Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016
Carregando...
Citações na Scopus
562
Tipo de produção
article
Data de publicação
2017
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE INC
Autores
WANG, Haidong
ABAJOBIR, Amanuel Alemu
ABATE, Kalkidan Hassen
ABBAFATI, Cristiana
ABBAS, Kaja M.
ABD-ALLAH, Foad
ABERA, Semaw Ferede
ABRAHA, Haftom Niguse
ABU-RADDAD, Laith J.
ABU-RMEILEH, Niveen M. E.
Citação
LANCET, v.390, n.10100, p.1084-1150, 2017
Resumo
Background Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. Methods We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0.5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Sociodemographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. Findings Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86.9 years (95% UI 86.7-87.2), and for men in Singapore, at 81.3 years (78.8-83.7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, and the gap between male and female life expectancy increased with progression to higher levels of SDI. Some countries with exceptional health performance in 1990 in terms of the difference in observed to expected life expectancy at birth had slower progress on the same measure in 2016. Interpretation Globally, mortality rates have decreased across all age groups over the past five decades, with the largest improvements occurring among children younger than 5 years. However, at the national level, considerable heterogeneity remains in terms of both level and rate of changes in age-specific mortality; increases in mortality for certain age groups occurred in some locations. We found evidence that the absolute gap between countries in age-specific death rates has declined, although the relative gap for some age-sex groups increased. Countries that now lead in terms of having higher observed life expectancy than that expected on the basis of development alone, or locations that have either increased this advantage or rapidly decreased the deficit from expected levels, could provide insight into the means to accelerate progress in nations where progress has stalled.
Palavras-chave
Referências
- Afshin A, 2017, NEW ENGL J MED, V377, P13, DOI 10.1056/NEJMoa1614362
- Asian Development Bank, 2012, WORLD SUST DEV TIM
- Balabanova D, 2013, LANCET, V381, P2118, DOI 10.1016/S0140-6736(12)62000-5
- Bhatt S, 2015, NATURE, V526, P207, DOI 10.1038/nature15535
- Bhutta ZA, 2008, LANCET, V371, P417, DOI 10.1016/S0140-6736(07)61693-6
- Blencowe H, 2016, LANCET GLOB HEALTH, V4, pE98, DOI 10.1016/S2214-109X(15)00275-2
- Bollinger L, INNOVATIONS EXPAND A
- Bor J, 2013, SCIENCE, V339, P961, DOI 10.1126/science.1230413
- Cesario SK, 2017, JOGNN-J OBST GYN NEO, V46, pE65, DOI 10.1016/j.jogn.2016.08.014
- Cochrane SH, 1979, FERTILITY ED WHAT DO
- Corroon M, 2014, MATERN CHILD HLTH J, V18, P307, DOI 10.1007/s10995-013-1266-1
- Couser WG, 2011, KIDNEY INT, V80, P1258, DOI 10.1038/ki.2011.368
