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

Mohsen Naghavi, H Wang, Rafael Lozano, Adrian Davis, Xiaofeng Liang, Maigeng Zhou, Stein Vollset, Ayse Ozgoren, Safa Abdalla, Foad Abd-Allah, Muna Aziz, Semaw Abera, Victor Aboyans, Biju Abraham, Jerry Abraham, Katrina Abuabara, Ibrahim Abubakar, Laith Abu-Raddad, Niveen Abu-Rmeileh, Tom AchokiAdemola Adelekan, Zanfina Ademi, Adofo Koranteng, Arsene Adou, Jose Adsuar, Johan Arnlov, Emilie Agardh, Dickens Akena, Mazin Al Khabouri, Deena Alasfoor, Mohammed Albittar, Miguel Alegretti, Alicia Aleman, Zewdie Alemu, Rafael Alfonso-Cristancho, Samia Alhabib, Mohammed Ali, Raghib Ali, F Alla, Faris Al Lami, Peter Allebeck, Mohammad AlMazroa, R Al-Shahi Salman, Ubai Alsharif, E Alvarez, Nelson Alvis-Guzman, Adansi Amankwaa, Azmeraw Amare, O Ameli, Hassan Amini, Walid Ammar, Ross Anderson, B Anderson, Carl Antonio, Palwasha Anwari, H Apfel, S Cunningham, Valentina Arsenijevic, Ali Artaman, Majed Asad, Rana Asghar, Reza Assadi, Lydia Atkins, Charles Atkinson, Alaa Badawi, Maria Bahit, Talal Bakfalouni, Kalpana Balakrishnan, Shivanthi Balalla, Amitava Banerjee, Ryan Barber, Suzanne Barker-Collo, Simon Barquera, L Barregard, Lope Barrero, T Barrientos-Gutierrez, S Basu, Arin Basu, M Basulaiman, Justin Beardsley, Neeraj Bedi, E Beghi, Tolesa Bekele, Michelle Bell, C Benjet, Derrick Bennett, I Bensenor, Habib Benzian, Amelia Bertozzi-Villa, Tariku Beyene, Neeraj Bhala, Zulfiqar Bhutta, Boris Bikbov, Aref Abdulhak, S Biryukov, Jed Blore, Fiona Blyth, M Bohensky, Guilherme Borges, Dipan Bose, Soufiane Boufous, Rupert Bourne, L Boyers, Michael Brainin, Michael Brauer, Carol Brayne, A Brazinova, Nicholas Breitborde, Hermann Brenner, A Briggs, Jonathan Brown, Traolach Brugha, Geoffrey Buckle, Linh Ngoc Bui, G Bukhman, Michael Burch, I Campos Nonato, Helene Carabin, Rosario Cardenas, Jonathon Carapetis, David Carpenter, V Caso, C Castanda-Orjuela, Ruben Castro, Ferran Catala-Lopez, F Cavalleri, Jungchen Chang, Fiona Charlson, Xuan Che, Honglei Chen, Yingyao Chen, Jian Sheng Chen, Zhengming Chen, Peggy Chiang, Odgerel Chimed-Ochir, Rajiv Chowdhury, Hanne Christensen, Costas Christophi, Tingwu Chuang, Sumeet Chugh, Massimo Cirillo, Matthew Coates, Luc Coffeng, Megan Coggeshall, Aaron Cohen, V Colistro, Samantha Colquhoun, Mercedes Colomar, Leslie Cooper, Cyrus Cooper, L Coppola, Monica Cortinovis, Karen Courville, Benjamin Cowie, Michael Criqui, John Crump, L Cuevas-Nasu, Iuri Da Costa Leite, Kaustubh Dabhadkar, Lalit Dandona, Rakhi Dandona, Emily Dansereau, P Dargan, Anand Dayama, V De la Cruz-Gongora, S De La Vega, Diego De Leo, Louisa Degenhardt, Borja Del Pozo-Cruz, Robert Dellavalle, Kebede Deribe, Don Des Jarlais, Muluken Dessalegn, Gabrielle deVeber, Samath Dharmaratne, Mukesh Dherani, Cesar Diaz-Torne, J-L Diaz-Ortega, Daniel Dicker, Eric Ding, K Dokova, E Dorsey, Tim Driscoll, Leilei Duan, Herbert Duber, Adnan Durrani, Beth Ebel, Karen Edmond, Richard Ellenbogen, Y