950ff513bd301db5f932d7d9-0Adedoyin, Rufus Adesoji-84fc0bb933bb9ff247cda9f35406ff61-0Adekanmbi, Victor T-e61819d7aa2c70a57ded8f98f24e51c4-0Ademi, Zanfina-244384081418339dd051b719eea79eb7-0Adetokunboh, Olatunji O-adc3c1a0fbe4e0fcc186e9c39f20aab6-0Adib, Mina G-5e2e4a2b955c99a7148bf2835df4da1e-0Admasie, Amha-3886ac12611046939e2700837619b6cb-0Adsuar, Jose C-baf85df62abf1a7c7551a6af0dc965f5-0Afanvi, Kossivi Agbélénko-8ab9da633de1822d6740ff2bd12e2e8a-0Afarideh, Mohsen-16092959beee378428077dd5e6d04832-0Agarwal, Gina-264b1b6b950696d5c41cdcd383a30c3e-0Aggarwal, Anju-f8be93a84e70ebfb86441e91f9451992-0Aghayan, Sargis A-58cc18e7d481a0d431f2a3c93ee71b4e-0Agrawal, Anurag-509f342b1575b999d5ec6bd3f612df26-0Agrawal, Sutapa-f12c5d24e93e2c07c6321cb7dce96069-0Ahmadi, Alireza-219a6a30c7460d2b398c05ca35d5a1e1-0Ahmadi Moghadam, M-094a65b0c8189b7125eca1b8f5afae2e-0Ahmadieh, Hamid-6f9d23d4531563d07e9d3039d16294bc-0Ahmed, Muktar Beshir-827a98e28bbeb4ad75edaadbc87a6956-0Aichour, Amani Nidhal-84ac126cb31640764728380f61311b50-0Aichour, Ibtihel-984dfc4e36d078e7665d8d90220e472f-0Aichour, Miloud Taki Eddine-8ea68860413c6b03f5c2f7f808fc3e59-0Akbari, Mohammad Esmaeil-f41dc784812f38441d1a970abcd1e76f-0Akinyemiju, Tomi F.-aa496f0e0203c38d494058c117171fd1-0Akseer, Nadia-a208855455ad6ca542b60f1c9d6f0076-0Al Aly, Ziyad-5727374838f3b814fee2209100046f1f-0Al Eyadhy, Ayman A-4e6eed03ca8f2b345b91a02928d77d95-0Al Mekhlafi, H. 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Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017
No full textBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data.Methods We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting.Findings Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 39% (95% uncertainty interval [UI] 3.1-4. 6) from 1990 to 2017; however, the all-age YLD rate increased by 7.2% (6.0-8.4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7.9% (6 6-9. 2) for males and 6.5% (5.4-7.7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs 1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-hatin and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]).Interpretation Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd
Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017
No full textAbstract: Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 39% (95% uncertainty interval [UI] 3.1-4. 6) from 1990 to 2017; however, the all-age YLD rate increased by 7.2% (6.0-8.4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7.9% (6 6-9. 2) for males and 6.5% (5.4-7.7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs 1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-hatin and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). Interpretation Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd
Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017
No full textAbstract: Background How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted life years (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severity of ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-specific mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Sociodemographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7.4 years (95% uncertainty interval 74-7.8), from 65.6 years (65.3-65- 8) in 1990 to 73.0 years (72.7-73.3) in 2017. The increase in years of life varied from 5.1 years (5.0-5.3) in high SDI countries to 12.0 years (11.3-12.8) in low SDI countries. Of the additional years of life expected at birth, 26.3% (20.1-33.1) were expected to be spent in poor health in high SDI countries compared with 11.7% (8.8-15.1) in low-middle SDI countries. HALE at birth increased by 6.3 years (5.9-6.7), from 57.0 years (54.6-59.1) in 1990 to 63.3 years (60.5-65.7) in 2017. The increase varied from 3.8 years (3.4-4.1) in high SDI countries to 10.5 years (9.8-11.2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1.0 year (0.4-1.7) in Saint Vincent and the Grenadines (62.4 years [59.9-64.7] in 1990 to 63.5 years [60.9-65.8] in 2017) to 23.7 years (21.9-25.6) in Eritrea (30.7 years [28.9-32.2] in 1990 to 54.4 years [51.5-57.1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1.4 years (0.6-2.3) in Algeria to 11.9 years (10.9-12.9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75.8 years [72.4-78.7]) and males (72.6 years [69 " 8-75.0]) and the lowest estimates were in Central African Republic (47.0 years [43.7-50.2] for females and 42.8 years [40.1-45.6] for males). Globally, in 2017, the five leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41.3% (38.8-43.5) for communicable diseases and by 49"8% (47.9-51.6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40.1% (36.8-43.0), although age-standardised DALY rates decreased by 18.1% (16.0-20.2). Interpretation With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low S DI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd
Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017
No full text© 2018 The Author(s). Background: Assessments of age-specifc mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Afairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specifc mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in diferent components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings: Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation: This analysis of age-sex-specifc mortality shows that there are remarkably complex patterns in population mortality across countries. The fndings of this study highlight global successes, such as the large decline in under-5 mortality, which refects signifcant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing
Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017
No full textBackground:
The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data.
Methods:
We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting.
Findings:
Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1–4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0–8·4) while the total sum of global YLDs increased from 562 million (421–723) to 853 million (642–1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6–9·2) for males and 6·5% (5·4–7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782–3252] per 100 000 in males vs s1400 [1279–1524] per 100 000 in females), transport injuries (3322 [3082–3583] vs 2336 [2154–2535]), and self-harm and interpersonal violence (3265 [2943–3630] vs 5643 [5057–6302]).
Interpretation:
Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury
Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018
No full textAnemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations
Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017
No full textBackground:
How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted life-years (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severity of ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years.
Methods:
We used data for age-specific mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Socio-demographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males.
Findings:
Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1–7·8), from 65·6 years (65·3–65·8) in 1990 to 73·0 years (72·7–73·3) in 2017. The increase in years of life varied from 5·1 years (5·0–5·3) in high SDI countries to 12·0 years (11·3–12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1–33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8–15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9–6·7), from 57·0 years (54·6–59·1) in 1990 to 63·3 years (60·5–65·7) in 2017. The increase varied from 3·8 years (3·4–4·1) in high SDI countries to 10·5 years (9·8–11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4–1·7) in Saint Vincent and the Grenadines (62·4 years [59·9–64·7] in 1990 to 63·5 years [60·9–65·8] in 2017) to 23·7 years (21·9–25·6) in Eritrea (30·7 years [28·9–32·2] in 1990 to 54·4 years [51·5–57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6–2·3) in Algeria to 11·9 years (10·9–12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4–78·7]) and males (72·6 years [69·8–75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7–50·2] for females and 42·8 years [40·1–45·6] for males). Globally, in 2017, the five leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8–43·5) for communicable diseases and by 49·8% (47·9–51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8–43·0), although age-standardised DALY rates decreased by 18·1% (16·0–20·2).
Interpretation:
With increasing life expectancy in most countries, the question of whether the additional years of life gained are spent in good health or poor health has been increasingly relevant because of the potential policy implications, such as health-care provisions and extending retirement ages. In some locations, a large proportion of those additional years are spent in poor health. Large inequalities in HALE and disease burden exist across countries in different SDI quintiles and between sexes. The burden of disabling conditions has serious implications for health system planning and health-related expenditures. Despite the progress made in reducing the burden of communicable diseases and neonatal disorders in low SDI countries, the speed of this progress could be increased by scaling up proven interventions. The global trends among non-communicable diseases indicate that more effort is needed to maximise HALE, such as risk prevention and attention to upstream determinants of health
