Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016

Wang, Haidong, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M., Abd-Allah, Foad, Abera, Semaw Ferede, Abraha, Haftom Niguse, Abu-Raddad, Laith J., Abu-Rmeileh, Niveen M. E., Adedeji, Isaac Akinkunmi, Adedoyin, Rufus Adesoji, Adetifa, Ifedayo Morayo O., Adetokunboh, Olatunji, Afshin, Ashkan, Aggarwal, Rakesh, Agrawal, Anurag, Agrawal, Sutapa, Kiadaliri, Aliasghar Ahmad, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Ibthiel, Aichour, Miloud Taki Eddine, Aiyar, Sneha, Akanda, Shafqat, Akinyemiju, Tomi F., Akseer, Nadia, Al-Eyadhy, Ayman, Al Lami, Faris Hasan, Alabed, Samer, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore, Alasfoor, Deena, Aldridge, Robert William, Alene, Kefyalew Addis, Alhabib, Samia, Ali, Raghib, Alizadeh-Navaei, Reza, Aljunid, Syed M., Alkaabi, Juma M., Alkerwi, Ala'a, Alla, Francois, Allam, Shalini D., Allebeck, Peter, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A., Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T., Ameh, Emmanuel A., Amini, Erfan, Ammar, Walid, Amoako, Yaw Ampem, Anber, Nahla, Andrei, Catalina Liliana, Androudi, Sofia, Ansari, Hossein, Ansha, Mustafa Geleto, Antonio, Carl Abelardo T., Anwari, Palwasha, Arnlov, Johan, Arora, Megha, Al Artaman, Aryal, Krishna Kumar, Asayesh, Hamid, Asgedom, Solomon Weldegebreal, Asghar, Rana Jawad, Assadi, Reza, Atey, Tesfay Mehari, Atre, Sachin R., Avila-Burgos, Leticia, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Babalola, Tesleem Kayode, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Balalla, Shivanthi, Barac, Aleksandra, Barber, Ryan M., Barboza, Miguel A., Barker-Collo, Suzanne L., Barnighausen, Till, Barquera, Simon, Barregard, Lars, Barrero, Lope H., Baune, Bernhard T., Bazargan-Hejazi, Shahrzad, Bedi, Neeraj, Beghi, Ettore, Bejot, Yannick, Bekele, Bayu Begashaw, Bell, Michelle L., Bello, Aminu K., Bennett, Derrick A., Bennett, James R., Bensenor, Isabela M., Benson, Jennifer, Berhane, Adugnaw, Berhe, Derbew Fikadu, Bernabe, Eduardo, Beuran, Mircea, Beyene, Addisu Shunu, Bhala, Neeraj, Bhansali, Anil, Bhaumik, Soumyadeep, Bhutta, Zulfiqar A., Bikbov, Boris, Birungi, Charles, Biryukov, Stan, Bisanzio, Donal, Bizuayehu, Habtamu Mellie, Bjerregaard, Peter, Blosser, Christopher D., Boneya, Dube Jara, Boufous, Soufiane, Bourne, Rupert R. A., Brazinova, Alexandra, Breitborde, Nicholas J. K., Brenner, Hermann, Brugha, Traolach S., Bukhman, Gene, Negesa, Lemma, Bulto, Bulto, Bumgarner, Blair Randal, Burch, Michael, Butt, Zahid A., Cahill, Leah E., Cahuana-Hurtado, Lucero, Campos-Nonato, Ismael Ricardo, Car, Josip, Car, Mate, Crdenas, Rosario, Carpenter, David O., Carrero, Juan Jesus, Carter, Austin, Castaneda-Orjuela, Carlos A., Rivas, Jacqueline Castillo, Castro, Franz F., Castro, Ruben Estanislao, Catala-Lopez, Ferran, Chen, Honglei, Chiang, Peggy Pei-Chia, Chibalabala, Mirriam, Chisumpa, Vesper Hichilombwe, Chitheer, Abdulaal A., Choi, Jee-Young Jasmine, Christensen, Hanne, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Cirillo, Massimo, Cohen, Aaron J., Colquhoun, Samantha M., Coresh, Josef, Criqui, Michael H., Cromwell, Elizabeth A., Crump, John A., Dandona, Lalit, Dandona, Rakhi, Dargan, Paul I., das Neves, Jose, Davey, Gail, Davitoiu, Dragos V., Davletov, Kairat, de Courten, Barbora, De Leo, Diego, Degenhardt, Louisa, Deiparine, Selina, Dellavalle, Robert P., Deribe, Kebede, Deribew, Amare, Des Jarlais, Don C., Dey, Subhojit, Dharmaratne, Samath D., Dherani, Mukesh K., Diaz-Torne, Cesar, Ding, Eric