Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

The Lancet, Journal Year: 2024, Volume and Issue: 403(10440), P. 2133 - 2161

Published: April 17, 2024

Detailed, comprehensive, and timely reporting on population health by underlying causes of disability premature death is crucial to understanding responding complex patterns disease injury burden over time across age groups, sexes, locations. The availability estimates can promote evidence-based interventions that enable public researchers, policy makers, other professionals implement strategies mitigate diseases. It also facilitate more rigorous monitoring progress towards national international targets, such as the Sustainable Development Goals. For three decades, Global Burden Diseases, Injuries, Risk Factors Study (GBD) has filled need. A global network collaborators contributed production GBD 2021 providing, reviewing, analysing all available data. are updated routinely with additional data refined analytical methods. presents, for first time, loss due COVID-19 pandemic.

Language: Английский

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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

The Lancet, Journal Year: 2024, Volume and Issue: 403(10440), P. 2100 - 2132

Published: April 3, 2024

Summary

Background

Regular, detailed reporting on population health by underlying cause of death is fundamental for public decision making. Cause-specific estimates mortality and the subsequent effects life expectancy worldwide are valuable metrics to gauge progress in reducing rates. These particularly important following large-scale spikes, such as COVID-19 pandemic. When systematically analysed, rates allow comparisons consequences causes globally over time, providing a nuanced understanding effect these global populations.

Methods

The Global Burden Diseases, Injuries, Risk Factors Study (GBD) 2021 cause-of-death analysis estimated years lost (YLLs) from 288 age-sex-location-year 204 countries territories 811 subnational locations each year 1990 until 2021. used 56 604 data sources, including vital registration verbal autopsy well surveys, censuses, surveillance systems, cancer registries, among others. As with previous GBD rounds, cause-specific most were using Cause Death Ensemble model—a modelling tool developed assess out-of-sample predictive validity different statistical models covariate permutations combine those results produce estimates—with alternative strategies adapted model insufficient data, substantial changes study period, or unusual epidemiology. YLLs computed product number deaths cause-age-sex-location-year standard at age. part process, uncertainty intervals (UIs) generated 2·5th 97·5th percentiles 1000-draw distribution metric. We decomposed death, location, show also coefficient variation fraction affected 90% highlight concentrations mortality. Findings reported counts age-standardised Methodological improvements include expansion under-5-years age group four new groups, enhanced methods account stochastic sparse inclusion other pandemic-related mortality—which includes excess associated pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, pertussis. For this analysis, 199 country-years 5 21 94 types added rounds.

Findings

leading same 2019 they 1990; descending order, were, ischaemic heart disease, stroke, chronic obstructive pulmonary infections. In 2021, however, replaced stroke second-leading 94·0 (95% UI 89·2–100·0) per 100 000 population. pandemic shifted rankings five causes, lowering third-leading disease fourth-leading position. highest occurred sub-Saharan Africa (271·0 [250·1–290·7] population) Latin America Caribbean (195·4 [182·1–211·4] population). lowest high-income super-region (48·1 [47·4–48·8] southeast Asia, east Oceania (23·2 [16·3–37·2] Globally, steadily improved between 18 22 investigated causes. Decomposition regional showed positive that reductions enteric neonatal deaths, others have contributed survival period. However, net reduction 1·6 primarily due increased Life was highly variable super-regions gaining 8·3 (6·7–9·9) overall, while having smallest (0·4 years). largest (3·6 Additionally, 53 concentrated less than 50% became progressively more since 1990, when only 44 pattern. concentration phenomenon discussed heuristically respect HIV/AIDS, disorders, tuberculosis, measles.

Interpretation

Long-standing gains many been disrupted adverse which spread unevenly Despite there has continued combatting several notable Each seven an overall improvement obscuring negative our findings regarding driving increases hold clear policy utility. Analyses shifting trends reveal once widespread globally, now increasingly geographically. concentration, alongside further investigation changing risks, interventions, relevant policy, present opportunity deepen mortality-reduction strategies. Examining patterns might areas where successful interventions implemented. Translating successes certain remain entrenched can inform policies work improve people everywhere.

Funding

Bill & Melinda Gates Foundation.

Language: Английский

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Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

The Lancet, Journal Year: 2024, Volume and Issue: 403(10440), P. 2162 - 2203

Published: May 1, 2024

Summary

Background

Understanding the health consequences associated with exposure to risk factors is necessary inform public policy and practice. To systematically quantify contributions of factor exposures specific outcomes, Global Burden Diseases, Injuries, Risk Factors Study (GBD) 2021 aims provide comprehensive estimates levels, relative risks, attributable burden disease for 88 in 204 countries territories 811 subnational locations, from 1990 2021.

Methods

The GBD analysis used data 54 561 total distinct sources produce epidemiological their outcomes a 631 risk–outcome pairs. Pairs were included on basis data-driven determination association. Age-sex-location-year-specific generated at global, regional, national levels. Our approach followed comparative assessment framework predicated causal web hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) given outcome occurring as function estimated separately each pair, summary values (SEVs), representing risk-weighted prevalence, theoretical minimum levels (TMRELs) factor. These calculate population fraction (PAF; ie, proportional change that would occur if reduced TMREL). product PAFs outcome, measured disability-adjusted life-years (DALYs), yielded measures (ie, proportion particular or combination factors). Adjustments mediation applied account relationships involving act indirectly via intermediate Attributable stratified by Socio-demographic Index (SDI) quintile presented counts, age-standardised rates, rankings. complement RR burden, newly developed proof (BPRF) methods yield supplementary, conservative interpretations associations based consistency underlying evidence, accounting unexplained heterogeneity between input different studies. Estimates reported represent mean value across 500 draws estimate's distribution, 95% uncertainty intervals (UIs) calculated 2·5th 97·5th percentile draws.