Elshrek, Sergei Ermakov, Holly Erskine, B Eshrati, Alireza Esteghamati, K Estep, Saman Fahimi, T Furst, Emerito Faraon, A Fahrion, Farshad Farzadfar, Derek Fay, A Feigl, Manuela Felicio, Seyed Fereshtehnejad, J Fernandes, A Ferrari, Thomas Fleming, N Foigt, Kyle Foreman, Mohammad Forouzanfar, Francis Gerry Fowkes, Urbano Paleo, Richard Franklin, N Futran, Lynne Gaffikin, Ketevan Gambashidze, Fortune Gankpe, F Garc-Guerra, Ana Garcia, Johanna Geleijnse, Bradford Gessner, Katherine Gibney, Richard Gillum, Stuart Gilmour, Ibrahim Ginawi, Maurice Giroud, Elizabeth Glaser, S Goenka, H Dantes, Philimon Gona, Diego Gonzalez-Medina, Caterina Guinovart, Rahul Gupta, Rajeev Gupta, Richard Gosselin, C Gotay, Atsushi Goto, Hebe Gouda, Nicholas Graetz, K Greenwell, Harish Gugnani, David Gunnell, Reyna Gutiierez, Juanita Haagsma, Nima Hafezi-Nejad, Holly Hagan, M Hagstromer, Yara Halasa, Randah Hamadeh, H Hamavid, Mouhanad Hammami, Jamie Hancock, Graeme Hankey, Gillian Hansen, Hilda Harb, H Harewood, Josep Haro, Rasmus Havmoeller, Roderick Hay, Simon Hay, Mohammad Hedayati, Ileana Pi, Kyle Heuton, P Heydarpour, Hideki Higashi, M Hijar, Hans Hoek, Howard Hoffman, John Hornberger, H Hosgood III, Mazeda Hossain, Peter Hotez, Damian Hoy, Mohamed Hsairi, Guoqing Hu, John Huang, Michael Huffman, Andrew Hughes, Abdullatif Husseini, Chantal Huynh, M Iannerone, Kim Iburg, Bulat Idrisov, N Ikeda, Kaire Innos, Manami Inoue, F Islami, S Ismayilova, Kathryn Jacobsen, S Jassal, Sudha Jayaraman, Paul Jensen, Vivekanand Jha, Ying Jiang, Gouhong Jiang, Jost Jonas, Justin Joseph, Knud Juel, Edmond Kabagambe, Haidong Kan, Andre Karch, C Karimkhani, Ganesan Karthikeyan, Nicholas Kassebaum, Anil Kaul, Norito Kawakami, Konstantin Kazanjan, Dhruv Kazi, Andrew Kemp, Andre Kengne, Andre Keren, Maia Kereselidze, Yousef Khader, Shams Khalifa, Ejaz Khan, Gulfaraz Khan, Young-Ho Khang, C Kieling, Yohannes Kinfu, Jonas Kinge, Daniel Kim, Songroul Kim, M Kivipelto, Luke Knibbs, Anne Knudsen, Yoshihiro Kokubo, Soewarta Kosen, M Kotagal, M Kravchenko, S Krishnaswami, H Krueger, Barthelemy Defo, Ernst Kuipers, B Kucuk Bicer, Chanda Kulkarni, Veena Kulkarni, Kaushalendra Kumar, Ravi Kumar, Gene Kwan, Hmwe Hmwe Kyu, Taavi Lai, Arjun Balji, Ratilal Lalloo, Tea Lallukka, Hilton Lam, Qing Lan, Lansingh Van, Heidi Larson, Anders Larsson, Pablo Lavados, A. Lawrynowicz, Janet Leasher, Paul Lee, James Leigh, Mall Leinsalu, Ricky Leung, Carly Levitz, Bin Li, Yichong Li, Yongmei Li, Chelsea Liddell, Stephen Lim, Graca De Lima, Margaret Lind, Steven Lipshultz, Shiwei Liu, Yang Liu, Belinda Lloyd, Katherine Lofgren, Giancarlo Logroscino, Stephanie London, Joannie Lortet-Tieulent, Paulo Lotufo, Robyn Lucas, Raimundas Lunevicius, Ronan Lyons, Stefan Ma, Vasco Machado, Michael MacIntyre, Mark MacKay, Jennifer MacLachlan, Carlos Magis-Rodriguez, Abbas Mahdi, Marek Majdan, Reza Malekzadeh, Srikanth Mangalam, Christopher Mapoma, Marape Marape, Wagner Marcenes, Christopher