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.
Level 3 - non-randomized controlled study
Systematic epidemiological modeling and demographic surveillance synthesis across global population datasets (by design analogy).
PubMed 30496103 · doi:10.1016/S0140-6736(18)32203-7
What was done
The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimated age-, sex-, and cause-specific mortality for 282 causes across 195 countries and territories from 1980 to 2017. Data were compiled from vital registration, verbal autopsy, cancer registries, surveys, police records, and surveillance systems. Statistical modeling tools, including the Cause of Death Ensemble model (CODEm), were used alongside redistribution algorithms for non-specific or intermediate International Classification of Diseases (ICD) codes. Population sizes, fertility rates, age-standardised death rates, and years of life lost (YLLs) were independently estimated.
What was found
In 2017, non-communicable diseases (NCDs) caused 73.4% (95% uncertainty interval [UI] 72.5-74.1) of total global deaths, communicable, maternal, neonatal, and nutritional (CMNN) conditions caused 18.6% (17.9-19.6), and injuries caused 8.0% (7.7-8.2). Between 2007 and 2017: - Total NCD deaths increased by 22.7% (21.5-23.9; an additional 7.61 million deaths [7.20-8.01]), while the age-standardised NCD death rate fell by 7.9% (7.0-8.8). - CMNN deaths fell by 22.2% (20.0-24.0) and the CMNN death rate fell by 31.8% (30.1-33.3). - Total injury deaths increased by 2.3% (0.5-4.0), while the injury death rate dropped by 13.7% (12.2-15.1) to 57.9 deaths (55.9-59.2) per 100,000. - Deaths from substance use disorders increased from 284,000 (268,000-289,000) to 352,000 (334,000-363,000). - Conflict and terrorism deaths rose by 118.0% (88.8-148.6). - Lower respiratory infection deaths dropped 36.4% (32.2-40.6) in children younger than 5 years, but increased 33.6% (31.2-36.1) in adults older than 70 years. - The leading causes of YLLs shifted between 1990 and 2017: neonatal disorders, lower respiratory infections, and diarrhoeal diseases ranked second, fourth, and fifth in 2017, while ischaemic heart disease ranked first and stroke ranked third.
Why it matters
This study provides comprehensive global benchmarks tracking the epidemiological shift toward non-communicable diseases and highlights emerging increases in mortality from substance use and conflict.
Limits
The estimates rely heavily on statistical modeling and redistribution algorithms to compensate for missing, incomplete, or low-quality vital registration data in many regions. Data from verbal autopsies carry substantial risk of misclassification, and subnational resolution remains unavailable for most included nations.
Cited by
- context Cardiovascular and cerebrovascular disease, cancer, and neurodegenerative disease together account for approximately 75% of deaths.