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

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Dicker, DanielNguyen, GrantAbate, DeguAbate, Lkidan HassenAbay, Solomon M.Abbafati, CristianaAbbasi, NooshinAbbastabar, HcdayatAbd-Allah, FoadAbdela, JeinalAbdelalim, AhmedAbdel-Rahman, OmarAbdi, AlirezaAbdollahpour, IbrahimAbdulkader, Rizwan SuliankatchiAbdurahman, Ahmed AbdulahiAbebe, Haftom TemesgenAbebe, MollaAbebe, ZegeyeAbebo, Teshome AbukaAboyans, VictorAbraha, Haftom NiguseAbrham, Aklilu RobaAbu-Raddad, Laith JamalAbu-Rmeileh, Niveen MlMbessi, Manfred Mario Kokou AreasAcharya, PawanAdebayo, Oladimeji M.Adedeji, Isaac AkinkimmiAdedoyin, Rufus AdesojiAdekanmbi, VictorAdetokunboh, Olatunji O.Adhena, Beyene MeressaAdhikari, Tara BanalAdib, Mina G.Adou, Arsene KouablanAdsuar, Jose C.Afaridern, MohsenAfshin, AshkanAgarwal, GinaAggarwal, RakeshAghayan, Sargis AgbasiAgrawal, SutapaAgrawal, AnuragAhmadi, MehdiAhmadi, AlirezaAhmadieh, HamidAhmed, Mohamed Lemine Cheikh BrahimAhmed, SayemAhmed, Muktar BeshirAichour, Amani NidhalAichour, IbtihelAichour, Miloud Taki EddineAkanda, Ali S.Akbari, Mohammad EsmaeilAkibu, MohammedAkinyemi, Rufus OlusolaAkinyemiju, TomiAkseer, NadiaAlandab, FaresAl-Aly, ZiyadAlam, KhurshidAlebel, AnimutAleman, Alicia V.Alene, Kefyalew AddisAl-Eyadhy, AymanAli, RaghibAlijanzadely, MehranAlizadeh-Navaei, RezaAljunid, Syed MohamedAlkerwi, Ala'aAlla, FrancoisAllebeck, PeterAllen, Christine A.Alonso, JordiAl-Raddadi, Rajaa M.Alsharif, UbaiAltirkawi, KhalidAlvis-Cituman, NelsonAmare, Azmeraw T.Amini, ErfanAmmar, WalidAmoako, Yaw AmpemAnber, Nahla HamedAndrei, Catalina LilianaAndroudi, SofiaAnimut, Megbani DebalkieAnjomshoa, MinaAnlay, Degefaye ZelalemAnsari, HosseinAnsariadi, AnsariadiAnsha, Mustafa GeletoAntonio, Carl Abelardo T.Appiah, Seth Christopher YawAremu, OlatundeAreri, Habtarnu AberaArnlov, JohanAroma, MeghaArtaman, AlAryal, Krishna K.Asadi-Lari, MohsenAsayesh, HamidAsfaw, Ephrem TsegayAsgedom, Solomon WeldegebrealAssadi, RezaAtaro, ZerihunAtey, Tesfay Mehan MehariAthari, Seyyed ShamsadinAtique, SulemanAtre, Sachin R.Atteraya, Madhu SudhanAttia, Engi F.Ausloos, MarcelAvila-Burgos, LeticiaAvokpaho, Euripide F. G. A.Awasthi, Ash IshAwuah, BaffourQuintanilla, Beatriz Paulina AyalaAyele, Henok TadesseAyele, YohanesAyer, RakeshAyuk, Tam Be B.Azzopardi, Peter S.Azzopardi-Muscat, NatashaBadali, HamidBadawi, AlaaBalakrishnan, KalpanaBali, Ayele GeletoBanach, MaciejBanstola, ArmitBarac, AleksandraBarboza, Miguel A.Barquera, SimonBarrero, Lope H.Basaleem, HudaBassat, QuiqueBasu, ArindamBasu, SanjayBaune, Bernhard T.Bazargan-Hejazi, ShahrzadBedi, NeerajBeghi, EttoreBehzadifar, MasoudBehzadifar, MeysamBejot, YannickBekele, Bayu BegashawBelachew, Abate BekeleBelay, Aregawi GebreyesusBelay, EzraBelay, Saba AbrahamBelay, Yihalem AbebeBell, Michelle L.Bello, Aminu K.Bennett, Derrick A.Bensenor, Isabela M.Berhane, AdugnawBerman, Adam E.Bernabe, EduardoBernstein, Robert S.Bertolacci, Gregory J.Beuran, MirceaBeyranvand, TinaBhala, NeerajBhatia, EeshBhatt, SamirBhattarai, SurajBhaumik, SoumyadeeepBhutta, Zulfiqar A.Biadgo, BeleteBijani, AliBikbov, BorisBililign, NigusBin