Format

Send to

Choose Destination
See comment in PubMed Commons below
Lancet. 2015 Jan 10;385(9963):117-71. doi: 10.1016/S0140-6736(14)61682-2. Epub 2014 Dec 18.

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.

Collaborators (712)

Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M, Vollset SE, Ozgoren AA, Abdalla S, Abd-Allah F, Abdel Aziz MI, Abera SF, Aboyans V, Abraham B, Abraham JP, Abuabara KE, Abubakar I, Abu-Raddad LJ, Abu-Rmeileh NM, Achoki T, Adelekan A, Ademi Z, Adofo K, Adou AK, Adsuar JC, Ärnlov J, Agardh EE, Akena D, Al Khabouri MJ, Alasfoor D, Albittar M, Alegretti MA, Aleman AV, Alemu ZA, Alfonso-Cristancho R, Alhabib S, Ali MK, Ali R, Alla F, Al Lami F, Allebeck P, AlMazroa MA, Al-Shahi Salman R, Alsharif U, Alvarez E, Alviz-Guzman N, Amankwaa AA, Amare AT, Ameli O, Amini H, Ammar W, Anderson HR, Anderson BO, Antonio CA, Anwari P, Apfel H, Argeseanu Cunningham S, Arsic Arsenijevic VS, Artaman A, Asad MM, Asghar RJ, Assadi R, Atkins LS, Atkinson C, Badawi A, Bahit MC, Bakfalouni T, Balakrishnan K, Balalla S, Banerjee A, Barber RM, Barker-Collo SL, Barquera S, Barregard L, Barrero LH, Barrientos-Gutierrez T, Basu A, Basu S, Basulaiman MO, Beardsley J, Bedi N, Beghi E, Bekele T, Bell ML, Benjet C, Bennett DA, Bensenor IM, Benzian H, Bertozzi-Villa A, Beyene TJ, Bhala N, Bhalla A, Bhutta ZA, Bikbov B, Bin Abdulhak A, Biryukov S, Blore JD, Blyth FM, Bohensky MA, Borges G, Bose D, Boufous S, Bourne RR, Boyers LN, Brainin M, Brauer M, Brayne CE, Brazinova A, Breitborde N, Brenner H, Briggs AD, Brown JC, Brugha TS, Buckle GC, Bui LN, Bukhman G, Burch M, Campos Nonato IR, Carabin H, Cárdenas R, Carapetis J, Carpenter DO, Caso V, Castañeda-Orjuela CA, Castro RE, Catalá-López F, Cavalleri F, Chang JC, Charlson FC, Che X, Chen H, Chen Y, Chen JS, Chen Z, Chiang PP, Chimed-Ochir O, Chowdhury R, Christensen H, Christophi CA, Chuang TW, Chugh SS, Cirillo M, Coates MM, Coffeng LE, Coggeshall MS, Cohen A, Colistro V, Colquhoun SM, Colomar M, Cooper LT, Cooper C, Coppola LM, Cortinovis M, Courville K, Cowie BC, Criqui MH, Crump JA, Cuevas-Nasu L, da Costa Leite I, Dabhadkar KC, Dandona L, Dandona R, Dansereau E, Dargan PI, Dayama A, De la Cruz-Góngora V, de la Vega SF, De Leo D, Degenhardt L, del Pozo-Cruz B, Dellavalle RP, Deribe K, Des Jarlais DC, Dessalegn M, deVeber GA, Dharmaratne SD, Dherani M, Diaz-Ortega JL, Diaz-Torne C, Dicker D, Ding EL, Dokova K, Dorsey ER, Driscoll TR, Duan L, Duber HC, Durrani AM, Ebel BE, Edmond KM, Ellenbogen RG, Elshrek Y, Ermakov SP, Erskine HE, Eshrati B, Esteghamati A, Estep K, Fürst T, Fahimi S, Fahrion AS, Faraon EJ, Farzadfar F, Fay DF, Feigl AB, Feigin VL, Felicio MM, Fereshtehnejad SM, Fernandes JG, Ferrari AJ, Fleming TD, Foigt N, Foreman K, Forouzanfar MH, Fowkes FG, Paleo UF, Franklin RC, Futran ND, Gaffikin L, Gambashidze K, Gankpé FG, García-Guerra FA, Garcia AC, Geleijnse JM, Gessner BD, Gibney KB, Gillum RF, Gilmour S, Ginawi IA, Giroud M, Glaser EL, Goenka S, Gomez Dantes H, Gona P, Gonzalez-Medina D, Guinovart C, Gupta R, Gupta R, Gosselin RA, Gotay CC, Goto