L., Dixit, Priyanka, Djalalinia, Shirin, Huyen Phuc Do, Doku, David Teye, Donnelly, Christl Ann, Priscila, Kadine, dos Santos, Bender, Douwes-Schultz, Dirk, Driscoll, Tim R., Duan, Leilei, Dubey, Manisha, Duncan, Bruce Bartholow, Dwivedi, Laxmi Kant, Ebrahimi, Hedyeh, El Bcheraoui, Charbel, Ellingsen, Christian Lycke, Enayati, Ahmadali, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshetie, Setegn, Eshrati, Babak, Eskandarieh, Sharareh, Esteghamati, Alireza, Estep, Kara, Fanuel, Belayneh Bekele Fanuel, Faro, Andre, Farvid, Maryam S., Farzadfar, Farshad, Feigin, Valery L., Fereshtehnejad, Seyed-Mohammad, Fernandes, Jefferson G., Fernandes, Joao C., Feyissa, Tesfaye Regassa, Filip, Irina, Fischer, Florian, Foigt, Nataliya, Foreman, Kyle J., Frank, Tahvi, Franklin, Richard C., Fraser, Maya, Friedman, Joseph, Frostad, Joseph J., Fullman, Nancy, Furst, Thomas, Furtado, Joao M., Futran, Neal D., Gakidou, Emmanuela, Gambashidze, Ketevan, Gamkrelidze, Amiran, Gankpe, Fortune Gbetoho, Garcia-Basteiro, Alberto L., Gebregergs, Gebremedhin Berhe, Gebrehiwot, Tsegaye Tewelde, Gebrekidan, Kahsu Gebrekirstos, Gebremichael, Mengistu Welday, Gelaye, Amha Admasie, Geleijnse, Johanna M., Gemechu, Bikila Lencha, Gemechu, Kasiye Shiferaw, Genova-Maleras, Ricard, Gesesew, Hailay Abrha, Gething, Peter W., Gibney, Katherine B., Gill, Paramjit Singh, Gillum, Richard F., Giref, Ababi Zergaw, Girma, Bedilu Weji, Giussani, Giorgia, Goenka, Shifalika, Gomez, Beatriz, Gona, Philimon N., Gopalani, Sameer Vali, Goulart, Alessandra Carvalho, Graetz, Nicholas, Gugnani, Harish Chander, Gupta, Prakash C., Gupta, Rahul, Gupta, Rajeev, Gupta, Tanush, Gupta, Vipin, Haagsma, Juanita A., Hafezi-Nejad, Nima, Bidgoli, Hassan Haghparast, Hakuzimana, Alex, Halasa, Yara A., Hamadeh, Randah Ribhi, Hambisa, Mitiku Teshome, Hamidi, Samer, Hammami, Mouhanad, Hancock, Jamie, Handal, Alexis J., Hankey, Graeme J., Hao, Yuantao, Harb, Hilda L., Hareri, Habtamu Abera, Harikrishnan, Sivadasanpillai, Haro, Josep Maria, Hassanvand, Mohammad Sadegh, Havmoeller, Rasmus, Hay, Roderick J., Hay, Simon I., He, Fei, Heredia-Pi, Ileana Beatriz, Herteliu, Claudiu, Hilawe, Esayas Haregot, Hoek, Hans W., Horita, Nobuyuki, Hosgood, H. Dean, Hostiuc, Sorin, Hotez, Peter J., Hoy, Damian G., Hsairi, Mohamed, Htet, Aung Soe, Hu, Guoqing, Huang, Hsiang, Huang, John J., Iburg, Kim Moesgaard, Igumbor, Ehimario Uche, Ileanu, Bogdan Vasile, Inoue, Manami, Irenso, Asnake Ararsa, Irvine, Caleb M. S., Islam, Nazrul, Jacobsen, Kathryn H., Jaenisch, Thomas, Jahanmehr, Nader, Jakovljevic, Mihajlo B., Javanbakht, Mehdi, Jayatilleke, Achala Upendra, Jeemon, Panniyammakal, Jensen, Paul N., Jha, Vivekanand, Jin, Ye, John, Denny, John, Oommen, Johnson, Sarah Charlotte, Jonas, Jost B., Jurisson, Mikk, Kabir, Zubair, Kadel, Rajendra, Kahsay, Amaha, Kalkonde, Yogeshwar, Kamal, Ritul, Kan, Haidong, Karch, Andre, Karema, Corine Kakizi, Karimi, Seyed M., Karthikeyan, Ganesan, Kasaeian, Amir, Kassaw, Nigussie Assefa, Kassebaum, Nicholas J., Kastor, Anshul, Katikireddi, Srinivasa Vittal, Kaul, Anil, Kawakami, Norito, Kazanjan, Konstantin, Keiyoro, Peter Njenga, Kelbore, Sefonias Getachew, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Ketema, Ezra Belay, Khader, Yousef Saleh, Khalil, Ibrahim A., Khan, Ejaz Ahmad, Khan, Gulfaraz and Khang, Young-Ho (2017) Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet, 390 10100: 1084-1150. doi:10.1016/S0140-6736(17)31833-0


Author Wang, Haidong
Abajobir, Amanuel Alemu
Abate, Kalkidan Hassen
Abbafati, Cristiana
Abbas, Kaja M.
