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CRIS Current Research Information System
Background Up-to-date evidence on levels and trends for age-sex-specifi c all-cause and cause-specifi c mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries.
Methods We estimated age-sex-specifi c all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specifi c causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions.
Findings Global life expectancy for both sexes increased from 65.3 years (UI 65.0-65.6) in 1990, to 71.5 years (UI 71.0-71.9) in 2013, while the number of deaths increased from 47.5 million (UI 46.8-48.2) to 54.9 million (UI 53.6-56.3) over the same interval. Global progress masked variation by age and sex: for children, average absolute diff erences between countries decreased but relative diff erences increased. For women aged 25-39 years and older than 75 years and for men aged 20-49 years and 65 years and older, both absolute and relative diff erences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10.7%, from 4.3 million deaths in 1990 to 4.8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions.
Interpretation For most countries, the general pattern of reductions in age-sex specifi c mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.
Correction Naghavi, M., Wang, H., Lozano, R., Davis, A., Liang, X., Zhou, M., et al. (2015). Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. THE LANCET, 385(9963), 117-171 [10.1016/S0140-6736(14)61682-2].
Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013
Correction Naghavi, Mohsen;Wang, Haidong;Lozano, Rafael;Davis, Adrian;Liang, Xiaofeng;Zhou, Maigeng;Vollset, Stein Emil;Ozgoren, Ayse Abbasoglu;Abdalla, Safa;Abd Allah, Foad;Aziz, Muna I. Abdel;Abera, Semaw Ferede;Aboyans, Victor;Abraham, Biju;Abraham, Jerry P.;Abuabara, Katrina E.;Abubakar, Ibrahim;Abu Raddad, Laith J.;Abu Rmeileh, Niveen M. E.;Achoki, Tom;Adelekan, Ademola;Ademi, Zanfina;Adofo, Koranteng;Adou, Arse Kouablan;Adsuar, Jos C.;Ärnlöv, Johan;Agardh, Emilie Elisabet;Akena, Dickens;Al Khabouri, Mazin J.;Alasfoor, Deena;Albittar, Mohammed;Alegretti, Miguel Angel;Aleman, Alicia V.;Alemu, Zewdie Aderaw;Alfonso Cristancho, Rafael;Alhabib, Samia;Ali, Mohammed K.;Ali, Raghib;Alla, Francois;Al Lami, Faris;Allebeck, Peter;Almazroa, Mohammad A.;Al Shahi Salman, Rustam;Alsharif, Ubai;Alvarez, Elena;Alviz Guzman, Nelson;Amankwaa, Adansi A.;Amare, Azmeraw T.;Ameli, Omid;Amini, Hassan;Ammar, Walid;Anderson, H. Ross;Anderson, Benjamin O.;Antonio, Carl Abelardo T.;Anwari, Palwasha;Apfel, Henry;Cunningham, Solveig Argeseanu;Arsenijevic, Valentina S. Arsic;Artaman, Al;Asad, Majed Masoud;Asghar, Rana