Child and adolescent health from 1990 to 2015: Findings from the global burden of diseases, injuries, and risk factors 2015 study

The Global Burden of Disease Child and Adolescent Health Collaboration

Research output: Contribution to journalReview article

74 Citations (Scopus)

Abstract

IMPORTANCE: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health. OBJECTIVE: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion. EVIDENCE REVIEW: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss. FINDINGS: Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3%(95%UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries. CONCLUSIONS AND RELEVANCE: Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.

Original languageEnglish
Pages (from-to)573-592
Number of pages20
JournalJAMA Pediatrics
Volume171
Issue number6
DOIs
Publication statusPublished - 1 Jun 2017

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Wounds and Injuries
Demography
Mortality
Health
Uncertainty
Deaf-Blind Disorders
Age Groups
Nutrition Disorders
Hemoglobinopathies
Child Mortality
Developmental Disabilities
Geography
Global Burden of Disease
Child Health
Adolescent Health
Africa South of the Sahara
Population Growth
Reproductive Health
Malnutrition
Intellectual Disability

Cite this

The Global Burden of Disease Child and Adolescent Health Collaboration. / Child and adolescent health from 1990 to 2015 : Findings from the global burden of diseases, injuries, and risk factors 2015 study. In: JAMA Pediatrics. 2017 ; Vol. 171, No. 6. pp. 573-592.
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abstract = "IMPORTANCE: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health. OBJECTIVE: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion. EVIDENCE REVIEW: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss. FINDINGS: Global child and adolescent mortality decreased from 14.18 million (95{\%} uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95{\%} UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75{\%}) in 2015 than was the case in 1990 (61{\%}). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3{\%}(95{\%}UI, 3.1{\%}-5.6{\%}) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries. CONCLUSIONS AND RELEVANCE: Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.",
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Dean} and Guoqing Hu and Jacobsen, {Kathryn H.} and Jakovljevic, {Mihajlo B.} and Jayaraman, {Sudha P.} and Vivekanand Jha and Tariku Jibat and Johnson, {Catherine O.} and Jost Jonas and Amir Kasaeian and Norito Kawakami and Keiyoro, {Peter N.} and Ibrahim Khalil and Khang, {Young Ho} and Jagdish Khubchandani and Kiadaliri, {Aliasghar A.Ahmad} and Christian Kieling and Daniel Kim and Niranjan Kissoon and Knibbs, {Luke D.} and Ai Koyanagi and Krohn, {Kristopher J.} and Defo, {Barthelemy Kuate} and Bicer, {Burcu Kucuk} and Rachel Kulikoff and Kumar, {G. Anil} and Lal, {Dharmesh Kumar} and Lam, {Hilton Y.} and Larson, {Heidi J.} and Anders Larsson and Laryea, {Dennis Odai} and Janni Leung and Lim, {Stephen S.} and Lo, {Loon Tzian} and Lo, {Warren D.} and Looker, {Katharine J.} and Lotufo, {Paulo A.} and {El Razek}, {Hassan Magdy Abd} and Reza Malekzadeh and Shifti, {Desalegn Markos} and Mohsen Mazidi and Meaney, {Peter A.} and Meles, {Kidanu Gebremariam} and Peter Memiah and Walter Mendoza and Mengistie, {Mubarek Abera} and Mengistu, {Gebremichael Welday} and Mensah, {George A.} and Miller, {Ted R.} and Charles Mock and Alireza Mohammadi and Shafiu Mohammed and Lorenzo Monasta and Ulrich Mueller and Chie Nagata and Aliya Naheed and Grant Nguyen and {Le Nguyen}, Quyen and Elaine Nsoesie and Oh, {In Hwan} and Anselm Okoro and Olusanya, {Jacob Olusegun} and Olusanya, {Bolajoko O.} and Alberto Ortiz and Deepak Paudel and Pereira, {David M.} and Norberto Perico and Max Petzold and Phillips, {Michael Robert} and Polanczyk, {Guilherme V.} and Farshad Pourmalek and Mostafa Qorbani and Anwar Rafay and Vafa Rahimi-Movaghar and Mahfuzar Rahman and Rai, {Rajesh Kumar} and Usha Ram and Zane Rankin and Giuseppe Remuzzi and Renzaho, {Andre M.N.} and Roba, {Hirbo Shore} and David Rojas-Rueda and Luca Ronfani and Rajesh Sagar and Sanabria, {Juan Ramon} and Mohammed, {Muktar Sano Kedir} and Santos, {Itamar S.} and Maheswar Satpathy and Monika Sawhney and Ben Schottker and Schwebel, {David C.} and Scott, {James G.} and Sepanlou, {Sadaf G.} and Amira Shaheen and Shaikh, {Masood Ali} and June She and Rahman Shiri and Ivy Shiue and Sigfusdottir, {Inga Dora} and Jasvinder Singh and Naris Silpakit and Alison Smith and Chandrashekhar Sreeramareddy and Stanaway, {Jeffrey D.} and Stein, {Dan J.} and Caitlyn Steiner and Sufiyan, {Muawiyyah Babale} and Soumya Swaminathan and Rafael Tabares-Seisdedos and Tabb, {Karen M.} and Fentaw Tadese and Mohammad Tavakkoli and Bineyam Taye and Stephanie Teeple and Tegegne, {Teketo Kassaw} and Shifa, {Girma Temam} and Terkawi, {Abdullah Sulieman} and Bernadette Thomas and Thomson, {Alan J.} and Ruoyan Tobe-Gai and Marcello Tonelli and Tran, {Bach Xuan} and Christopher Troeger and Ukwaja, {Kingsley N.} and Olalekan Uthman and Tommi Vasankari and Narayanaswamy Venketasubramanian and Vlassov, {Vasiliy Victorovich} and Elisabete Weiderpass and Robert Weintraub and Gebrehiwot, {Solomon Weldemariam} and Ronny Westerman and Williams, {Hywel C.} and Wolfe, {Charles D.A.} and Rachel Woodbrook and Yuichiro Yano and Naohiro Yonemoto and Yoon, {Seok Jun} and Younis, {Mustafa Z.} and Chuanhua Yu and {El Sayed Zaki}, Maysaa and Murray, {Christopher J.L.}",
year = "2017",
month = "6",
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doi = "10.1001/jamapediatrics.2017.0250",
language = "English",
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pages = "573--592",
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issn = "1072-4710",
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}