Margono, Guy Marks, Melvin Marzan, Joseph Masci, Mohammad Mashal, Felix Masiye, Amanda Mason-Jones, Richard Matzopolous, Bongani Mayosi, Tasara Mazorodze, John McGrath, Abigail McKay, Martin McKee, Abigail McLain, Peter Meaney, Man Mehndiratta, Fabiola Mejia-Rodriguez, Yohannes Melaku, Michele Meltzer, Z Memish, Walter Mendoza, George Mensah, A Meretoja, Francis Mhimbira, Ted Miller, Edward Mills, Santosh Mishra, Charles Mock, Terrie Moffitt, Norlinah Ibrahim, Karzan Mohammad, Ali Mokdad, Glen Mola, Lorenzo Monasta, Jonathan De La Cruz Monis, Julio Hernandez, Marcella Montico, Thomas Montine, Meghan Mooney, Ami Moore, Mazier Moradi-Lakeh, Andrew Moran, Rintaro Mori, Joanna Moschandreas, Wilkister Moturi, Madeline Moyer, Dariush Mozaffarian, Ulrich Mueller, Mitsuru Mukaigawara, Erin Mullany, Joseph Murray, Adetoun Mustapha, Paria Naghavi, Aliya Naheed, Kovin Naidoo, Luigi Naldi, Devina Nand, Vinay Nangia, Kabayam Narayan, Denis Nash, Jamal Nasher, Chakib Nejjari, Robert Nelson, Marian Neuhouser, Sudan Neupane, Polly Newcomb, Lori Newman, Charles Newton, Marie Ng, Frida Ngalesoni, Grant Nguyen, Nhung Nguyen, Muhammad Nisar, Sandra Nolte, Ole Norheim, Rosana Norman, Bo Norrving, Luke Nyakarahuka, Shaun Odell, Martin O'Donnell, Takayoshi Ohkubo, Summer Ohno, Bolajoko Olusanya, Saad Omer, John Opio, Orish Orisakwe, Katrina Ortblad, Alberto Ortiz, Maria Otayza, Amanda Pain, Jeyaraj Pandian, Carlo Panelo, Panniyammakal Jeemon, Christina Papachristou, Angel Caicedo, Scott Patten, George Patton, Vinod Paul, Boris Pavlin, Neil Pearce, Carlos Pelligrini, David Pereira, Sophie Peresson, Rogelio Perez-Padilla, Fernando Perez-Ruiz, Norberto Perico, Aslam Pervaiz, Konrad Pesudovs, Carrie Peterson, Max Petzold, Bryan Phillips, David Phillips, Michael Phillips, Dietrich Plass, Frederic Piel, Dan Poenaru, Suzanne Polinder, Svetlana Popova, Richie Poulton, Farshad Pourmalek, D Prabhakaran, Dima Qato, Amado Quezada, Duane Quistberg, Felicia Rabito, Anwar Rafay, Kazem Rahimi, Vafa Rahimi-Movaghar, Sajjad Rahman, Murugesan Raju, Ivo Rakovac, Saleem Rana, Amany Refaat, Giuseppe Remuzzi, Antonio Ribeiro, Stefano Ricci, Patricia Riccio, Latonia Richardson, Jan Richardus, Bayard Roberts, D Roberts, Margaret Robinson, Anna Roca, Alina Rodriguez, David Rojas-Rueda, Luca Ronfani, Robin Room, Gregory Roth, Dietrich Rothenbacher, David Rothstein, Jane Rowley, Nobhojit Roy, George Ruhago, Lesley Rushton, Sankar Sambandam, Kjetil Soreide, Mohammad Saeedi, Sukanta Saha, Ramesh Sahathevan, Mohammad Sahraian, Berhe Sahle, Joshua Salomon, Deborah Salvo, Genesis Samonte, Uchechukwu Sampson, Juan Sanabria, Logan Sandar, Itamar Santos, Maheswar Satpathy, Monika Sawhney, Mete Saylan, Peter Scarborough, Ben Schottker, Jurgen Schmidt, Ione Schneider, Austin Schumacher, David Schwebel, James Scott, Sadaf Sepanlou, Edson Servan-Mori, Katya Shackelford, Amira Shaheen, Saeid Shahraz, Marina Shakh-Nazarova, Siyi Shangguan, Jun She, Sara