J.;Assadi, Reza;Atkins, Lydia S.;Atkinson, Charles;Badawi, Alaa;Bahit, Maria C.;Bakfalouni, Talal;Balakrishnan, Kalpana;Balalla, Shivanthi;Banerjee, Amitava;Barber, Ryan M.;Barker Collo, Suzanne L.;Barquera, Simon;Barregard, Lars;Barrero, Lope H.;Barrientos Gutierrez, Tonatiuh;Basu, Arindam;Basu, Sanjay;Basulaiman, Mohammed Omar;Beardsley, Justin;Bedi, Neeraj;Beghi, Ettore;Bekele, Tolesa;Bell, Michelle L.;Benjet, Corina;Bennett, Derrick A.;Bensenor, Isabela M.;Benzian, Habib;Bertozzi Villa, Amelia;Beyene, Tariku Jibat;Bhala, Neeraj;Bhalla, Ashish;Bhutta, Zulfiqar A.;Bikbov, Boris;Abdulhak, Aref Bin;Biryukov, Stan;Blore, Jed D.;Blyth, Fiona M.;Bohensky, Megan A.;Borges, Guilherme;Bose, Dipan;Boufous, Soufiane;Bourne, Rupert R.;Boyers, Lindsay N.;Brainin, Michael;Brauer, Michael;Brayne, Carol E. G.;Brazinova, Alexandra;Breitborde, Nicholas;Brenner, Hermann;Briggs, Adam D. M.;Brown, Jonathan C.;Brugha, Traolach S.;Buckle, Geoffrey C.;Bui, Linh Ngoc;Bukhman, Gene;Burch, Michael;Campos Nonato, Ismael Ricardo;Carabin, He;Cárdenas, Rosario;Carapetis, Jonathan;Carpenter, David O.;Caso, Valeria;Castanda Orjuela, Carlos A.;Castro, Ruben Estanislao;Catalá López, Ferrán;Cavalleri, Fiorella;Chang, Jung Chen;Charlson, Fiona C.;Che, Xuan;Chen, Honglei;Chen, Yingyao;Chen, Jian Sheng;Chen, Zhengming;Chiang, Peggy Pei Chia;Chimed Ochir, Odgerel;Chowdhury, Rajiv;Christensen, Hanne;Christophi, Costas A.;Chuang, Ting Wu;Chugh, Sumeet S.;Cirillo, Massimo;Coates, Matthew M.;Coffeng, Luc Edgar;Coggeshall, Megan S.;Cohen, Aaron;Colistro, Valentina;Colquhoun, Samantha M.;Colomar, Mercedes;Cooper, Leslie Trumbull;Cooper, Cyrus;Coppola, Luis M.;Cortinovis, Monica;Courville, Karen;Cowie, Benjamin C.;Criqui, Michael H.;Crump, John A.;Cuevas Nasu, Lucia;Da Costa Leite, Iuri;Dabhadkar, Kaustubh C.;Dandona, Lalit;Dandona, Rakhi;Dansereau, Emily;Dargan, Paul I.;Dayama, Anand;De la Cruz Góngora, Vanessa;De La Vega, Shelley F.;De Leo, Diego;Degenhardt, Louisa;Del Pozo Cruz, Borja;Dellavalle, Robert P.;Deribe, Kebede;Des Jarlais, Don C.;Dessalegn, Muluken;Deveber, Gabrielle A.;Dharmaratne, Samath D.;Dherani, Mukesh;Diaz Ortega, Jose Luis;Diaz Torne, Cesar;Dicker, Daniel;Ding, Eric L.;Dokova, Klara;Dorsey, E. Ray;Driscoll, Tim R.;Duan, Leilei;Duber, Herbert C.;Durrani, Adnan M.;Ebel, Beth E.;Edmond, Karen M.;Ellenbogen, Richard G.;Elshrek, Yousef;Ermakov, Sergey Petrovich;Erskine, Holly E.;Eshrati, Babak;Esteghamati, Alireza;Estep, Kara;Fürst, Thomas;Fahimi, Saman;Fahrion, Anna S.;Faraon, Emerito Jose A.;Farzadfar, Farshad;Fay, Derek F. J.;Feigl, Andrea B.;Feigin, Valery L.;Felicio, Manuela Mendonca;Fereshtehnejad, Seyed Mohammad;Fernandes, Jefferson G.;Ferrari, Alize