Sayeed, Muhammad ShandaatBirlik, Sait MentesBirungi, CharlesBisanzio, DonalBiswas, TuhinBjorge, ToneBleyer, ArchieBasara, Berrak BoraBose, DipanBosetti, CristinaBoufous, SoufianeBourne, RupertBrady, Oliver J.Bragazzi, Nicola LuigiBrant, Luisa C.Brazinova, AlexandraBreitborde, Nicholas J. K.Brenner, HermannBritton, GabrielleBrugha, TraolachBurke, Kristin E.Busse, ReinhardButt, Zahid A.Cahuana-Hurtado, LuceroCallender, Charlton S. K. H.Campos-Nonato, Ismael R.Rincon, Julio Cesar CampuzanoCano, JorgeCar, MateCardenas, RosarioCaneras, GiuliaCanero, Juan J.Carter, AustinCarvalho, FelixCasaneda-Orjuela, Carlos A.Rivas, Jacqueline CastilloCastro, FranzCatala-Lopez, FerranCavlin, AlanurCerin, EsterChaiah, YazanChamps, Ana PaulaChang, Hsing-YiChang, Jung-ChenChattopadhyay, AparajitaChaturvedi, PankajChen, WanqingChiang, Peggy Pei-ChiaChimed-Ochir, OdgerelChin, Ken LeeChisumpa, Vesper HichilombweChitheer, AbchilaalChoi, Jee-Young J.Christensen, HanneChristopher, Devasahayam J.Chung, Sheng-ChiaCicuttini, Flavia M.Ciobanu, Liliana G.Cirillo, MassimoClaro, Rafael M.Cohen, Aaron J.Collado-Mateo, DanielConstantin, Maria-MagdalenaConti, SaraCooper, CyrusCooper, Leslie TrumbullCortesi, Paolo AngeloCortinovis, MonicaCousin, EwertonCriqui, Michael H.Cromwell, Elizabeth A.Crowe, Christopher StephenCrump, John A.Cucu, AlexandraCunningham, MatthewDaba, Alemneh KabetaDachew, Berihun AssefaDadi, Abel FekaaduDandona, LalitDandona, RakhiDang, Anh KimDargan, Paul I.Daryani, AhmadDas, Siddharth K.Das Gupta, Rajatdas Neves, JoseDasa, Tamirat TesfayeDash, Aditya PrasadWeaver, Nicole DavisDavitoiu, Dragos VirgilDavletov, KairatDayama, Anandde Courten, BarboraDe la Hoz, Fernando PioDe Leo, DiegoDe Neve, Jan-WalterDegefa, Meaza GinnaDegenhardt, LouisaDegfie, Tizta T.Deiparine, SelinaDellavalle, Robert P.Demoz, Gebre TeklemariamDemtsu, Balem BetsuDenova-Gutierrez, EdgarDeribe, KebedeDervenis, NikolaosDes Jarlais, Don C.Dessie, Getenet AyalewDey, SubhojitDharmaratne, Samath DhammindaDhimal, MeghnathDing, Eric L.Djalalinia, ShirinDoku, David TeyeDolan, Kate A.Donnelly, Christi A.Dorsey, E. 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Issue Date
10-11월-2018
Publisher
ELSEVIER SCIENCE INC
Citation
LANCET, v.392, no.10159, pp.1684 - 1735
Indexed
SCIE
SCOPUS
Journal Title
LANCET
Volume
392
Number
10159
Start Page
1684
End Page
1735
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/126253
DOI
10.1016/S0140-6736(18)31891-9
ISSN
0140-6736
Abstract
Background Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (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 systetns, sample registration systetns, 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-specific 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 different 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 tnales, 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-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant 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, wotnen, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing. Copyright C) 2018 The Author(s). Published by Elsevier Ltd.
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