Child and adolescent health from 1990 to 2015 : Findings from the global burden of diseases, injuries, and risk factors 2015 study. / The Global Burden of Disease Child and Adolescent Health Collaboration.

In: JAMA Pediatrics, Vol. 171, No. 6, 01.06.2017, p. 573-592.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Child and adolescent health from 1990 to 2015

T2 - Findings from the global burden of diseases, injuries, and risk factors 2015 study

AU - The Global Burden of Disease Child and Adolescent Health Collaboration

AU - Kassebaum, Nicholas

AU - Kyu, Hmwe Hmwe

AU - Zoeckler, Leo

AU - Olsen, Helen Elizabeth

AU - Thomas, Katie

AU - Pinho, Christine

AU - Bhutta, Zulfiqar A.

AU - Dandona, Lalit

AU - Ferrari, Alize

AU - Ghiwot, Tsegaye Tewelde

AU - Hay, Simon I.

AU - Kinfu, Yohannes

AU - Liang, Xiaofeng

AU - Lopez, Alan

AU - Malta, Deborah Carvalho

AU - Mokdad, Ali H.

AU - Naghavi, Mohsen

AU - Patton, George C.

AU - Salomon, Joshua

AU - Sartorius, Benn

AU - Topor-Madry, Roman

AU - Vollset, Stein Emil

AU - Werdecker, Andrea

AU - Whiteford, Harvey A.

AU - Abate, Kalkidan Hasen

AU - Abbas, Kaja

AU - Damtew, Solomon Abrha

AU - Ahmed, Muktar Beshir

AU - Akseer, Nadia

AU - Al-Raddadi, Rajaa

AU - Alemayohu, Mulubirhan Assefa

AU - Altirkawi, Khalid

AU - Abajobir, Amanuel Alemu

AU - Amare, Azmeraw T.