J.;Fleming, Thomas D.;Foigt, Nataliya;Foreman, Kyle;Forouzanfar, Mohammad H.;Fowkes, F. Gerry R.;Paleo, Urbano Fra;Franklin, Richard C.;Futran, Neal D.;Gaffikin, Lynne;Gambashidze, Ketevan;Gankpé, Fortuné Gbétoho;Garc Guerra, Francisco Armando;Garcia, Ana Cristina;Geleijnse, Johanna M.;Gessner, Bradford D.;Gibney, Katherine B.;Gillum, Richard F.;Gilmour, Stuart;Ginawi, Ibrahim Abdelmageem Mohamed;Giroud, Maurice;Glaser, Elizabeth L.;Goenka, Shifalika;Dantes, Hector Gomez;Gona, Philimon;Gonzalez Medina, Diego;Guinovart, Caterina;Gupta, Rahul;Gupta, Rajeev;Gosselin, Richard A.;Gotay, Carolyn C.;Goto, Atsushi;Gouda, Hebe N.;Graetz, Nicholas;Greenwell, K. Fern;Gugnani, Harish Chander;Gunnell, David;Gutiiérez, Reyna A.;Haagsma, Juanita;Hafezi Nejad, Nima;Hagan, Holly;Hagstromer, Maria;Halasa, Yara A.;Hamadeh, Randah Ribhi;Hamavid, Hannah;Hammami, Mouhanad;Hancock, Jamie;Hankey, Graeme J.;Hansen, Gillian M.;Harb, Hilda L.;Harewood, Heather;Haro, Josep Maria;Havmoeller, Rasmus;Hay, Roderick J.;Hay, Simon I.;Hedayati, Mohammad T.;Pi, Ileana B. Heredia;Heuton, Kyle R.;Heydarpour, Pouria;Higashi, Hideki;Hijar, Martha;Hoek, Hans W.;Hoffman, Howard J.;Hornberger, John C.;Hosgood, H. Dean;Hossain, Mazeda;Hotez, Peter J.;Hoy, Damian G.;Hsairi, Mohamed;Hu, Guoqing;Huang, John J.;Huffman, Mark D.;Hughes, Andrew J.;Husseini, Abdullatif;Huynh, Chantal;Iannarone, Marissa;Iburg, Kim M.;Idrisov, Bulat T.;Ikeda, Nayu;Innos, Kaire;Inoue, Manami;Islami, Farhad;Ismayilova, Samaya;Jacobsen, Kathryn H.;Jassal, Simerjot;Jayaraman, Sudha P.;Jensen, Paul N.;Jha, Vivekanand;Jiang, Guohong;Jiang, Ying;Jonas, Jost B.;Joseph, Jonathan;Juel, Knud;Kabagambe, Edmond Kato;Kan, Haidong;Karch, Andr;Karimkhani, Chante;Karthikeyan, Ganesan;Kassebaum, Nicholas;Kaul, Anil;Kawakami, Norito;Kazanjan, Konstantin;Kazi, Dhruv S.;Kemp, Andrew H.;Kengne, Andre Pascal;Keren, Andre;Kereselidze, Maia;Khader, Yousef Saleh;Ali Hassan Khalifa, Shams Eldin;Khan, Ejaz Ahmed;Khan, Gulfaraz;Khang, Young Ho;Kieling, Christian;Kinfu, Yohannes;Kinge, Jonas M.;Kim, Daniel;Kim, Sungroul;Kivipelto, Miia;Knibbs, Luke;Knudsen, Ann Kristin;Kokubo, Yoshihiro;Kosen, Sowarta;Kotagal, Meera;Kravchenko, Michael A.;Krishnaswami, Sanjay;Krueger, Hans;Defo, Barthelemy Kuate;Kuipers, Ernst J.;Kucuk Bicer, Burcu;Kulkarni, Chanda;Kulkarni, Veena S.;Kumar, Kaushalendra;Kumar, Ravi B.;Kwan, Gene F.;Kyu, Hmwe;Lai, Taavi;Balaji, Arjun Lakshmana;Lalloo, Ratilal;Lallukka, Tea;Lam, Hilton;Lan, Qing;Lansingh, Van C.;Larson, Heidi J.;Larsson, Anders;Lavados, Pablo M.;Lawrynowicz, Alicia E. B.;Leasher, Janet L.;Lee, Jong Tae;Leigh, James;Leinsalu, Mall;Leung, Ricky;Levitz, Carly;Li, Bin;Li, Yichong;Li, Yongmei;Liddell, Chelsea;Lim, Stephen