Abd-Allah, Foad
Abera, Semaw Ferede
Abraha, Haftom Niguse
Abu-Raddad, Laith J.
Abu-Rmeileh, Niveen M. E.
Adedeji, Isaac Akinkunmi
Adedoyin, Rufus Adesoji
Adetifa, Ifedayo Morayo O.
Adetokunboh, Olatunji
Afshin, Ashkan
Aggarwal, Rakesh
Agrawal, Anurag
Agrawal, Sutapa
Kiadaliri, Aliasghar Ahmad
Ahmed, Muktar Beshir
Aichour, Amani Nidhal
Aichour, Ibthiel
Aichour, Miloud Taki Eddine
Aiyar, Sneha
Akanda, Shafqat
Akinyemiju, Tomi F.
Akseer, Nadia
Al-Eyadhy, Ayman
Al Lami, Faris Hasan
Alabed, Samer
Alahdab, Fares
Al-Aly, Ziyad
Alam, Khurshid
Alam, Noore
Alasfoor, Deena
Aldridge, Robert William
Alene, Kefyalew Addis
Alhabib, Samia
Ali, Raghib
Alizadeh-Navaei, Reza
Aljunid, Syed M.
Alkaabi, Juma M.
Alkerwi, Ala'a
Alla, Francois
Allam, Shalini D.
Allebeck, Peter
Al-Raddadi, Rajaa
Alsharif, Ubai
Altirkawi, Khalid A.
Martin, Elena Alvarez
Alvis-Guzman, Nelson
Amare, Azmeraw T.
Ameh, Emmanuel A.
Amini, Erfan
Ammar, Walid
Amoako, Yaw Ampem
Anber, Nahla
Andrei, Catalina Liliana
Androudi, Sofia
Ansari, Hossein
Ansha, Mustafa Geleto
Antonio, Carl Abelardo T.
Anwari, Palwasha
Arnlov, Johan
Arora, Megha
Al Artaman
Aryal, Krishna Kumar
Asayesh, Hamid
Asgedom, Solomon Weldegebreal
Asghar, Rana Jawad
Assadi, Reza
Atey, Tesfay Mehari
Atre, Sachin R.
Avila-Burgos, Leticia
Avokpaho, Euripide Frinel G. Arthur
Awasthi, Ashish
Quintanilla, Beatriz Paulina Ayala
Babalola, Tesleem Kayode
Bacha, Umar
Badawi, Alaa
Balakrishnan, Kalpana
Balalla, Shivanthi
Barac, Aleksandra
Barber, Ryan M.
Barboza, Miguel A.
Barker-Collo, Suzanne L.
Barnighausen, Till
Barquera, Simon
Barregard, Lars
Barrero, Lope H.
Baune, Bernhard T.
Bazargan-Hejazi, Shahrzad
Bedi, Neeraj
Beghi, Ettore
Bejot, Yannick
Bekele, Bayu Begashaw
Bell, Michelle L.
Bello, Aminu K.
Bennett, Derrick A.
Bennett, James R.
Bensenor, Isabela M.
Benson, Jennifer
Berhane, Adugnaw
Berhe, Derbew Fikadu
Bernabe, Eduardo
Beuran, Mircea
Beyene, Addisu Shunu
Bhala, Neeraj
Bhansali, Anil
Bhaumik, Soumyadeep
Bhutta, Zulfiqar A.
Bikbov, Boris
Birungi, Charles
Biryukov, Stan
Bisanzio, Donal
Bizuayehu, Habtamu Mellie
Bjerregaard, Peter
Blosser, Christopher D.
