Searched for: school:SOM
Department/Unit:Population Health
Association between exposure to sexually explicit content in the electronic media and sexual intentions of in-school adolescents in Southwest Nigeria
Adeolu, Josephine; Owoaje, Eme; Olumide, Adesola
BACKGROUND:Many adolescents are exposed to a significant amount of sexual content in the media. This has far-reaching effects on their sexual practices as this exposure is occurring at a period when most adolescents are often not sure of the choices to make, and the choices they make during adolescence affect their health when they become adults. The aim of this study was to assess the association between exposure of in-school adolescents to sexual content in the electronic media and their sexual intentions. METHODS:In this cross-sectional study, information was obtained from 750 senior secondary school students in private and public schools using interviewer-administered questionnaire. Sexual media content in the movies, music video and Internet was assessed using a modified version of the sexual media diet tool. The dependent variable was sexual intention; the main independent variable was exposure to sexually explicit content in the media and confounders that were controlled for selected individual (age, sex, religiosity, self-esteem and attachment to parents), family (parents' marital status, parents' type of marriage, hands-on parenting and parent-adolescent communication on sex) and environmental factors (school connectedness and influence from peers) which were previously reported to be associated with sexual intentions of adolescents. Chi-square test was used to determine associations between sexual content of the electronic media and adolescents' sexual intentions, and confounders were controlled for using logistic regression analysis. RESULTS:Thirty-six percent of respondents were exposed to overtly explicit sexual content from all forms of media in the 3 months prior to this study. Twenty-four percent of the adolescents indicated their intention to have sex within 12 months following the study. Predictors of sexual intention were as follows: moderate [odds ratio, OR=2.21 (95% confidence interval, CI: 1.22-3.99)] and high exposure to sexual content in the media [OR=3.02 (95% CI: 1.69-5.43]; attending a public school [OR=2.19 (95% CI: 1.26-3.83)]; moderate peer pressure [OR=2.36 (95% CI: 1.41-3.95)] and high peer pressure [OR=10.32 (95% CI: 2.94-36.31)]; and previous history of sexual intercourse [OR=3.89 (95% CI: 2.25-6.76)]. CONCLUSION/CONCLUSIONS:Many adolescents were exposed to sexually explicit content in the media and this had a strong association with sexual intention. Interventions to censor sexually explicit content in the media are required to protect adolescents from the consequences of early exposure to sex.
PMID: 27740921
ISSN: 2191-0278
CID: 4306122
Using photovoice in adolescent health research: a case-study of the Well-being of Adolescents in Vulnerable Environments (WAVE) Study in Ibadan, Nigeria
Olumide, Adesola O; Adebayo, Emmanuel S; Ojengbede, Oladosu A
Photovoice is a participatory action research method in which people are given cameras and asked to take pictures of specific issues within their community. It is often used among marginalised populations. This method helps people capture specific issues within their community using photographs, critically discuss these issues within a group and present their findings to inform policies within their community. Photovoice has been used in developed countries and among adult participants; however, the extent to which it has been used in developing countries and among adolescent participants is yet to be extensively reported. In this paper, we describe the use of photovoice among male and female adolescents aged 15-19 years who participated in the qualitative phase (phase I) of the Well-being of Adolescents in Vulnerable Environments (WAVE) study in Ibadan, Nigeria. The main study was conducted among adolescents residing in disadvantaged communities within five global cities (Baltimore, USA; Ibadan, Nigeria; Johannesburg, South Africa; New Delhi, India and Shanghai, China). Our findings revealed that adolescents in Ibadan were very eager to participate, remained fully engaged throughout the process and the data obtained were rich and detailed. Some challenges encountered with using this method were that younger adolescents had a tendency to attain saturation when taking pictures much earlier than older adolescents; however, they equally discussed the pictures taken enthusiastically. Overall, our findings affirm that photovoice as a data collection method can be successfully used in research among adolescents in developing countries like Nigeria.
PMID: 27740918
ISSN: 2191-0278
CID: 4306112
Neighborhood perceptions and hypertension among low-income black women: a qualitative study
Al-Bayan, Maliyhah; Islam, Nadia; Edwards, Shawneaqua; Duncan, Dustin T
BACKGROUND: The majority of studies examining the role of neighborhoods and hypertension-related outcomes have been quantitative in nature and very few studies have examined specific disadvantaged populations, including low-income housing residents. The objective of this study was to use qualitative interviews to explore low-income Black women's perceptions of their neighborhoods and to understand how those perceptions may affect their health, especially as it relates to blood pressure. METHODS: Seventeen Black female participants, living in public housing communities in New York City, completed one semi-structured, audiotaped interview in July of 2014. All interviews were transcribed, coded, and analyzed for emerging themes using N'Vivo 10 software. RESULTS: Three major themes emerged: (1) social connectedness, (2) stress factors, and (3) availability of food options. For example, factors that caused stress varied throughout the study population. Sources of stress included family members, employment, and uncleanliness within the neighborhood. Many participants attributed their stress to personal issues, such as lack of employment and relationships. In addition, the general consensus among many participants was that there should be a greater density of healthy food options in their neighborhoods. Some believed that the pricing of fresh foods in the neighborhoods should better reflect the financial status of the residents in the community. CONCLUSIONS: Various neighborhood influences, including neighborhood disorder and lack of healthy food options, are factors that appear to increase Black women's risk of developing high blood pressure. Implications of this research include the need to develop interventions that promote good neighborhood infrastructure (e.g. healthy food stores to encourage good nutrition habits and well-lit walking paths to encourage daily exercise), in addition to interventions that increase hypertension awareness in low-income neighborhoods.
PMCID:5062878
PMID: 27733142
ISSN: 1471-2458
CID: 2278432
Three new pancreatic cancer susceptibility signals identified on chromosomes 1q32.1, 5p15.33 and 8q24.21
Zhang, Mingfeng; Wang, Zhaoming; Obazee, Ofure; Jia, Jinping; Childs, Erica J; Hoskins, Jason; Figlioli, Gisella; Mocci, Evelina; Collins, Irene; Chung, Charles C; Hautman, Christopher; Arslan, Alan A; Beane-Freeman, Laura; Bracci, Paige M; Buring, Julie; Duell, Eric J; Gallinger, Steven; Giles, Graham G; Goodman, Gary E; Goodman, Phyllis J; Kamineni, Aruna; Kolonel, Laurence N; Kulke, Matthew H; Malats, Nuria; Olson, Sara H; Sesso, Howard D; Visvanathan, Kala; White, Emily; Zheng, Wei; Abnet, Christian C; Albanes, Demetrius; Andreotti, Gabriella; Brais, Lauren; Bueno-de-Mesquita, H Bas; Basso, Daniela; Berndt, Sonja I; Boutron-Ruault, Marie-Christine; Bijlsma, Maarten F; Brenner, Hermann; Burdette, Laurie; Campa, Daniele; Caporaso, Neil E; Capurso, Gabriele; Cavestro, Giulia Martina; Cotterchio, Michelle; Costello, Eithne; Elena, Joanne; Boggi, Ugo; Gaziano, J Michael; Gazouli, Maria; Giovannucci, Edward L; Goggins, Michael; Gross, Myron; Haiman, Christopher A; Hassan, Manal; Helzlsouer, Kathy J; Hu, Nan; Hunter, David J; Iskierka-Jazdzewska, Elzbieta; Jenab, Mazda; Kaaks, Rudolf; Key, Timothy J; Khaw, Kay-Tee; Klein, Eric A; Kogevinas, Manolis; Krogh, Vittorio; Kupcinskas, Juozas; Kurtz, Robert C; Landi, Maria T; Landi, Stefano; Le Marchand, Loic; Mambrini, Andrea; Mannisto, Satu; Milne, Roger L; Neale, Rachel E; Oberg, Ann L; Panico, Salvatore; Patel, Alpa V; Peeters, Petra H M; Peters, Ulrike; Pezzilli, Raffaele; Porta, Miquel; Purdue, Mark; Quiros, J Ramon; Riboli, Elio; Rothman, Nathaniel; Scarpa, Aldo; Scelo, Ghislaine; Shu, Xiao-Ou; Silverman, Debra T; Soucek, Pavel; Strobel, Oliver; Sund, Malin; Malecka-Panas, Ewa; Taylor, Philip R; Tavano, Francesca; Travis, Ruth C; Thornquist, Mark; Tjonneland, Anne; Tobias, Geoffrey S; Trichopoulos, Dimitrios; Vashist, Yogesh; Vodicka, Pavel; Wactawski-Wende, Jean; Wentzensen, Nicolas; Yu, Herbert; Yu, Kai; Zeleniuch-Jacquotte, Anne; Kooperberg, Charles; Risch, Harvey A; Jacobs, Eric J; Li, Donghui; Fuchs, Charles; Hoover, Robert; Hartge, Patricia; Chanock, Stephen J; Petersen, Gloria M; Stolzenberg-Solomon, Rachael S; Wolpin, Brian M; Kraft, Peter; Klein, Alison P; Canzian, Federico; Amundadottir, Laufey T
Genome-wide association studies (GWAS) have identified common pancreatic cancer susceptibility variants at 13 chromosomal loci in individuals of European descent. To identify new susceptibility variants, we performed imputation based on 1000 Genomes (1000G) Project data and association analysis using 5,107 case and 8,845 control subjects from 27 cohort and case-control studies that participated in the PanScan I-III GWAS. This analysis, in combination with a two-staged replication in an additional 6,076 case and 7,555 control subjects from the PANcreatic Disease ReseArch (PANDoRA) and Pancreatic Cancer Case-Control (PanC4) Consortia uncovered 3 new pancreatic cancer risk signals marked by single nucleotide polymorphisms (SNPs) rs2816938 at chromosome 1q32.1 (per allele odds ratio (OR) = 1.20, P = 4.88x10-15), rs10094872 at 8q24.21 (OR = 1.15, P = 3.22x10-9) and rs35226131 at 5p15.33 (OR = 0.71, P = 1.70x10-8). These SNPs represent independent risk variants at previously identified pancreatic cancer risk loci on chr1q32.1 (NR5A2), chr8q24.21 (MYC) and chr5p15.33 (CLPTM1L-TERT) as per analyses conditioned on previously reported susceptibility variants. We assessed expression of candidate genes at the three risk loci in histologically normal (n = 10) and tumor (n = 8) derived pancreatic tissue samples and observed a marked reduction of NR5A2 expression (chr1q32.1) in the tumors (fold change -7.6, P = 5.7x10-8). This finding was validated in a second set of paired (n = 20) histologically normal and tumor derived pancreatic tissue samples (average fold change for three NR5A2 isoforms -31.3 to -95.7, P = 7.5x10-4-2.0x10-3). Our study has identified new susceptibility variants independently conferring pancreatic cancer risk that merit functional follow-up to identify target genes and explain the underlying biology.
