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Showing content from https://pubmed.ncbi.nlm.nih.gov/25530442/ below:

Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

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• PMID: 25530442
• PMCID: PMC4340604
• DOI: 10.1016/S0140-6736(14)61682-2

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GBD 2013 Mortality and Causes of Death Collaborators. Lancet. 2015.

• PMID: 25530442
• PMCID: PMC4340604
• DOI: 10.1016/S0140-6736(14)61682-2

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Background: Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries.

Methods: We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions.

Findings: Global life expectancy for both sexes increased from 65.3 years (UI 65.0-65.6) in 1990, to 71.5 years (UI 71.0-71.9) in 2013, while the number of deaths increased from 47.5 million (UI 46.8-48.2) to 54.9 million (UI 53.6-56.3) over the same interval. Global progress masked variation by age and sex: for children, average absolute differences between countries decreased but relative differences increased. For women aged 25-39 years and older than 75 years and for men aged 20-49 years and 65 years and older, both absolute and relative differences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10.7%, from 4.3 million deaths in 1990 to 4.8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100,000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions.

Interpretation: For most countries, the general pattern of reductions in age-sex specific mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.

Funding: Bill & Melinda Gates Foundation.

Copyright © 2015 Elsevier Ltd. All rights reserved.

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ICD=International Classification of Diseases. BTL=basic tabulation…

ICD=International Classification of Diseases. BTL=basic tabulation list. MI ratio=mortality:incidence ratio. CODEm=Cause of Death Ensemble model. YLLs=years of life lost. EPP=UNAIDS Estimates and Projects Package.

ATG=Antigua and Barbuda.…

ATG=Antigua and Barbuda. VCT=Saint Vincent and the Grenadines. LCA=Saint Lucia. TTO=Trinidad and Tobago. TLS=Timor-Leste. FSM=Federated States of Micronesia.

Solid points show age groups for which the mean absolute difference between countries has increased and hollow points show those for which mean absolute difference has decreased.

An interactive figure with these data is available at http://vizhub.healthdata.org/le . Changes in life expectancy as a result of specific causes were decomposed from the difference between all-cause lifetables and cause-deleted lifetables (mortality set to zero for a specific cause). Because all changes in life expectancy are based on cross-sectional lifetables, the cause-specific changes add up to the total change in life-expectancy. NTDs=neglected tropical diseases.

(A) Of children…

(A) Of children younger than age 1 month per person-year of exposure. (B) Of children aged 1–59 months per person-year of exposure. The set of causes is mutually exclusive and collectively exhaustive. SIDS=sudden infant death syndrome.

An interactive version of this figure is available at http://vizhub.healthdata.org/gbd-compare/ . COPD=chronic obstructive pulmonary disease.

COPD=chronic obstructive pulmonary disease.

The…

The top 15 global causes of years of life lost are coloured. VCT=Saint Vincent and the Grenadines. TTO=Trinidad and Tobago. FSM=Federated States of Micronesia. PNG=Papua New Guinea. UAE=United Arab Emirates. CAR=Central African Republic. STP=São Tomé and Princípe. IHD=ischaemic heart disease. LRI=lower respiratory infections. Road inj=road injuries. NN Preterm=preterm birth complications. NN enceph=neonatal encephalitis. Congenital=congenital disorders. C=cancer. COPD=chronic obstructive pulmonary disease. CKD=chronic kidney disease. CMP=cardiomyopathies. Other cardio=other cardiovascular disease. Drugs=drug use disorders. Alcohol=alcohol use disorders. Violence=interpersonal violence. HTN HD=hypertensive heart disease. F body asp=pulmonary aspiration and foreign body in airway. NN sepsis=neonatal sepsis. PEM=protein–energy malnutrition. TB=tuberculosis. Vis leish=visceral leishmaniasis. Other mech=other mechanical forces. Endocrine=endocrine, metabolic, blood, and immune disorders. Maternal=maternal disorders. Sickle=sickle cell disorders.

The…

The top 15 global causes of years of life lost are coloured. VCT=Saint Vincent and the Grenadines. TTO=Trinidad and Tobago. FSM=Federated States of Micronesia. PNG=Papua New Guinea. UAE=United Arab Emirates. CAR=Central African Republic. STP=São Tomé and Princípe. IHD=ischaemic heart disease. LRI=lower respiratory infections. Road inj=road injuries. NN Preterm=preterm birth complications. NN enceph=neonatal encephalitis. Congenital=congenital disorders. C=cancer. COPD=chronic obstructive pulmonary disease. CKD=chronic kidney disease. CMP=cardiomyopathies. Other cardio=other cardiovascular disease. Drugs=drug use disorders. Alcohol=alcohol use disorders. Violence=interpersonal violence. HTN HD=hypertensive heart disease. F body asp=pulmonary aspiration and foreign body in airway. NN sepsis=neonatal sepsis. PEM=protein–energy malnutrition. TB=tuberculosis. Vis leish=visceral leishmaniasis. Other mech=other mechanical forces. Endocrine=endocrine, metabolic, blood, and immune disorders. Maternal=maternal disorders. Sickle=sickle cell disorders.

The…

The top 15 global causes of years of life lost are coloured. VCT=Saint Vincent and the Grenadines. TTO=Trinidad and Tobago. FSM=Federated States of Micronesia. PNG=Papua New Guinea. UAE=United Arab Emirates. CAR=Central African Republic. STP=São Tomé and Princípe. IHD=ischaemic heart disease. LRI=lower respiratory infections. Road inj=road injuries. NN Preterm=preterm birth complications. NN enceph=neonatal encephalitis. Congenital=congenital disorders. C=cancer. COPD=chronic obstructive pulmonary disease. CKD=chronic kidney disease. CMP=cardiomyopathies. Other cardio=other cardiovascular disease. Drugs=drug use disorders. Alcohol=alcohol use disorders. Violence=interpersonal violence. HTN HD=hypertensive heart disease. F body asp=pulmonary aspiration and foreign body in airway. NN sepsis=neonatal sepsis. PEM=protein–energy malnutrition. TB=tuberculosis. Vis leish=visceral leishmaniasis. Other mech=other mechanical forces. Endocrine=endocrine, metabolic, blood, and immune disorders. Maternal=maternal disorders. Sickle=sickle cell disorders.

The…

The top 15 global causes of years of life lost are coloured. VCT=Saint Vincent and the Grenadines. TTO=Trinidad and Tobago. FSM=Federated States of Micronesia. PNG=Papua New Guinea. UAE=United Arab Emirates. CAR=Central African Republic. STP=São Tomé and Princípe. IHD=ischaemic heart disease. LRI=lower respiratory infections. Road inj=road injuries. NN Preterm=preterm birth complications. NN enceph=neonatal encephalitis. Congenital=congenital disorders. C=cancer. COPD=chronic obstructive pulmonary disease. CKD=chronic kidney disease. CMP=cardiomyopathies. Other cardio=other cardiovascular disease. Drugs=drug use disorders. Alcohol=alcohol use disorders. Violence=interpersonal violence. HTN HD=hypertensive heart disease. F body asp=pulmonary aspiration and foreign body in airway. NN sepsis=neonatal sepsis. PEM=protein–energy malnutrition. TB=tuberculosis. Vis leish=visceral leishmaniasis. Other mech=other mechanical forces. Endocrine=endocrine, metabolic, blood, and immune disorders. Maternal=maternal disorders. Sickle=sickle cell disorders.

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