Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015

a systematic analysis for the Global Burden of Disease Study 2015

H. Wang, Mahsen Naghavi, Craig Allen, R. M. Barber, A. Carter, D. C. Casey, F. J. Charlson, A. Z. Chen, Michael Coates, M. Coggeshall, L. Dandona, D. J. Dicker, H. E. Erskine, A. J. Ferrari, C. Fitzmaurice, Kyle Foreman, Mohammad H. Forouzanfar, M. S. Fraser, N. Fullman, E. M. Goldberg & 231 others N. Graetz, J. A. Haagsma, Simon I. Hay, C. Huynh, C. O. Johnson, N. J. Kassebaum, X. R. Kulikoff, M. J. Kutz, H. H. Kyu, H. J. Larson, J. Leung, S Lim, Marcus Lind, Rafael Lozano, N. Marquez, J. Mikesell, Ali H. Mokdad, M. D. Mooney, G. Nguyen, E. Nsoesie, David M Pigott, C. Pinho, G. A. Roth, L. Sandar, N. Silpakit, A. Sligar, R. J.D. Sorensen, J. Stanaway, C Steiner, S. Teeple, Mark A B Thomas, C. Troeger, A. VanderZanden, S. E. Vollset, V. Wanga, H. A. Whiteford, T. Wolock, L. Zoeckler, T. Achoki, A. Afshin, L. T. Alexander, G. M. Anderson, B. Bell, S. Biryukov, J. D. Blore, A. Brown, J. Brown, K. Cercy, A. Chew, A. J. Cohen, F. Daoud, E. Dossou, K. Estep, Abraham Flaxman, J. Friedman, J. Frostad, W. W. Godwin, J. Hancock, L. Kemmer, I. A. Khalil, P. Y. Liu, F. Masiye, A. Millear, M. Mirarefin, A. Misganaw, Maziar Moradi-Lakeh, K. Morgan, Maryanne Ng, Arnab Pain, J. Quame-Amaglo, P. Rao, M. B. Reitsma, K. A. Shackelford, P. J. Sur, J. A. Wagner, Theo Vos, A. D. Lopez, C. J.L. Murray, R. G. Ellenbogen, C. N. Mock, D. A. Quistberg, B. O. Anderson, C. D. Blosser, N. D. Futran, S. R. Heckbert, P. N. Jensen, T. J. Montine, D. L. Tirschwell, D. A. Watkins, Z A Bhutta, M. I. Nisar, N. Akseer, N. K.M. Alam, L. D. Knibbs, Ratilal Lalloo, H. N. Gouda, John McGrath, P. Jeemon, R. Dandona, G. A. Kumar, Peter W. Gething, C Cooper, S. C. Darby, A. Deribew, MUHAMMAD REDZWAN S. RASHID ALI, D. A. Bennett, Vivekanand JHA, K. Rahimi, Y. Kinfu, I. D.A. Faghmous, S. M. Langan, M. McKee, G. V.S. Murthy, Neil Pearce, B. Roberts, I. R. Campos-Nonato, J. C. Campuzano, H. Gomez-Dantes, I. B. Heredia-Pi, F. Mejia-Rodriguez, J. C. Montañez Hernandez, P. Montero, M. J. Rios Blancas, E. E. Servan-Mori, S. Villalpando, L. Duan, Shanlin Liu, L Wang, P. Ye, X. Liang, S. Yu, G. A. Mensah, J. A. Salomon, A. L. Thorne-Lyman, O. N. Ajala, T. Bärnighausen, E. L. Ding, M. S. Farvid, G. R. Wagner, P. James, M. Osman, M. G. Shrime, J. R.A. Fitchett, A. K. Knudsen, C. L. Ellingsen, N. H. Krog, Maja Savic, A. D. Hailu, O. F. Norheim, K. H. Abate, T. T. Gebrehiwot, A. T. Gebremedhin, C. Abbafati, K. M. Abbas, F. Abd-Allah, S. F. Abera, Y. A. Melaku, F. H. Tesfay, G. Y. Abyu, A. F. Aregay, B. D. Betsu, A. A. Gebru, G. B. Hailu, A. Z. Yalew, H. G. Yebyo, D. M.X. Abreu, E. B. Franca, L. J. Abu-Raddad, A. L. Adelekan, R. O. Akinyemi, F. A. Ojelabi, Z. Ademi, T. Fürst, Peter Azzopardi, B. C. Cowie, K. B. Gibney, J. H. MacLachlan, A. Meretoja, K. Alam, Rohan Borschmann, S. M. Colquhoun, G. C. Patton, R. G. Weintraub, C. E.I. Szoeke, Lakshmi Vijayakumar, M. A. Bohensky, H. R. Taylor, T. Wijeratne, A. K. Adou, J. C. Adsuar, K. A. Afanvi, E. E. Agardh, Jurgen Rehm, A. Badawi, M. P. Lindsay, Svetlana Popova, A. Agarwal, A. Agrawal, P. J. Hotez, A. Ahmad, B. Norrving, A. S. Akanda, T. F. Akinyemiju, D. C. Schwebel, J. A. Singh, F. H. Al Lami, S. Alabed, Z. Al-Aly, T. R. Driscoll, A. H. Kemp, James Leigh, A. B. Mekonnen, D. Alasfoor, S. F. Aldhahri, K. A. Altirkawi, A. S. Terkawi, R. W. Aldridge, A Banerjee, T. Tillmann, M. A. Alegretti, A. V. Aleman, F. Cavalleri, V. Colistro, Z. A. Alemu, S. Alhabib, A. Alkerwi, F. Alla, P. Allebeck, J. J. Carrero, J. R. Carapetis, GBD 2015 Mortality and Causes of Death Collaborators

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Abstract

Background: Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. 