PMCID:5340084
PMID: 27579533
ISSN: 1949-2553
CID: 2232522
Accuracy of Prostate-Specific Antigen Values in Prostate Cancer Registries [Letter]
Mittakanti, Harsha R; Thomas, I-Chun; Chung, Benjamin I; Sonn, Geoffrey A; Brooks, James D; Leppert, John T; Shelton, Jeremy B; Cooperberg, Mathew R; Makarov, Danil V; Skolarus, Ted A
PMID: 27458297
ISSN: 1527-7755
CID: 2191492
Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015
Vos, Theo; Allen, Christine; Arora, Megha; Barber, Ryan M; Bhutta, Zulfiqar A; Brown, Alexandria; Carter, Austin; Casey, Daniel C; Charlson, Fiona J; Chen, Alan Z; Coggeshall, Megan; Cornaby, Leslie; Dandona, Lalit; Dicker, Daniel J; Dilegge, Tina; Erskine, Holly E; Ferrari, Alize J; Fitzmaurice, Christina; Fleming, Tom; Forouzanfar, Mohammad H; Fullman, Nancy; Gething, Peter W; Goldberg, Ellen M; Graetz, Nicholas; Haagsma, Juanita A; Johnson, Catherine O; Kassebaum, Nicholas J; Kawashima, Toana; Kemmer, Laura; Khalil, Ibrahim A; Kinfu, Yohannes; Kyu, Hmwe H; Leung, Janni; Liang, Xiaofeng; Lim, Stephen S; Lopez, Alan D; Lozano, Rafael; Marczak, Laurie; Mensah, George A; Mokdad, Ali H; Naghavi, Mohsen; Nguyen, Grant; Nsoesie, Elaine; Olsen, Helen; Pigott, David M; Pinho, Christine; Rankin, Zane; Reinig, Nikolas; Salomon, Joshua A; Sandar, Logan; Smith, Alison; Stanaway, Jeffrey; Steiner, Caitlyn; Teeple, Stephanie; Thomas, Bernadette A; Troeger, Christopher; Wagner, Joseph A; Wang, Haidong; Wanga, Valentine; Whiteford, Harvey A; Zoeckler, Leo; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M; Abd-Allah, Foad; Abraham, Biju; Abubakar, Ibrahim; Abu-Raddad, Laith J; Abu-Rmeileh, Niveen ME; Ackerman, Ilana N; Adebiyi, Akindele Olupelumi; Ademi, Zanfina; Adou, Arsene Kouablan; Afanvi, Kossivi Agbelenko; Agardh, Emilie Elisabet; Agarwal, Arnav; Kiadaliri, Aliasghar Ahmad; Ahmadieh, Hamid; Ajala, Oluremi N; Akinyemi, Rufus Olusola; Akseer, Nadia; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore KM; Aldhahri, Saleh Fahed; Alegretti, Miguel Angel; Alemu, Zewdie Aderaw; Alexander, Lily T; Alhabib, Samia; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Al-Raddadi, Rajaa; Alsharif, Ubai; Altirkawi, Khalid A; Alvis-Guzman, Nelson; Amare, Azmeraw T; Amberbir, Alemayehu; Amini, Heresh; Ammar, Walid; Amrock, Stephen Marc; Andersen, Hjalte H; Anderson, Gregory M; Anderson, Benjamin; Antonio, Carl Abelardo T; Aregay, Atsede Fantahun; Arnlov, Johan; Al Artaman; Asayesh, Hamid; Assadi, Reza; Atique, Suleman; Avokpaho, Euripide Frinel GArthur; Awasthi, Ashish; Quintanilla, Beatriz Paulina Ayala; Azzopardi, Peter; Bacha, Umar; Badawi, Alaa; Balakrishnan, Kalpana; Banerjee, Amitava; Barac, Aleksandra; Barker-Collo, Suzanne L; Barnighausen, Till; Barregard, Lars; Barrero, Lope H; Basu, Arindam; Bazargan-Hejazi, Shahrzad; Bell, Brent; Bell, Michelle L; Bennett, Derrick A; Bensenor, Isabela M; Benzian, Habib; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Demtsu; Beyene, Addisu Shunu; Bhala, Neeraj; Bhatt, Samir; Biadgilign, Sibhatu; Bienhofff, Kelly; Bikbov, Boris; Biryukov, Stan; Bisanzio, Donal; Bjertness, Espen; Blore, Jed; Borschmann, Rohan; Boufous, Soufiane; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas JK; Brown, Jonathan; Buchbinder, Rachelle; Buckle, Geoffrey Colin; Butt, Zahid A; Calabria, Bianca; Ricardo Campos-Nonato, Ismael; Cesar Campuzano, Julio; Carabin, Helene; Cardenas, Rosario; Carpenter, David O; Carrero, Juan Jesus; Castaneda-Orjuela, Carlos A; Castillo Rivas, Jacqueline; Catala-Lopez, Ferran; Chang, Jung-Chen; Chiang, Peggy Pei-Chia; Chibueze, Chioma Ezinne; Chisumpa, Vesper Hichilombwe; Choi, Jee-Young Jasmine; Chowdhury, Rajiv; Christensen, Hanne; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G; Cirillo, Massimo; Coates, Matthew M; Colquhoun, Samantha M; Cooper, Cyrus; Cortinovis, Monica; Crump, John A; Damtew, Solomon Abrha; Dandona, Rakhi; Daoud, Farah; Dargan, Paul I; das Neves, Jose; Davey, Gail; Davis, Adrian C; De Leo, Diego; Degenhardt, Louisa; Del Gobbo, Liana C; Dellavalle, Robert P; Deribe, Kebede; Deribew, Amare; Derrett, Sarah; Des Jarlais, Don C; Dharmaratne, Samath D; Dhillon, Preet K; Diaz-Torne, Cesar; Ding, Eric L; Driscoll, Tim R; Duan, Leilei; Dubey, Manisha; Duncan, Bruce Bartholow; Ebrahimi, Hedyeh; Ellenbogen, Richard G; Elyazar, Iqbal; Endres, Matthias; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Eshrati, Babak; Estep, Kara; Farid, Talha A; Sofia e Sa Farinha, Carla; Faro, Andre; Farvid, Maryam S; Farzadfar, Farshad; Feigin, Valery L; Felson, David T; Fereshtehnejad, Seyed-Mohammad; Fernandes, Jefferson G; Fernandes, Joao C; Fischer, Florian; Fitchett, Joseph RA; Foreman, Kyle; Fowkes, Gerry R; Fox, Jordan; Franklin, Richard C; Friedman, Joseph; Frostad, Joseph; Furst, Thomas; Futran, Neal D; Gabbe, Belinda; Ganguly, Parthasarathi; Gankpe, Fortune Gbetoho; Gebre, Teshome; Gebrehiwot, Tsegaye Tewelde; Gebremedhin, Amanuel Tesfay; Geleijnse, Johanna M; Gessner, Bradford D; Gibney, Katherine B; Ginawi, Ibrahim Abdelmageem Mohamed; Giref, Ababi Zergaw; Giroud, Maurice; Gishu, Melkamu Dedefo; Glaser, Elizabeth; Godwin, William W; Gomez-Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Gotay, Carolyn C; Goto, Atsushi; Gouda, Hebe N; Grainger, Rebecca; Greaves, Felix; Guillemin, Francis; Guo, Yuming; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Gutierrez, Reyna A; Haile, Demewoz; Hailu, Alemayehu Desalegne; Hailu, Gessessew Bugssa; Halasa, Yara A; Hamadeh, Randah Ribhi; Hamidi, Samer; Hammami, Mouhanad; Hancock, Jamie; Handal, Alexis J; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Harikrishnan, Sivadasanpillai; Maria Haro, Josep; Havmoeller, Rasmus; Hay, Roderick J; Beatriz Heredia-Pi, Ileana; Heydarpour, Pouria; Hoek, Hans W; Horino, Masako; Horita, Nobuyuki; Hosgood, HDean; Hoy, Damian G; Htet, Aung Soe; Huang, Hsiang; Huang, John J; Huynh, Chantal; Iannarone, Marissa; Iburg, Kim Moesgaard; Innos, Kaire; Inoue, Manami; Iyer, Veena J; Jacobsen, Kathryn H; Jahanmehr, Nader; Jakovljevic, Mihajlo B; Javanbakht, Mehdi; Jayatilleke, Achala Upendra; Jee, Sun Ha; Jeemon, Panniyammakal; Jensen, Paul N; Jiang, Ying; Jibat, Tariku; Jimenez-Corona, Aida; Jin, Ye; Jonas, Jost B; Kabir, Zubair; Kalkonde, Yogeshwar; Kamal, Ritul; Kan, Haidong; Karch, Andre; Karema, Corine Kakizi; Karimkhani, Chante; Kasaeian, Amir; Kaul, Anil; Kawakami, Norito; Karimkhani, Chante; Kasaeian, Amir; Kaul, Anil; Kawakami, Norito; Keiyoro, Peter Njenga; Kemp, Andrew Haddon; Keren, Andre; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khaiff, Abdur Rahman; Khaiff, Ejaz Ahmad; Khang, Young-Ho; Khera, Sahil; Khoja, Tawfik Ahmed Muthafer; Khubchandani, Jagdish; Kieling, Christian; Kim, Pauline; Kim, Cho-il; Kim, Daniel; Kim, Yun Jin; Kissoon, Niranjan; Knibbs, Luke D; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kolte, Dhaval; Kopec, Jacek A; Kosen, Soewarta; Kotsakis, Georgios A; Koul, Parvaiz A; Koyanagi, Ai; Kravchenko, Michael; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kudom, Andreas A; Kuipers, Ernst J; Kumar, GAnil; Kutz, Michael; Kwan, Gene F; Lal, Aparna; Lalloo, Ratilal; Lallukka, Tea; Lam, Hilton; Lam, Jennifer O; Langan, Sinead M; Larsson, Anders; Lavados, Pablo M; Leasher, Janet L; Leigh, James; Leung, Ricky; Levi, Miriam; Li, Yichong; Li, Yongmei; Liang, Juan; Liu, Shiwei; Liu, Yang; Lloyd, Belinda K; Lo, Warren D; Logroscino, Giancarlo; Looker, Katharine J; Lotufo, Paulo A; Lunevicius, Raimundas; Lyons, Ronan A; Mackay, Mark T; Abd El Razek, Mohammed Magdy; Mahdavi, Mandi; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Marcenes, Wagner; Margolis, David Joel; Martinez-Raga, Jose; Masiye, Felix; Massano, Joao; McGarvey, Stephen Theodore; McGrath, John J; McKee, Martin; McMahon, Brian J; Meaney, Peter A; Mehari, Alem; Meija-Rodriguez, Fabiola; Mekonnen, Alemayehu B; Melaku, Yohannes Adama; Memiah, Peter; Memish, Ziad A; Mendoza, Walter; Meretoja, Atte; Meretoja, Tuomo J; Mhimbira, Francis Apolinary; Miller, Ted R; Mills, Edward J; Mirarefin, Mojde; Mitchell, Philip B; Mock, Charles N; Mohammadi, Alireza; Mohammed, Shafiu; Monasta, Lorenzo; Montanez Hernandez, Julio Cesar; Montico, Marcella; Mooney, Meghan D; Moradi-Lakeh, Maziar; Morawska, Lidia; Mueller, Ulrich