S.;De Lima, Graça Maria Ferreira;Lind, Maggie L.;Lipshultz, Steven E.;Liu, Shiwei;Liu, Yang;Lloyd, Belinda K.;Lofgren, Katherine T.;Logroscino, Giancarlo;London, Stephanie J.;Lortet Tieulent, Joannie;Lotufo, Paulo A.;Lucas, Robyn M.;Lunevicius, Raimundas;Lyons, Ronan Anthony;Ma, Stefan;Pedro Machado, Vasco Manuel;Macintyre, Michael F.;Mackay, Mark T.;Maclachlan, Jennifer H.;Magis Rodriguez, Carlos;Mahdi, Abbas A.;Majdan, Marek;Malekzadeh, Reza;Mangalam, Srikanth;Mapoma, Christopher Chabila;Marape, Marape;Marcenes, Wagner;Margono, Christopher;Marks, Guy B.;Marzan, Melvin Barrientos;Masci, Joseph R.;Mashal, Mohammad Taufiq;Masiye, Felix;Mason Jones, Amanda J.;Matzopolous, Richard;Mayosi, Bongani M.;Mazorodze, Tasara T.;Mcgrath, John J.;Mckay, Abigail C.;Mckee, Martin;Mclain, Abigail;Meaney, Peter A.;Mehndiratta, Man Mohan;Mejia Rodriguez, Fabiola;Melaku, Yohannes Adama;Meltzer, Michele;Memish, Ziad A.;Mendoza, Walter;Mensah, George A.;Meretoja, Atte;Mhimbira, Francis A.;Miller, Ted R.;Mills, Edward J.;Misganaw, Awoke;Mishra, Santosh K.;Mock, Charles N.;Moffitt, Terrie E.;Ibrahim, Norlinah Mohamed;Mohammad, Karzan Abdulmuhsin;Mokdad, Ali H.;Mola, Glen Liddell;Monasta, Lorenzo;De La Cruz Monis, Jonathan;Hernandez, Julio C. Montanêz;Montico, Marcella;Montine, Thomas J.;Mooney, Meghan D.;Moore, Ami R.;Moradi Lakeh, Maziar;Moran, Andrew E.;Mori, Rintaro;Moschandreas, Joanna;Moturi, Wilkister Nyaora;Moyer, Madeline L.;Mozaffarian, Dariush;Mueller, Ulrich O.;Mukaigawara, Mitsuru;Mullany, Erin C.;Murray, Joseph;Mustapha, Adetoun;Naghavi, Paria;Naheed, Aliya;Naidoo, Kovin S.;Naldi, Luigi;Nand, Devina;Nangia, Vinay;Narayan, K. M. Venkat;Nash, Denis;Nasher, Jamal;Nejjari, Chakib;Nelson, Robert G.;Neuhouser, Marian;Neupane, Sudan Prasad;Newcomb, Polly A.;Newman, Lori;Newton, Charles R.;Ng, Marie;Ngalesoni, Frida Namnyak;Nguyen, Grant;Nguyen, Nhung Thi Trang;Nisar, Muhammad Imran;Nolte, Sandra;Norheim, Ole F.;Norman, Rosana E.;Norrving, Bo;Nyakarahuka, Luke;Odell, Shaun;O'Donnell, Martin;Ohkubo, Takayoshi;Ohno, Summer Lockett;Olusanya, Bolajoko O.;Omer, Saad B.;Opio, John Nelson;Orisakwe, Orish Ebere;Ortblad, Katrina F.;Ortiz, Alberto;Otayza, Maria Lourdes K.;Pain, Amanda W.;Pandian, Jeyaraj D.;Panelo, Carlo Irwin;Panniyammakal, Jeemon;Papachristou, Christina;Paternina Caicedo, Angel J.;Patten, Scott B.;Patton, George C.;Paul, Vinod K.;Pavlin, Boris;Pearce, Neil;Pellegrini, Carlos A.;Pereira, David M.;Peresson, Sophie C.;Perez Padilla, Rogelio;Perez Ruiz, Fernando P.;Perico, Norberto;Pervaiz, Aslam;Pesudovs, Konrad;Peterson, Carrie B.;Petzold, Max;Phillips, Bryan K.;Phillips, David E.;Phillips, Michael