182 research outputs found
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic : a comprehensive demographic analysis for the Global Burden of Disease Study 2021
No full textAustin E. Schumacher, Hmwe Hmwe Kyu, Amirali Aali, Cristiana Abbafati, Jaffar Abbas, Rouzbeh Abbasgholizadeh, Madineh Akram Abbasi, Mohammadreza Abbasian, Samar Abd ElHafeez, Michael Abdelmasseh, Sherief Abd-Elsalam, Ahmed Abdelwahab, Mohammad Abdollahi, Meriem Abdoun, Auwal Abdullahi, Ame Mehadi Abdurehman, Mesfin Abebe, Aidin Abedi, Armita Abedi, Tadesse M. Abegaz, Roberto Ariel Abeldaño Zuñiga, E. S. Abhilash, Olugbenga Olusola Abiodun, Richard Gyan Aboagye, Hassan Abolhassani, Mohamed Abouzid, Lucas Guimarães Abreu, Woldu Aberhe Abrha, Michael R.M. Abrigo, Dariush Abtahi, Samir Abu Rumeileh, Niveen ME Abu-Rmeileh, Salahdein Aburuz, Ahmed Abu-Zaid, Juan Manuel Acuna, Tim Adair, Isaac Yeboah Addo, Oladimeji M. Adebayo, Oyelola A. Adegboye, Victor Adekanmbi, Bashir Aden, Abiola Victor Adepoju, Charles Oluwaseun Adetunji, Temitayo Esther Adeyeoluwa, Olorunsola Israel Adeyomoye, Rishan Adha, Amin Adibi, Wirawan Adikusuma, Qorinah Estiningtyas Sakilah Adnani, Saryia Adra, Abel Afework, Aanuoluwapo Adeyimika Afolabi, Ali Afraz, Shadi Afyouni, Saira Afzal, Pradyumna Agasthi, Shahin Aghamiri, Antonella Agodi, Williams Agyemang-Duah, Bright Opoku Ahinkorah, Aqeel Ahmad, Danish Ahmad, Firdos Ahmad, Muayyad M. Ahmad, Tauseef Ahmad, Keivan Ahmadi, Amir Mahmoud Ahmadzade, Mohadese Ahmadzade, Ayman Ahmed, Haroon Ahmed, Luai A. Ahmed, Muktar Beshir Ahmed, Syed Anees Ahmed, Marjan Ajami, Budi Aji, Olufemi Ajumobi, Gizachew Taddesse Akalu, Essona Matatom Akara, Karolina Akinosoglou, Sreelatha Akkala, Samuel Akyirem, Hanadi Al Hamad, Syed Mahfuz Al Hasan, Ammar Al Homsi, Mohammad Al Qadire, Moein Ala, Timothy Olukunle Aladelusi, Tareq Mohammed Ali AL-Ahdal, Samer O. Alalalmeh, Ziyad Al-Aly, Khurshid Alam, Manjurul Alam, Zufishan Alam, Rasmieh Mustafa Al-amer, Fahad Mashhour Alanezi, Turki M. Alanzi, Mohammed Albashtawy, Mohammad T. AlBataineh, Robert W. Aldridge, Sharifullah Alem
Hepatitis B Surface Antigen (HbsAg) Prevalence and Risk Factors in Women of Childbearing Age in Eastern Algeria
No full textBackground: Hepatitis B is the most common chronic viral infection and a significant contributor to morbidity and death globally. Based on the mother's hepatitis B e antigen (HBeAg) status, the probability of perinatal HBV infection in children delivered to mothers with HBV ranges from 10% to 85%.Aim: to determine the prevalence of hepatitis B virus infection among women of childbearing age in the eastern region of Algeria and investigate risk factors for infection to recommend ways to reduce the disease's impact on neonatal morbidity and mortality.Methods: We conducted a cross-sectional study in Sétif, Algeria, from 2005 to 2007 to assess the prevalence of Hepatitis B Surface Antigen among women of childbearing age. This study is the first and only one in Algeria. Data on risk factors, obstetrics, and sociodemographic were gathered using structured questionnaire; they were subsequently tested using an enzymelinked immunosorbent assay for HBsAg. The data collected were entered and processed using Epi info 3.3.2 software. Infection prevalence, sociodemographic, clinical, obstetric and risk factors variable frequency distributions were calculated. The student's t-test and Fisher's exact test were applied, at a significance level of 5%.Results: There are834 women of childbearing age's medical records were examined for this study. 1% of HBsAg test findings were positive. Positive HBsAg didn't significantly correlate with any other variables, including age, place of residence, municipality, marital status, occupation, parity, current pregnancy, reason for current consultation, transmission risk factors (blood transfusion, recent piercing, dental care, shared personal hygiene equipment, injection with multiple use equipment, tattoo, scarification, partner characteristics). However, history of jaundice has a significant protective effect against HBsAg positive.Conclusion: Although our results classify the two municipalities studied as low prevalence areas (< 2%). Prenatal HBsAg screening is strongly advised
Physical modeling of a liquefiable soil-sheet pile retaining wall system