O; Mullany, Erin; Mumford, John Everett; Murdoch, Michele E; Nachega, Jean B; Nagel, Gabriele; Naheed, Aliya; Naldi, Luigi; Nangia, Vinay; Newton, John N; Ng, Marie; Ngalesoni, Frida Namnyak; Quyen Le Nguyen; Nisar, Muhammad Imran; Nkamedjie Pete, Patrick Martial; Nona, Joan M; Norheim, Ole F; Norman, Rosana E; Norrving, Bo; Nunes, Bruno P; Ogbo, Felix Akpojene; Oh, In-Hwan; Ohkubo, Takayoshi; Olivares, Pedro R; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Ortiz, Alberto; Osman, Majdi; Ota, Erika; Mahesh, PA; Park, Eun-Kee; Parsaeian, Mahboubeh; de Azeredo Passos, Valeria Maria; Paternina Caicedo, Angel J; Patten, Scott B; Patton, George C; Pereira, David M; Perez-Padilla, Rogelio; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Piel, Frederic B; Pillay, Julian David; Pishgar, Farhad; Plass, Dietrich; Platts-Mills, James A; Polinder, Suzanne; Pond, Constance D; Popova, Svetlana; Poulton, Richie G; Pourmalek, Farshad; Prabhakaran, Dorairaj; Prasad, Noela M; Qorbani, Mostafa; Rabiee, Rynaz HS; Radfar, Amir; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rajsic, Sasa; Ram, Usha; Rao, Puja; Refaat, Amany H; Reitsma, Marissa B; Remuzzi, Giuseppe; Resnikofff, Serge; Reynolds, Alex; Ribeiro, Antonio L; Rios Blancas, Maria Jesus; Rolm, Hirbo Shore; Rojas-Rueda, David; Ronfani, Luca; Roshandel, Gholamreza; Roth, Gregory A; Rothenbacher, Dietrich; Roy, Ambuj; Sagar, Rajesh; Sahathevan, Ramesh; Sanabria, Juan R; Dolores Sanchez-Nino, Maria; Santos, Itamar S; Santos, Joao Vasco; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Schaub, Michael P; Schmidt, Maria Ines; Schneider, Ione JC; Schottker, Ben; Schwebel, David C; Scott, James G; Seedat, Soraya; Sepanlou, Sadaf G; Servan-Mori, Edson E; Shackelford, Katya A; Shaheen, Amira; Shaikh, Masood Ali; Sharma, Rajesh; Sharma, Upasana; Shen, Jiabin; Shepard, Donald S; Sheth, Kevin N; Shibuya, Kenji; Shin, Min-Jeong; Shiri, Rahman; Shiue, Ivy; Shrime, Mark G; Sigfusdottir, Inga Dora; Silva, Diego Augusto Santos; Alves Silveira, Dayane Gabriele; Singh, Abhishek; Singh, Jasvinder A; Singh, Om Prakash; Singh, Prashant Kumar; Sivonda, Anna; Skirbekk, Vegard; Skogen, Jens Christoffer; Sligar, Amber; Silwa, Karen; Soljak, Michael; Soreide, Kjetil; Soriano, Joan B; Sposato, Luciano A; Sreeramareddy, Chandrashekhar T; Stathopoulou, Vasiliki; Steel, Nicholas; Stein, Dan J; Steiner, Timothy J; Steinke, Sabine; Stovner, Lars; Stroumpoulis, Konstantinos; Sunguya, Bruno F; Sur, Patrick; Swaminathan, Soumya; Sykes, Bryan L; Szoeke, Cassandra EI; Tabares-Seisdedos, Rafael; Takala, Jukka S; Landon, Nikhil; Tanne, David; Tavakkoli, Mohammad; Taye, Bineyam; Taylor, Hugh R; Te Ao, Braden J; Tedla, Bemnet Amare; Terkawi, Abdullah Sulieman; Thomson, Alan J; Thorne-Lyman, Andrew L; Thrift, Amanda G; Thurston, George D; Tobe-Gai, Ruoyan; Tonelli, Marcello; Topor-Madry, Roman; Topouzis, Fotis; Tran, Bach Xuan; Dimbuene, Zacharie Tsala; Tsilimbaris, Miltiadis; Tura, Abera Kenay; Tuzcu, Emin Murat; Tyrovolas, Stefanos; Ukwaja, Kingsley N; Undurraga, Eduardo A; Uneke, Chigozie Jesse; Uthman, Olalekan A; van Gool, Coen H; Varakin, Yuri Y; Vasankari, Tommi; Venketasubramanian, Narayanaswamy; Verma, Raj Kumar; Violante, Francesco S; Vladimirov, Sergey K; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Wagner, Gregory R; Waller, Stephen G; Wang, Linhong; Watkins, David A; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Westerman, Ronny; White, Richard A; Williams, Hywel C; Wiysonge, Charles Shey; Wolfe, Charles DA; Won, Sungho; Woodbrook, Rachel; Wubshet, Mamo; Xavier, Denis; Xu, Gelin; Yadav, Ajit Kumar; Yan, Lijing L; Yano, Yuichiro; Yaseri, Mehdi; Ye, Pengpeng; Yebyo, Henock Gebremedhin; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zeeb, Hajo; Zhou, Maigeng; Zodpey, Sanjay; Zuhlke, Liesl Joanna; Murray, Christopher JL; GBD 2015 Dis Injury Incidence
Background Non-fatal outcomes of disease and injury increasingly detract from the ability of the world's population to live in full health, a trend largely attributable to an epidemiological transition in many countries from causes affecting children, to non-communicable diseases (NCDs) more common in adults. For the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015), we estimated the incidence, prevalence, and years lived with disability for diseases and injuries at the global, regional, and national scale over the period of 1990 to 2015. Methods We estimated incidence and prevalence by age, sex, cause, year, and geography with a wide range of updated and standardised analytical procedures. Improvements from GBD 2013 included the addition of new data sources, updates to literature reviews for 85 causes, and the identification and inclusion of additional studies published up to November, 2015, to expand the database used for estimation of non-fatal outcomes to 60 900 unique data sources. Prevalence and incidence by cause and sequelae were determined with DisMod-MR 2.1, an improved version of the DisMod-MR Bayesian meta-regression tool first developed for GBD 2010 and GBD 2013. For some causes, we used alternative modelling strategies where the complexity of the disease was not suited to DisMod-MR 2.1 or where incidence and prevalence needed to be determined from other data. For GBD 2015 we created a summary indicator that combines measures of income per capita, educational attainment, and fertility (the Socio-demographic Index [SDI]) and used it to compare observed patterns of health loss to the expected pattern for countries or locations with similar SDI scores. Findings We generated 9.3 billion estimates from the various combinations of prevalence, incidence, and YLDs for causes, sequelae, and impairments by age, sex, geography, and year. In 2015, two causes had acute incidences in excess of 1 billion: upper respiratory infections (17.2 billion, 95% uncertainty interval [UI] 15.4-19.2 billion) and diarrhoeal diseases (2.39 billion, 2.30-2.50 billion). Eight causes of chronic disease and injury each affected more than 10% of the world's population in 2015: permanent caries, tension-type headache, iron-deficiency anaemia, age-related and other hearing loss, migraine, genital herpes, refraction and accommodation disorders, and ascariasis. The impairment that affected the greatest number of people in 2015 was anaemia, with 2.36 billion (2.35-2.37 billion) individuals affected. The second and third leading impairments by number of individuals affected were hearing loss and vision loss, respectively. Between 2005 and 2015, there was little change in the leading causes of years lived with disability (YLDs) on a global basis. NCDs accounted for 18 of the leading 20 causes of age-standardised YLDs on a global scale. Where rates were decreasing, the rate of decrease for YLDs was slower than that of years of life lost (YLLs) for nearly every cause included in our analysis. For low SDI geographies, Group 1 causes typically accounted for 20-30% of total disability, largely attributable to nutritional deficiencies, malaria, neglected tropical diseases, HIV/AIDS, and tuberculosis. Lower back and neck pain was the leading global cause of disability in 2015 in most countries. The leading cause was sense organ disorders in 22 countries in Asia and Africa and one in central Latin America; diabetes in four countries in Oceania; HIV/AIDS in three southern sub-Saharan African countries; collective violence and legal intervention in two north African and Middle Eastern countries; iron-deficiency anaemia in Somalia and Venezuela; depression in Uganda; onchoceriasis in Liberia; and other neglected tropical diseases in the Democratic Republic of the Congo. Interpretation Ageing of the world's population is increasing the number of people living with sequelae of diseases and injuries. Shifts in the epidemiological profile driven by socioeconomic change also contribute to the continued increase in years lived with disability (YLDs) as well as the rate of increase in YLDs. Despite limitations imposed by gaps in data availability and the variable quality of the data available, the standardised and comprehensive approach of the GBD study provides opportunities to examine broad trends, compare those trends between countries or subnational geographies, benchmark against locations at similar stages of development, and gauge the strength or weakness of the estimates available