A, Gouda HN, Graetz N, Greenwell KF, Gugnani HC, Gunnell D, Gutiérrez RA, Haagsma J, Hafezi-Nejad N, Hagan H, Hagstromer M, Halasa YA, Hamadeh RR, Hamavid H, Hammami M, Hancock J, Hankey GJ, Hansen GM, Harb HL, Harewood H, Haro JM, Havmoeller R, Hay RJ, Hay SI, Hedayati MT, Heredia Pi IB, Heuton KR, Heydarpour P, Higashi H, Hijar M, Hoek HW, Hoffman HJ, Hornberger JC, Hosgood HD, Hossain M, Hotez PJ, Hoy DG, Hsairi M, Hu G, Huang JJ, Huffman MD, Hughes AJ, Husseini A, Huynh C, Iannarone M, Iburg KM, Idrisov BT, Ikeda N, Innos K, Inoue M, Islami F, Ismayilova S, Jacobsen KH, Jassal S, Jayaraman SP, Jensen PN, Jha V, Jiang G, Jiang Y, Jonas JB, Joseph J, Juel K, Kabagambe EK, Kan H, Karch A, Karimkhani C, Karthikeyan G, Kassebaum N, Kaul A, Kawakami N, Kazanjan K, Kazi DS, Kemp AH, Kengne AP, Keren A, Kereselidze M, Khader YS, Khalifa SE, Khan EA, Khan G, Khang YH, Kieling C, Kinfu Y, Kinge JM, Kim D, Kim S, Kivipelto M, Knibbs L, Knudsen AK, Kokubo Y, Kosen S, Kotagal M, Kravchenko MA, Krishnaswami S, Krueger H, Kuate Defo B, Kuipers EJ, Kucuk Bicer B, Kulkarni C, Kulkarni VS, Kumar K, Kumar RB, Kwan GF, Kyu H, Lai T, Lakshmana Balaji A, Lalloo R, Lallukka T, Lam H, Lan Q, Lansingh VC, Larson HJ, Larsson A, Lavados PM, Lawrynowicz AE, Leasher JL, Lee JT, Leigh J, Leinsalu M, Leung R, Levitz C, Li B, Li Y, Li Y, Liddell C, Lim SS, de Lima GM, Lind ML, Lipshultz SE, Liu S, Liu Y, Lloyd BK, Lofgren KT, Logroscino G, London SJ, Lortet-Tieulent J, Lotufo PA, Lucas RM, Lunevicius R, Lyons RA, Ma S, Machado VM, MacIntyre MF, Mackay MT, MacLachlan JH, Magis-Rodriguez C, Mahdi AA, Majdan M, Malekzadeh R, Mangalam S, Mapoma CC, Marape M, Marcenes W, Margono C, Marks GB, Marzan MB, Masci JR, Mashal MT, Masiye F, Mason-Jones AJ, Matzopolous R, Mayosi BM, Mazorodze TT, McGrath JJ, McKay AC, McKee M, McLain A, Meaney PA, Mehndiratta MM, Mejia-Rodriguez F, Melaku YA, Meltzer M, Memish ZA, Mendoza W, Mensah GA, Meretoja A, Mhimbira FA, Miller TR, Mills EJ, Misganaw A, Mishra SK, Mock CN, Moffitt TE, Mohamed Ibrahim N, Mohammad KA, Mokdad AH, Mola GL, Monasta L, Monis Jde L, Montañez Hernandez JC, Montico M, Montine TJ, Mooney MD, Moore AR, Moradi-Lakeh M, Moran AE, Mori R, Moschandreas J, Moturi WN, Moyer ML, Mozaffarian D, Mueller UO, Mukaigawara M, Mullany EC, Murray J, Mustapha A, Naghavi P, Naheed A, Naidoo KS, Naldi L, Nand D, Nangia V, Narayan KM, Nash D, Nasher J, Nejjari C, Nelson RG, Neuhouser M, Neupane SP, Newcomb PA, Newman L, Newton CR, Ng M, Ngalesoni FN, Nguyen G, Nguyen Nt, Nisar MI, Nolte S, Norheim OF, Norman RE, Norrving B, Nyakarahuka L, Odell S, O'Donnell M, Ohkubo T, Ohno SL, Olusanya BO, Omer SB, Opio JN, Orisakwe OE, Ortblad KF, Ortiz A, Otayza ML, Pain AW, Pandian JD, Panelo CI, Panniyammakal J, Papachristou C, Paternina Caicedo AJ, Patten SB, Patton GC, Paul VK, Pavlin B, Pearce N, Pellegrini CA, Pereira DM, Peresson SC, Perez-Padilla R, Perez-Ruiz FP, Perico N, Pervaiz A, Pesudovs K, Peterson CB, Petzold M, Phillips BK, Phillips DE, Phillips MR, Plass D, Piel FB, Poenaru D, Polinder S, Popova S, Poulton