AU - Antonio, Carl A.T.

AU - Arnlov, Johan

AU - Artaman, Al

AU - Asayesh, Hamid

AU - Avokpaho, Euripide Frinel G.Arthur

AU - Awasthi, Ashish

AU - Quintanilla, Beatriz Paulina Ayala

AU - Bacha, Umar

AU - Betsu, Balem Demtsu

AU - Barac, Aleksandra

AU - Barnighausen, Till Winfried

AU - Baye, Estifanos

AU - Bedi, Neeraj

AU - Bensenor, Isabela M.

AU - Berhane, Adugnaw

AU - Bernabe, Eduardo

AU - Bernal, Oscar Alberto

AU - Beyene, Addisu Shunu

AU - Biadgilign, Sibhatu

AU - Bikbov, Boris

AU - Boyce, Cheryl Anne

AU - Brazinova, Alexandra

AU - Hailu, Gessessew Bugssa

AU - Carter, Austin

AU - Castaneda-Orjuela, Carlos A.

AU - Catala-Lopez, Ferran

AU - Charlson, Fiona J.

AU - Chitheer, Abdulaal A.

AU - Choi, Jee Young Jasmine

AU - Ciobanu, Liliana G.

AU - Crump, John

AU - Dandona, Rakhi

AU - Dellavalle, Robert P.

AU - Deribew, Amare

AU - DeVeber, Gabrielle

AU - Dicker, Daniel

AU - Ding, Eric L.

AU - Dubey, Manisha

AU - Endries, Amanuel Yesuf

AU - Erskine, Holly E.

AU - Faraon, Emerito Jose Aquino

AU - Faro, Andre

AU - Farzadfar, Farshad

AU - Fernandes, Joao C.

AU - Fijabi, Daniel Obadare

AU - Fitzmaurice, Christina

AU - Fleming, Thomas D.

AU - Flor, Luisa Sorio

AU - Foreman, Kyle J.

AU - Franklin, Richard C.

AU - Fraser, Maya S.

AU - Frostad, Joseph J.

AU - Fullman, Nancy

AU - Gebregergs, Gebremedhin Berhe

AU - Gebru, Alemseged Aregay

AU - Geleijnse, Johanna M.

AU - Gibney, Katherine B.

AU - Yihdego, Mahari Gidey

AU - Ginawi, Ibrahim Abdelmageem Mohamed

AU - Gishu, Melkamu Dedefo

AU - Gizachew, Tessema Assefa

AU - Glaser, Elizabeth

AU - Gold, Audra L.

AU - Goldberg, Ellen

AU - Gona, Philimon

AU - Goto, Atsushi

AU - Gugnani, Harish Chander

AU - Jiang, Guohong

AU - Gupta, Rajeev

AU - Tesfay, Fisaha Haile

AU - Hankey, Graeme J.

AU - Havmoeller, Rasmus

AU - Hijar, Martha

AU - Horino, Masako

AU - Hosgood, H. Dean

AU - Hu, Guoqing

AU - Jacobsen, Kathryn H.

AU - Jakovljevic, Mihajlo B.

AU - Jayaraman, Sudha P.

AU - Jha, Vivekanand

AU - Jibat, Tariku

AU - Johnson, Catherine O.

AU - Jonas, Jost

AU - Kasaeian, Amir

AU - Kawakami, Norito

AU - Keiyoro, Peter N.

AU - Khalil, Ibrahim

AU - Khang, Young Ho

AU - Khubchandani, Jagdish

AU - Kiadaliri, Aliasghar A.Ahmad

AU - Kieling, Christian

AU - Kim, Daniel

AU - Kissoon, Niranjan

AU - Knibbs, Luke D.

AU - Koyanagi, Ai

AU - Krohn, Kristopher J.

AU - Defo, Barthelemy Kuate

AU - Bicer, Burcu Kucuk

AU - Kulikoff, Rachel

AU - Kumar, G. Anil

AU - Lal, Dharmesh Kumar

AU - Lam, Hilton Y.

AU - Larson, Heidi J.