PMCID:5055577
PMID: 27733282
ISSN: 1474-547x
CID: 2374712
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, Haidong; Naghavi, Mohsen; Allen, Christine; Barber, Ryan M; Bhutta, Zulfiqar A; Carter, Austin; Casey, Daniel C; Charlson, Fiona J; Chen, Alan Zian; Coates, Matthew M; Coggeshall, Megan; Dandona, Lalit; Dicker, Daniel J; Erskine, Holly E; Ferrari, Alize J; Fitzmaurice, Christina; Foreman, Kyle; Forouzanfar, Mohammad H; Fraser, Maya S; Pullman, Nancy; Gething, Peter W; Goldberg, Ellen M; Graetz, Nicholas; Haagsma, Juanita A; Hay, Simon I; Huynh, Chantal; Johnson, Catherine; Kassebaum, Nicholas J; Kinfu, Yohannes; Kulikoff, Xie Rachel; Kutz, Michael; Kyu, Hmwe H; Larson, Heidi J; Leung, Janni; Liang, Xiaofeng; Lim, Stephen S; Lind, Margaret; Lozano, Rafael; Marquez, Neal; Mensah, George A; Mikesell, Joe; Mokdad, Ali H; Mooney, Meghan D; Nguyen, Grant; Nsoesie, Elaine; Pigott, David M; Pinho, Christine; Roth, Gregory A; Salomon, Joshua A; Sandar, Logan; Silpakit, Naris; Sligar, Amber; Sorensen, Reed JD; Stanaway, Jeffrey; Steiner, Caitlyn; Teeple, Stephanie; Thomas, Bernadette A; Troeger, Christopher; VanderZanden, Amelia; Vollset, Stein Emil; Wanga, Valentine; Whiteford, Harvey A; Wolock, Timothy; Zoeckler, Leo; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M; Abd-Allah, Foad; Abera, Semaw Ferede; Abreu, Daisy MX; Abu-Raddad, Laith J; Abyu, Gebre Yitayih; Achoki, Tom; Adelekan, Ademola Lukman; Ademi, Zanfina; Adou, Arsene Kouablan; Adsuar, Jose C; Afanvi, Kossivi Agbelenko; Afshin, Ashkan; Agardh, Emilie Elisabet; Agarwal, Arnav; Agrawal, Anurag; Kiadaliri, Aliasghar Ahmad; Ajala, Oluremi N; Akanda, All Shafqat; Akinyemi, Rufus Olusola; Akinyemiju, Tomi F; Akseer, Nadia; Al Lami, Faris Hasan; Alabed, Samer; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore KM; Alasfoor, Deena; Aldhahri, Saleh Fahed; Aldridge, Robert William; Alegretti, Miguel Angel; Aleman, Alicia V; Alemu, Zewdie Aderaw; Alexander, Lily T; Alhabib, Samia; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Al-Raddadi, Rajaa; Alsharif, Ubai; Altirkawi, Khalid A; Martin, Elena Alvarez; Alvis-Guzman, Nelson; Amare, Azmeraw T; Amegah, Adeladza Kofi; Ameh, Emmanuel A; Amini, Heresh; Ammar, Walid; Amrock, Stephen Marc; Andersen, Hjalte H; Anderson, Benjamin; Anderson, Gregory M; Antonio, Carl Abelardo T; Aregay, Atsede Fantahun; Arnlov, Johan; Arsenijevic, Valentina SArsic; Al Artaman; Asayesh, Hamid; Asghar, Rana Jawad; Atique, Suleman; Arthur Avokpaho, Euripide Frinel G; Awasthi, Ashish; Azzopardi, Peter; Bacha, Umar; Badawi, Alaa; Bahit, Maria C; Balakrishnan, Kalpana; Banerjee, Amitava; Barac, Aleksandra; Barker-Collo, Suzanne L; Barnighausen, Till; Barregard, Lars; Barrero, Lope H; Basu, Arindam; Basu, Sanjay; Bayou, Yibeltal Tebekaw; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Beghi, Ettore; Belay, Haileeyesus Adamu; Bell, Brent; Bell, Michelle L; Bello, Aminu K; Bennett, Derrick A; Bensenor, Isabela M; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Demtsu; Beyene, Addisu Shunu; Bhala, Neeraj; Bhalla, Ashish; Biadgilign, Sibhatu; Bikbov, Boris; Bin Abdulhak, Aref A; Biroscak, Brian J; Biryukov, Stan; Bjertness, Espen; Blore, Jed D; Blosser, Christopher D; Bohensky, Megan A; Borschmann, Rohan; Bose, Dipan; Bourne, Rupert RA; Brainin, Michael; Brayne, Carol EG; Brazinova, Alexandra; Breitborde, Nicholas JK; Brenner, Hermann; Brewer, Jerry D; Brown, Alexandria; Brown, Jonathan; Brugha, Traolach S; Buckle, Geoffrey Colin; Butt, Zahid A; Calabria, Bianca; Campos-Novato, Ismael Ricardo; Campuzano, Julio Cesar; Carapetis, Jonathan R; Cardenas, Rosario; Carpenter, David; Carrero, Juan Jesus; Castaneda-Oquela, Carlos A; Rivas, Jacqueline Castillo; Catala-Lopez, Ferran; Cavalleri, Fiorella; Cercy, Kelly; Cerda, Jorge; Chen, Wanqing; Chew, Adrienne; Chiang, Peggy Pei -Chia; Chibalabala, Mirriam; Chibueze, Chioma Ezinne; Chimed-Ochir, Odgerel; Chisumpa, Vesper Hichilombwe; Choi, Jee-Young Jasmine; Chowdhury, Rajiv; Christensen, Hanne; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G; Cirillo, Massimo; Cohen, Aaron J; Colistro, Valentina; Colomar, Mercedes; Colquhoun, Samantha M; Cooper, Cyrus; Cooper, Leslie Trumbull; Cortinovis, Monica; Cowie, Benjamin C; Crump, John A; Damsere-Derry, James; Danawi, Hadi; Dandona, Rakhi; Daoud, Farah; Darby, Sarah C; Dargan, Paul I; das Neves, Jose; Davey, Gail; Davis, Adrian C; Davitoiu, Dragos V; de Castro, EFilipa; de Jager, Pieter; De Leo, Diego; Degenhardt, Louisa; Dellavalle, Robert P; Deribe, Kebede; Deribew, Amare; Dharmaratne, Samath D; Dhillon, Preet K; Diaz-Torne, Cesar; Ding, Eric L; dos Santos, Kadine Priscila Bender; Dossou, Edem; Driscoll, Tim R; Duan, Leilei; Dubey, Manisha; Bartholow, Bruce; Ellenbogen, Richard G; Lycke, Christian; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Eshrati, Babak; Esteghamati, Alireza; Estep, Kara; Faghmous, Imad DA; Fahimi, Saman; Jose, Emerito; Farid, Talha A; Sa Farinha, Carla Sofia e; Faro, Andre; Farvid, Maryam S; Farzadfar, Farshad; Feigin, Valery L; Fereshtehnejad, Seyed-Mohammad; Fernandes, Jefferson G; Fernandes, Joao C; Fischer, Florian; Fitchett, Joseph RA; Flaxman, Abraham; Foigt, Nataliya; Fowkes, FGerry R; Franca, Elisabeth Barboza; Franklin, Richard C; Friedman, Joseph; Frostad, Joseph; Hirst, Thomas; Futran, Neal D; Gall, Seana L; Gambashidze, Ketevan; Gamkrelidze, Amiran; Ganguly, Parthasarathi; Gankpe, Fortune Gbetoho; Gebre, Teshome; Gebrehiwot, Tsegaye Tsewelde; Gebremedhin, Amanuel Tesfay; Gebru, Alemseged Aregay; Geleijnse, Johanna M; Gessner, Bradford D; Ghoshal, Aloke Gopal; Gibney, Katherine B; Gillum, Richard F; Gilmour, Stuart; Giref, Ababi Zergaw; Giroud, Maurice; Gishu, Melkamu Dedefo; Giussani, Giorgia; Glaser, Elizabeth; Godwin, William W; Gomez-Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Gosselin, Richard A; Gotay, Carolyn C; Goto, Atsushi; Gouda, Hebe N; Greaves, Felix; Gugnani, Harish Chander; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Gutierrez, Reyna A; Hafezi-Nejad, Nima; Haile, Demewoz; Hailu, Alemayehu Desalegne; Hailu, Gessessew Bugssa; Halasa, Yara A; Hamadeh, Randah Ribhi; Hamidi, Samer; Hancock, Jamie; Handal, Alexis J; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Harikrishnan, Sivadasanpillai; Haro, Josep Maria; Havmoeller, Rasmus; Heckbert, Susan R; Heredia-Pi, Ileana Beatriz; Heydarpour, Pouria; Hilderink, Henk BM; Hoek, Hans W; Hogg, Robert S; Horino, Masako; Horita, Nobuyuki; Hosgood, HDean; Hotez, Peter J; Hoy, Damian G; Hsairi, Mohamed; Htet, Aung Soe; Than Htike, Maung Maung; Hu, Guoqing; Huang, Cheng; Huang, Hsiang; Huiart, Laetitia; Husseini, Abdullatif; Huybrechts, Inge; Huynh, Grace; Iburg, Kim Moesgaard; Innos, Kaire; Inoue, Manami; Iyer, Veena J; Jacobs, Troy A; Jacobsen, Kathryn H; Jahanmehr, Nader; Jakovljevic, Mihajlo B; James, Peter; Javanbakht, Mehdi; Jayaraman, Sudha P; Jayatilleke, Achala Upendra; Jeemon, Panniyammakal; Jensen, Paul N; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jibat, Tariku; Jimenez-Corona, Aida; Jonas, Jost B; Joshi, Tushar Kant; Kabir, Zubair; Karnak, Ritul; Kan, Haidong; Kant, Surya; Karch, Andre; Karema, Corine Kakizi; Karimkhani, Chante; Karletsos, Dimitris; Karthikeyan, Ganesan; Kasaeian, Amir; Katibeh, Marzieh; Kaul, Anil; Kawakami, Norito; Kayibanda, Jeanne Francoise; Keiyoro, Peter Njenga; Kemmer, Laura; Kemp, Andrew Haddon; Kengne, Andre Pascal; Keren, Andre; Kereselidze, Maia; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khalil, Ibrahim A; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khang, Young-Ho; Khera, Sahil; Muthafer Khoja, Tawfik Ahmed; Kieling, Christian; Kim, Daniel; Kim, Yun Jin; Kissela, Brett M; Kissoon, Niranjan; Knibbs, Luke D; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kolte, Dhaval; Kopec, Jacek A; Kosen, Soewarta; Koul, Parvaiz A; Koyanagi, Ai; Krog, Norun Hjertager; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kudom, Andreas A; Kuipers, Ernst J; Kulkarni, Veena S; Kumar, GAnil; Kwan, Gene