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

GBD 2013 Mortality and Causes of Death Collaborators, (2015) 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. Lancet, 385 (9963). pp. 117-171.

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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.

Item ID: 38544
Item Type: Article (Research - C1)
ISSN: 1474-547X
Additional Information:

GBD 2013 Mortality and Causes of Death Collaborators: 712 authors including JCU-affiliated author Richard C. Franklin.

Mohsen Naghavi, Haidong Wang, Rafael Lozano, Adrian Davis, Xiaofeng Liang, Maigeng Zhou, Stein Emil Vollset, Ayse Abbasoglu Ozgoren*, Safa Abdalla, Foad Abd-Allah, Muna I Abdel Aziz, Semaw Ferede Abera, Victor Aboyans, Biju Abraham, Jerry P Abraham, Katrina E Abuabara, Ibrahim Abubakar, Laith J Abu-Raddad, Niveen ME Abu-Rmeileh, Tom Achoki, Ademola Adelekan, Zanfina Ademi, Koranteng Adofo, Arséne Kouablan Adou, José C Adsuar, Johan Ärnlov, Emilie Elisabet Agardh, Dickens Akena, Mazin J Al Khabouri, Deena Alasfoor, Mohammed Albittar, Miguel Angel Alegretti, Alicia V Aleman, Zewdie Aderaw Alemu, Rafael Alfonso-Cristancho, Samia Alhabib, Mohammed K Ali, Raghib Ali, Francois Alla, Faris Al Lami, Peter Allebeck, Mohammad A AlMazroa, Rustam Al-Shahi Salman, Ubai Alsharif, Elena Alvarez, Nelson Alviz-Guzman, Adansi A Amankwaa, Azmeraw T Amare, Omid Ameli, Hassan Amini, Walid Ammar, H Ross Anderson, Benjamin O Anderson, Carl Abelardo T Antonio, Palwasha Anwari, Henry Apfel, Solveig Argeseanu Cunningham, Valentina S Arsic Arsenijevic, Al Artaman, Majed Masoud Asad, Rana J Asghar, Reza Assadi, Lydia S Atkins, Charles Atkinson, Alaa Badawi, Maria C Bahit, Talal Bakfalouni, Kalpana Balakrishnan, Shivanthi Balalla, Amitava Banerjee, Ryan M Barber, Suzanne L Barker-Collo, Simon Barquera, Lars Barregard, Lope H Barrero, Tonatiuh Barrientos-Gutierrez, Arindam Basu, Sanjay Basu, Mohammed Omar Basulaiman, Justin Beardsley, Neeraj Bedi, Ettore Beghi, Tolesa Bekele, Michelle L Bell, Corina Benjet, Derrick A Bennett, Isabela M Bensenor, Habib Benzian, Amelia Bertozzi-Villa, Tariku Jibat Beyene, Neeraj Bhala, Ashish Bhalla, Zulfiqar A Bhutta, Boris Bikbov, Aref Bin Abdulhak, Stan Biryukov, Jed D Blore, Fiona M Blyth, Megan A Bohensky, Guilherme Borges, Dipan Bose, Soufiane Boufous, Rupert R Bourne, Lindsay N Boyers, Michael Brainin, Michael Brauer, Carol E G Brayne, Alexandra Brazinova, Nicholas Breitborde, Hermann Brenner, Adam D M Briggs, Jonathan C Brown, Traolach S Brugha, Geoffrey C Buckle, Linh Ngoc Bui, Gene Bukhman, Michael Burch, Ismael Ricardo Campos Nonato, Hélène Carabin, Rosario Cárdenas, Jonathan Carapetis, David O Carpenter, Valeria Caso, Carlos A Castañeda-Orjuela, Ruben Estanislao Castro, Ferrán Catalá-López, Fiorella Cavalleri, Jung-Chen Chang, Fiona C Charlson, Xuan Che, Honglei Chen, Yingyao Chen, Jian Sheng Chen, Zhengming Chen, Peggy Pei-Chia Chiang, Odgerel Chimed-Ochir, Rajiv Chowdhury, Hanne Christensen, Costas A Christophi, Ting-Wu Chuang, Sumeet S Chugh, Massimo Cirillo, Matthew M Coates, Luc Edgar Coffeng, Megan S Coggeshall, Aaron Cohen, Valentina Colistro, Samantha M Colquhoun, Mercedes Colomar, Leslie Trumbull Cooper, Cyrus Cooper, Luis M Coppola, Monica Cortinovis, Karen Courville, Benjamin C Cowie, Michael H Criqui, John A Crump, Lucia Cuevas-Nasu, Iuri da Costa Leite, Kaustubh C Dabhadkar, Lalit Dandona, Rakhi Dandona, Emily Dansereau, Paul I Dargan, Anand Dayama, Vanessa De la Cruz-Góngora, Shelley F de la Vega, Diego De Leo, Louisa Degenhardt, Borja del Pozo-Cruz, Robert P Dellavalle, Kebede Deribe, Don C Des Jarlais, Muluken Dessalegn, Gabrielle A deVeber, Samath D Dharmaratne, Mukesh Dherani, Jose-Luis Diaz-Ortega, Cesar Diaz-Torne, Daniel Dicker, Eric L Ding, Klara