R.;Plass, Dietrich;Piel, Frédéric Bernard;Poenaru, Dan;Polinder, Suzanne;Popova, Svetlana;Poulton, Richie G.;Pourmalek, Farshad;Prabhakaran, Dorairaj;Qato, Dima;Quezada, Amado D.;Quistberg, D. Alex;Rabito, Felicia;Rafay, Anwar;Rahimi, Kazem;Rahimi Movaghar, Vafa;Rahman, Sajjad U. R.;Raju, Murugesan;Rakovac, Ivo;Rana, Saleem M.;Refaat, Amany;Remuzzi, Giuseppe;Ribeiro, Antonio L.;Ricci, Stefano;Riccio, Patricia M.;Richardson, Lee;Richardus, Jan Hendrik;Roberts, Bayard;Roberts, D. Allen;Robinson, Margaret;Roca, Anna;Rodriguez, Alina;Rojas Rueda, David;Ronfani, Luca;Room, Robin;Roth, Gregory A.;Rothenbacher, Dietrich;Rothstein, David H.;Rowley, Jane T. F.;Roy, Nobhojit;Ruhago, George M.;Rushton, Lesley;Sambandam, Sankar;Søreide, Kjetil;Saeedi, Mohammad Yahya;Saha, Sukanta;Sahathevan, Ramesh;Sahraian, Mohammad Ali;Sahle, Berhe Weldearegawi;Salomon, Joshua A.;Salvo, Deborah;Samonte, Genesis May J.;Sampson, Uchechukwu;Sanabria, Juan Ramon;Sandar, Logan;Santos, Itamar S.;Satpathy, Maheswar;Sawhney, Monika;Saylan, Mete;Scarborough, Peter;Schöttker, Ben;Schmidt, Jürgen C.;Schneider, Ione J. C.;Schumacher, Austin E.;Schwebel, David C.;Scott, James G.;Sepanlou, Sadaf G.;Servan Mori, Edson E.;Shackelford, Katya;Shaheen, Amira;Shahraz, Saeid;Shakh Nazarova, Marina;Shangguan, Siyi;She, Jun;Sheikhbahaei, Sara;Shepard, Donald S.;Shibuya, Kenji;Shinohara, Yukito;Shishani, Kawkab;Shiue, Ivy;Shivakoti, Rupak;Shrime, Mark G.;Sigfusdottir, Inga Dora;Silberberg, Donald H.;Silva, Andrea P.;Simard, Edgar P.;Sindi, Shireen;Singh, Jasvinder A.;Singh, Lavanya;Sioson, Edgar;Skirbekk, Vegard;Sliwa, Karen;So, Samuel;Soljak, Michael;Soneji, Samir;Soshnikov, Sergey S.;Sposato, Luciano A.;Sreeramareddy, Chandrashekhar T.;Stanaway, Jeffrey D.;Stathopoulou, Vasiliki Kalliopi;Steenland, Kyle;Stein, Claudia;Steiner, Caitlyn;Stevens, Antony;Stöckl, Heidi;Straif, Kurt;Stroumpoulis, Konstantinos;Sturua, Lela;Sunguya, Bruno F.;Swaminathan, Soumya;Swaroop, Mamta;Sykes, Bryan L.;Tabb, Karen M.;Takahashi, Ken;Talongwa, Roberto Tchio;Tan, Feng;Tanne, David;Tanner, Marcel;Tavakkoli, Mohammad;Ao, Braden Te;Teixeira, Carolina Maria;Templin, Tara;Tenkorang, Eric Yeboah;Terkawi, Abdullah Sulieman;Thomas, Bernadette A.;Thorne Lyman, Andrew L.;Thrift, Amanda G.;Thurston, George D.;Tillmann, Taavi;Tirschwell, David L.;Tleyjeh, Imad M.;Tonelli, Marcello;Topouzis, Fotis;Towbin, Jeffrey A.;Toyoshima, Hideaki;Traebert, Jefferson;Tran, Bach X.;Truelsen, Thomas;Trujillo, Ulises;Trillini, Matias;Dimbuene, Zacharie Tsala;Tsilimbaris, Miltiadis;Tuzcu, E. Murat;Ubeda, Clotilde;Uchendu, Uche S.;Ukwaja, Kingsley N.;Undurraga, Eduardo A.;Vallely, Andrew J.;Van De Vijver, Steven;Van Gool, Coen