TY - JOUR
T1 - Global, regional, and national age-sex specifc mortality for 264 causes of death, 1980-2016
T2 - A systematic analysis for the Global Burden of Disease Study 2016
AU - GBD 2016 Causes of Death Collaborators
AU - Naghavi, Mohsen
AU - Abajobir, Amanuel Alemu
AU - Abbafati, Cristiana
AU - Abbas, Kaja M.
AU - Abd-Allah, Foad
AU - Abera, Semaw Ferede
AU - Aboyans, Victor
AU - Adetokunboh, Olatunji
AU - Ärnlöv, Johan
AU - Afshin, Ashkan
AU - Agrawal, Anurag
AU - Kiadaliri, Aliasghar Ahmad
AU - Ahmadi, Alireza
AU - Ahmed, Muktar Beshir
AU - Aichour, Amani Nidhal
AU - Aichour, Ibtihel
AU - Aichour, Miloud Taki Eddine
AU - Aiyar, Sneha
AU - Al-Eyadhy, Ayman
AU - Alahdab, Fares
AU - Al-Aly, Ziyad
AU - Alam, Khurshid
AU - Alam, Noore
AU - Alam, Tahiya
AU - Alene, Kefyalew Addis
AU - Ali, Syed Danish
AU - Alizadeh-Navaei, Reza
AU - Alkaabi, Juma M.
AU - Alkerwi, Ala'a
AU - Alla, François
AU - Allebeck, Peter
AU - Allen, Christine
AU - Al-Raddadi, Rajaa
AU - Alsharif, Ubai
AU - Altirkawi, Khalid A.
AU - Alvis-Guzman, Nelson
AU - Amare, Azmeraw T.
AU - Amini, Erfan
AU - Ammar, Walid
AU - Amoako, Yaw Ampem
AU - Anber, Nahla
AU - Andersen, Hjalte H.
AU - Andrei, Catalina Liliana
AU - Androudi, Sofa
AU - Ansari, Hossein
AU - Antonio, Carl Abelardo T.
AU - Anwari, Palwasha
AU - Arora, Megha
AU - Artaman, Al
AU - Aryal, Krishna Kumar
AU - Asayesh, Hamid
AU - Asgedom, Solomon W.
AU - Atey, Tesfay Mehari
AU - Avila-Burgos, Leticia
AU - Avokpaho, Euripide Frinel G.Arthur
AU - Awasthi, Ashish
AU - Quintanilla, Beatriz Paulina Ayala
AU - Béjot, Yannick
AU - Babalola, Tesleem Kayode
AU - Bacha, Umar
AU - Balakrishnan, Kalpana
AU - Barac, Aleksandra
AU - Barboza, Miguel A.
AU - Barker-Collo, Suzanne L.
AU - Barquera, Simon
AU - Barregard, Lars
AU - Barrero, Lope H.
AU - Baune, Bernhard T.
AU - Bedi, Neeraj
AU - Beghi, Ettore
AU - Bekele, Bayu Begashaw
AU - Bell, Michelle L.
AU - Bennett, James R.
AU - Bensenor, Isabela M.
AU - Berhane, Adugnaw
AU - Bernabé, Eduardo
AU - Betsu, Balem Demtsu
AU - Beuran, Mircea
AU - Bhatt, Samir
AU - Biadgilign, Sibhatu
AU - Bienhof, Kelly
AU - Bikbov, Boris
AU - Bisanzio, Donal
AU - Bourne, Rupert R.A.
AU - Breitborde, Nicholas J.K.
AU - Bulto, Lemma Negesa Bulto
AU - Bumgarner, Blair R.
AU - Butt, Zahid A.
AU - Cárdenas, Rosario
AU - Cahuana-Hurtado, Lucero
AU - Cameron, Ewan
AU - Campuzano, Julio Cesar
AU - Car, Josip
AU - Carrero, Juan Jesus
AU - Carter, Austin
AU - Casey, Daniel C.