No full textDecember 2024School of EngineeringSheet-pile walls are retaining structures that are prone to liquefaction-induced lateral spreading in waterfront areas. This dissertation explores the dynamic behavior of soil-sheet pile retaining wall systems under seismic loading, focusing on the effects of various parameters such as peak ground acceleration (PGA), number of peak cycles, Arias Intensity, soil density, and embedment ratio. The Liquefaction Experiments and Analysis Projects (LEAP) is a global research collaboration aimed at producing reliable test data to advance and verify numerical models for soil liquefaction studies. The study employs a series of dynamic centrifuge tests performed at the Rensselaer Polytechnic Institute (RPI) as part of the LEAP 2020 and LEAP 2022 projects. The LEAP 2020 experiments simulated the seismic response of retaining wall systems in saturated granular soil to understand the soil-structure interaction and liquefaction phenomena. The problem involved a floating sheet pile wall supporting a deposit of liquefiable soil. The experimental setup of the LEAP 2020 models featured a backfill height to embedment support ratio of 2:1. These experiments investigated the impact of varying mass density and input motions on soil-structural interaction. As part of the LEAP 2020 research campaign, test RPI-LEAP 20-E was conducted at the RPI centrifuge facility by Dr. Evangelia Korre to assess the seismic behavior of the sheet pile wall. Subsequently, the author of this thesis performed the RPI-LEAP 20-S test at the same facility as a repeat experiment, achieving results that were highly consistent with the initial test.
Within the framework of LEAP 2022, a series of six centrifuge experiments, RPI-LEAP 22-5, RPI-LEAP 22-10-1, RPI-LEAP 22-10-2, RPI-LEAP 22-10-3, RPI-LEAP 22-19, and RPI-LEAP 22-36 were conducted at RPI to investigate the impact of varied input motion parameters (Number of peak cycles, motion duration and PGA) on the retaining wall models. LEAP 22 models had an increased embedment depth with an embedment ratio of 1:1.
The key findings from the LEAP 22 experiments indicated that higher PGAs lead to increased soil-structure interaction, manifesting in higher accelerations, pore water pressures, and lateral displacements of the retaining walls. An increase in Arias Intensity, while maintaining a comparable number of peak cycles, resulted in greater lateral displacement of the retaining wall. The settlement of the backfill surface away from the wall was found to increase with a higher number of peak cycles. The experiments also highlighted the significant role of soil density in mitigating seismic impacts, with denser soil models showing lower displacements. Additionally, varying the embedment ratio of the sheet-pile walls significantly influences their seismic performance, with deeper embedment reducing wall displacements and rotations. The study underscores the importance of considering PGA, number of cycles, Arias Intensity, and soil properties in designing resilient geotechnical structures.
The experimental results contribute to a better understanding of the complex dynamic behavior of retaining wall systems and provide valuable data for validating numerical models used in predicting soil liquefaction and seismic responses. This research highlights the critical factors influencing the stability of geotechnical structures in seismic-prone areas and offers insights for improving design and risk assessment practices.Ph
Profil Epidémiologique des cancers colorectaux dans la région Est et Sud-Est de l’Algérie
No full textIntroduction. Colorectal cancer is the third leading cause of cancer death in the world
and its incidence continues to increase in developing countries adopting the Western
way of life. Objective. The purpose of this regional study covering 19 wilayas of the
country is to provide data on the incidence of colorectal cancer, to study its
geographical distribution and its evolution. Material and Methods. This is a
multicenter descriptive epidemiological study from January 1, 2014 to December 31,
2018 on all cases of colorectal cancer diagnosed in the Eastern region and Southeastern of Algeria. The regional incidence of cancers is estimated from validated
registries. Results. The gender distribution of colorectal cancer between 2014 – 2018
shows that: In men, the crude incidence rate was 14,6 per 100 000 inhabitants, which
corresponds to a standardized rate of 19.3 per 100 000 inhabitants and it represents
15.9% of all male cancers. In women, the gross incidence rate was 14.0 per 100 000
inhabitants, which corresponds to a standardized rate of 18.2 per 100 000 inhabitants
and represents 11.2% of all female cancers. The incidence rates of these cancers
increase with age from 40 years in both sexes, they are higher in Annaba in both sexes.