Methods: We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography–year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). 

Findings: Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4–61·9) in 1980 to 71·8 years (71·5–72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7–17·4), to 62·6 years (56·5–70·2). Total deaths increased by 4·1% (2·6–5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8–18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6–16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9–14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1–44·6), malaria (43·1%, 34·7–51·8), neonatal preterm birth complications (29·8%, 24·8–34·9), and maternal disorders (29·1%, 19·3–37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000–183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000–532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. 

Interpretation: At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Funding Bill & Melinda Gates Foundation.

Original languageEnglish
Pages (from-to)1459-1544
Number of pages86
JournalLancet
Volume388
Issue number10053
DOIs
Publication statusPublished - 8 Oct 2016
Externally publishedYes

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Life Expectancy
Cause of Death
Mortality
Population Growth
Demography
Geography
Global Burden of Disease
Acquired Immunodeficiency Syndrome
Africa South of the Sahara
Mothers
HIV
Violence
Respiratory Tract Infections
Malaria
Uncertainty
Myocardial Ischemia
Infant, Newborn, Diseases
Ebola Hemorrhagic Fever
Syria
Pneumococcal Pneumonia

Cite this

Wang, H. ; Naghavi, Mahsen ; Allen, Craig ; Barber, R. M. ; Carter, A. ; Casey, D. C. ; Charlson, F. J. ; Chen, A. Z. ; Coates, Michael ; Coggeshall, M. ; Dandona, L. ; Dicker, D. J. ; Erskine, H. E. ; Ferrari, A. J. ; Fitzmaurice, C. ; Foreman, Kyle ; Forouzanfar, Mohammad H. ; Fraser, M. S. ; Fullman, N. ; Goldberg, E. M. ; Graetz, N. ; Haagsma, J. A. ; Hay, Simon I. ; Huynh, C. ; Johnson, C. O. ; Kassebaum, N. J. ; Kulikoff, X. R. ; Kutz, M. J. ; Kyu, H. H. ; Larson, H. J. ; Leung, J. ; Lim, S ; Lind, Marcus ; Lozano, Rafael ; Marquez, N. ; Mikesell, J. ; Mokdad, Ali H. ; Mooney, M. D. ; Nguyen, G. ; Nsoesie, E. ; Pigott, David M ; Pinho, C. ; Roth, G. A. ; Sandar, L. ; Silpakit, N. ; Sligar, A. ; Sorensen, R. J.D. ; Stanaway, J. ; Steiner, C ; Teeple, S. ; Thomas, Mark A B ; Troeger, C. ; VanderZanden, A. ; Vollset, S. E. ; Wanga, V. ; Whiteford, H. A. ; Wolock, T. ; Zoeckler, L. ; Achoki, T. ; Afshin, A. ; Alexander, L. T. ; Anderson, G. M. ; Bell, B. ; Biryukov, S. ; Blore, J. D. ; Brown, A. ; Brown, J. ; Cercy, K. ; Chew, A. ; Cohen, A. J. ; Daoud, F. ; Dossou, E. ; Estep, K. ; Flaxman, Abraham ; Friedman, J. ; Frostad, J. ; Godwin, W. W. ; Hancock, J. ; Kemmer, L. ; Khalil, I. A. ; Liu, P. Y. ; Masiye, F. ; Millear, A. ; Mirarefin, M. ; Misganaw, A. ; Moradi-Lakeh, Maziar ; Morgan, K. ; Ng, Maryanne ; Pain, Arnab ; Quame-Amaglo, J. ; Rao, P. ; Reitsma, M. B. ; Shackelford, K. A. ; Sur, P. J. ; Wagner, J. A. ; Vos, Theo ; Lopez, A. D. ; Murray, C. J.L. ; Ellenbogen, R. G. ; Mock, C. N. ; Quistberg, D. A. ; Anderson, B. O. ; Blosser, C. D. ; Futran, N. D. ; Heckbert, S. R. ; Jensen, P. N. ; Montine, T. J. ; Tirschwell, D. L. ; Watkins, D. A. ; Bhutta, Z A ; Nisar, M. I. ; Akseer, N. ; Alam, N. K.M. ; Knibbs, L. D. ; Lalloo, Ratilal ; Gouda, H. N. ; McGrath, John ; Jeemon, P. ; Dandona, R. ; Kumar, G. A. ; Gething, Peter W. ; Cooper, C ; Darby, S. C. ; Deribew, A. ; ALI, MUHAMMAD REDZWAN S. RASHID ; Bennett, D. A. ; JHA, Vivekanand ; Rahimi, K. ; Kinfu, Y. ; Faghmous, I. D.A. ; Langan, S. M. ; McKee, M. ; Murthy, G. V.S. ; Pearce, Neil ; Roberts, B. ; Campos-Nonato, I. R. ; Campuzano, J. C. ; Gomez-Dantes, H. ; Heredia-Pi, I. B. ; Mejia-Rodriguez, F. ; Montañez Hernandez, J. C. ; Montero, P. ; Rios Blancas, M. J. ; Servan-Mori, E. E. ; Villalpando, S. ; Duan, L. ; Liu, Shanlin ; Wang, L ; Ye, P. ; Liang, X. ; Yu, S. ; Mensah, G. A. ; Salomon, J. A. ; Thorne-Lyman, A. L. ; Ajala, O. N. ; Bärnighausen, T. ; Ding, E. L. ; Farvid, M. S. ; Wagner, G. R. ; James, P. ; Osman, M. ; Shrime, M. G. ; Fitchett, J. R.A. ; Knudsen, A. K. ; Ellingsen, C. L. ; Krog, N. H. ; Savic, Maja ; Hailu, A. D. ; Norheim, O. F. ; Abate, K. H. ; Gebrehiwot, T. T. ; Gebremedhin, A. T. ; Abbafati, C. ; Abbas, K. M. ; Abd-Allah, F. ; Abera, S. F. ; Melaku, Y. A. ; Tesfay, F. H. ; Abyu, G. Y. ; Aregay, A. F. ; Betsu, B. D. ; Gebru, A. A. ; Hailu, G. B. ; Yalew, A. Z. ; Yebyo, H. G. ; Abreu, D. M.X. ; Franca, E. B. ; Abu-Raddad, L. J. ; Adelekan, A. L. ; Akinyemi, R. O. ; Ojelabi, F. A. ; Ademi, Z. ; Fürst, T. ; Azzopardi, Peter ; Cowie, B. C. ; Gibney, K. B. ; MacLachlan, J. H. ; Meretoja, A. ; Alam, K. ; Borschmann, Rohan ; Colquhoun, S. M. ; Patton, G. C. ; Weintraub, R. G. ; Szoeke, C. E.I. ; Vijayakumar, Lakshmi ; Bohensky, M. A. ; Taylor, H. R. ; Wijeratne, T. ; Adou, A. K. ; Adsuar, J. C. ; Afanvi, K. A. ; Agardh, E. E. ; Rehm, Jurgen ; Badawi, A. ; Lindsay, M. P. ; Popova, Svetlana ; Agarwal, A. ; Agrawal, A. ; Hotez, P. J. ; Ahmad, A. ; Norrving, B. ; Akanda, A. S. ; Akinyemiju, T. F. ; Schwebel, D. C. ; Singh, J. A. ; Al Lami, F. H. ; Alabed, S. ; Al-Aly, Z. ; Driscoll, T. R. ; Kemp, A. H. ; Leigh, James ; Mekonnen, A. B. ; Alasfoor, D. ; Aldhahri, S. F. ; Altirkawi, K. A. ; Terkawi, A. S. ; Aldridge, R. W. ; Banerjee, A ; Tillmann, T. ; Alegretti, M. A. ; Aleman, A. V. ; Cavalleri, F. ; Colistro, V. ; Alemu, Z. A. ; Alhabib, S. ; Alkerwi, A. ; Alla, F. ; Allebeck, P. ; Carrero, J. J. ; Carapetis, J. R. ; GBD 2015 Mortality and Causes of Death Collaborators. / Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015 : a systematic analysis for the Global Burden of Disease Study 2015. In: Lancet. 2016 ; Vol. 388, No. 10053. pp. 1459-1544.
@article{a41a044130de479a9e814436da6579e4,
title = "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015",
abstract = "Background: Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods: We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography–year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings: Globally, life expectancy from birth increased from 61·7 years (95{\%} uncertainty interval 61·4–61·9) in 1980 to 71·8 years (71·5–72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7–17·4), to 62·6 years (56·5–70·2). Total deaths increased by 4·1{\%} (2·6–5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0{\%} (15·8–18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1{\%} (12·6–16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1{\%} (11·9–14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1{\%}, 39·1–44·6), malaria (43·1{\%}, 34·7–51·8), neonatal preterm birth complications (29·8{\%}, 24·8–34·9), and maternal disorders (29·1{\%}, 19·3–37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000–183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000–532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation: At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Funding Bill & Melinda Gates Foundation.",
author = "H. Wang and Mahsen Naghavi and Craig Allen and Barber, {R. M.} and A. Carter and Casey, {D. C.} and Charlson, {F. J.} and Chen, {A. Z.} and Michael Coates and M. Coggeshall and L. Dandona and Dicker, {D. J.} and Erskine, {H. E.} and Ferrari, {A. J.} and C. Fitzmaurice and Kyle Foreman and Forouzanfar, {Mohammad H.} and Fraser, {M. S.} and N. Fullman and Goldberg, {E. M.} and N. Graetz and Haagsma, {J. A.} and Hay, {Simon I.} and C. Huynh and Johnson, {C. O.} and Kassebaum, {N. J.} and Kulikoff, {X. R.} and Kutz, {M. J.} and Kyu, {H. H.} and Larson, {H. J.} and J. Leung and S Lim and Marcus Lind and Rafael Lozano and N. Marquez and J. Mikesell and Mokdad, {Ali H.} and Mooney, {M. D.} and G. Nguyen and E. Nsoesie and Pigott, {David M} and C. Pinho and Roth, {G. A.} and L. Sandar and N. Silpakit and A. Sligar and Sorensen, {R. J.D.} and J. Stanaway and C Steiner and S. Teeple and Thomas, {Mark A B} and C. Troeger and A. VanderZanden and Vollset, {S. E.