AU - Castañeda-Orjuela, Carlos A.
AU - Catalá-López, Ferrán
AU - Charlson, Fiona J.
AU - Chibueze, Chioma Ezinne
AU - Chimed-Ochir, Odgerel
AU - Chisumpa, Vesper Hichilombwe
AU - Chitheer, Abdulaal A.
AU - Christopher, Devasahayam Jesudas
AU - Ciobanu, Liliana G.
AU - Cirillo, Massimo
AU - Cohen, Aaron J.
AU - Colombara, Danny
AU - Cooper, Cyrus
AU - Cowie, Benjamin C.
AU - Criqui, Michael H.
AU - Dandona, Lalit
AU - Dandona, Rakhi
AU - Dargan, Paul I.
AU - Das Neves, José
AU - Davitoiu, Dragos V.
AU - Davletov, Kairat
AU - De Courten, Barbora
AU - Degenhardt, Louisa
AU - Deiparine, Selina
AU - Deribe, Kebede
AU - Deribew, Amare
AU - Dey, Subhojit
AU - Dicker, Daniel
AU - Ding, Eric L.
AU - Djalalinia, Shirin
AU - Do, Huyen Phuc
AU - Doku, David Teye
AU - Douwes-Schultz, Dirk
AU - Driscoll, Tim R.
AU - Dubey, Manisha
AU - Duncan, Bruce Bartholow
AU - Echko, Michelle
AU - El-Khatib, Ziad Ziad
AU - Ellingsen, Christian Lycke
AU - Enayati, Ahmadali
AU - Erskine, Holly E.
AU - Eskandarieh, Sharareh
AU - Esteghamati, Alireza
AU - Ermakov, Sergey P.
AU - Estep, Kara
AU - Sa Farinha, Carla Sofae
AU - Faro, André
AU - Farzadfar, Farshad
AU - Feigin, Valery L.
AU - Fereshtehnejad, Seyed Mohammad
AU - Fernandes, João C.
AU - Ferrari, Alize J.
AU - Feyissa, Tesfaye Regassa
AU - Filip, Irina
AU - Finegold, Samuel
AU - Fischer, Florian
AU - Fitzmaurice, Christina
AU - Flaxman, Abraham D.
AU - Foigt, Nataliya
AU - Frank, Tahvi
AU - Fraser, Maya
AU - Fullman, Nancy
AU - Fürst, Thomas
AU - Furtado, Joao M.
AU - Gakidou, Emmanuela
AU - Garcia-Basteiro, Alberto L.
AU - Gebre, Teshome
AU - Gebregergs, Gebremedhin Berhe
AU - Gebrehiwot, Tsegaye Tewelde
AU - Gebremichael, Delelegn Yilma
AU - Giroud, Maurice
AU - Genova-Maleras, Ricard
AU - Gesesew, Hailay Abrha
AU - Gething, Peter W.
AU - Gillum, Richard F.
AU - Ginawi, Ibrahim Abdelmageem Mohamed
AU - Giref, Ababi Zergaw
AU - Giroud, Maurice
AU - Giussani, Giorgia
AU - Godwin, William W.
AU - Gold, Audra L.
AU - Goldberg, Ellen M.
AU - Gona, Philimon N.
AU - Gopalani, Sameer Vali
AU - Gouda, Hebe N.
AU - Goulart, Alessandra Carvalho
AU - Griswold, Max
AU - Gupta, Prakash C.
AU - Gupta, Rajeev
AU - Gupta, Tanush
AU - Gupta, Vipin
AU - Haagsma, Juanita A.
AU - Hafezi-Nejad, Nima
AU - Hailu, Alemayehu Desalegne
AU - Hailu, Gessessew Bugssa
AU - Hamadeh, Randah Ribhi
AU - Hambisa, Mitiku Teshome
AU - Hamidi, Samer
AU - Hammami, Mouhanad
AU - Hancock, Jamie
AU - Handal, Alexis J.