F; Lal, Aparna; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lam, Hilton; Lam, Jennifer O; Langan, Sinead M; Lansingh, Van C; Larsson, Anders; Laryea, Dennis Odai; Latif, Asma Abdul; Lawrynowicz, Alicia Elena Beatriz; Leigh, James; Levi, Miriam; Li, Yongmei; Lindsay, MPatrice; Lipshultz, Steven E; Liu, Patrick Y; Liu, Shiwei; Liu, Yang; Lo, Loon-Tzian; Logroscino, Giancarlo; Lotufo, Paulo A; Lucas, Robyn M; Lunevicius, Raimundas; Lyons, Ronan A; Ma, Stefan; Pedro Machado, Vasco Manuel; Mackay, Mark T; MacLachlan, Jennifer H; Abd El Razek, Hassan Magdy; Abd El Razek, Mohammed Magdy; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Ayele Manamo, Wondimu Ayele; Mandisarisa, John; Mangalam, Srikanth; Mapoma, Chabila C; Marcenes, Wagner; Margolis, David Joel; Martin, Gerard Robert; Martinez-Raga, Jose; Marzan, Melvin Barrientos; Masiye, Felix; Mason-Jones, Amanda J; Massano, Joao; Matzopoulos, Richard; Mayosi, Bongani M; McGarvey, Stephen Theodore; McGrath, John J; Mckee, Martin; McMahon, Brian J; Meaney, Peter A; Mehari, Alem; Mehndiratta, Man Mohan; Mena-Rodriguez, Fabiola; Mekonnen, Alemayehu B; Melaku, Yohannes Adama; Memiah, Peter; Memish, Ziad A; Mendoza, Walter; Meretoja, Atte; Meretoja, Tuomo J; Mhimbira, Francis Apolinary; Micha, Renata; Miller, Ted R; Mirarefin, Mojde; Misganaw, Awoke; Mock, Charles N; Abdulmuhsin Mohammad, Karzan; Mohammadi, Alireza; Mohammed, Shafiu; Mohan, Viswanathan; Mola, Glen Liddell D; Monasta, Lorenzo; Montanez Hernandez, Julio Cesar; Montero, Pablo; Montico, Marcella; Montine, Thomas J; Moradi-Lakeh, Maziar; Morawska, Lidia; Morgan, Katherine; Mori, Rintaro; Mozaffarian, Dariush; Mueller, Ulrich; Satyanarayana Murthy, Gudlavalleti Venkata; Murthy, Srinivas; Musa, Kamarul Imran; Nachega, Jean B; Nagel, Gabriele; Naidoo, Kovin S; Naik, Nitish; Naldi, Luigi; Nangia, Vinay; Nash, Denis; Nejjari, Chakib; Neupane, Subas; Newton, Charles R; Newton, John N; Ng, Marie; Ngalesoni, Frida Namnyak; Ngirabega, Jean de Dieu; Quyen Le Nguyen; Nisar, Muhammad Imran; Nkamedjie Pete, Patrick Martial; Nomura, Marika; Norheim, Ole F; Norman, Paul E; Norrving, Bo; Nyakarahuka, Luke; Ogbo, Felix Akpojene; Ohkubo, Takayoshi; Ojelabi, Foluke Adetola; Olivares, Pedro R; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Opio, John Nelson; Oren, Eyal; Ortiz, Alberto; Osman, Majdi; Ota, Erika; Ozdemir, Raziye; Pa, Mahesh; Pandian, Jeyaraj D; Pant, Puspa Raj; Papachristou, Christina; Park, Eun-Kee; Park, Jae-Hyun; Parry, Charles D; Parsaeian, Mahboubeh; Caicedo, Angel JPaternina; Patten, Scott B; Patton, George C; Paul, Vinod K; Pearce, Neil; Pedro, Joao Mario; Stokic, Ljiljana Pejin; Pereira, David M; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Piel, Frederic B; Pillay, Julian David; Plass, Dietrich; Platts-Mills, James A; Polinder, Suzanne; Pope, CArden; Popova, Svetlana; Poulton, Richie G; Pourmalek, Farshad; Prabhakaran, Dorairaj; Qorbani, Mostafa; Quame-Amaglo, Justice; Quistberg, DAlex; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rajavi, Zhale; Rajsic, Sasa; Raju, Murugesan; Rakovac, Ivo; Rana, Saleem M; Ranabhat, Chhabi L; Rangaswamy, Thara; Rao, Puja; Rao, Sowmya R; Refaat, Amany H; Rehm, Jurgen; Reitsma, Marissa B; Remuzzi, Giuseppe; Resnikofff, Serge; Ribeiro, Antonio L; Ricci, Stefano; Blancas, Maria Jesus Rios; Roberts, Bayard; Roca, Anna; Rojas-Rueda, David; Ronfani, Luca; Roshandel, Gholamreza; Rothenbacher, Dietrich; Roy, Ambuj; Roy, Nawal K; Ruhago, George Mugambage; Sagar, Rajesh; Saha, Sukanta; Sahathevan, Ramesh; Saleh, Muhammad Muhammad; Sanabria, Juan R; Sanchez-Nino, Maria Dolores; Sanchez-Riera, Lidia; Santos, Itamar S; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Schaub, Michael P; Schmidt, Maria Ines; Schneider, Ione JC; Schottker, Ben; Schutte, Aletta E; Schwebel, David C; Seedat, Soraya; Sepanlou, Sadaf G; Servan-Mori, Edson E; Shackelford, Katya A; Shaddick, Gavin; Shaheen, Amira; Shahraz, Saeid; Shaikh, Masood Ali; Shakh-Nazarova, Marina; Sharma, Rajesh; She, Jun; Sheikhbahaei, Sara; Shen, Jiabin; Shen, Ziyan; Shepard, Donald S; Sheth, Kevin N; Shetty, Balakrishna P; Shi, Peilin; Shibuya, Kenji; Shin, Min-Jeong; Shiri, Rahman; Shiue, Ivy; Shrime, Mark G; Sigfusdottir, Inga Dora; Silberberg, Donald H; Silva, Diego Augusto Santos; Silveira, Dayane Gabriele Alves; Silverberg, Jonathan I; Simard, Edgar P; Singh, Abhishek; Singh, Gitanjali M; Singh, Jasvinder A; Singh, Om Prakash; Singh, Prashant Kumar; Singh, Virendra; Soneji, Samir; Soreide, Kjetil; Soriano, Joan B; Sposato, Luciano A; Sreeramareddy, Chandrashekhar T; Stathopoulou, Vasiliki; Stein, Dan J; Stein, Murray B; Stranges, Saverio; Stroumpoulis, Konstantinos; Sunguya, Bruno F; Sur, Patrick; Swaminathan, Soumya; Sykes, Bryan L; Szoeke, Cassandra EI; Tabares-Seisdedos, Rafael; Tabb, Karen M; Takahashi, Ken; Takala, Jukka S; Talongwa, Roberto Tchio; Tandon, Nikhil; Tavakkoli, Mohammad; Taye, Bineyam; Taylor, Hugh R; Ao, Braden JTe; Tedla, Bemnet Amare; Tefera, Worku Mekonnen; Ten Have, Margreet; Terkawi, Abdullah Sulieman; Tesfay, Fisaha Haile; Tessema, Gizachew Assefa; Thomson, Alan J; Thorne-Lyman, Andrew L; Thrift, Amanda G; Thurston, George D; Tillmann, Taavi; Tirschwell, David L; Tonelli, Marcello; Topor-Madry, Roman; Topouzis, Fotis; Nx, Jeffrey Allen Towb; Traebert, Jefferson; Tran, Bach Xuan; Truelsen, Thomas; Trujillo, Ulises; Tura, Abera Kenay; Tuzcu, Emin Murat; Uchendu, Uche S; Ukwaja, Kingsley N; Undurraga, Eduardo A; Uthman, Olalekan A; Van Dingenen, Rita; Van Donkelaar, Aaron; Vasankari, Tommi; Vasconcelos, Ana Maria Nogales; Venketasubramanian, Narayanaswamy; Vidavalur, Ramesh; Vijayakumar, Lakshmi; Villalpando, Salvador; Violante, Francesco S; Vlassov, Vasiliy Victorovich; Wagner, Joseph A; Wagner, Gregory R; Wallin, Mitchell T; Wang, Linhong; Watkins, David A; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Westerman, Ronny; White, Richard A; Wijeratne, Tissa; Wilkinson, James D; Williams, Hywel C; Wiysonge, Charles Shey; Woldeyohannes, Solomon Meseret; Wolfe, Charles DA; Won, Sungho; Wong, John Q; Woolf, Anthony D; Xavier, Denis; Xiao, Qingyang; Xu, Gelin; Yakob, Bereket; Yalew, Ayalnesh Zemene; Yan, Lijing L; Yano, Yuichiro; Yaseri, Mehdi; Ye, Pengpeng; Yebyo, Henock Gebremedhin; Yip, Paul; Yirsaw, Biruck Desalegn; Yonemoto, Naohiro; Yonga, Gerald; Younis, Mustafa Z; Yu, Shicheng; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zannad, Faiez; Zavala, Diego E; Zeeb, Hajo; Zeleke, Berihun M; Zhang, Hao; Zodpey, Sanjay; Zonies, David; Zuhlke, Liesl Joanna; Vos, Theo; Lopez, Alan D; Murray, Christopher JL; GBD 015 Mortality and Causes Death
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
PMCID:5388903
PMID: 27733281
ISSN: 1474-547x
CID: 2374702
Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015
Forouzanfar, Mohammad H; Afshin, Ashkan; Alexander, Lily T; Anderson, HRoss; Bhutta, Zulficiar A; Biryukov, Stan; Brauer, Michael; Burnett, Richard; Cercy, Kelly; Charlson, Fiona J; Cohen, Aaron J; Dandona, Lalit; Estep, Kara; Ferrari, Alize J; Frostad, Joseph J; Fullman, Nancy; Gething, Peter W; Godwin, William W; Griswold, Max; Kinfu, Yohannes; Kyu, Hmwe H; Larson, Heidi J; Liang, Xiaofeng; Lim, Stephen S; Liu, Patrick Y; Lopez, Alan D; Lozano, Rafael; Marczak, Laurie; Mensah, George A; Mokdad, Ali H; Moradi-Lakeh, Maziar; Naghavi, Mohsen; Neal, Bruce; Reitsma, Marissa B; Roth, Gregory A; Salomon, Joshua A; Sur, Patrick J; Vos, Theo; Wagner, Joseph A; Wang, Haidong; Zhao, Yi; Zhou, Maigeng; Aasvang, Gunn Marit; Amanuel; Abajobir, Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana; Abbas, Kaja M; Abd-Allah, Foad; Abdulle, Abdishakur M; Abera, Semaw Ferede; Abraham, Biju; Abu-Raddad, Laith J; Abyu, Gebre Yitayih; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Ademi, Zanfina; Adou, Arsene Kouablan; Adsuar, Jose C; Agardh, Emilie Elisabet; Agarwal, Arnav; Agrawal, Anurag; Kiadaliri, Aliasghar Ahmad; Ajala, Oluremi N; Akinyemiju, Tomi F; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore KM; Aldhahri, Saleh Fahed; Aldridge, Robert William; Alemu, Zewdie Aderaw; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Allebeck, Peter; Alsharif, Ubai; Altirkawi, Khalid A; Alvarez Martin, Elena; Alvis-Guzman, Nelson; Amare, Azmeraw