} and V. Wanga and Whiteford, {H. A.} and T. Wolock and L. Zoeckler and T. Achoki and A. Afshin and Alexander, {L. T.} and Anderson, {G. M.} and B. Bell and S. Biryukov and Blore, {J. D.} and A. Brown and J. Brown and K. Cercy and A. Chew and Cohen, {A. J.} and F. Daoud and E. Dossou and K. Estep and Abraham Flaxman and J. Friedman and J. Frostad and Godwin, {W. W.} and J. Hancock and L. Kemmer and Khalil, {I. A.} and Liu, {P. Y.} and F. Masiye and A. Millear and M. Mirarefin and A. Misganaw and Maziar Moradi-Lakeh and K. Morgan and Maryanne Ng and Arnab Pain and J. Quame-Amaglo and P. Rao and Reitsma, {M. B.} and Shackelford, {K. A.} and Sur, {P. J.} and Wagner, {J. A.} and Theo Vos and Lopez, {A. D.} and Murray, {C. J.L.} and Ellenbogen, {R. G.} and Mock, {C. N.} and Quistberg, {D. A.} and Anderson, {B. O.} and Blosser, {C. D.} and Futran, {N. D.} and Heckbert, {S. R.} and Jensen, {P. N.} and Montine, {T. J.} and Tirschwell, {D. L.} and Watkins, {D. A.} and Bhutta, {Z A} and Nisar, {M. I.} and N. Akseer and Alam, {N. K.M.} and Knibbs, {L. D.} and Ratilal Lalloo and Gouda, {H. N.} and John McGrath and P. Jeemon and R. Dandona and Kumar, {G. A.} and Gething, {Peter W.} and C Cooper and Darby, {S. C.} and A. Deribew and ALI, {MUHAMMAD REDZWAN S. RASHID} and Bennett, {D. A.} and Vivekanand JHA and K. Rahimi and Y. Kinfu and Faghmous, {I. D.A.} and Langan, {S. M.} and M. McKee and Murthy, {G. V.S.} and Neil Pearce and B. Roberts and Campos-Nonato, {I. R.} and Campuzano, {J. C.} and H. Gomez-Dantes and Heredia-Pi, {I. B.} and F. Mejia-Rodriguez and {Monta{\~n}ez Hernandez}, {J. C.} and P. Montero and {Rios Blancas}, {M. J.} and Servan-Mori, {E. E.} and S. Villalpando and L. Duan and Shanlin Liu and L Wang and P. Ye and X. Liang and S. Yu and Mensah, {G. A.} and Salomon, {J. A.} and Thorne-Lyman, {A. L.} and Ajala, {O. N.} and T. B{\"a}rnighausen and Ding, {E. L.} and Farvid, {M. S.} and Wagner, {G. R.} and P. James and M. Osman and Shrime, {M. G.} and Fitchett, {J. R.A.} and Knudsen, {A. K.} and Ellingsen, {C. L.} and Krog, {N. H.} and Maja Savic and Hailu, {A. D.} and Norheim, {O. F.} and Abate, {K. H.} and Gebrehiwot, {T. T.} and Gebremedhin, {A. T.} and C. Abbafati and Abbas, {K. M.} and F. Abd-Allah and Abera, {S. F.} and Melaku, {Y. A.} and Tesfay, {F. H.} and Abyu, {G. Y.} and Aregay, {A. F.} and Betsu, {B. D.} and Gebru, {A. A.} and Hailu, {G. B.} and Yalew, {A. Z.} and Yebyo, {H. G.} and Abreu, {D. M.X.} and Franca, {E. B.} and Abu-Raddad, {L. J.} and Adelekan, {A. L.} and Akinyemi, {R. O.} and Ojelabi, {F. A.} and Z. Ademi and T. F{\"u}rst and Peter Azzopardi and Cowie, {B. C.} and Gibney, {K. B.} and MacLachlan, {J. H.} and A. Meretoja and K. Alam and Rohan Borschmann and Colquhoun, {S. M.} and Patton, {G. C.} and Weintraub, {R. G.} and Szoeke, {C. E.I.} and Lakshmi Vijayakumar and Bohensky, {M. A.} and Taylor, {H. R.} and T. Wijeratne and Adou, {A. K.} and Adsuar, {J. C.} and Afanvi, {K. A.} and Agardh, {E. E.} and Jurgen Rehm and A. Badawi and Lindsay, {M. P.} and Svetlana Popova and A. Agarwal and A. Agrawal and Hotez, {P. J.} and A. Ahmad and B. Norrving and Akanda, {A. S.} and Akinyemiju, {T. F.} and Schwebel, {D. C.} and Singh, {J. A.} and {Al Lami}, {F. H.} and S. Alabed and Z. Al-Aly and Driscoll, {T. R.} and Kemp, {A. H.} and James Leigh and Mekonnen, {A. B.} and D. Alasfoor and Aldhahri, {S. F.} and Altirkawi, {K. A.} and Terkawi, {A. S.} and Aldridge, {R. W.} and A Banerjee and T. Tillmann and Alegretti, {M. A.} and Aleman, {A. V.} and F. Cavalleri and V. Colistro and Alemu, {Z. A.} and S. Alhabib and A. Alkerwi and F. Alla and P. Allebeck and Carrero, {J. J.} and Carapetis, {J. R.} and {GBD 2015 Mortality and Causes of Death Collaborators}",
year = "2016",
month = "10",
day = "8",
doi = "10.1016/S0140-6736(16)31012-1",
language = "English",
volume = "388",
pages = "1459--1544",
journal = "Lancet",
issn = "0140-6736",
publisher = "The Lancet Publishing Group",
number = "10053",

