Age-specific and sex-specific mortality in 187 countries, 1970-2010: a systematic analysis for the Global Burden of Disease Study 2010

Wang, Haidong, Dwyer-Lindgren, Laura, Lofgren, Katherine T., Rajaratnam, Julie Knoll, Marcus, Jacob R., Levin-Rector, Alison, Levitz, Carly E., Lopez, Alan D. and Murray, Christopher J. L. (2012) Age-specific and sex-specific mortality in 187 countries, 1970-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 380 9859: 2071-2094. doi:10.1016/S0140-6736(12)61719-X

Author Wang, Haidong
Dwyer-Lindgren, Laura
Lofgren, Katherine T.
Rajaratnam, Julie Knoll
Marcus, Jacob R.
Levin-Rector, Alison
Levitz, Carly E.
Lopez, Alan D.
Murray, Christopher J. L.
Title Age-specific and sex-specific mortality in 187 countries, 1970-2010: a systematic analysis for the Global Burden of Disease Study 2010
Journal name Lancet   Check publisher's open access policy
ISSN 0140-6736
Publication date 2012-12
Sub-type Article (original research)
DOI 10.1016/S0140-6736(12)61719-X
Volume 380
Issue 9859
Start page 2071
End page 2094
Total pages 24
Place of publication London, United Kingdom
Publisher The Lancet Publishing Group
Collection year 2013
Language eng
Formatted abstract
Background Estimation of the number and rate of deaths by age and sex is a key first stage for calculation of the burden of disease in order to constrain estimates of cause-specific mortality and to measure premature mortality in populations. We aimed to estimate life tables and annual numbers of deaths for 187 countries from 1970 to 2010. Methods We estimated trends in under-5 mortality rate; children aged 0-4 years) and probability of adult death (15-59 years) for each country with all available data. Death registration data were available for more than 100 countries and we corrected for undercount with improved death distribution methods. We applied refined methods to survey data on sibling survival that correct for survivor, zero-sibling, and recall bias. We separately estimated mortality from natural disasters and wars. We generated final estimates of under-5 mortality and adult mortality from the data with Gaussian process regression. We used these results as input parameters in a relational model life table system. We developed a model to extrapolate mortality to 110 years of age. All death rates and numbers have been estimated with 95% uncertainty intervals (95% UIs). Findings From 1970 to 2010, global male life expectancy at birth increased from 56 4 years (95% UI 55 5-57 2) to 67 5 years (66 9-68 1) and global female life expectancy at birth increased from 61 2 years (60 2-62 0) to 73 3 years (72 8-73 8). Life expectancy at birth rose by 3-4 years every decade from 1970, apart from during the 1990s; increase in male life expectancy of 1 4 years and in female life expectancy of 1 6 years). Substantial reductions in mortality occurred in eastern and southern sub-Saharan Africa since 2004, coinciding with increased coverage of antiretroviral therapy and preventive measures against malaria. Sex-specific changes in life expectancy from 1970 to 2010 ranged from gains of 23-29 years in the Maldives and Bhutan to declines of 1-7 years in Belarus, Lesotho, Ukraine, and Zimbabwe. Globally, 52 8 million (95% UI 51 6-54 1 million) deaths occurred in 2010, which is about 13 5% more than occurred in 1990 (46 5 million [45 7-47 4 million]), and 21 9% more than occurred in 1970 (43 3 million [42 2-44 6 million]). Proportionally more deaths in 2010 occurred at age 70 years and older (42 8% in 2010 vs 33 1% in 1990), and 22 9% occurred at 80 years or older. Deaths in children younger than 5 years declined by almost 60% since 1970 (16 4 million [16 1-16 7 million] in 1970 vs 6 8 million [6 6-7 1 million] in 2010), especially at ages 1-59 months (10 8 million [10 4-11 1 million] in 1970 vs 4 0 million [3 8-4 2 million] in 2010). In all regions, including those most affected by HIV/AIDS, we noted increases in mean ages at death. Interpretation Despite global and regional health crises, global life expectancy has increased continuously and substantially in the past 40 years. Yet substantial heterogeneity exists across age groups, among countries, and over different decades. 179 of 187 countries have had increases in life expectancy after the slowdown in progress in the 1990s. Efforts should be directed to reduce mortality in low-income and middle-income countries. Potential underestimation of achievement of the Millennium Development Goal 4 might result from limitations of demographic data on child mortality for the most recent time period. Improvement of civil registration system worldwide is crucial for better tracking of global mortality.
Keyword Less Developed Countries
Sub Saharan Africa
Population Health Data
Adult Mortality
Child Mortality
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
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