Boneya, Dube Jara
Boufous, Soufiane
Bourne, Rupert R. A.
Brazinova, Alexandra
Breitborde, Nicholas J. K.
Brenner, Hermann
Brugha, Traolach S.
Bukhman, Gene
Negesa, Lemma
Bulto, Bulto
Bumgarner, Blair Randal
Burch, Michael
Butt, Zahid A.
Cahill, Leah E.
Cahuana-Hurtado, Lucero
Campos-Nonato, Ismael Ricardo
Car, Josip
Car, Mate
Crdenas, Rosario
Carpenter, David O.
Carrero, Juan Jesus
Carter, Austin
Castaneda-Orjuela, Carlos A.
Rivas, Jacqueline Castillo
Castro, Franz F.
Castro, Ruben Estanislao
Catala-Lopez, Ferran
Chen, Honglei
Chiang, Peggy Pei-Chia
Chibalabala, Mirriam
Chisumpa, Vesper Hichilombwe
Chitheer, Abdulaal A.
Choi, Jee-Young Jasmine
Christensen, Hanne
Christopher, Devasahayam Jesudas
Ciobanu, Liliana G.
Cirillo, Massimo
Cohen, Aaron J.
Colquhoun, Samantha M.
Coresh, Josef
Criqui, Michael H.
Cromwell, Elizabeth A.
Crump, John A.
Dandona, Lalit
Dandona, Rakhi
Dargan, Paul I.
das Neves, Jose
Davey, Gail
Davitoiu, Dragos V.
Davletov, Kairat
de Courten, Barbora
De Leo, Diego
Degenhardt, Louisa
Deiparine, Selina
Dellavalle, Robert P.
Deribe, Kebede
Deribew, Amare
Des Jarlais, Don C.
Dey, Subhojit
Dharmaratne, Samath D.
Dherani, Mukesh K.
Diaz-Torne, Cesar
Ding, Eric L.
Dixit, Priyanka
Djalalinia, Shirin
Huyen Phuc Do
Doku, David Teye
Donnelly, Christl Ann
Priscila, Kadine
dos Santos, Bender
Douwes-Schultz, Dirk
Driscoll, Tim R.
Duan, Leilei
Dubey, Manisha
Duncan, Bruce Bartholow
Dwivedi, Laxmi Kant
Ebrahimi, Hedyeh
El Bcheraoui, Charbel
Ellingsen, Christian Lycke
Enayati, Ahmadali
Endries, Aman Yesuf
Ermakov, Sergey Petrovich
Eshetie, Setegn
Eshrati, Babak
Eskandarieh, Sharareh
Esteghamati, Alireza
Estep, Kara
Fanuel, Belayneh Bekele Fanuel
Faro, Andre
Farvid, Maryam S.
Farzadfar, Farshad
Feigin, Valery L.
Fereshtehnejad, Seyed-Mohammad
Fernandes, Jefferson G.
Fernandes, Joao C.
Feyissa, Tesfaye Regassa
Filip, Irina
Fischer, Florian
Foigt, Nataliya
Foreman, Kyle J.
Frank, Tahvi
Franklin, Richard C.
Fraser, Maya
Friedman, Joseph
Frostad, Joseph J.
Fullman, Nancy
Furst, Thomas
Furtado, Joao M.
Futran, Neal D.
Gakidou, Emmanuela
Gambashidze, Ketevan
Gamkrelidze, Amiran
Gankpe, Fortune Gbetoho
Garcia-Basteiro, Alberto L.
Gebregergs, Gebremedhin Berhe
Gebrehiwot, Tsegaye Tewelde
Gebrekidan, Kahsu Gebrekirstos
Gebremichael, Mengistu Welday
Gelaye, Amha Admasie
Geleijnse, Johanna M.
Gemechu, Bikila Lencha
Gemechu, Kasiye Shiferaw
Genova-Maleras, Ricard
Gesesew, Hailay Abrha
Gething, Peter W.
Gibney, Katherine B.
Gill, Paramjit Singh
Gillum, Richard F.
Giref, Ababi Zergaw
Girma, Bedilu Weji
Giussani, Giorgia
Goenka, Shifalika
Gomez, Beatriz
Gona, Philimon N.
Gopalani, Sameer Vali
Goulart, Alessandra Carvalho
Graetz, Nicholas
Gugnani, Harish Chander
Gupta, Prakash C.