AU - Larsson, Anders

AU - Laryea, Dennis Odai

AU - Leung, Janni

AU - Lim, Stephen S.

AU - Lo, Loon Tzian

AU - Lo, Warren D.

AU - Looker, Katharine J.

AU - Lotufo, Paulo A.

AU - El Razek, Hassan Magdy Abd

AU - Malekzadeh, Reza

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AU - Meles, Kidanu Gebremariam

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AU - Mengistu, Gebremichael Welday

AU - Mensah, George A.

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AU - Mohammed, Shafiu

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AU - Nagata, Chie

AU - Naheed, Aliya

AU - Nguyen, Grant

AU - Le Nguyen, Quyen

AU - Nsoesie, Elaine

AU - Oh, In Hwan

AU - Okoro, Anselm

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AU - Ortiz, Alberto

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AU - Pereira, David M.

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AU - Polanczyk, Guilherme V.

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AU - Ram, Usha

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AU - Remuzzi, Giuseppe

AU - Renzaho, Andre M.N.

AU - Roba, Hirbo Shore

AU - Rojas-Rueda, David

AU - Ronfani, Luca

AU - Sagar, Rajesh

AU - Sanabria, Juan Ramon

AU - Mohammed, Muktar Sano Kedir

AU - Santos, Itamar S.

AU - Satpathy, Maheswar

AU - Sawhney, Monika

AU - Schottker, Ben

AU - Schwebel, David C.

AU - Scott, James G.

AU - Sepanlou, Sadaf G.

AU - Shaheen, Amira

AU - Shaikh, Masood Ali

AU - She, June

AU - Shiri, Rahman

AU - Shiue, Ivy

AU - Sigfusdottir, Inga Dora

AU - Singh, Jasvinder

AU - Silpakit, Naris

AU - Smith, Alison

AU - Sreeramareddy, Chandrashekhar

AU - Stanaway, Jeffrey D.

AU - Stein, Dan J.

AU - Steiner, Caitlyn

AU - Sufiyan, Muawiyyah Babale

AU - Swaminathan, Soumya

AU - Tabares-Seisdedos, Rafael

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AU - Tavakkoli, Mohammad

AU - Taye, Bineyam

AU - Teeple, Stephanie

AU - Tegegne, Teketo Kassaw

AU - Shifa, Girma Temam

AU - Terkawi, Abdullah Sulieman

AU - Thomas, Bernadette

AU - Thomson, Alan J.

AU - Tobe-Gai, Ruoyan

AU - Tonelli, Marcello

AU - Tran, Bach Xuan

AU - Troeger, Christopher

AU - Ukwaja, Kingsley N.

AU - Uthman, Olalekan

AU - Vasankari, Tommi

AU - Venketasubramanian, Narayanaswamy

AU - Vlassov, Vasiliy Victorovich

AU - Weiderpass, Elisabete

AU - Weintraub, Robert

AU - Gebrehiwot, Solomon Weldemariam

AU - Westerman, Ronny

AU - Williams, Hywel C.

AU - Wolfe, Charles D.A.

AU - Woodbrook, Rachel

AU - Yano, Yuichiro

AU - Yonemoto, Naohiro

AU - Yoon, Seok Jun

AU - Younis, Mustafa Z.

AU - Yu, Chuanhua

AU - El Sayed Zaki, Maysaa

AU - Murray, Christopher J.L.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - IMPORTANCE: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health. OBJECTIVE: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion. EVIDENCE REVIEW: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss. FINDINGS: Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3%(95%UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries. CONCLUSIONS AND RELEVANCE: Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.

AB - IMPORTANCE: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health. OBJECTIVE: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion. EVIDENCE REVIEW: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss. FINDINGS: Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3%(95%UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries. CONCLUSIONS AND RELEVANCE: Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.

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U2 - 10.1001/jamapediatrics.2017.0250

DO - 10.1001/jamapediatrics.2017.0250

M3 - Review article

VL - 171

SP - 573

EP - 592

JO - Archives of Pediatrics & Adolescent Medicine

JF - Archives of Pediatrics & Adolescent Medicine

SN - 1072-4710

IS - 6

ER -