- Davis S, 2013, BMC PUBLIC HEALTH, V13, DOI 10.1186/1471-2458-13-S3-S21
- Department of Peace and Conflict Research, UPPS CONFL DAT PROGR
- Di Angelantonio E, 2016, LANCET, V388, P776, DOI 10.1016/S0140-6736(16)30175-1
- Dieleman JL, 2016, LANCET, V387, P2536, DOI 10.1016/S0140-6736(16)30168-4
- Dodds F., 2014, EARTH SUMMIT 2002 NE
- Duflo E, 2015, AM ECON REV, V105, P2757, DOI 10.1257/aer.20121607
- Danto Arthur C., 1984, MALARIA J, V58, P5
- ESREY SA, 1986, EPIDEMIOL REV, V8, P117
- Fewtrell L, 2005, LANCET INFECT DIS, V5, P42, DOI 10.1016/S1473-3099(04)01253-8
- Flegal KM, 2013, JAMA-J AM MED ASSOC, V309, P71, DOI 10.1001/jama.2012.113905
- Fuchs R, 2010, VIENNA YEARB POPUL R, V8, P175, DOI 10.1553/POPULATIONYEARBOOK2010S175
- Gakidou E, 2006, DEMOGRAPHY, V43, P569, DOI 10.1353/dem.2006.0024
- Gakidou E, 2010, LANCET, V376, P959, DOI 10.1016/S0140-6736(10)61257-3
- Gates MF, 2014, SCIENCE, V345, P1273, DOI 10.1126/science.1258882
- GBD, 2015, LANCET HIV
- GBD, 2015, LANCET, V388, P1725, DOI 10.1016/S0140-6736(16)31575-6
- GBD, 2015, LANCET, V390, P231, DOI 10.1016/S0140-6736(1017)30818-30818
- GBD, 2015, LANCET, V388, P1659
- GBD, 2015, LANCET, V389, P1885
- Ghobarah HA, 2004, SOC SCI MED, V59, P869, DOI 10.1016/j.socscimed.2003.11.043
- Gomez-Dantes H, 2016, LANCET, V388, P2386, DOI 10.1016/S0140-6736(16)31773-1
- Granich R, 2015, PLOS ONE, V10, DOI 10.1371/journal.pone.0131353
- Gregg EW, 2014, NEW ENGL J MED, V370, P1514, DOI 10.1056/NEJMoa1310799
- Guha-Sapir D, CRED OFDA INT DISAST
- Haakenstad A, 2016, HEALTH AFFAIR, V35, P242, DOI 10.1377/hlthaff.2015.1080
- Halstead SB, 1985, GOOD HLTH LOW COST
- Helleringer S, 2014, DEMOGRAPHY, V51, P387, DOI 10.1007/s13524-013-0268-3
- Hill K, 2013, ADOLESCENT MORTALITY
- Hill K, 2009, DEMOGR RES, V21, P235, DOI 10.4054/DemRes.2009.21.9
- The International Institute for Strategic Studies, ARM CONFL DAT
- Jacobson M A, 1998, AIDS, V12 Suppl A, pS157
- Jakovljevic Mihajlo B, 2015, Front Public Health, V3, P65, DOI 10.3389/fpubh.2015.00065
- Jamison DT, 2013, LANCET, V382, P1898, DOI 10.1016/S0140-6736(13)62105-4
- Kaplan Jonathan E., 2009, Morbidity and Mortality Weekly Report, V58, P1
- Kassebaum N, 2017, JAMA PEDIATR, V171, P573, DOI 10.1001/jamapediatrics.2017.0250
- Lawn JE, 2008, PAEDIATR PERINAT EP, V22, P410, DOI 10.1111/j.1365-3016.2008.00960.x
- Leon DA, 1997, LANCET, V350, P383, DOI 10.1016/S0140-6736(97)03360-6
- Lim SS, 2011, PLOS MED, V8, DOI 10.1371/journal.pmed.1001091
- Lopez AD, 2015, BMC MED, V13, DOI 10.1186/s12916-015-0333-4
- Masquelier B, 2017, AIDS, V31, pS77, DOI 10.1097/QAD.0000000000001332
- Masquelier B, 2013, DEMOGRAPHY, V50, P207, DOI 10.1007/s13524-012-0149-1
- McCrary J, 2011, AM ECON REV, V101, P158, DOI 10.1257/aer.101.1.158
- Mikkelsen L, 2015, LANCET, V386, P1395, DOI 10.1016/S0140-6736(15)60171-4
- Murray CJL, 2014, LANCET, V384, P1005, DOI 10.1016/S0140-6736(14)60844-8
- Murray CJL, 2010, PLOS MED, V7, DOI 10.1371/journal.pmed.1000262