AU - Hankey, Graeme J.
AU - Hao, Yuantao
AU - Harb, Hilda L.
AU - Hareri, Habtamu Abera
AU - Hassanvand, Mohammad Sadegh
AU - Havmoeller, Rasmus
AU - Hay, Simon I.
AU - He, Fei
AU - Horita, Nobuyuki
AU - Henry, Nathaniel J.
AU - Heredia-Pi, Ileana Beatriz
AU - Herteliu, Claudiu
AU - Hoek, Hans W.
AU - Horino, Masako
AU - Horita, Nobuyuki
AU - Hosgood, H. Dean
AU - Hostiuc, Sorin
AU - Hotez, Peter J.
AU - Hoy, Damian G.
AU - Huynh, Chantal
AU - Iburg, Kim Moesgaard
AU - Ikeda, Chad
AU - Ileanu, Bogdan Vasile
AU - Irenso, Asnake Ararsa
AU - Irvine, Caleb Mackay Salpeter
AU - Jürisson, Mikk
AU - Jacobsen, Kathryn H.
AU - Jahanmehr, Nader
AU - Jakovljevic, Mihajlo B.
AU - Javanbakht, Mehdi
AU - Jayaraman, Sudha P.
AU - Jeemon, Panniyammakal
AU - Jha, Vivekanand
AU - John, Denny
AU - Johnson, Catherine O.
AU - Johnson, Sarah Charlotte
AU - Jonas, Jost B.
AU - Kabir, Zubair
AU - Kadel, Rajendra
AU - Kahsay, Amaha
AU - Kamal, Ritul
AU - Karch, André
AU - Karimi, Seyed M.
AU - Karimkhani, Chante
AU - Kasaeian, Amir
AU - Kassaw, Nigussie Assefa
AU - Kassebaum, Nicholas J.
AU - Katikireddi, Srinivasa Vittal
AU - Kawakami, Norito
AU - Keiyoro, Peter Njenga
AU - Kemmer, Laura
AU - Kesavachandran, Chandrasekharan Nair
AU - Takahashi, Ken
N1 - Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.
PY - 2017/9/16
Y1 - 2017/9/16
N2 - Background: Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specifc mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. Methods: We estimated cause-specifc deaths and years of life lost (YLLs) by age, sex, geography, and year. YLLs were calculated from the sum of each death multiplied by the standard life expectancy at each age. We used the GBD cause of death database composed of: vital registration (VR) data corrected for under-registration and garbage coding; national and subnational verbal autopsy (VA) studies corrected for garbage coding; and other sources including surveys and surveillance systems for specifc causes such as maternal mortality. To facilitate assessment of quality, we reported on the fraction of deaths assigned to GBD Level 1 or Level 2 causes that cannot be underlying causes of death (major garbage codes) by location and year. Based on completeness, garbage coding, cause list detail, and time periods covered, we provided an overall data quality rating for each location with scores ranging from 0 stars (worst) to 5 stars (best). We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to generate estimates for each location, year, age, and sex. We assessed observed and expected levels and trends of cause-specifc deaths in relation to the Socio-demographic Index (SDI), a summary indicator derived from measures of average income per capita, educational attainment, and total fertility, with locations grouped into quintiles by SDI. Relative to GBD 2015, we expanded the GBD cause hierarchy by 18 causes of death for GBD 2016. Findings: The quality of available data varied by location. Data quality in 25 countries rated in the highest category (5 stars), while 48, 30, 21, and 44 countries were rated at each of the succeeding data quality levels. Vital registration or verbal autopsy data were not available in 27 countries, resulting in the assignment of a zero value for data quality. Deaths from non-communicable diseases (NCDs) represented 72·3% (95% uncertainty interval [UI] 71·2-73·2) of deaths in 2016 with 19·3% (18·5-20·4) of deaths in