Findings

Among analysed this study, particulate matter air pollution was leading contributor global 2021, contributing 8·0% (95% UI 6·7–9·4) DALYs, high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight short gestation (5·6% [4·8–6·3]), fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics those aged 0–4 years 5–14 years), such unsafe water, sanitation, handwashing (WaSH) among factors, while older age groups, metabolic SBP, body-mass index (BMI), FPG, LDL cholesterol had greater impact. From 2000 there an observable shift challenges, marked decline number all-age DALYs broadly behavioural (decrease 20·7% [13·9–27·7]) environmental occupational 22·0% [15·5–28·8]), coupled 49·4% (42·3–56·9) increase all reflecting ageing populations changing lifestyles scale. Age-standardised DALY rates BMI FPG rose considerably (15·7% [9·9–21·7] 7·9% [3·3–12·9] FPG) over period, these increasing annually 1·8% (1·6–1·9) 1·3% (1·1–1·5) FPG. By contrast, risk-attributable many other declined, notably child growth failure water source, decreasing 71·5% (64·4–78·8) 66·3% (60·2–72·0) source. We separated into three groups according trajectory time: due largely declining (eg, diet trans-fat household pollution) but also proportionally smaller youth maternal malnutrition); which increased moderately spite exposure, smoking); both ambient pollution, BMI, SBP).

Interpretation

Substantial progress has been made reducing range particularly related health, WaSH, pollution. Maintaining efforts minimise impact especially SDI sustain progress. Successes moderating smoking-related highlight need advance policies reduce SBP. Troubling increases obesity syndrome indicate urgent identify implement interventions.

Funding

Bill & Melinda Gates Foundation.

Language: Английский

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Findings from the Global Burden of Disease Study 2021

The Lancet, Journal Year: 2024, Volume and Issue: 403(10440), P. 2259 - 2262

Published: May 1, 2024

Language: Английский

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Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050

The Lancet, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 1, 2024

Language: Английский

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Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

The Lancet, Journal Year: 2024, Volume and Issue: 403(10440), P. 2057 - 2099

Published: March 21, 2024

Language: Английский

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Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

The Lancet, Journal Year: 2024, Volume and Issue: 403(10440), P. 2204 - 2256

Published: May 1, 2024

Language: Английский

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Aging and cancer

Molecular Cancer, Journal Year: 2024, Volume and Issue: 23(1)

Published: May 18, 2024

Abstract Aging and cancer exhibit apparent links that we will examine in this review. The null hypothesis aging coincide because both are driven by time, irrespective of the precise causes, can be confronted with idea share common mechanistic grounds referred to as ‘hallmarks’. Indeed, several hallmarks also contribute carcinogenesis tumor progression, but some molecular cellular characteristics may reduce probability developing lethal cancer, perhaps explaining why very old age (> 90 years) is accompanied a reduced incidence neoplastic diseases. We discuss possibility process itself causes meaning time-dependent degradation supracellular functions accompanies produces byproduct or ‘age-associated disease’. Conversely, its treatment erode health drive process, has dramatically been documented for survivors diagnosed during childhood, adolescence, young adulthood. conclude connected superior including endogenous lifestyle factors, well bidirectional crosstalk, together render not only risk factor an important parameter must considered therapeutic decisions.

Language: Английский

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Global burden of cardiovascular diseases: projections from 2025 to 2050

European Journal of Preventive Cardiology, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 13, 2024

Abstract Aims The prediction of future trends in cardiovascular disease (CVD) mortality and their risk factors can assist policy-makers healthcare planning. This study aims to project geospatial CVDs underlying from 2025 2050. Methods results Using historical data on disability-adjusted life years (DALYs) the Global Burden Disease (GBD) 2019 study, encompassing period 1990 2019, Poisson regression was performed model DALYs associated with CVD its Subgroup analysis based GBD super-regions. Between 2050, a 90.0% increase prevalence, 73.4% crude mortality, 54.7% are projected, an expected 35.6 million deaths 2050 (from 20.5 2025). However, age-standardized prevalence will be relatively constant (−3.6%), decreasing (−30.5%) (−29.6%). In ischaemic heart remain leading cause (20 deaths) while high systolic blood pressure main factor driving (18.9 deaths). Central Europe, Eastern Asia super-region is set incur highest rate (305 per 100 000 population). Conclusion coming decades, global suggests that net effect summative preventative efforts likely continue unchanged. fall reflects improvement medical care following diagnosis. systems expect rapid rise driven by ageing populace. continued burden largely attributed atherosclerotic diseases. Registration Not applicable.

Language: Английский

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Disease burden of Parkinson's disease in China and its provinces from 1990 to 2021: findings from the global burden of disease study 2021

The Lancet Regional Health - Western Pacific, Journal Year: 2024, Volume and Issue: 46, P. 101078 - 101078

Published: May 1, 2024

Parkinson's disease (PD) has become a public health concern with global ageing. However, comprehensive assessments of the temporal and geographical trend PD burden in China remain insufficient. This study aimed to examine by age, gender, region during 1990-2021.

Language: Английский

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