- Murray CJL, 2003, POP STUD-J DEMOG, V57, P165, DOI 10.1080/0032472032000097083
- Murray CJL, 2002, BRIT MED J, V324, P346, DOI 10.1136/bmj.324.7333.346
- Nolte E, 2004, DOES HLTH CARE SAVE
- Nolte E, 2004, J EPIDEMIOL COMMUN H, V58, P326
- Nolte E, 2008, HEALTH AFFAIR, V27, P58, DOI 10.1377/hlthaff.27.1.58
- Nolte E, 2012, HEALTH AFFAIR, V31, P2114, DOI 10.1377/hlthaff.2011.0851
- Nolte E, 2011, HEALTH POLICY, V103, P47, DOI 10.1016/j.healthpol.2011.08.002
- Norheim O., 2013, ESTIMATED IMPACT LIF
- O'Hare B, 2013, J ROY SOC MED, V106, P408, DOI 10.1177/0141076813489680
- Obermeyer Z, 2010, PLOS MED, V7, DOI 10.1371/journal.pmed.1000260
- Patton GC, 2016, LANCET, V387, P2423, DOI 10.1016/S0140-6736(16)00579-1
- PRESTON SH, 1975, POP STUD-J DEMOG, V29, P231, DOI 10.2307/2173509
- Rehm J, 2016, SUBST ABUSE TREAT PR, V11, DOI 10.1186/s13011-016-0081-2
- Shkolnikov VM, 2013, DEMOGR RES, V28, P917, DOI 10.4054/DemRes.2013.28.32
- Stevens GA, 2016, LANCET, V388, pE19, DOI 10.1016/S0140-6736(16)30388-9
- Thomas B, 2015, J AM SOC NEPHROL, V26, P2621, DOI 10.1681/ASN.2014101017
- Tonelli M, 2006, J AM SOC NEPHROL
- United Nations, 1995, REP WORLD SUMM SOC D
- United Nations. Department of International Economic and Social Affairs, 1982, POPUL B UN, V14, P54
- United Nations, 2000, UN MILL DECL
- UN Development Programme, 2016, HUM DEV REP 2015
- United Nations Children's Fund, 1990, POPUL DEV REV, V16, P798
- UN Population Division, 2015, EST LIF TABL DEV COU
- UN Population Division, WORLD POP PROSP 2015
- UN Population Division, 2002, METH EST AD MORT
- UNAIDS, 2016, QUICK START GUID SPE
- UNDP, UN SUST DEV GOALS
- UNICEF WHO World Bank and UN DESA/Population Division, 2015, LEV TRENDS CHILD MOR
- US Census Bureau, INT PROGR INT DAT BA
- Victora C, 2013, SELECTED ANAL INEQUA
- Wang H, 2012, LANCET
- Wang HD, 2016, LANCET, V388, P1459, DOI 10.1016/S0140-6736(16)31012-1
- WHO, 2016, WHO METH DAT SOURC L
- World Health Organization, 2016, WORLD HLTH STAT 2016
- WHO, 2017, WHO METH DAT SOURC G
- WHO, 1946, CONST WHO
- WHO, 2008, COMM SOC DET HLTH FI
- World Health Organization (WHO), 2005, INT HLTH REG
- Xu J, 2016, MORTALITY US
- You DZ, 2015, LANCET, V386, P2275, DOI 10.1016/S0140-6736(15)00120-8
- Zatu MC, 2016, EUR J PREV CARDIOL, V23, P308, DOI 10.1177/2047487314563447
- Zolopa AR, 2009, PLOS ONE, V4, DOI 10.1371/journal.pone.0005575
- [Anonymous], STRAUSS CTR INT SECU
- [Anonymous], 2015, P NATL ACAD SCI USA, V112, P15078
Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - HU
Artigos e Materiais de Revistas Científicas - LIM/20
Artigos e Materiais de Revistas Científicas - LIM/23
Artigos e Materiais de Revistas Científicas - LIM/51
Carregar mais Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - HU
Artigos e Materiais de Revistas Científicas - LIM/20
Artigos e Materiais de Revistas Científicas - LIM/23
Artigos e Materiais de Revistas Científicas - LIM/51