that year occurring from communicable, maternal, neonatal, and nutritional (CMNN) diseases and a further 8·43% (8·00-8·67) from injuries. Although age-standardised rates of death from NCDs decreased globally between 2006 and 2016, total numbers of these deaths increased; both numbers and age-standardised rates of death from CMNN causes decreased in the decade 2006-16 - age-standardised rates of deaths from injuries decreased but total numbers varied little. In 2016, the three leading global causes of death in children under-5 were lower respiratory infections, neonatal preterm birth complications, and neonatal encephalopathy due to birth asphyxia and trauma, combined resulting in 1·80 million deaths (95% UI 1·59 million to 1·89 million). Between 1990 and 2016, a profound shift toward deaths at older ages occurred with a 178% (95% UI 176-181) increase in deaths in ages 90-94 years and a 210% (208-212) increase in deaths older than age 95 years. The ten leading causes by rates of age-standardised YLL signifcantly decreased from 2006 to 2016 (median annualised rate of change was a decrease of 2·89%); the median annualised rate of change for all other causes was lower (a decrease of 1·59%) during the same interval. Globally, the fve leading causes of total YLLs in 2016 were cardiovascular diseases; diarrhoea, lower respiratory infections, and other common infectious diseases; neoplasms; neonatal disorders; and HIV/AIDS and tuberculosis. At a fner level of disaggregation within cause groupings, the ten leading causes of total YLLs in 2016 were ischaemic heart disease, cerebrovascular disease, lower respiratory infections, diarrhoeal diseases, road injuries, malaria, neonatal preterm birth complications, HIV/AIDS, chronic obstructive pulmonary disease, and neonatal encephalopathy due to birth asphyxia and trauma. Ischaemic heart disease was the leading cause of total YLLs in 113 countries for men and 97 countries for women. Comparisons of observed levels of YLLs by countries, relative to the level of YLLs expected on the basis of SDI alone, highlighted distinct regional patterns including the greater than expected level of YLLs from malaria and from HIV/AIDS across sub-Saharan Africa; diabetes mellitus, especially in Oceania; interpersonal violence, notably within Latin America and the Caribbean; and cardiomyopathy and myocarditis, particularly in eastern and central Europe. The level of YLLs from ischaemic heart disease was less than expected in 117 of 195 locations. Other leading causes of YLLs for which YLLs were notably lower than expected included neonatal preterm birth complications in many locations in both south Asia and southeast Asia, and cerebrovascular disease in western Europe. Interpretation: The past 37 years have featured declining rates of communicable, maternal, neonatal, and nutritional diseases across all quintiles of SDI, with faster than expected gains for many locations relative to their SDI. A global shift towards deaths at older ages suggests success in reducing many causes of early death. YLLs have increased globally for causes such as diabetes mellitus or some neoplasms, and in some locations for causes such as drug use disorders, and confict and terrorism. Increasing levels of YLLs might refect outcomes from conditions that required high levels of care but for which efective treatments remain elusive, potentially increasing costs to health systems.
