Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017

Gregory A. Roth, Degu Abate, Kalkidan Hassen Abate, Solomon M. Abay, Cristiana Abbafati, Nooshin Abbasi, Hedayat Abbastabar, Foad Abd-Allah, Jemal Abdela, Ahmed Abdelalim, Ibrahim Abdollahpour, Rizwan Suliankatchi Abdulkader, Haftom Temesgen Abebe, Molla Abebe, Zegeye Abebe, Ayenew Negesse Abejie, Semaw F. Abera, Olifan Zewdie Abil, Haftom Niguse Abraha, Aklilu Roba AbrhamLaith Jamal Abu-Raddad, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Abdu A. Adamu, Oladimeji M. Adebayo, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O. Adetokunboh, Beyene Meressa Adhena, Mina G. Adib, Amha Admasie, Ashkan Afshin, Gina Agarwal, Kareha M. Agesa, Anurag Agrawal, Sutapa Agrawal, Alireza Ahmadi, Mehdi Ahmadi, Muktar Beshir Ahmed, Sayem Ahmed, Amani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Mohammad Esmaeil Akbari, Rufus Olusola Akinyemi, Nadia Akseer, Ziyad Al-Aly, Ayman Al-Eyadhy, Rajaa M. Al-Raddadi, Fares Alahdab, Khurshid Alam, Tahiya Alam, Animut Alebel, Kefyalew Addis Alene, Mehran Alijanzadeh, Reza Alizadeh-Navaei, Syed Mohamed Aljunid, Ala'a Alkerwi, Francois Alla, Peter Allebeck, Jordi Alonso, Khalid Altirkawi, Nelson Alvis-Guzman, Azmeraw T. Amare, Leopold N. Aminde, Erfan Amini, Walid Ammar, Yaw Ampem Amoako, Nahla Hamed Anber, Catalina Liliana Andrei, Sofia Androudi, Megbaru Debalkie Animut, Mina Anjomshoa, Hossein Ansari, Mustafa Geleto Ansha, Carl Abelardo T. Antonio, Palwasha Anwari, Olatunde Aremu, Johan Arnlov, Amit Arora, Monika Arora, Al Artaman, Krishna K. Aryal, Hamid Asayesh, Ephrem Tsegay Asfaw, Zerihun Ataro, Suleman Atique, Sachin R. Atre, Marcel Ausloos, Euripide F.G.A. Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Yohanes Ayele, Rakesh Ayer, Peter S. Azzopardi, Arefeh Babazadeh, Umar Bacha, Hamid Badali, Alaa Badawi, Ayele Geleto Bali, Katherine E. Ballesteros, Maciej Banach, Kajori Banerjee, Marlena S. Bannick, Joseph Adel Mattar Banoub, Miguel A. Barboza, Suzanne Lyn Barker-Collo, Till Winfried Barnighausen, Simon Barquera, Lope H. Barrero, Quique Bassat, Sanjay Basu, Bernhard T. Baune, Habtamu Wondifraw Baynes, Shahrzad Bazargan-Hejazi, Neeraj Bedi, Ettore Beghi, Masoud Behzadifar, Meysam Behzadifar, Yannick Bejot, Bayu Begashaw Bekele, Abate Bekele Belachew, Ezra Belay, Yihalem Abebe Belay, Michelle L. Bell, Aminu K. Bello, Derrick A. Bennett, Isabela M. Bensenor, Adam E. Berman, Eduardo Bernabe, Robert S. Bernstein, Gregory J. Bertolacci, Mircea Beuran, Tina Beyranvand, Ashish Bhalla, Suraj Bhattarai, Soumyadeeep Bhaumik, Zulfiqar A. Bhutta, Belete Biadgo, Molly H. Biehl, Ali Bijani, Boris Bikbov, Ver Bilano, Nigus Bililign, Muhammad Shahdaat Bin Sayeed, Donal Bisanzio, Tuhin Biswas, Brigette F. Blacker, Berrak Bora Basara, Rohan Borschmann, Cristina Bosetti, Kayvan Bozorgmehr, Oliver J. Brady, Luisa C. Brant, Carol Brayne, Alexandra Brazinova, Nicholas J.K. Breitborde, Hermann Brenner, Paul Svitil Briant, Gabrielle Britton, Traolach Brugha, Reinhard Busse, Zahid A. Butt, Charlton S.K.H. Callender, Ismael R. Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Mate Car, Rosario Cardenas, Giulia Carreras, Juan J. Carrero, Austin Carter, Felix Carvalho, Carlos A. Castaneda-Orjuela, Jacqueline Castillo Rivas, Chris D. Castle, Clara Castro, Franz Castro, Ferran Catala-Lopez, Ester Cerin, Yazan Chaiah, Jung Chen Chang, Fiona J. Charlson, Pankaj Chaturvedi, Peggy Pei Chia Chiang, Odgerel Chimed-Ochir, Vesper Hichilombwe Chisumpa, Abdulaal Chitheer, Rajiv Chowdhury, Hanne Christensen, Devasahayam J. Christopher, Sheng Chia Chung, Flavia M. Cicuttini, Liliana G. Ciobanu, Massimo Cirillo, Aaron J. Cohen, Leslie Trumbull Cooper, Paolo Angelo Cortesi, Monica Cortinovis, Ewerton Cousin, Benjamin C. Cowie, Michael H. Criqui, Elizabeth A. Cromwell, Christopher Stephen Crowe, John A. Crump, Matthew Cunningham, Alemneh Kabeta Daba, Abel Fekadu Dadi, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Paul I. Dargan, Ahmad Daryani, Siddharth K. Das, Rajat Das Gupta, Jose Das Neves, Tamirat Tesfaye Dasa, Aditya Prasad Dash, Adrian C. Davis, Nicole Davis Weaver, Dragos Virgil Davitoiu, Kairat Davletov, Fernando Pio De La Hoz, Jan Walter De Neve, Meaza Girma Degefa, Louisa Degenhardt, Tizta T. Degfie, Selina Deiparine, Gebre Teklemariam Demoz, Balem Betsu Demtsu, Edgar Denova-Gutierrez, Kebede Deribe, Nikolaos Dervenis, Don C. Des Jarlais, Getenet Ayalew Dessie, Subhojit Dey, Samath D. Dharmaratne, Daniel Dicker, Mesfin Tadese Dinberu, Eric L. Ding, M. Ashworth Dirac, Shirin Djalalinia, Klara Dokova, David Teye Doku, Christl A. Donnelly, E. Ray Dorsey, Pratik P. Doshi, Dirk Douwes-Schultz, Kerrie E. Doyle, Tim R. Driscoll, Manisha Dubey, Eleonora Dubljanin, Eyasu Ejeta Duken, Bruce B. Duncan, Andre R. Duraes, Hedyeh Ebrahimi, Soheil Ebrahimpour, Dumessa Edessa, David Edvardsson, Anne Elise Eggen, Charbel El Bcheraoui, Maysaa El Sayed Zaki, Ziad El-Khatib, Hajer Elkout, Christian Lycke Ellingsen, Matthias Endres, Aman Yesuf Endries, Benjamin Er, Holly E. Erskine, Babak Eshrati, Sharareh Eskandarieh, Reza Esmaeili, Alireza Esteghamati, Mahdi Fakhar, Hamed Fakhim, Mahbobeh Faramarzi, Mohammad Fareed, Farzaneh Farhadi, Carla Sofia Esá Farinha, Andre Faro, Maryam S. Farvid, Farshad Farzadfar, Mohammad Hosein Farzaei, Valery L. Feigin, Andrea B. Feigl, Netsanet Fentahun, Seyed Mohammad Fereshtehnejad, Eduarda Fernandes, Joao C. Fernandes, Alize J. Ferrari, Garumma Tolu Feyissa, Irina Filip, Samuel Finegold, Florian Fischer, Christina Fitzmaurice, Nataliya A. Foigt, Kyle J. Foreman, Carla Fornari, Tahvi D. Frank, Takeshi Fukumoto, John E. Fuller, Nancy Fullman, Thomas Furst, Joao M. Furtado, Neal D. Futran, Silvano Gallus, Alberto L. Garcia-Basteiro, Miguel A. Garcia-Gordillo, William M. Gardner, Abadi Kahsu Gebre, Tsegaye Tewelde Gebrehiwot, Amanuel Tesfay Gebremedhin, Bereket Gebremichael, Teklu Gebrehiwo Gebremichael, Tilayie Feto Gelano, Johanna M. Geleijnse, Ricard Genova-Maleras, Yilma Chisha Dea Geramo, Peter W. Gething, Kebede Embaye Gezae, Mohammad Rasoul Ghadami, Reza Ghadimi, Khalil Ghasemi Falavarjani, Maryam Ghasemi-Kasman, Mamata Ghimire, Katherine B. Gibney, Paramjit Singh Gill, Tiffany K. Gill, Richard F. Gillum, Ibrahim Abdelmageed Ginawi, Maurice Giroud, Giorgia Giussani, Shifalika Goenka, Ellen M. Goldberg, Srinivas Goli, Hector Gomez-Dantes, Philimon N. Gona, Sameer Vali Gopalani, Taren M. Gorman, Atsushi Goto, Alessandra C. Goulart, Elena V. Gnedovskaya, Ayman Grada, Giuseppe Grosso, Harish Chander Gugnani, Andre Luiz Sena Guimaraes, Yuming Guo, Prakash C. Gupta, Rahul Gupta, Rajeev Gupta, Tanush Gupta, Reyna Alma Gutierrez, Bishal Gyawali, Juanita A. Haagsma, Nima Hafezi-Nejad, Tekleberhan B. 