T; Amberbir, Alemayehu; Amegah, Adeladza Kofi; Amini, Heresh; Ammar, Walid; Amrock, Stephen Marc; Andersen, Hjalte H; Anderson, Benjamin O; Antonio, Carl Abelardo T; Anwar, Palwasha; Arnlov, Johan; Al Artaman; Asayesh, Hamid; Asghar, Rana Jawad; Assadi, Reza; Atique, Suleman; Avokpaho, Euripide Frinel GArthur; Awasthi, Ashish; Quintanilla, Beatriz Paulina Ayala; Azzopardi, Peter; Bacha, Umar; Badawi, Alaa; Bahit, Maria C; Balakrishnan, Kalpana; Barac, Aleksandra; Barber, Ryan M; Barker-Collo, Suzanne L; Baernighausen, Till; Barquera, Simon; Barregard, Lars; Barrero, Lope H; Basu, Sanjay; Bans, Carolina; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Beghi, Ettore; Bell, Michelle L; Bello, Aminu K; Bennett, Derrick A; Bensenor, Isabela M; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Demtsu; Beyene, Addisu Shunu; Bhala, Neeraj; Bhansali, Anil; Bhatt, Samir; Biadgilign, Sibhatu; Bikbov, Boris; Bisanzio, Donal; Bjertness, Espen; Blore, Jed D; Borschmann, Rohan; Boufous, Soufiane; Bourne, Rupert RA; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas JK; Brenner, Hermann; Broday, David M; Brugha, Traolach S; Brunekreef, Bert; Butt, Zahid A; Cahill, Leah E; Calabria, Bianca; Ricardo Campos-Nonato, Ismael; Cardenas, Rosario; Carpenter, David; Casey, Daniel C; Castaneda-Oquela, Carlos A; Castillo Rivas, Jacqueline; Estanislao Castro, Ruben; Catala-Lopez, Ferran; Chang, Jung-Chen; Chiang, Peggy Pei-Chia; Chibalabala, Mirriam; Chimed-Ochir, Odgerel; Chisumpa, Vesper Hichilombwe; Chitheer, Abdulaal A; Choi, Jee-Young Jasmine; Christensen, Hanne; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G; Coates, Matthew M; Colquhoun, Samantha M; Cooper, Leslie Trumbull; Cooperrider, Kimberly; Cornaby, Leslie; Cortinovis, Monica; Crump, John A; Cuevas-Nasu, Lucia; Damasceno, Albertino; Dandona, Rakhi; Darby, Sarah C; Dargan, Paul I; das Neves, Jose; Davis, Adrian C; Davletov, Kairat; Filipa de Castro, E; De la Cruz-Gongora, Vanessa; De Leo, Diego; Degenhardt, Louisa; Del Gobbo, Liana C; del Pozo-Cruz, Borja; Dellavalle, Robert P; Deribew, Amare; Des Jarlais, Don C; Dharmaratne, Samath D; Dhillon, Preet K; Diaz-Tome, Cesar; Dicker, Daniel; Ding, Eric L; Dorsey, ERay; Doyle, Kerrie E; Driscoll, Tim R; Duan, Leilei; Dubey, Manisha; Duncan, Bruce Bartholow; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Erskine, Holly E; Eshrati, Babak; Esteghamati, Alireza; Fahimi, Saman; Aquino Faraon, Emerito Jose; Farid, Talha A; Sofia E Sa Farinha, Carla; Faro, Andre; Farvid, Maryam S; Farzadfar, Farshad; Feigin, Valery L; Fereshtehnejad, Seyed-Mohammad; Fernandes, Jefferson G; Fischer, Florian; Fitchett, Joseph RA; Fleming, Tom; Foigt, Nataliya; Foreman, Kyle; Fowkes, FGerry R; Franklin, Richard C; Fuerst, Thomas; Futran, Neal D; Gakidou, Emmanuela; Garcia-Basteiro, Alberto L; Gebrehiwot, Tsegaye Tewelde; Gebremedhin, Amanuel Tesfay; Geleijnse, Johanna M; Gessner, Bradford D; Giref, Ababi Zergaw; Giroud, Maurice; Gishu, Melkamu Dedefo; Goenka, Shifalika; Carmen Gomez-Cabrera, Mari; Gomez-Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Gotay, Carolyn C; Goto, Atsushi; Gouda, Hebe N; Gugnani, Harish Chander; Guillemin, Francis; Guo, Yuming; Gupta, Rahul; Gupta, Rajeev; Gutierrez, Reyna A; Haagsma, Juanita A; Hafezi-Nejad, Nima; Haile, Demewoz; Hailu, Gessessew Bugssa; Halasa, Yara A; Hamadeh, Randah Ribhi; Hamidi, Samer; Handal, Alexis J; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Harikrishnan, Sivadasanpillai; Maria Haro, Josep; Hassanvand, Mohammad Sadegh; Hassen, Tahir Ahmed; Havmoeller, Rasmus; Beatriz Heredia-Pi, Ileana; Francisco Hernandez-Llanes, Norberto; Heydarpour, Pouria; Hoek, Hans W; Hoffman, Howard J; Horino, Masako; Horita, Nobuyuki; Hosgood, HDean; Hoy, Damian G; Hsairi, Mohamed; Htet, Aung Soe; Hu, Guoqing; Huang, John J; Husseini, Abdullatif; Hutchings, Sally J; Huybrechts, Inge; Iburg, Kim Moesgaard; Idrisov, Bulat T; Ileanu, Bogdan Vasile; Inoue, Manami; Jacobs, Troy A; Jacobsen, Kathryn H; Jahanmehr, Nader; Jakovljevic, Mihajlo B; Jansen, Henrica AFM; Jassal, Simerjot K; Javanbakht, Mehdi; Jayatilleke, Achala Upendra; Jee, Sun Ha; Jeemon, Panniyammakal; Jha, Vivekanand; Jiang, Ying; Jibat, Tariku; Jin, Ye; Johnson, Catherine O; Jonas, Jost B; Kabir, Zubair; Kalkonde, Yogeshwar; Kamal, Ritul; Kan, Haidong; Karch, Andre; Karema, Corine Kakizi; Karimkhani, Chante; Kasaeian, Amir; Kaul, Anil; Kawakami, Norito; Kazi, Dhruv S; Keiyoro, Peter Njenga; Kemp, Andrew Haddon; Kengne, Andre Pascal; Keren, Andre; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khang, Young-Ho; Khatibzadeh, Shahab; Khera, Sahil; Khoja, Tawfik Ahmed Muthafer; Khubchandani, Jagdish; Kieling, Christian; Kim, Cho-il; Kim, Daniel; Kimokoti, Ruth W; Kissoon, Niranjan; Kivipelto, Miia; Knibbs, Luke D; Kokubo, Yoshihiro; Kopec, Jacek A; Koul, Parvaiz A; Koyanagi, Ai; Kravchenko, Michael; Kromhout, Hans; Krueger, Hans; Ku, Tiffany; Defo, Barthelemy Kuate; Kuchenbecker, Ricardo S; Bicer, Burcu Kucuk; Kuipers, Ernst J; Kumar, GAnil; Kwan, Gene F; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lallukka, Tea; Lan, Qing; Larsson, Anders; Latif, Asma Abdul; Beatriz Lawrynowicz, Alicia Elena; Leasher, Janet L; Leigh, James; Leung, Janni; Levi, Miriam; Li, Xiaohong; Li, Yichong; Liang, Juan; Liu, Shiwei; Lloyd, Belinda K; Logroscino, Giancarlo; Lotufo, Paulo A; Lunevicius, Raimundas; Maclntyre, Michael; Mahdavi, Mandi; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Malta, Deborah Carvalho; Manamo, Wondimu Ayele Ayele; Mapoma, Chabila C; Marcenes, Wagner; Martin, Randall V; Martinez-Raga, Jose; Masiye, Felix; Matsushita, Kunihiro; Matzopoulos, Richard; Mayosi, Bongani M; McGrath, John J; McKee, Martin; Meaney, Peter A; Medina, Catalina; Mehari, Alem; Mena-Rodriguez, Fabiola; Mekonnen, Alemayehu B; Melaku, Yohannes Adama; Memish, Ziad A; Mendoza, Walter; Mensink, Gert BM; Meretoja, Atte; Meretoja, Tuomo J; Mesfin, Yonatan Moges; Mhimbira, Francis Apolinary; Miller, Ted R; Mills, Edward J; Mirarefin, Mojde; Misganaw, Awoke; Mock, Charles N; Mohammadi, Alireza; Mohammed, Shafiu; Mola, Glen Liddell D; Monasta, Lorenzo; Montanez Hernandez, Julio Cesar; Montico, Marcella; Morawska, Lidia; Mori, Rintaro; Mozaffarian, Dariush; Mueller, Ulrich O; Mullany, Erin; Mumford, John Everett; Murthy, Gudlavalleti Venkata Satyanarayana; Nachega, Jean B; Naheed, Aliya; Nangia, Vinay; Nassiri, Nariman; Newton, John N; Ng, Marie; Quyen Le Nguyen; Nisar, Muhammad Imran; Pete, Patrick Martial Nkamedjie; Norheim, Ole F; Norman, Rosana E; Norrving, Bo; Nyakarahuka, Luke; Obermeyer, Carla Makhlouf; Ogbo, Felix Akpojene; Oh, In-Hwan; Oladimeji, Olanrewaju; Olivares, Pedro R; Olsen, Helen; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Opio, John Nelson; Oren, Eyal; Orozco, Ricardo; Ortiz, Alberto; Ota, Erika; Mahesh, PA; Pana, Adrian; Park, Eun-Kee; Parry, Charles D; Parsaeian, Mahboubeh; Patel, Tejas; Caicedo, Angel JPaternina; Patil, Snehal T; Patten, Scott B; Patton, George C; Pearce, Neil; Pereira, David M; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Piel, Frederic B; Pillay, Julian David; Plass, Dietrich; Polinder, Suzanne; Pond, Constance D; Pope, CArden; Pope, Daniel; Popova, Svetlana; Poulton, Richie G; Pourmalek, Farshad; Prasad, Noela M; Qorbani, Mostafa; Rabiee, Rynaz HS; Radfar, Amir; Rafay, Anwar; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rajsic, Sasa; Raju, Murugesan; Ram, Usha; Rana, Saleem M; Ranganathan, Kavitha; Rao, Puja; Razo Garcia, Christian Aspacia; Refaat, Amany H; Rehm, Colin D; Rehm, Jurgen; Reinig, Nikolas; Remuzzi, Giuseppe; Resnikoff, Serge; Ribeiro, Antonio L; Rivera, Juan A; Rolm, Hirbo Shore; Rodriguez, Anna; Rodriguez-Ramirez, Sonia; Rojas-Rueda, David; Roman, Yesenia; Ronfani, Luca; Roshandel, Gholamreza; Rothenbacher, Dietrich; Roy, Ambuj; Saleh, Muhammad Muhammad; Sanabria, Juan R; Dolores Sanchez-Nino, Maria; Sanchez-Pimienta, Tania G; Sandar, Logan; Santomauro, Damian F; Santos, Itamar S; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Schmidhuber, Josef; Schmidt, Maria Ines; Schneider, Ione JC; Schoettker, Ben; Schutte, Aletta E; Schwebel, David C; Scott, James G; Seedat, Soraya; Sepanlou, Sadaf G; Servan-Mori, Edson