H.;Varakin, Yuri Y.;Vasankari, Tommi J.;Vasconcelos, Ana Maria Nogales;Vavilala, Monica S.;Venketasubramanian, N.;Vijayakumar, Lakshmi;Villalpando, Salvador;VIOLANTE, FRANCESCO SAVERIO;Vlassov, Vasiliy Victorovich;Wagner, Gregory R.;Waller, Stephen G.;Wang, Jianli;Wang, Linhong;Wang, Xiaorong;Wang, Yanping;Warouw, Tati Suryati;Weichenthal, Scott;Weiderpass, Elisabete;Weintraub, Robert G.;Wenzhi, Wang;Werdecker, Andrea;Wessells, K. Ryan R.;Westerman, Ronny;Whiteford, Harvey A.;Wilkinson, James D.;Williams, Thomas Neil;Woldeyohannes, Solomon Meseret;Wolfe, Charles D. A.;Wolock, Timothy M.;Woolf, Anthony D.;Wong, John Q.;Wright, Jonathan L.;Wulf, Sarah;Wurtz, Brittany;Xu, Gelin;Yang, Yang C.;Yano, Yuichiro;Yatsuya, Hiroshi;Yip, Paul;Yonemoto, Naohiro;Yoon, Seok Jun;Younis, Mustafa;Yu, Chuanhua;Jin, Kim Yun;El Sayed Zaki, Maysaa;Zamakhshary, Mohammed Fouad;Zeeb, Hajo;Zhang, Yong;Zhao, Yong;Zheng, Yingfeng;Zhu, Jun;Zhu, Shankuan;Zonies, David;Zou, Xiao Nong;Zunt, Joseph R.;Vos, Theo;Lopez, Alan D.;Murray, Christopher J. L.;Alcalá Cerra, G.;Balala, S.;Chang, C. C.;Gosslin, R. A.;Hu, H.;Karam, N.;Sabin, N.;Temesgen, A. M.
2015
Abstract
Background Up-to-date evidence on levels and trends for age-sex-specifi c all-cause and cause-specifi c mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries.
Methods We estimated age-sex-specifi c all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specifi c causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions.
Findings Global life expectancy for both sexes increased from 65.3 years (UI 65.0-65.6) in 1990, to 71.5 years (UI 71.0-71.9) in 2013, while the number of deaths increased from 47.5 million (UI 46.8-48.2) to 54.9 million (UI 53.6-56.3) over the same interval. Global progress masked variation by age and sex: for children, average absolute diff erences between countries decreased but relative diff erences increased. For women aged 25-39 years and older than 75 years and for men aged 20-49 years and 65 years and older, both absolute and relative diff erences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10.7%, from 4.3 million deaths in 1990 to 4.8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions.
Interpretation For most countries, the general pattern of reductions in age-sex specifi c mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.
Correction Naghavi, M., Wang, H., Lozano, R., Davis, A., Liang, X., Zhou, M., et al. (2015). Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. THE LANCET, 385(9963), 117-171 [10.1016/S0140-6736(14)61682-2].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/522370
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.