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Huang, Abdullatif Husseini, Mohammedaman Mama Hussen, Susan Hutfless, Bulat Idrisov, Olayinka Stephen Ilesanmi, Usman Iqbal, Seyed Sina Naghibi Irvani, Caleb Mackay Salpeter Irvine, Nazrul Islam, Sheikh Mohammed Shariful Islam, Farhad Islami, Kathryn H. Jacobsen, Leila Jahangiry, Nader Jahanmehr, Sudhir Kumar Jain, Mihajlo Jakovljevic, Moti Tolera Jalu, Spencer L. James, Mehdi Javanbakht, Achala Upendra Jayatilleke, Panniyammakal Jeemon, Kathy J. Jenkins, Ravi Prakash Jha, Vivekanand Jha, Catherine O. Johnson, Sarah C. Johnson, Jost B. Jonas, Ankur Joshi, Jacek Jerzy Jozwiak, Suresh Banayya Jungari, Mikk Jurisson, Zubair Kabir, Rajendra Kadel, Amaha Kahsay, Rizwan Kalani, Manoochehr Karami, Behzad Karami Matin, Andre Karch, Corine Karema, Hamidreza Karimi-Sari, Amir Kasaeian, Dessalegn H. Kassa, Getachew Mullu Kassa, Tesfaye Dessale Kassa, Nicholas J. Kassebaum, Srinivasa Vittal Katikireddi, Anil Kaul, Zhila Kazemi, Ali Kazemi Karyani, Dhruv Satish Kazi, Adane Teshome Kefale, Peter Njenga Keiyoro, Grant Rodgers Kemp, Andre Pascal Kengne, Andre Keren, Chandrasekharan Nair Kesavachandran, Yousef Saleh Khader, Behzad Khafaei, Morteza Abdullatif Khafaie, Alireza Khajavi, Nauman Khalid, Ibrahim A. Khalil, Ejaz Ahmad Khan, Muhammad Shahzeb Khan, Muhammad Ali Khan, Young Ho Khang, Mona M. Khater, Abdullah T. Khoja, Ardeshir Khosravi, Mohammad Hossein Khosravi, Jagdish Khubchandani, Aliasghar A. Kiadaliri, Getiye D. Kibret, Zelalem Teklemariam Kidanemariam, Daniel N. Kiirithio, Daniel Kim, Young Eun Kim, Yun Jin Kim, Ruth W. Kimokoti, Yohannes Kinfu, Adnan Kisa, Katarzyna Kissimova-Skarbek, Mika Kivimaki, Ann Kristin Skrindo Knudsen, Jonathan M. Kocarnik, Sonali Kochhar, Yoshihiro Kokubo, Tufa Kolola, Jacek A. Kopec, Parvaiz A. Koul, Ai Koyanagi, Michael A. Kravchenko, Kewal Krishan, Barthelemy Kuate Defo, Burcu Kucuk Bicer, G. Anil Kumar, Manasi Kumar, Pushpendra Kumar, Michael J. Kutz, Igor Kuzin, Hmwe Hmwe Kyu, Deepesh P. Lad, Sheetal D. Lad, Alessandra Lafranconi, Dharmesh Kumar Lal, Ratilal Lalloo, Tea Lallukka, Jennifer O. Lam, Faris Hasan Lami, Van C. Lansingh, Sonia Lansky, Heidi J. Larson, Arman Latifi, Kathryn Mei Ming Lau, Jeffrey V. Lazarus, Georgy Lebedev, Paul H. Lee, James Leigh, Mostafa Leili, Cheru Tesema Leshargie, Shanshan Li, Yichong Li, Juan Liang, Lee Ling Lim, Stephen S. Lim, Miteku Andualem Limenih, Shai Linn, Shiwei Liu, Yang Liu, Rakesh Lodha, Chris Lonsdale, Alan D. Lopez, Stefan Lorkowski, Paulo A. Lotufo, Rafael Lozano, Raimundas Lunevicius, Stefan Ma, Erlyn Rachelle King Macarayan, Mark T. Mackay, Jennifer H. MacLachlan, Emilie R. Maddison, Fabiana Madotto, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Dhaval P. 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Meretoja, Tomislav Mestrovic, Haftay Berhane Mezgebe, Bartosz Miazgowski, Tomasz Miazgowski, Anoushka I. Millear, Ted R. Miller, Molly Katherine Miller-Petrie, G. K. Mini, Parvaneh Mirabi, Mojde Mirarefin, Andreea Mirica, Erkin M. Mirrakhimov, Awoke Temesgen Misganaw, Habtamu Mitiku, Babak Moazen, Karzan Abdulmuhsin Mohammad, Moslem Mohammadi, Noushin Mohammadifard, Mohammed A. Mohammed, Shafiu Mohammed, Viswanathan Mohan, Ali H. Mokdad, Mariam Molokhia, Lorenzo Monasta, Ghobad Moradi, Maziar Moradi-Lakeh, Mehdi Moradinazar, Paula Moraga, Lidia Morawska, Ilais Moreno Velasquez, Joana