Gupta, Rahul
Gupta, Rajeev
Gupta, Tanush
Gupta, Vipin
Haagsma, Juanita A.
Hafezi-Nejad, Nima
Bidgoli, Hassan Haghparast
Hakuzimana, Alex
Halasa, Yara A.
Hamadeh, Randah Ribhi
Hambisa, Mitiku Teshome
Hamidi, Samer
Hammami, Mouhanad
Hancock, Jamie
Handal, Alexis J.
Hankey, Graeme J.
Hao, Yuantao
Harb, Hilda L.
Hareri, Habtamu Abera
Harikrishnan, Sivadasanpillai
Haro, Josep Maria
Hassanvand, Mohammad Sadegh
Havmoeller, Rasmus
Hay, Roderick J.
Hay, Simon I.
He, Fei
Heredia-Pi, Ileana Beatriz
Herteliu, Claudiu
Hilawe, Esayas Haregot
Hoek, Hans W.
Horita, Nobuyuki
Hosgood, H. Dean
Hostiuc, Sorin
Hotez, Peter J.
Hoy, Damian G.
Hsairi, Mohamed
Htet, Aung Soe
Hu, Guoqing
Huang, Hsiang
Huang, John J.
Iburg, Kim Moesgaard
Igumbor, Ehimario Uche
Ileanu, Bogdan Vasile
Inoue, Manami
Irenso, Asnake Ararsa
Irvine, Caleb M. S.
Islam, Nazrul
Jacobsen, Kathryn H.
Jaenisch, Thomas
Jahanmehr, Nader
Jakovljevic, Mihajlo B.
Javanbakht, Mehdi
Jayatilleke, Achala Upendra
Jeemon, Panniyammakal
Jensen, Paul N.
Jha, Vivekanand
Jin, Ye
John, Denny
John, Oommen
Johnson, Sarah Charlotte
Jonas, Jost B.
Jurisson, Mikk
Kabir, Zubair
Kadel, Rajendra
Kahsay, Amaha
Kalkonde, Yogeshwar
Kamal, Ritul
Kan, Haidong
Karch, Andre
Karema, Corine Kakizi
Karimi, Seyed M.
Karthikeyan, Ganesan
Kasaeian, Amir
Kassaw, Nigussie Assefa
Kassebaum, Nicholas J.
Kastor, Anshul
Katikireddi, Srinivasa Vittal
Kaul, Anil
Kawakami, Norito
Kazanjan, Konstantin
Keiyoro, Peter Njenga
Kelbore, Sefonias Getachew
Kemp, Andrew Haddon
Kengne, Andre Pascal
Keren, Andre
Kereselidze, Maia
Kesavachandran, Chandrasekharan Nair
Ketema, Ezra Belay
Khader, Yousef Saleh
Khalil, Ibrahim A.
Khan, Ejaz Ahmad
Khan, Gulfaraz
Khang, Young-Ho
Title Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016
Journal name Lancet   Check publisher's open access policy
ISSN 0140-6736
Publication date 2017-09-01
Year available 2017
Sub-type Article (original research)
DOI 10.1016/S0140-6736(17)31833-0
Open Access Status Not yet assessed
Volume 390
Issue 10100
Start page 1084
End page 1150
Total pages 67
Place of publication NEW YORK
Publisher ELSEVIER SCIENCE INC
Language eng
Abstract Background: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. Methods: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0.5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. Findings: Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates - a measure of relative inequality - increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86.9 years (95% UI 86.7-87.2), and for men in Singapore, at 81.3 years (78.8-83.7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, and the gap between male and female life expectancy increased with progression to higher levels of SDI. Some countries with exceptional health performance in 1990 in terms of the difference in observed to expected life expectancy at birth had slower progress on the same measure in 2016. Interpretation Globally, mortality rates have decreased across all age groups over the past five decades, with the largest improvements occurring among children younger than 5 years. However, at the national level, considerable heterogeneity remains in terms of both level and rate of changes in age-specific mortality; increases in mortality for certain age groups occurred in some locations. We found evidence that the absolute gap between countries in age-specific death rates has declined, although the relative gap for some age-sex groups increased. Countries that now lead in terms of having higher observed life expectancy than that expected on the basis of development alone, or locations that have either increased this advantage or rapidly decreased the deficit from expected levels, could provide insight into the means to accelerate progress in nations where progress has stalled.
Keyword Developing-Countries
Russian Mortality
Child-Mortality
Health
Hiv
Metaanalysis
Survival
Alcohol
Income
Death
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

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Sub-type: Article (original research)
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