Dokova, E Ray Dorsey, Tim R Driscoll, Leilei Duan, Herbert C Duber, Adnan M Durrani, Beth E Ebel, Karen M Edmond, Richard G Ellenbogen, Yousef Elshrek, Sergey Petrovich Ermakov, Holly E Erskine, Babak Eshrati, Alireza Esteghamati, Kara Estep, Thomas Fürst, Saman Fahimi, Anna S Fahrion, Emerito Jose A Faraon, Farshad Farzadfar, Derek FJ Fay, Andrea B Feigl, Valery L Feigin, Manuela Mendonca Felicio, Seyed-Mohammad Fereshtehnejad, Jefferson G Fernandes, Alize J Ferrari, Thomas D Fleming, Nataliya Foigt, Kyle Foreman, Mohammad H Forouzanfar, F Gerry R Fowkes, Urbano Fra Paleo, Richard C Franklin, Neal D Futran, Lynne Gaffikin, Ketevan Gambashidze, Fortuné Gbètoho Gankpé, Francisco Armando García-Guerra, Ana Cristina Garcia, Johanna M Geleijnse, 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Suzanne Polinder, Svetlana Popova, Richie G Poulton, Farshad Pourmalek, Dorairaj Prabhakaran, Dima Qato, Amado D Quezada, D Alex Quistberg, Felicia Rabito, Anwar Rafay, Kazem Rahimi, Vafa Rahimi-Movaghar, Sajjad UR Rahman, Murugesan Raju, Ivo Rakovac, Saleem M Rana, Amany Refaat, Giuseppe Remuzzi, Antonio L Ribeiro, Stefano Ricci, Patricia M Riccio, Lee Richardson, Jan Hendrik Richardus, Bayard Roberts, D Allen Roberts, Margaret Robinson, Anna Roca, Alina Rodriguez, David Rojas-Rueda, Luca Ronfani, Robin Room, Gregory A Roth, Dietrich Rothenbacher, David H Rothstein, Jane TF Rowley, Nobhojit Roy, George M Ruhago, Lesley Rushton, Sankar Sambandam, Kjetil Søreide, Mohammad Yahya Saeedi, Sukanta Saha, Ramesh Sahathevan, Mohammad Ali Sahraian, Berhe Weldearegawi Sahle, Joshua A Salomon, Deborah Salvo, Genesis May J Samonte, Uchechukwu Sampson, Juan Ramon Sanabria, Logan Sandar, Itamar S Santos, Maheswar Satpathy, Monika Sawhney, Mete Saylan, Peter Scarborough, Ben Schöttker, Jürgen C 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Ao, Carolina Maria Teixeira, Tara Templin, Eric Yeboah Tenkorang, Abdullah Sulieman Terkawi, Bernadette A Thomas, Andrew L Thorne-Lyman, Amanda G Thrift, George D Thurston, Taavi Tillmann, David L Tirschwell, Imad M Tleyjeh, Marcello Tonelli, Fotis Topouzis, Jeffrey A Towbin, Hideaki Toyoshima, Jefferson Traebert, Bach X Tran, Thomas Truelsen, Ulises Trujillo, Matias Trillini, Zacharie Tsala Dimbuene, Miltiadis Tsilimbaris, E Murat Tuzcu, Clotilde Ubeda, Uche S Uchendu, Kingsley N Ukwaja, Eduardo A Undurraga, Andrew J Vallely, Steven van de Vijver, Coen H van Gool, Yuri Y Varakin, Tommi J Vasankari, Ana Maria Nogales Vasconcelos, Monica S Vavilala, N Venketasubramanian, Lakshmi Vijayakumar, Salvador Villalpando, Francesco S Violante, Vasiliy Victorovich Vlassov, Gregory R Wagner, Stephen G Waller, JianLi Wang, Linhong Wang, XiaoRong Wang, Yanping Wang, Tati Suryati Warouw, Scott Weichenthal, Elisabete Weiderpass, Robert G Weintraub, Wang Wenzhi, Andrea Werdecker, K Ryan R Wessells, Ronny Westerman, Harvey A Whiteford, James D Wilkinson, Thomas Neil Williams, Solomon Meseret Woldeyohannes, Charles DA Wolfe, Timothy M Wolock, Anthony D Woolf, John Q Wong, Jonathan L Wright, Sarah Wulf, Brittany Wurtz, Gelin Xu, Yang C Yang, Yuichiro Yano, Hiroshi Yatsuya, Paul Yip, Naohiro Yonemoto, Seok-Jun Yoon, Mustafa Younis, Chuanhua Yu, Kim Yun Jin, Maysaa El Sayed Zaki, Mohammed Fouad Zamakhshary, Hajo Zeeb, Yong Zhang, Yong Zhao, Yingfeng Zheng, Jun Zhu, Shankuan Zhu, David Zonies, Xiao Nong Zou, Joseph R Zunt, Theo Vos†, Alan D Lopez†, Christopher JL Murray†.

*Authors here onwards listed alphabetically.

†Joint senior authors.

Date Deposited: 08 May 2015 01:39
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 100%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920408 Health Status (e.g. Indicators of Well-Being) @ 100%
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