}

Wang, H, Naghavi, M, Allen, C, Barber, RM, Carter, A, Casey, DC, Charlson, FJ, Chen, AZ, Coates, M, Coggeshall, M, Dandona, L, Dicker, DJ, Erskine, HE, Ferrari, AJ, Fitzmaurice, C, Foreman, K, Forouzanfar, MH, Fraser, MS, Fullman, N, Goldberg, EM, Graetz, N, Haagsma, JA, Hay, SI, Huynh, C, Johnson, CO, Kassebaum, NJ, Kulikoff, XR, Kutz, MJ, Kyu, HH, Larson, HJ, Leung, J, Lim, S, Lind, M, Lozano, R, Marquez, N, Mikesell, J, Mokdad, AH, Mooney, MD, Nguyen, G, Nsoesie, E, Pigott, DM, Pinho, C, Roth, GA, Sandar, L, Silpakit, N, Sligar, A, Sorensen, RJD, Stanaway, J, Steiner, C, Teeple, S, Thomas, MAB, Troeger, C, VanderZanden, A, Vollset, SE, Wanga, V, Whiteford, HA, Wolock, T, Zoeckler, L, Achoki, T, Afshin, A, Alexander, LT, Anderson, GM, Bell, B, Biryukov, S, Blore, JD, Brown, A, Brown, J, Cercy, K, Chew, A, Cohen, AJ, Daoud, F, Dossou, E, Estep, K, Flaxman, A, Friedman, J, Frostad, J, Godwin, WW, Hancock, J, Kemmer, L, Khalil, IA, Liu, PY, Masiye, F, Millear, A, Mirarefin, M, Misganaw, A, Moradi-Lakeh, M, Morgan, K, Ng, M, Pain, A, Quame-Amaglo, J, Rao, P, Reitsma, MB, Shackelford, KA, Sur, PJ, Wagner, JA, Vos, T, Lopez, AD, Murray, CJL, Ellenbogen, RG, Mock, CN, Quistberg, DA, Anderson, BO, Blosser, CD, Futran, ND, Heckbert, SR, Jensen, PN, Montine, TJ, Tirschwell, DL, Watkins, DA, Bhutta, ZA, Nisar, MI, Akseer, N, Alam, NKM, Knibbs, LD, Lalloo, R, Gouda, HN, McGrath, J, Jeemon, P, Dandona, R, Kumar, GA, Gething, PW, Cooper, C, Darby, SC, Deribew, A, ALI, MUHAMMADREDZWANSRASHID, Bennett, DA, JHA, V, Rahimi, K, Kinfu, Y, Faghmous, IDA, Langan, SM, McKee, M, Murthy, GVS, Pearce, N, Roberts, B, Campos-Nonato, IR, Campuzano, JC, Gomez-Dantes, H, Heredia-Pi, IB, Mejia-Rodriguez, F, Montañez Hernandez, JC, Montero, P, Rios Blancas, MJ, Servan-Mori, EE, Villalpando, S, Duan, L, Liu, S, Wang, L, Ye, P, Liang, X, Yu, S, Mensah, GA, Salomon, JA, Thorne-Lyman, AL, Ajala, ON, Bärnighausen, T, Ding, EL, Farvid, MS, Wagner, GR, James, P, Osman, M, Shrime, MG, Fitchett, JRA, Knudsen, AK, Ellingsen, CL, Krog, NH, Savic, M, Hailu, AD, Norheim, OF, Abate, KH, Gebrehiwot, TT, Gebremedhin, AT, Abbafati, C, Abbas, KM, Abd-Allah, F, Abera, SF, Melaku, YA, Tesfay, FH, Abyu, GY, Aregay, AF, Betsu, BD, Gebru, AA, Hailu, GB, Yalew, AZ, Yebyo, HG, Abreu, DMX, Franca, EB, Abu-Raddad, LJ, Adelekan, AL, Akinyemi, RO, Ojelabi, FA, Ademi, Z, Fürst, T, Azzopardi, P, Cowie, BC, Gibney, KB, MacLachlan, JH, Meretoja, A, Alam, K, Borschmann, R, Colquhoun, SM, Patton, GC, Weintraub, RG, Szoeke, CEI, Vijayakumar, L, Bohensky, MA, Taylor, HR, Wijeratne, T, Adou, AK, Adsuar, JC, Afanvi, KA, Agardh, EE, Rehm, J, Badawi, A, Lindsay, MP, Popova, S, Agarwal, A, Agrawal, A, Hotez, PJ, Ahmad, A, Norrving, B, Akanda, AS, Akinyemiju, TF, Schwebel, DC, Singh, JA, Al Lami, FH, Alabed, S, Al-Aly, Z, Driscoll, TR, Kemp, AH, Leigh, J, Mekonnen, AB, Alasfoor, D, Aldhahri, SF, Altirkawi, KA, Terkawi, AS, Aldridge, RW, Banerjee, A, Tillmann, T, Alegretti, MA, Aleman, AV, Cavalleri, F, Colistro, V, Alemu, ZA, Alhabib, S, Alkerwi, A, Alla, F, Allebeck, P, Carrero, JJ, Carapetis, JR & GBD 2015 Mortality and Causes of Death Collaborators 2016, 'Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015', Lancet, vol. 388, no. 10053, pp. 1459-1544. https://doi.org/10.1016/S0140-6736(16)31012-1