Conclusion. the frequency of colorectal cancer will not stop growing in this region if
no preventive measures are taken such as a decrease in the prevalence of the main
risk factors, namely smoking and obesity. However, recent advances in screening,
early detection and treatment options will reduce mortality even in the face of
increasing incidence
Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019
No full textBackground: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries.Full Tex
Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019
No full textBackground
Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10–24 years during the past three decades.
Methods
Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional injuries for adolescents in 204 countries. Burden is reported in absolute numbers and age-standardised rates per 100 000 population by sex, age group (10–14, 15–19, and 20–24 years), and sociodemographic index (SDI) with 95% uncertainty intervals (UIs). We report percentage changes in deaths and DALYs between 1990 and 2019.
Findings
In 2019, 369 061 deaths (of which 214 337 [58%] were transport related) and 31·1 million DALYs (of which 16·2 million [52%] were transport related) among adolescents aged 10–24 years were caused by transport and unintentional injuries combined. If compared with other causes, transport and unintentional injuries combined accounted for 25% of deaths and 14% of DALYs in 2019, and showed little improvement from 1990 when such injuries accounted for 26% of adolescent deaths and 17% of adolescent DALYs. Throughout adolescence, transport and unintentional injury fatality rates increased by age group. The unintentional injury burden was higher among males than females for all injury types, except for injuries related to fire, heat, and hot substances, or to adverse effects of medical treatment. From 1990 to 2019, global mortality rates declined by 34·4% (from 17·5 to 11·5 per 100 000) for transport injuries, and by 47·7% (from 15·9 to 8·3 per 100 000) for unintentional injuries. However, in low-SDI nations the absolute number of deaths increased (by 80·5% to 42 774 for transport injuries and by 39·4% to 31 961 for unintentional injuries). In the high-SDI quintile in 2010–19, the rate per 100 000 of transport injury DALYs was reduced by 16·7%, from 838 in 2010 to 699 in 2019. This was a substantially slower pace of reduction compared with the 48·5% reduction between 1990 and 2010, from 1626 per 100 000 in 1990 to 838 per 100 000 in 2010. Between 2010 and 2019, the rate of unintentional injury DALYs per 100 000 also remained largely unchanged in high-SDI countries (555 in 2010 vs 554 in 2019; 0·2% reduction). The number and rate of adolescent deaths and DALYs owing to environmental heat and cold exposure increased for the high-SDI quintile during 2010–19.
Interpretation
As other causes of mortality are addressed, inadequate progress in reducing transport and unintentional injury mortality as a proportion of adolescent deaths becomes apparent. The relative shift in the burden of injury from high-SDI countries to low and low–middle-SDI countries necessitates focused action, including global donor, government, and industry investment in injury prevention. The persisting burden of DALYs related to transport and unintentional injuries indicates a need to prioritise innovative measures for the primary prevention of adolescent injury.Full Tex
Increased susceptibility to liver fibrosis with age is correlated with an altered inflammatory response.
No full textInternational audienceIt has been suggested that increasing age is correlated with an acceleration of the progression of liver fibrosis induced by various agents, such as hepatitis C virus or chronic alcohol consumption. However, the cellular and molecular changes underlying this predisposition are not entirely understood. In the context of an aging population, it becomes challenging to decipher the mechanisms responsible for this higher susceptibility of older individuals to this acquired liver disorder. To address this issue, we induced liver fibrosis by carbon tetrachloride (CCl(4)) chronic administration to 8-week- and 15-month-old mice. We confirmed that susceptibility to fibrosis development increased with age and showed that aging did not affect fibrosis resolution capacity. We then focused on the impairment of hepatocyte proliferation, oxidative stress, and inflammation as potential mechanisms accelerating the development of fibrosis in the elderly. We detected no inhibition of hepatocyte proliferation after CCl(4) injury in 15-month-old mice, whereas it was inhibited after a partial hepatectomy. Finally, we observed that, in a context in which liver oxidative stress was not differentially increased in both experimental groups, there was a higher recruitment of inflammatory cells, including mostly macrophages and lymphocytes, oriented toward a T helper 2 (T(H)2) response in older mice. Our data show that in conditions of equivalent levels of oxidative stress and maintained hepatocyte proliferative capacity, an increased inflammatory reaction mainly composed of CD4(+) lymphocytes and macrophages expressing T(H)2 cytokines is the main factor involved in the higher susceptibility to fibrosis with increasing age
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
No full textSummary
Background:
Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period.
Methods:
22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution.
Findings:
Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations.
Interpretation:
Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic.Summary
Background:
Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period.
Methods:
22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution.
Findings:
Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations.
Interpretation:
Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic
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