Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: A systematic analysis for the Global Burden of Disease Study 2017

GBD 2017 Mortality Collaborators, Daniel Dicker, Grant Nguyen, Degu Abate, Kalkidan Hassen Abate, Solomon M. Abay, Cristiana Abbafati, Nooshin Abbasi, Hedayat Abbastabar, Foad Abd-Allah, Jemal Abdela, Ahmed Abdelalim, Omar Abdel-Rahman, Alireza Abdi, Ibrahim Abdollahpour, Rizwan Suliankatchi Abdulkader, Ahmed Abdulahi Abdurahman, Haftom Temesgen Abebe, Molla Abebe, Zegeye AbebeTeshome Abuka Abebo, Victor Aboyans, Haftom Niguse Abraha, Aklilu Roba Abrham, Laith Jamal Abu-Raddad, Niveen M.E. Abu-Rmeileh, Manfred Mario Kokou Accrombessi, Pawan Acharya, Oladimeji M. Adebayo, Isaac Akinkunmi Adedeji, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O. Adetokunboh, Beyene Meressa Adhena, Tara Ballav Adhikari, Mina G. Adib, Arsène Kouablan Adou, Jose C. Adsuar, Mohsen Afarideh, Ashkan Afshin, Gina Agarwal, Rakesh Aggarwal, Sargis Aghasi Aghayan, Sutapa Agrawal, Anurag Agrawal, Mehdi Ahmadi, Alireza Ahmadi, Hamid Ahmadieh, Mohamed Lemine Cheikh Brahim Ahmed, Sayem Ahmed, Muktar Beshir Ahmed, Amani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Ali S. Akanda, Mohammad Esmaeil Akbari, Mohammed Akibu, Rufus Olusola Akinyemi, Tomi Akinyemiju, Nadia Akseer, Fares Alahdab, Ziyad Al-Aly, Khurshid Alam, Animut Alebel, Alicia V. Aleman, Kefyalew Addis Alene, Ayman Al-Eyadhy, Raghib Ali, Mehran Alijanzadeh, Reza Alizadeh-Navaei, Syed Mohamed Aljunid, Ala’a Alkerwi, François Alla, Peter Allebeck, Christine A. Allen, Jordi Alonso, Rajaa M. Al-Raddadi, Ubai Alsharif, Khalid Altirkawi, Nelson Alvis-Guzman, Azmeraw T. Amare, Erfan Amini, Walid Ammar, Yaw Ampem Amoako, Nahla Hamed Anber, Catalina Liliana Andrei, Sofia Androudi, Megbaru Debalkie Animut, Mina Anjomshoa, Degefaye Zelalem Anlay, Hossein Ansari, Ansariadi Ansariadi, Mustafa Geleto Ansha, Carl Abelardo T. Antonio, Seth Christopher Yaw Appiah, Olatunde Aremu, Habtamu Abera Areri, Johan Ärnlöv, Megha Arora, Al Artaman, Krishna K. Aryal, Mohsen Asadi-Lari, Hamid Asayesh, Ephrem Tsegay Asfaw, Solomon Weldegebreal Asgedom, Reza Assadi, Zerihun Ataro, Tesfay Mehari Mehari Atey, Seyyed Shamsadin Athari, Suleman Atique, Sachin R. Atre, Madhu Sudhan Atteraya, Engi F. Attia, Marcel Ausloos, Leticia Avila-Burgos, Euripide F.G.A. Avokpaho, Ashish Awasthi, Baffour Awuah, Beatriz Paulina Ayala Quintanilla, Henok Tadesse Ayele, Yohanes Ayele, Rakesh Ayer, Tambe B. Ayuk, Peter S. Azzopardi, Natasha Azzopardi-Muscat, Hamid Badali, Alaa Badawi, Kalpana Balakrishnan, Ayele Geleto Bali, Maciej Banach, Amrit Banstola, Aleksandra Barac, Miguel A. Barboza, Simon Barquera, Lope H. Barrero, Huda Basaleem, Quique Bassat, Arindam Basu, Sanjay Basu, Bernhard T. Baune, Shahrzad Bazargan-Hejazi, Neeraj Bedi, Ettore Beghi, Masoud Behzadifar, Meysam Behzadifar, Yannick Béjot, Bayu Begashaw Bekele, Abate Bekele Belachew, Aregawi Gebreyesus Belay, Ezra Belay, Saba Abraham Belay, Yihalem Abebe Belay, Michelle L. Bell, Aminu K. Bello, Derrick A. Bennett, Isabela M. Bensenor, Adugnaw Berhane, Adam E. Berman, Eduardo Bernabe, Robert S. Bernstein, Gregory J. Bertolacci, Mircea Beuran, Tina Beyranvand, Neeraj Bhala, Eesh Bhatia, Samir Bhatt, Suraj Bhattarai, Soumyadeeep Bhaumik, Zulfiqar A. Bhutta, Belete Biadgo, Ali Bijani, Boris Bikbov, Nigus Bililign, Muhammad Shahdaat Bin Sayeed, Sait Mentes Birlik, Charles Birungi, Donal Bisanzio, Tuhin Biswas, Tone Bjørge , Archie Bleyer, Berrak Bora Basara, Dipan Bose, Cristina Bosetti, Soufiane Boufous, Rupert Bourne, Oliver J. Brady, Nicola Luigi Bragazzi, Luisa C. Brant, Alexandra Brazinova, Nicholas J.K. Breitborde, Hermann Brenner, Gabrielle Britton, Traolach Brugha, Kristin E. Burke, Reinhard Busse, Zahid A. Butt, Lucero Cahuana-Hurtado, Charlton S.K.H. Callender, Ismael R. Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Mate Car, Rosario Cárdenas , Giulia Carreras, Juan J. Carrero, Austin Carter, Félix Carvalho, Carlos A. Castañeda-Orjuela, Jacqueline Castillo Rivas, Franz Castro, Ferrán Catalá-López, Alanur Çavlin, Ester Cerin, Yazan Chaiah, Ana Paula Champs, Hsing Yi Chang, Jung Chen Chang, Aparajita Chattopadhyay, Pankaj Chaturvedi, Wanqing Chen, Peggy Pei Chia Chiang, Odgerel Chimed-Ochir, Ken Lee Chin, Vesper Hichilombwe Chisumpa, Abdulaal Chitheer, Jee Young J. Choi, Hanne Christensen, Devasahayam J. Christopher, Sheng Chia Chung, Flavia M. Cicuttini, Liliana G. Ciobanu, Massimo Cirillo, Rafael M. Claro, Aaron J. Cohen, Daniel Collado-Mateo, Maria Magdalena Constantin, Sara Conti, Cyrus Cooper, Leslie Trumbull Cooper, Paolo Angelo Cortesi, Monica Cortinovis, Ewerton Cousin, Michael H. Criqui, Elizabeth A. Cromwell, Christopher Stephen Crowe, John A. Crump, Alexandra Cucu, Matthew Cunningham, Alemneh Kabeta Daba, Konrad Pesudovs, Molla Mesele Wassie

Research output: Contribution to journalArticlepeer-review

304 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1684-1735
Number of pages52
JournalThe Lancet
Volume392
Issue number10159
DOIs
Publication statusPublished - 10 Nov 2018
Externally publishedYes

Keywords

  • age-specific mortality
  • systematic analysis
  • GBD 2017
  • life expectancy
  • mortality rates

Fingerprint Dive into the research topics of 'Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: A systematic analysis for the Global Burden of Disease Study 2017'. Together they form a unique fingerprint.

Cite this