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015 : a systematic analysis for the Global Burden of Disease Study 2015. / Wang, H.; Naghavi, Mahsen; Allen, Craig; Barber, R. M.; Carter, A.; Casey, D. C.; Charlson, F. J.; Chen, A. Z.; Coates, Michael; Coggeshall, M.; Dandona, L.; Dicker, D. J.; Erskine, H. E.; Ferrari, A. J.; Fitzmaurice, C.; Foreman, Kyle; Forouzanfar, Mohammad H.; Fraser, M. S.; Fullman, N.; Goldberg, E. M.; Graetz, N.; Haagsma, J. A.; Hay, Simon I.; Huynh, C.; Johnson, C. O.; Kassebaum, N. J.; Kulikoff, X. R.; Kutz, M. J.; Kyu, H. H.; Larson, H. J.; Leung, J.; Lim, S; Lind, Marcus; Lozano, Rafael; Marquez, N.; Mikesell, J.; Mokdad, Ali H.; Mooney, M. D.; Nguyen, G.; Nsoesie, E.; Pigott, David M; Pinho, C.; Roth, G. A.; Sandar, L.; Silpakit, N.; Sligar, A.; Sorensen, R. J.D.; Stanaway, J.; Steiner, C; Teeple, S.; Thomas, Mark A B; Troeger, C.; VanderZanden, A.; Vollset, S. E.; Wanga, V.; Whiteford, H. A.; Wolock, T.; Zoeckler, L.; Achoki, T.; Afshin, A.; Alexander, L. T.; Anderson, G. M.; Bell, B.; Biryukov, S.; Blore, J. D.; Brown, A.; Brown, J.; Cercy, K.; Chew, A.; Cohen, A. J.; Daoud, F.; Dossou, E.; Estep, K.; Flaxman, Abraham; Friedman, J.; Frostad, J.; Godwin, W. W.; Hancock, J.; Kemmer, L.; Khalil, I. A.; Liu, P. Y.; Masiye, F.; Millear, A.; Mirarefin, M.; Misganaw, A.; Moradi-Lakeh, Maziar; Morgan, K.; Ng, Maryanne; Pain, Arnab; Quame-Amaglo, J.; Rao, P.; Reitsma, M. B.; Shackelford, K. A.; Sur, P. J.; Wagner, J. A.; Vos, Theo; Lopez, A. D.; Murray, C. J.L.; Ellenbogen, R. G.; Mock, C. N.; Quistberg, D. A.; Anderson, B. O.; Blosser, C. D.; Futran, N. D.; Heckbert, S. R.; Jensen, P. N.; Montine, T. J.; Tirschwell, D. L.; Watkins, D. A.; Bhutta, Z A; Nisar, M. I.; Akseer, N.; Alam, N. K.M.; Knibbs, L. D.; Lalloo, Ratilal; Gouda, H. N.; McGrath, John; Jeemon, P.; Dandona, R.; Kumar, G. A.; Gething, Peter W.; Cooper, C; Darby, S. C.; Deribew, A.; ALI, MUHAMMAD REDZWAN S. RASHID; Bennett, D. A.; JHA, Vivekanand; Rahimi, K.; Kinfu, Y.; Faghmous, I. D.A.; Langan, S. M.; McKee, M.; Murthy, G. V.S.; Pearce, Neil; Roberts, B.; Campos-Nonato, I. R.; Campuzano, J. C.; Gomez-Dantes, H.; Heredia-Pi, I. B.; Mejia-Rodriguez, F.; Montañez Hernandez, J. C.; Montero, P.; Rios Blancas, M. J.; Servan-Mori, E. E.; Villalpando, S.; Duan, L.; Liu, Shanlin; Wang, L; Ye, P.; Liang, X.; Yu, S.; Mensah, G. A.; Salomon, J. A.; Thorne-Lyman, A. L.; Ajala, O. N.; Bärnighausen, T.; Ding, E. L.; Farvid, M. S.; Wagner, G. R.; James, P.; Osman, M.; Shrime, M. G.; Fitchett, J. R.A.; Knudsen, A. K.; Ellingsen, C. L.; Krog, N. H.; Savic, Maja; Hailu, A. D.; Norheim, O. F.; Abate, K. H.; Gebrehiwot, T. T.; Gebremedhin, A. T.; Abbafati, C.; Abbas, K. M.; Abd-Allah, F.; Abera, S. F.; Melaku, Y. A.; Tesfay, F. H.; Abyu, G. Y.; Aregay, A. F.; Betsu, B. D.; Gebru, A. A.; Hailu, G. B.; Yalew, A. Z.; Yebyo, H. G.; Abreu, D. M.X.; Franca, E. B.; Abu-Raddad, L. J.; Adelekan, A. L.; Akinyemi, R. O.; Ojelabi, F. A.; Ademi, Z.; Fürst, T.; Azzopardi, Peter; Cowie, B. C.; Gibney, K. B.; MacLachlan, J. H.; Meretoja, A.; Alam, K.; Borschmann, Rohan; Colquhoun, S. M.; Patton, G. C.; Weintraub, R. G.; Szoeke, C. E.I.; Vijayakumar, Lakshmi; Bohensky, M. A.; Taylor, H. R.; Wijeratne, T.; Adou, A. K.; Adsuar, J. C.; Afanvi, K. A.; Agardh, E. E.; Rehm, Jurgen; Badawi, A.; Lindsay, M. P.; Popova, Svetlana; Agarwal, A.; Agrawal, A.; Hotez, P. J.; Ahmad, A.; Norrving, B.; Akanda, A. S.; Akinyemiju, T. F.; Schwebel, D. C.; Singh, J. A.; Al Lami, F. H.; Alabed, S.; Al-Aly, Z.; Driscoll, T. R.; Kemp, A. H.; Leigh, James; Mekonnen, A. B.; Alasfoor, D.; Aldhahri, S. F.; Altirkawi, K. A.; Terkawi, A. S.; Aldridge, R. W.; Banerjee, A; Tillmann, T.; Alegretti, M. A.; Aleman, A. V.; Cavalleri, F.; Colistro, V.; Alemu, Z. A.; Alhabib, S.; Alkerwi, A.; Alla, F.; Allebeck, P.; Carrero, J. J.; Carapetis, J. R.; GBD 2015 Mortality and Causes of Death Collaborators.