RG, Pourmalek F, Prabhakaran D, Qato D, Quezada AD, Quistberg DA, Rabito F, Rafay A, Rahimi K, Rahimi-Movaghar V, Rahman SU, Raju M, Rakovac I, Rana SM, Refaat A, Remuzzi G, Ribeiro AL, Ricci S, Riccio PM, Richardson L, Richardus JH, Roberts B, Roberts DA, Robinson M, Roca A, Rodriguez A, Rojas-Rueda D, Ronfani L, Room R, Roth GA, Rothenbacher D, Rothstein DH, Rowley JT, Roy N, Ruhago GM, Rushton L, Sambandam S, Søreide K, Saeedi MY, Saha S, Sahathevan R, Sahraian MA, Sahle BW, Salomon JA, Salvo D, Samonte GM, Sampson U, Sanabria JR, Sandar L, Santos IS, Satpathy M, Sawhney M, Saylan M, Scarborough P, Schöttker B, Schmidt JC, Schneider IJ, Schumacher AE, Schwebel DC, Scott JG, Sepanlou SG, Servan-Mori EE, Shackelford K, Shaheen A, Shahraz S, Shakh-Nazarova M, Shangguan S, She J, Sheikhbahaei S, Shepard DS, Shibuya K, Shinohara Y, Shishani K, Shiue I, Shivakoti R, Shrime MG, Sigfusdottir ID, Silberberg DH, Silva AP, Simard EP, Sindi S, Singh JA, Singh L, Sioson E, Skirbekk V, Sliwa K, So S, Soljak M, Soneji S, Soshnikov SS, Sposato LA, Sreeramareddy CT, Stanaway JD, Stathopoulou VK, Steenland K, Stein C, Steiner C, Stevens A, Stöckl H, Straif K, Stroumpoulis K, Sturua L, Sunguya BF, Swaminathan S, Swaroop M, Sykes BL, Tabb KM, Takahashi K, Talongwa RT, Tan F, Tanne D, Tanner M, Tavakkoli M, Ao BT, Teixeira CM, Templin T, Tenkorang EY, Terkawi AS, Thomas BA, Thorne-Lyman AL, Thrift AG, Thurston GD, Tillmann T, Tirschwell DL, Tleyjeh IM, Tonelli M, Topouzis F, Towbin JA, Toyoshima H, Traebert J, Tran BX, Truelsen T, Trujillo U, Trillini M, Tsala Dimbuene Z, Tsilimbaris M, Tuzcu EM, Ubeda C, Uchendu US, Ukwaja KN, Undurraga EA, Vallely AJ, van de Vijver S, van Gool CH, Varakin YY, Vasankari TJ, Vasconcelos AM, Vavilala MS, Venketasubramanian N, Vijayakumar L, Villalpando S, Violante FS, Vlassov VV, Wagner GR, Waller SG, Wang J, Wang L, Wang X, Wang Y, Warouw TS, Weichenthal S, Weiderpass E, Weintraub RG, Wenzhi W, Werdecker A, Wessells KR, Westerman R, Whiteford HA, Wilkinson JD, Williams TN, Woldeyohannes SM, Wolfe CD, Wolock TM, Woolf AD, Wong JQ, Wright JL, Wulf S, Wurtz B, Xu G, Yang YC, Yano Y, Yatsuya H, Yip P, Yonemoto N, Yoon SJ, Younis M, Yu C, Yun Jin K, Zaki Mel S, Zamakhshary MF, Zeeb H, Zhang Y, Zhao Y, Zheng Y, Zhu J, Zhu S, Zonies D, Zou XN, Zunt JR, Vos T, Lopez AD, Murray CJ.

Abstract

BACKGROUND:

Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific 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-specific 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-specific 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 differences between countries decreased but relative differences 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 differences 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 specific 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.

FUNDING:

Bill & Melinda Gates Foundation.

PMID:
25530442
PMCID:
PMC4340604
DOI:
10.1016/S0140-6736(14)61682-2
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science Icon for PubMed Central
    Loading ...
    Support Center