E; Shaheen, Amira; Shahraz, Saeid; Shaikh, Masood Ali; Levy, Teresa Shamah; Sharma, Rajesh; She, Jun; Sheikhbahaei, Sara; Shen, Jiabin; Sheth, Kevin N; Shi, Peilin; Shibuya, Kenji; Shigematsu, Mika; Shin, Min-Jeong; Shiri, Rahman; Shishani, Kawkab; Shiue, Ivy; Shrime, Mark G; Sigfusdottir, Inga Dora; Silva, Diego Augusto Santos; Alves Silveira, Dayane Gabriele; Silverberg, Jonathan I; Simard, Edgar P; Sindi, Shireen; Singh, Abhishek; Singh, Jasvinder A; Singh, Prashant Kumar; Slepak, Erica Leigh; Soljak, Michael; Soneji, Samir; Sorensen, Reed JD; Sposato, Luciano A; Sreeramareddy, Chandrashekhar T; Stathopoulou, Vasiliki; Steckling, Nadine; Steel, Nicholas; Stein, Dan J; Stein, Murray B; Stockl, Heidi; Stranges, Saverio; Stroumpoulis, Konstantinos; Sunguya, Bruno F; Swaminathan, Soumya; Sykes, Bryan L; Szoeke, Cassandra EI; Tabares-Seisdedos, Rafael; Takahashi, Ken; Talongwa, Roberto Tchio; Landon, Nikhil; Tanne, David; Tavakkoli, Mohammad; Taye, Belaynew Wasie; Taylor, Hugh R; Tedla, Bemnet Amare; Tefera, Worku Mekonnen; Tegegne, Teketo Kassaw; Tekle, Dejen Yemane; Terkawi, Abdullah Sulieman; Thakur, JS; Thomas, Bernadette A; Thomas, Matthew Lloyd; Thomson, Alan J; Thorne-Lyman, Andrew L; Thrift, Amanda G; Thurston, George D; Tillmann, Taavi; Tobe-Gai, Ruoyan; Tobollik, Myriam; Topor-Madry, Roman; Topouzis, Fotis; Towbin, Jeffrey Allen; Bach Xuan Tran; Dimbuene, Zacharie Tsala; Tsilimparis, Nikolaos; Tura, Abera Kenay; Tuzcu, Emin Murat; Tyrovolas, Stefanos; Ukwaja, Kingsley N; Undurraga, Eduardo A; Uneke, Chigozie Jesse; Uthman, Olalekan A; van Donkelaar, Aaron; van Os, Jim; Varakin, Yuri Y; Vasankari, Tommi; Veerman, JLennert; Venketasubramanian, Narayanaswamy; Violante, Francesco S; Vollset, Stein Emil; Wagner, Gregory R; Waller, Stephen G; Wang, JianLi; Wang, Linhong; Wang, Yanping; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Westerman, Ronny; Whiteford, Harvey A; Wijeratne, Tissa; Wiysonge, Charles Shey; Wolfe, Charles DA; Won, Sungho; Woolf, Anthony D; Wubshet, Mamo; Xavier, Denis; Xu, Gelin; Yadav, Ajit Kumar; Yakob, Bereket; Yalew, Ayalnesh Zemene; Yano, Yuichiro; Yaseri, Mehdi; Ye, Pengpeng; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zhu, Jun; Zipkin, Ben; Zodpey, Sanjay; Zuhlke, Liesl Joanna; Murray, Christopher JL; GBD 2015 Risk Factors
Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors-the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57.8% (95% CI 56.6-58.8) of global deaths and 41.2% (39.8-42.8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211.8 million [192.7 million to 231.1 million] global DALYs), smoking (148.6 million [134.2 million to 163.1 million]), high fasting plasma glucose (143.1 million [125.1 million to 163.5 million]), high BMI (120.1 million [83.8 million to 158.4 million]), childhood undernutrition (113.3 million [103.9 million to 123.4 million]), ambient particulate matter (103.1 million [90.8 million to 115.1 million]), high total cholesterol (88.7 million [74.6 million to 105.7 million]), household air pollution (85.6 million [66.7 million to 106.1 million]), alcohol use (85.0 million [77.2 million to 93.0 million]), and diets high in sodium (83.0 million [49.3 million to 127.5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden
PMCID:5388856
PMID: 27733284
ISSN: 1474-547x
CID: 2374732
Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015
Wang, Haidong; Bhutta, Zulfiriar A; Coates, Matthew M; Coggeshall, Megan; Dandona, Lalit; Diallo, Khassoum; Franca, Elisabeth Barboza; Fraser, Maya; Fullman, Nancy; Gething, Peter W; Hay, Simon I; Kinfu, Yohannes; Kita, Maaya; Kulikoff, Xie Rachel; Larson, Heidi J; Liang, Juan; Liang, Xiaofeng; Lind, Margaret; Lopez, Alan D; Lozano, Rafael; Mensah, George A; Mikesell, Joseph B; Mokdad, Ali H; Mooney, Meghan D; Nguyen, Grant; Rakovac, Ivo; Salomon, Joshua A; Silpakit, Naris; Sligar, Amber; Sorensen, Reed JD; Vos, Theo; Zhu, Jun; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbas, Kaja M; Abd-Allah, Foad; Abdulle, Abdishakur M; Abera, Semaw Ferede; Aboyans, Victor; Abraham, Biju; Abubakar, Ibrahim; Abu-Raddad, Laith J; Abu-Rmeileh, Niveen ME; Abyu, Gebre Yitayih; Achoki, Tom; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Adelekan, Ademola Lukman; Adou, Arsene Kouablan; Agarwal, Arnav; Ajala, Oluremi N; Akinyemiju, Tomi F; Akseer, Nadia; Alam, Khurshid; Alam, Noore KM; Alasfoor, Deena; Aldridge, Robert William; Alegretti, Miguel Angel; Alemu, Zewdie Aderaw; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Al-Raddadi, Rajaa; Alsharif, Ubai; Altirkawi, Khalid A; Martin, Elena Alvarez; Alvis-Guzman, Nelson; Amare, Azmeraw T; Amberbir, Alemayehu; Amegah, Adeladza Kofi; Ameh, Emmanuel A; Ammar, Walid; Amrock, Stephen Marc; Andersen, Hjalte H; Anderson, Gregory M; Antonio, Carl Abelardo T; Arnlov, Johan; Al Artaman; Asayesh, Hamid; Asghar, Rana Jawad; Assadi, Reza; Atique, Suleman; Avokpaho, Euripide Frinel GArthur; Awasthi, Ashish; Quintanilla, Beatriz Paulina Ayala; Bacha, Umar; Badawi, Alaa; Balakrishnan, Kalpana; Banerjee, Amitava; Banigbe, Bolanle F; Barac, Aleksandra; Barber, Ryan M; Barker-Collo, Suzanne L; Barnighausen, Till; Barrero, Lope H; Bayou, Tigist Assefa; Bayou, Yibeltal Tebekaw; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Bekele, Tolesa; Bell, Michelle L; Bello, Aminu K; Bennett, Derrick A; Bensenor, Isabela M; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Demtsu; Bhatt, Samir; Biadgilign, Sibhatu; Bikbov, Boris; Birlik, Sait Mentes; Bisanzio, Donal; Bjertness, Espen; Blore, Jed D; Bourne, Rupert RA; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas JK; Brown, Alexandria; Buckle, Geoffrey Colin; Burch, Michael; Butt, Zahid A; Campos-Nonato, Ismael Ricardo; Campuzano, Julio Cesar; Cardenas, Rosario; Carpenter, David; Carrero, Juan Jesus; Carter, Austin; Casey, Daniel C; Castaneda-Oquela, Carlos A; Rivas, Jacqueline Castillo; Castro, Ruben Estanislao; Catala-Lopez, Ferran; Cercy, Kelly; Chang, Hsing-Yi; Chang, Jung-Chen; Chibueze, Chioma Ezinne; Chisumpa, Vesper Hichilombwe; Choi, Jee-Young Jasmine; Chowdhury, Rajiv; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G; Colquhoun, Samantha M; Cooper, Cyrus; Cornaby, Leslie; Damtew, Solomon Abrha; Danawi, Hadi; Dandona, Rakhi; das Neves, Jose; Davis, Adrian C; de Jager, Pieter; De Leo, Diego; Degenhardt, Louisa; Deribe, Kebede; Deribew, Amare; Jarlais, Don CDes; deVeber, Gabrielle A; Dharmaratne, Samath D; Dhillon, Preet K; Ding, Eric L; Doshi, Pratik Pinal; Doyle, Kerrie E; Duan, Leilei; Dubey, Manisha; Ebrahimi, Hedyeh; Ellingsen, Christian Lycke; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Eshrati, Babak; Esteghamati, Alireza; Faraon, Emerito Jose Aquino; Farid, Talha A; Farinha, Carla Sofia e Sa; Faro, Andre; Farvid, Maryam S; Farzadfar, Farshad; Fereshtehnejad, Seyed-Mohammad; Fernandes, Joao C; Fischer, Florian; Fitchett, Joseph RA; Foigt, Nataliya; Franklin, Richard C; Friedman, Joseph; Furst, Thomas; Gambashidze, Ketevan; Gamkrelidze, Amiran; Ganguly, Parthasarathi; Gebre, Teshome; Gebrehiwot, Tsegaye Tewelde; Gebremedhin, Amanuel Tesfay; Gebru, Alemseged Aregay; Gelefinse, Johanna M; Gessner, Bradford D; Ginawi, Ibrahim Abdelmageem Mohamed; Giref, Ababi Zergaw; Gishu, Melkamu Dedefo; Gomez-Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Goto, Atsushi; Gouda, Hebe N; Gugnani, Harish Chander; Guo, Yuming; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Gyawali, Bishal; Haagsma, Juanita A; Hafezi-Nejad, Nima; Haile, Demewoz; Hailu, Alemayehu Desalegne; Hailu, Gessessew Bugssa; Hamadeh, Randah Ribhi; Hancock, Jamie; Handal, Alexis J; Hankey, Graeme J; Harb, Hilda L; Harikrishnan, Sivadasanpillai; Harun, Kimani M; Havmoeller, Rasmus; Hay, Roderick J; Heredia-Pi, Ileana Beatriz; Hoek, Hans W; Horino, Masako; Horita, Nobuyuki; Hosgood, HDean; Hotez, Peter J; Hoy, Damian G; Hsairi, Mohamed; Hu, Guoqing; Huang, Cheng; Huang, John J; Huang, Hsiang; Huiart, Laetitia; Iburg, Kim Moesgaard; Idrisov, Bulat T; Innos, Kaire; Jacobsen, Kathryn H; Jahanmehr, Nader; Javanbakht, Mehdi; Jayatilleke, Achala Upendra; Jee, Sun Ha; Jeemon, Panniyammakal; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jibat, Tariku; Jin, Ye; Jonas, Jost