AB - Background: Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specifc mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. Methods: We estimated cause-specifc deaths and years of life lost (YLLs) by age, sex, geography, and year. YLLs were calculated from the sum of each death multiplied by the standard life expectancy at each age. We used the GBD cause of death database composed of: vital registration (VR) data corrected for under-registration and garbage coding; national and subnational verbal autopsy (VA) studies corrected for garbage coding; and other sources including surveys and surveillance systems for specifc causes such as maternal mortality. To facilitate assessment of quality, we reported on the fraction of deaths assigned to GBD Level 1 or Level 2 causes that cannot be underlying causes of death (major garbage codes) by location and year. Based on completeness, garbage coding, cause list detail, and time periods covered, we provided an overall data quality rating for each location with scores ranging from 0 stars (worst) to 5 stars (best). We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to generate estimates for each location, year, age, and sex. We assessed observed and expected levels and trends of cause-specifc deaths in relation to the Socio-demographic Index (SDI), a summary indicator derived from measures of average income per capita, educational attainment, and total fertility, with locations grouped into quintiles by SDI. Relative to GBD 2015, we expanded the GBD cause hierarchy by 18 causes of death for GBD 2016. Findings: The quality of available data varied by location. Data quality in 25 countries rated in the highest category (5 stars), while 48, 30, 21, and 44 countries were rated at each of the succeeding data quality levels. Vital registration or verbal autopsy data were not available in 27 countries, resulting in the assignment of a zero value for data quality. Deaths from non-communicable diseases (NCDs) represented 72·3% (95% uncertainty interval [UI] 71·2-73·2) of deaths in 2016 with 19·3% (18·5-20·4) of deaths in that year occurring from communicable, maternal, neonatal, and nutritional (CMNN) diseases and a further 8·43% (8·00-8·67) from injuries. Although age-standardised rates of death from NCDs decreased globally between 2006 and 2016, total numbers of these deaths increased; both numbers and age-standardised rates of death from CMNN causes decreased in the decade 2006-16 - age-standardised rates of deaths from injuries decreased but total numbers varied little. In 2016, the three leading global causes of death in children under-5 were lower respiratory infections, neonatal preterm birth complications, and neonatal encephalopathy due to birth asphyxia and trauma, combined resulting in 1·80 million deaths (95% UI 1·59 million to 1·89 million). Between 1990 and 2016, a profound shift toward deaths at older ages occurred with a 178% (95% UI 176-181) increase in deaths in ages 90-94 years and a 210% (208-212) increase in deaths older than age 95 years. The ten leading causes by rates of age-standardised YLL signifcantly decreased from 2006 to 2016 (median annualised rate of change was a decrease of 2·89%); the median annualised rate of change for all other causes was lower (a decrease of 1·59%) during the same interval. Globally, the fve leading causes of total YLLs in 2016 were cardiovascular diseases; diarrhoea, lower respiratory infections, and other common infectious diseases; neoplasms; neonatal disorders; and HIV/AIDS and tuberculosis. At a fner level of disaggregation within cause groupings, the ten leading causes of total YLLs in 2016 were ischaemic heart disease, cerebrovascular disease, lower respiratory infections, diarrhoeal diseases, road injuries, malaria, neonatal preterm birth complications, HIV/AIDS, chronic obstructive pulmonary disease, and neonatal encephalopathy due to birth asphyxia and trauma. Ischaemic heart disease was the leading cause of total YLLs in 113 countries for men and 97 countries for women. Comparisons of observed levels of YLLs by countries, relative to the level of YLLs expected on the basis of SDI alone, highlighted distinct regional patterns including the greater than expected level of YLLs from malaria and from HIV/AIDS across sub-Saharan Africa; diabetes mellitus, especially in Oceania; interpersonal violence, notably within Latin America and the Caribbean; and cardiomyopathy and myocarditis, particularly in eastern and central Europe. The level of YLLs from ischaemic heart disease was less than expected in 117 of 195 locations. Other leading causes of YLLs for which YLLs were notably lower than expected included neonatal preterm birth complications in many locations in both south Asia and southeast Asia, and cerebrovascular disease in western Europe. Interpretation: The past 37 years have featured declining rates of communicable, maternal, neonatal, and nutritional diseases across all quintiles of SDI, with faster than expected gains for many locations relative to their SDI. A global shift towards deaths at older ages suggests success in reducing many causes of early death. YLLs have increased globally for causes such as diabetes mellitus or some neoplasms, and in some locations for causes such as drug use disorders, and confict and terrorism. Increasing levels of YLLs might refect outcomes from conditions that required high levels of care but for which efective treatments remain elusive, potentially increasing costs to health systems.
KW - Journal Article
UR - http://www.scopus.com/inward/record.url?scp=85031727040&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(17)32152-9
DO - 10.1016/S0140-6736(17)32152-9
M3 - Article
C2 - 28919116
SN - 0140-6736
VL - 390
SP - 1151
EP - 1210
JO - Lancet
JF - Lancet
IS - 10100
ER -