In: Lancet, Vol. 388, No. 10053, 08.10.2016, p. 1459-1544.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015

T2 - a systematic analysis for the Global Burden of Disease Study 2015

AU - Wang, H.

AU - Naghavi, Mahsen

AU - Allen, Craig

AU - Barber, R. M.

AU - Carter, A.

AU - Casey, D. C.

AU - Charlson, F. J.

AU - Chen, A. Z.

AU - Coates, Michael

AU - Coggeshall, M.

AU - Dandona, L.

AU - Dicker, D. J.

AU - Erskine, H. E.

AU - Ferrari, A. J.

AU - Fitzmaurice, C.

AU - Foreman, Kyle

AU - Forouzanfar, Mohammad H.

AU - Fraser, M. S.

AU - Fullman, N.

AU - Goldberg, E. M.

AU - Graetz, N.

AU - Haagsma, J. A.

AU - Hay, Simon I.

AU - Huynh, C.

AU - Johnson, C. O.

AU - Kassebaum, N. J.

AU - Kulikoff, X. R.

AU - Kutz, M. J.

AU - Kyu, H. H.

AU - Larson, H. J.

AU - Leung, J.

AU - Lim, S

AU - Lind, Marcus

AU - Lozano, Rafael

AU - Marquez, N.

AU - Mikesell, J.

AU - Mokdad, Ali H.

AU - Mooney, M. D.

AU - Nguyen, G.

AU - Nsoesie, E.

AU - Pigott, David M

AU - Pinho, C.

AU - Roth, G. A.

AU - Sandar, L.

AU - Silpakit, N.

AU - Sligar, A.

AU - Sorensen, R. J.D.

AU - Stanaway, J.

AU - Steiner, C

AU - Teeple, S.

AU - Thomas, Mark A B

AU - Troeger, C.

AU - VanderZanden, A.

AU - Vollset, S. E.

AU - Wanga, V.

AU - Whiteford, H. A.

AU - Wolock, T.

AU - Zoeckler, L.

AU - Achoki, T.

AU - Afshin, A.

AU - Alexander, L. T.

AU - Anderson, G. M.

AU - Bell, B.

AU - Biryukov, S.

AU - Blore, J. D.

AU - Brown, A.

AU - Brown, J.

AU - Cercy, K.

AU - Chew, A.

AU - Cohen, A. J.

AU - Daoud, F.

AU - Dossou, E.

AU - Estep, K.

AU - Flaxman, Abraham

AU - Friedman, J.

AU - Frostad, J.

AU - Godwin, W. W.

AU - Hancock, J.

AU - Kemmer, L.

AU - Khalil, I. A.

AU - Liu, P. Y.

AU - Masiye, F.

AU - Millear, A.

AU - Mirarefin, M.

AU - Misganaw, A.

AU - Moradi-Lakeh, Maziar

AU - Morgan, K.

AU - Ng, Maryanne

AU - Pain, Arnab

AU - Quame-Amaglo, J.

AU - Rao, P.

AU - Reitsma, M. B.

AU - Shackelford, K. A.

AU - Sur, P. J.

AU - Wagner, J. A.

AU - Vos, Theo

AU - Lopez, A. D.

AU - Murray, C. J.L.

AU - Ellenbogen, R. G.

AU - Mock, C. N.

AU - Quistberg, D. A.

AU - Anderson, B. O.

AU - Blosser, C. D.

AU - Futran, N. D.

AU - Heckbert, S. R.

AU - Jensen, P. N.

AU - Montine, T. J.

AU - Tirschwell, D. L.

AU - Watkins, D. A.

AU - Bhutta, Z A

AU - Nisar, M. I.

AU - Akseer, N.

AU - Alam, N. K.M.

AU - Knibbs, L. D.

AU - Lalloo, Ratilal

AU - Gouda, H. N.

AU - McGrath, John

AU - Jeemon, P.

AU - Dandona, R.

AU - Kumar, G. A.

AU - Gething, Peter W.

AU - Cooper, C

AU - Darby, S. C.

AU - Deribew, A.

AU - ALI, MUHAMMAD REDZWAN S. RASHID

AU - Bennett, D. A.

AU - JHA, Vivekanand

AU - Rahimi, K.

AU - Kinfu, Y.

AU - Faghmous, I. D.A.

AU - Langan, S. M.

AU - McKee, M.

AU - Murthy, G. V.S.