B; Kabir, Zubair; Kalkonde, Yogeshwar; Karnak, Ritul; Kan, Haidong; Kang, Gagandeep; Karch, Andre; Karema, Corine Kakizi; Kasaeian, Amir; Kaul, Anil; Kawakami, Norito; Kayibanda, Jeanne Francoise; Kazanjan, Konstantin; Keiyoro, Peter Njenga; Kemp, Andrew Haddon; Kengne, Andre Pascal; Keren, Andre; Kereselidze, Maia; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khalil, Ibrahim A; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khang, Young -Ho; Khonelidze, Irma; Khubchandani, Jagdish; Kim, Cho-il; Kim, Daniel; Kim, Yun Jin; Kissoon, Niranjan; Kivipelto, Miia; Knibbs, Luke D; Kokubo, Yoshihiro; Kosen, Soewarta; Koul, Parvaiz A; Koyanagi, Ai; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kudom, Andreas A; Kumar, GAnil; Kyu, Hmwe H; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lam, Hilton; Lam, Jennifer O; Lansingh, Van C; Larsson, Anders; Leigh, James; Leung, Ricky; Li, Yichong; Li, Yongmei; Lindsay, MPatrice; Liu, Patrick Y; Liu, Shiwei; Lloyd, Belinda K; Lo, Warren D; Logroscino, Giancarlo; Low, Nicola; Lunevicius, Raimundas; Lyons, Ronan A; Ma, Stefan; Abd El Razek, Hassan Magdy; Abd El Razek, Mohammed Magdy; Mandavi, Mandi; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Mapoma, Chabila C; 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Ye, Pengpeng; Yebyo, Henock Gebremedhin; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zeeb, Hajo; Zhang, Hao; Zhao, Yong; Zheng, Yingfeng; Zhou, Maigeng; Zodpey, Sanjay; Murray, Christopher JL; GBD 2015 Child Mortality
Background Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time. Methods Drawing from analytical approaches developed and refined in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1-4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980-2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specific mortality estimates were generated through a two-stage age-sex splitting process, and stillbirth estimates were produced with a mixed-effects model, which accounted for variable stillbirth definitions and data source-specific biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as differences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, 5.8 million (95% uncertainty interval [UI] 5.7-6.0) children younger than 5 years died in 2015, representing a 52.0% (95% UI 50.7-53.3) decrease in the number of under-5 deaths since 1990. Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42.4% (41.3-43.6) to 2.6 million (2.6-2.7) neonatal deaths and 47.0% (35.1-57.0) to 2.1 million (1.8-2.5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3.0% (2.6-3.3), falling short of the 4.4% annualised rate of decrease required to achieve MDG4. During this time, 58 countries met or exceeded the pace of progress required to meet MDG4. Between 2000, the year MDG4 was formally enacted, and 2015, 28 additional countries that did not achieve the 4.4% rate of decrease from 1990 met the MDG4 pace of decrease. However, absolute levels of under-5 mortality remained high in many countries, with 11 countries still recording rates exceeding 100 per 1000 livebirths in 2015. Marked decreases in under-5 deaths due to a number of communicable diseases, including lower respiratory infections, diarrhoeal diseases, measles, and malaria, accounted for much of the progress in lowering overall under-5 mortality in low-income countries. Compared with gains achieved for infectious diseases and nutritional deficiencies, the persisting toll of neonatal conditions and congenital anomalies on child survival became evident, especially in low-income and low-middle-income countries. We found sizeable heterogeneities in comparing observed and expected rates of under-5 mortality, as well as differences in observed and expected rates of change for under-5 mortality. At the global level, we recorded a divergence in observed and expected levels of under-5 mortality starting in 2000, with the observed trend falling much faster than what was expected based on SDI through 2015. Between 2000 and 2015, the world recorded 10.3 million fewer under-5 deaths than expected on the basis of improving SDI alone. Interpretation Gains in child survival have been large, widespread, and in many places in the world, faster than what was anticipated based on improving levels of development. Yet some countries, particularly in sub-Saharan Africa, still had high rates of under-5 mortality in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-effective intervention packages to innovative financing mechanisms, is vital to charting the pathways for ultimately ending preventable child deaths by 2030.
PMCID:5224696
PMID: 27733285
ISSN: 1474-547x
CID: 2374742
Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015
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Nachega, Jean B; Nagel, Gabriele; Naidoo, Kovin S; Naldi, Luigi; Nangia, Vinay; Neal, Bruce; Nejjari, Chakib; Newton, Charles R; Newton, John N; Ngalesoni, Frida Namnyak; Nguhiu, Peter; Nguyen, Grant; Quyen Le Nguyen; Nisar, Muhammad Imran; Pete, Patrick Martial Nkamedjie; Nolte, Sandra; Nomura, Marika; Norheim, Ole F; Norrving, Bo; Obermeyer, Carla Makhlouf; Ogbo, Felix Akpojene; Oh, In-Hwan; Oladimeji, Olanrewaju; Olivares, Pedro R; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Opio, John Nelson; Oren, Eyal; Ortiz, Alberto; Osborne, Richard H; Ota, Erika; Owolabi, Mayowa O; Mahesh, PA; Park, Eun-Kee; Park, Hye-Youn; Parry, Charles D; Parsaeian, Mahboubeh; Patel, Tejas; Patel, Vikram; Caicedo, Angel JPaternina; Patil, Snehal T; Patten, Scott B; Patton, George C; Paudel, Deepak; Pedro, Joao Mario; Pereira, David M; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Piel, Frederic B; Pillay, Julian David; Pinho, Christine; Pishgar, Farhad; Polinder, Suzanne; Poulton, Richie G; Pourmalek, Farshad; Qorbani, Mostafa; Rabiee, Rynaz HS; Radfar, Amir; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Rajsic, Sasa; Raju, Murugesan; Ram, Usha; Rana, Saleem M; Ranabhat, Chhabi Lal; Ranganathan, Kavitha; Rao, Puja C; Refaat, Amany H; Reitsma, Marissa B; Remuzzi, Giuseppe; Resnikoff, Serge; Ribeiro, Antonio L; Blancas, Maria Jesus Rios; Rolm, Hirbo Shore; Roberts, Bayard; Rodriguez, Mina; Rojas-Rueda, David; Ronfani, Luca; Roshandel, Gholamreza; Roth, Gregory A; Rothenbacher, Dietrich; Roy, Ambuj; Roy, Nobhojit; Sackey, Ben Benasco; Sagar, Rajesh; Saleh, Muhammad Muhammad; Sanabria, Juan R; Santomauro, Damian F; Santos, Itamar S; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Sawyer, Susan M; Schmidhuber, Josef; Schmidt, Maria Ines; Schneider, Ione JC; Schutte, Aletta E; Schwebel, David C; Seedat, Soraya; Sepanlou, Sadaf G; Servan-Mori, Edson E; Shackelford, Katya; 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Weiss, Daniel J; Werdecker, Andrea; Westerman, Ronny; Whiteford, Harvey A; Wilkinson, James D; Wiysonge, Charles Shey; Wolfe, Charles DA; Wolfe, Ingrid; Won, Sungho; Woolf, Anthony D; Workie, Shimelash Bitew; Wubshet, Mamo; Xu, Gelin; Yadav, Ajit Kumar; Yakob, Bereket; Yalew, Ayalnesh Zemene; Yan, Lijing L; Yano, Yuichiro; Yaseri, Mehdi; Ye, Pengpeng; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zambrana-Torrelio, Carlos; Zapata, Tomas; Zegeye, Elias Asfaw; Zhao, Yi; Zhou, Maigeng; Zodpey, Sanjay; Zonies, David; Murray, Christopher JL; GBD 2015 SDG Collaborators
Background In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). Methods We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices. Findings In 2015, the median health-related SDG index was 59.3 (95% uncertainty interval 56.8-61.8) and varied widely by country, ranging from 85.5 (84.2-86.5) in Iceland to 20.4 (15.4-24.9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r(2) = 0.88) and the MDG index (r(2) = 0.2), whereas the non-MDG index had a weaker relation with SDI (r(2) = 0.79). Between 2000 and 2015, the health-related SDG index improved by a median of 7.9 (IQR 5.0-10.4), and gains on the MDG index (a median change of 10.0 [6.7-13.1]) exceeded that of the non-MDG index (a median change of 5.5 [2.1-8.9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened. Interpretation GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs.
PMCID:5055583
PMID: 27665228
ISSN: 1474-547x
CID: 2374752