Sheikhbahaei, Donald Shepard, Kenji Shibuya, Yukito Shinohara, Kawkab Shishani, Ivy Shiue, Rupak Shivakoti, Mark Shrime, Inga Sigfusdottir, Donald Silberberg, Andrea Silva, Edgar Simard, Shireen Sindi, Jasvinder Singh, Lavanya Singh, Edgar Sioson, Vegard Skirbekk, Karen Sliwa, Samuel So, Michael Soljak, Samir Soneji, Sergey Soshnikov, Luciano Sposato, Chandrashekhar Sreeramareddy, Jeffrey Stanaway, Vasiliki Stathopoulou, Kyle Steenland, Claudia Stein, Caitlyn Steiner, Antony Stevens, Heidi Stockl, Kurt Straif, Konstantinos Stroumpoulis, Lela Sturua, Bruno Sunguya, Soumya Swaminathan, Mamta Swaroop, Bryan Sykes, Karen Tabb, Ken Takahashi, Robert Talongwa, Feng Tan, David Tanne, Marcel Tanner, Mohammad Tavakkoli, Braden Te Ao, Carolina Teixeira, Tara Templin, Eric Tenkorang, Abdullah Terkawi, Bernadette Thomas, Andrew Thorne-Lyman, Amanda Thrift, George Thurston, Taavi Tillmann, David Tirschwell, Imad Tleyjeh, Marcello Tonelli, Fotis Topouzis, Jeffrey Towbin, Hideaki Toyoshima, Jefferson Traebert, Bach Tran, Thomas Truelsen, Ulises Trujillo, Matias Trillini, Zacharie Dimbuene, Miltiadis Tsilimbaris, Murat Tuzcu, Clotilde Ubeda, Uche Uchendu, Kingsley Ukwaja, Eduardo Undurraga, Andrew Vallely, Steven Van De Vijver, Coen Van Gool, Yu Varakin, Tommi Vasankari, Ana Vasconcelos, Monica Vavilala, N Venketasubramanian, Lakshmi Vijayakumar, Salvador Villalpando, Francesco Violante, Vasiliy Vlassov, Gregory Wagner, Stephen Waller, Jianli Wang, Linhong Wang, Sharon Wang, Yanping Wang, Tati Warouw, Scott Weichenthal, Elisabete Weiderpass, Robert Weintraub, Wenzhi Wang, Andrea Werdecker, K Wessells, Ronny Westerman, Harvey Whiteford, James Wilkinson, Thomas Williams, Solomon Woldeyohannes, Charles Wolfe, Timothy Wolock, Anthony Woolf, John Wong, Jonathan Wright, Sarah Wulf, Brittany Wurtz, Gelin Xu, C Yang, Yuichiro Yano, Hiroshi Yatsuya, Paul Yip, Naohiro Yonemoto, Seokjun Yoon, Mustafa Younis, Chuanhua Yu, Kimyun Jin, Maysaa El Sayed Zaki, Mohammed Zamakhshary, Hajo Zeeb, Yong Zhang, Yong Zhao, Yinfeng Zheng, Jun Zhu, Shankuan Zhu, David Zonies, Xiaonong Zou, Joseph Zunt, Theo Vos, Alan Lopez, Christopher Murray, Gabriel Alcala-Cerra, Howard Hu, Nadim Karam, Nsanzimana Sabin, Awoke Temesgen

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    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.

    Original languageEnglish
    Pages (from-to)117-171
    Number of pages55
    JournalLancet
    Volume385
    Issue number9963
    DOIs
    Publication statusPublished - 2015

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    Naghavi, M., Wang, H., Lozano, R., Davis, A., Liang, X., Zhou, M., Vollset, S., Ozgoren, A., Abdalla, S., Abd-Allah, F., Aziz, M., Abera, S., Aboyans, V., Abraham, B., Abraham, J., Abuabara, K., Abubakar, I., Abu-Raddad, L., Abu-Rmeileh, N., ... Temesgen, A. (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. Lancet, 385(9963), 117-171. https://doi.org/10.1016/S0140-6736(14)61682-2