Morgado-Da-Costa, Shane Douglas Morrison, Marilita M. Moschos, Simin Mouodi, Seyyed Meysam Mousavi, Kindie Fentahun Muchie, Ulrich Otto Mueller, Satinath Mukhopadhyay, Kate Muller, John Everett Mumford, Jonah Musa, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Jean B. Nachega, Gabriele Nagel, Aliya Naheed, Azin Nahvijou, Gurudatta Naik, Sanjeev Nair, Farid Najafi, Luigi Naldi, Hae Sung Nam, Vinay Nangia, Jobert Richie Nansseu, Bruno Ramos Nascimento, Gopalakrishnan Natarajan, Nahid Neamati, Ionut Negoi, Ruxandra Irina Negoi, Subas Neupane, Charles R.J. Newton, Frida N. Ngalesoni, Josephine W. Ngunjiri, Anh Quynh Nguyen, Grant Nguyen, Ha Thu Nguyen, Huong Thanh Nguyen, Long Hoang Nguyen, Minh Nguyen, Trang Huyen Nguyen, Emma Nichols, Dina Nur Anggraini Ningrum, Yirga Legesse Nirayo, Molly R. Nixon, Nomonde Nolutshungu, Shuhei Nomura, Ole F. Norheim, Mehdi Noroozi, Bo Norrving, Jean Jacques Noubiap, Hamid Reza Nouri, Malihe Nourollahpour Shiadeh, Mohammad Reza Nowroozi, Peter S. Nyasulu, Christopher M. Odell, Richard Ofori-Asenso, Felix Akpojene Ogbo, In Hwan Oh, Olanrewaju Oladimeji, Andrew T. Olagunju, Pedro R. Olivares, Helen Elizabeth Olsen, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Kanyin L. 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Research output: Contribution to journalArticlepeer-review

1450 Scopus citations

Abstract

Background: Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods: The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries—Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODEm), to generate cause fractions and cause-specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings: At the broadest grouping of causes of death (Level 1), non-communicable diseases (NCDs) comprised the greatest fraction of deaths, contributing to 73·4% (95% uncertainty interval [UI] 72·5–74·1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 18·6% (17·9–19·6), and injuries 8·0% (7·7–8·2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22·7% (21·5–23·9), representing an additional 7·61 million (7·20–8·01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7·9% (7·0–8·8). The number of deaths for CMNN causes decreased by 22·2% (20·0–24·0) and the death rate by 31·8% (30·1–33·3). Total deaths from injuries increased by 2·3% (0·5–4·0) between 2007 and 2017, and the death rate from injuries decreased by 13·7% (12·2–15·1) to 57·9 deaths (55·9–59·2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000–289 000) globally in 2007 to 352 000 (334 000–363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118·0% (88·8–148·6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36·4% (32·2–40·6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33·6% (31·2–36·1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respiratory infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990—neonatal disorders, lower respiratory infections, and diarrhoeal diseases—were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation: Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Funding: Bill & Melinda Gates Foundation.
Original languageEnglish (US)
Pages (from-to)1736-1788
Number of pages53
JournalThe Lancet
Volume392
Issue number10159
DOIs
StatePublished - Nov 10 2018
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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