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dc.contributor.authorNaghavi, Mohsenen_US
dc.contributor.authorWang, Haidongen_US
dc.contributor.authorLozano, Rafaelen_US
dc.contributor.authorDavis, Adrianen_US
dc.contributor.authorLiang, Xiaofengen_US
dc.contributor.authorZhou, Maigengen_US
dc.contributor.authorVollset, Stein Emilen_US
dc.contributor.authorAbbasoglu Ozgoren, Ayseen_US
dc.contributor.authorAbdalla, Safaen_US
dc.contributor.authorAbd-Allah, Foaden_US
dc.contributor.authorAbdel Aziz, Muna I.en_US
dc.contributor.authorAbera, Semaw Feredeen_US
dc.contributor.authorAboyans, Victoren_US
dc.contributor.authorAbraham, Bijuen_US
dc.contributor.authorAbraham, Jerry P.en_US
dc.contributor.authorAbuabara, Katrina E.en_US
dc.contributor.authorAbubakar, Ibrahimen_US
dc.contributor.authorAbu-Raddad, Laith J.en_US
dc.contributor.authorAbu-Rmeileh, Niveen M.E.en_US
dc.contributor.authorAchoki, Tomen_US
dc.contributor.authorAdelekan, Ademolaen_US
dc.contributor.authorAdemi, Zanfinaen_US
dc.contributor.authorAdofo, Korantengen_US
dc.contributor.authorAdou, Arséne Kouablanen_US
dc.contributor.authorAdsuar, José C.en_US
dc.contributor.authorÄrnlov, Johanen_US
dc.contributor.authorAgardh, Emilie Elisabeten_US
dc.contributor.authorAkena, Dickensen_US
dc.contributor.authorAl Khabouri, Mazin J.en_US
dc.contributor.authorAlasfoor, Deenaen_US
dc.contributor.authorAlbittar, Mohammeden_US
dc.contributor.authorAlegretti, Miguel Angelen_US
dc.contributor.authorAleman, Alicia V.en_US
dc.contributor.authorAlemu, Zewdie Aderawen_US
dc.contributor.authorAlfonso-Cristancho, Rafaelen_US
dc.contributor.authorAlhabib, Samiaen_US
dc.contributor.authorAli, Mohammed K.en_US
dc.contributor.authorAli, Raghiben_US
dc.contributor.authorAlla, Francoisen_US
dc.contributor.authorAl Lami, Farisen_US
dc.contributor.authorAllebeck, Peteren_US
dc.contributor.authorAlMazroa, Mohammad A.en_US
dc.contributor.authorAl-Shahi Salman, Rustamen_US
dc.contributor.authorAlsharif, Ubaien_US
dc.contributor.authorAlvarez, Elenaen_US
dc.contributor.authorAlviz-Guzman, Nelsonen_US
dc.contributor.authorAmankwaa, Adansi A.en_US
dc.contributor.authorAmare, Azmeraw T.en_US
dc.contributor.authorAmeli, Omiden_US
dc.contributor.authorAmini, Hassanen_US
dc.contributor.authorAmmar, Waliden_US
dc.contributor.authorAnderson, H. Rossen_US
dc.contributor.authorAnderson, Benjamin O.en_US
dc.contributor.authorAntonio, Carl Abelardo T.en_US
dc.contributor.authorAnwari, Palwashaen_US
dc.contributor.authorApfel, Henryen_US
dc.contributor.authorArgeseanu Cunningham, Solveigen_US
dc.contributor.authorArsic Arsenijevic, Valentina S.en_US
dc.contributor.authorArtaman, Alen_US
dc.contributor.authorAsad, Majed Masouden_US
dc.contributor.authorAsghar, Rana J.en_US
dc.contributor.authorAssadi, Rezaen_US
dc.contributor.authorAtkins, Lydia S.en_US
dc.contributor.authorAtkinson, Charlesen_US
dc.contributor.authorBadawi, Alaaen_US
dc.contributor.authorBahit, Maria C.en_US
dc.contributor.authorBakfalouni, Talalen_US
dc.contributor.authorBalakrishnan, Kalpanaen_US
dc.contributor.authorBalalla, Shivanthien_US
dc.contributor.authorBanerjee, Amitavaen_US
dc.contributor.authorBarber, Ryan M.en_US
dc.contributor.authorBarker-Collo, Suzanne L.en_US
dc.contributor.authorBarquera, Simonen_US
dc.contributor.authorBarregard, Larsen_US
dc.contributor.authorBarrero, Lope H.en_US
dc.contributor.authorBarrientos-Gutierrez, Tonatiuhen_US
dc.contributor.authorBasu, Arindamen_US
dc.contributor.authorBasu, Sanjayen_US
dc.contributor.authorBasulaiman, Mohammed Omaren_US
dc.contributor.authorBeardsley, Justinen_US
dc.contributor.authorBedi, Neerajen_US
dc.contributor.authorBeghi, Ettoreen_US
dc.contributor.authorBekele, Tolesaen_US
dc.contributor.authorBell, Michelle L.en_US
dc.contributor.authorBenjet, Corinaen_US
dc.contributor.authorBennett, Derrick A.en_US
dc.contributor.authorBensenor, Isabela M.en_US
dc.contributor.authorBenzian, Habiben_US
dc.contributor.authorBertozzi-Villa, Ameliaen_US
dc.contributor.authorBeyene, Tariku Jibaten_US
dc.contributor.authorBhala, Neerajen_US
dc.contributor.authorBhalla, Ashishen_US
dc.contributor.authorBhutta, Zulfiqar A.en_US
dc.contributor.authorBikbov, Borisen_US
dc.contributor.authorBin Abdulhak, Arefen_US
dc.contributor.authorBiryukov, Stanen_US
dc.contributor.authorBlore, Jed D.en_US
dc.contributor.authorBlyth, Fiona M.en_US
dc.contributor.authorBohensky, Megan A.en_US
dc.contributor.authorBorges, Guilhermeen_US
dc.contributor.authorKaram, Nadimen_US
dc.description.abstractBackground Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. Findings Global life expectancy for both sexes increased from 65·3 years (UI 65·0-65·6) in 1990, to 71·5 years (UI 71·0-71·9) in 2013, while the number of deaths increased from 47·5 million (UI 46·8-48·2) to 54·9 million (UI 53·6-56·3) over the same interval. Global progress masked variation by age and sex: for children, average absolute differences between countries decreased but relative differences increased. For women aged 25-39 years and older than 75 years and for men aged 20-49 years and 65 years and older, both absolute and relative differences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10·7%, from 4·3 million deaths in 1990 to 4·8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. Interpretation For most countries, the general pattern of reductions in age-sex specific mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade. Funding Bill & Melinda Gates Foundation.en_US
dc.titleGlobal, 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 2013en_US
dc.typeJournal Articleen_US
dc.contributor.affiliationFaculty of Health Sciencesen_US
dc.relation.ispartoftextThe Lanceten_US
Appears in Collections:Department of Public Health
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