AU - Pearce, Neil

AU - Roberts, B.

AU - Campos-Nonato, I. R.

AU - Campuzano, J. C.

AU - Gomez-Dantes, H.

AU - Heredia-Pi, I. B.

AU - Mejia-Rodriguez, F.

AU - Montañez Hernandez, J. C.

AU - Montero, P.

AU - Rios Blancas, M. J.

AU - Servan-Mori, E. E.

AU - Villalpando, S.

AU - Duan, L.

AU - Liu, Shanlin

AU - Wang, L

AU - Ye, P.

AU - Liang, X.

AU - Yu, S.

AU - Mensah, G. A.

AU - Salomon, J. A.

AU - Thorne-Lyman, A. L.

AU - Ajala, O. N.

AU - Bärnighausen, T.

AU - Ding, E. L.

AU - Farvid, M. S.

AU - Wagner, G. R.

AU - James, P.

AU - Osman, M.

AU - Shrime, M. G.

AU - Fitchett, J. R.A.

AU - Knudsen, A. K.

AU - Ellingsen, C. L.

AU - Krog, N. H.

AU - Savic, Maja

AU - Hailu, A. D.

AU - Norheim, O. F.

AU - Abate, K. H.

AU - Gebrehiwot, T. T.

AU - Gebremedhin, A. T.

AU - Abbafati, C.

AU - Abbas, K. M.

AU - Abd-Allah, F.

AU - Abera, S. F.

AU - Melaku, Y. A.

AU - Tesfay, F. H.

AU - Abyu, G. Y.

AU - Aregay, A. F.

AU - Betsu, B. D.

AU - Gebru, A. A.

AU - Hailu, G. B.

AU - Yalew, A. Z.

AU - Yebyo, H. G.

AU - Abreu, D. M.X.

AU - Franca, E. B.

AU - Abu-Raddad, L. J.

AU - Adelekan, A. L.

AU - Akinyemi, R. O.

AU - Ojelabi, F. A.

AU - Ademi, Z.

AU - Fürst, T.

AU - Azzopardi, Peter

AU - Cowie, B. C.

AU - Gibney, K. B.

AU - MacLachlan, J. H.

AU - Meretoja, A.

AU - Alam, K.

AU - Borschmann, Rohan

AU - Colquhoun, S. M.

AU - Patton, G. C.

AU - Weintraub, R. G.

AU - Szoeke, C. E.I.

AU - Vijayakumar, Lakshmi

AU - Bohensky, M. A.

AU - Taylor, H. R.

AU - Wijeratne, T.

AU - Adou, A. K.

AU - Adsuar, J. C.

AU - Afanvi, K. A.

AU - Agardh, E. E.

AU - Rehm, Jurgen

AU - Badawi, A.

AU - Lindsay, M. P.

AU - Popova, Svetlana

AU - Agarwal, A.

AU - Agrawal, A.

AU - Hotez, P. J.

AU - Ahmad, A.

AU - Norrving, B.

AU - Akanda, A. S.

AU - Akinyemiju, T. F.

AU - Schwebel, D. C.

AU - Singh, J. A.

AU - Al Lami, F. H.

AU - Alabed, S.

AU - Al-Aly, Z.

AU - Driscoll, T. R.

AU - Kemp, A. H.

AU - Leigh, James

AU - Mekonnen, A. B.

AU - Alasfoor, D.

AU - Aldhahri, S. F.

AU - Altirkawi, K. A.

AU - Terkawi, A. S.

AU - Aldridge, R. W.

AU - Banerjee, A

AU - Tillmann, T.

AU - Alegretti, M. A.

AU - Aleman, A. V.

AU - Cavalleri, F.

AU - Colistro, V.

AU - Alemu, Z. A.

AU - Alhabib, S.

AU - Alkerwi, A.

AU - Alla, F.

AU - Allebeck, P.

AU - Carrero, J. J.

AU - Carapetis, J. R.

AU - GBD 2015 Mortality and Causes of Death Collaborators

PY - 2016/10/8

Y1 - 2016/10/8

N2 - Background: Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods: We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography–year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings: Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4–61·9) in 1980 to 71·8 years (71·5–72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7–17·4), to 62·6 years (56·5–70·2). Total deaths increased by 4·1% (2·6–5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8–18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6–16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9–14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1–44·6), malaria (43·1%, 34·7–51·8), neonatal preterm birth complications (29·8%, 24·8–34·9), and maternal disorders (29·1%, 19·3–37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000–183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000–532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation: At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Funding Bill & Melinda Gates Foundation.

AB - Background: Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods: We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography–year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings: Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4–61·9) in 1980 to 71·8 years (71·5–72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7–17·4), to 62·6 years (56·5–70·2). Total deaths increased by 4·1% (2·6–5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8–18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6–16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9–14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1–44·6), malaria (43·1%, 34·7–51·8), neonatal preterm birth complications (29·8%, 24·8–34·9), and maternal disorders (29·1%, 19·3–37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000–183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000–532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation: At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Funding Bill & Melinda Gates Foundation.

UR - http://www.scopus.com/inward/record.url?scp=84994158650&partnerID=8YFLogxK

U2 - 10.1016/S0140-6736(16)31012-1

DO - 10.1016/S0140-6736(16)31012-1

M3 - Article

VL - 388

SP - 1459

EP - 1544

JO - Lancet

JF - Lancet

SN - 0140-6736

IS - 10053

ER -