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Child and Adolescent Health From 1990 to 2015 : Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study

Kassebaum, Nicholas; Kyu, Hmwe; Zoeckler, Leo; Olsen, Helen Elizabeth; Thomas, Katie; Pinho, Christine; Bhutta, Zulfiqar A.; Dandona, Lalit; Ferrari, Alize J. and Ghiwot, Tsegaye Tewelde, et al. (2017) In JAMA Pediatrics 171(6). p.573-592
Abstract

Importance: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health.

Objective: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion.

Evidence Review: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19... (More)

Importance: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health.

Objective: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion.

Evidence Review: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss.

Findings: Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries.

Conclusions and Relevance: Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.

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JAMA Pediatrics
volume
171
issue
6
pages
573 - 592
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American Medical Association
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  • scopus:85020522016
  • wos:000402714300018
ISSN
2168-6211
DOI
10.1001/jamapediatrics.2017.0250
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English
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970a1c7a-d609-4f44-8059-580da30283f8
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2018-04-22 04:27:53
@article{970a1c7a-d609-4f44-8059-580da30283f8,
  abstract     = {<p>Importance: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health.</p><p>Objective: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion.</p><p>Evidence Review: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss.</p><p>Findings: Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries.</p><p>Conclusions and Relevance: Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.</p>},
  author       = {Kassebaum, Nicholas and Kyu, Hmwe and Zoeckler, Leo and Olsen, Helen Elizabeth and Thomas, Katie and Pinho, Christine and Bhutta, Zulfiqar A. and Dandona, Lalit and Ferrari, Alize J. and Ghiwot, Tsegaye Tewelde and Hay, Simon I. and Kinfu, Yohannes and Liang, Xiaofeng and Lopez, Alan D. and Malta, Deborah Carvalho and Mokdad, Ali H. and Naghavi, Mohsen and Patton, George C. and Salomon, Joshua A. and Sartorius, Benn and Topor-Madry, Roman and Vollset, Stein Emil and Werdecker, Andrea and Whiteford, Harvey A. and Abate, Kalkidan Hasen and Abbas, Kaja and Abreha Damtew, Solomon and Ahmed, Muktar Beshir and Akseer, Nadia and Al-Raddadi, Rajaa Mohammad Salem and Alemayohu, Mulubirhan Assefa and Altirkawi, Khalid A and Abajobir, Amanuel Alemu and Amare, Azmeraw T. and Antonio, Carl Abelardo T. and Arnlov, Johan and Artaman, Al and Asayesh, Hamid and Avokpaho, Euripide Frinel G Arthur and Awasthi, Ashish and Ayala Quintanilla, Beatriz Paulina and Bacha, Umar and Balem, Dimtsu and Barac, Aleksandra and Bärnighausen, Till Winfried and Baye, Estifanos and Bedi, Neeraj and Bensenor, Isabela M. and Berhane, Adugnaw and Bernabe, Eduardo and Bernal, Oscar Alberto and Beyene, Addisu Shunu and Biadgilign, Sibhatu and Bikbov, Boris and Boyce, Cheryl Anne and Brazinova, Alexandra and Hailu, Gessessew Bugssa and Carter, Austin and Castañeda-Orjuela, Carlos A and Catalá-López, Ferrán and Charlson, Fiona J. and Chitheer, Abdulaal A and Choi, Jee-Young Jasmine and Ciobanu, Liliana G and Crump, John A. and Dandona, Rakhi and Dellavalle, Robert P. and Deribew, Amare and deVeber, Gabrielle and Dicker, Daniel and Betsu, Balem Balm and Ding, Eric L. and Dubey, Manisha and Endries, Amanuel Yesuf and Erskine, Holly E. and Faraon, Emerito Jose Aquino and Faro, Andre and Farzadfar, Farshad and Fernandes, Joao C and Fijabi, Daniel Obadare and Fitzmaurice, Christina and Fleming, Thomas D. and Flor, Luisa Sorio and Foreman, Kyle J. and Franklin, Richard C. and Fraser, Maya S and Frostad, Joseph J and Fullman, Nancy and Gebregergs, Gebremedhin Berhe and Gebru, Alemseged Aregay and Geleijnse, Johanna M. and Gibney, Katherine B. and Gidey Yihdego, Mahari and Ginawi, Ibrahim Abdelmageem Mohamed and Gishu, Melkamu Dedefo and Gizachew, Tessema Assefa and Glaser, Elizabeth and Gold, Audra L and Goldberg, Ellen and Gona, Philimon and Goto, Atsushi and Gugnani, Harish Chander and Jiang, Guohong and Gupta, Rajeev and Tesfay, Fisaha Haile and Hankey, Graeme J. and Havmoeller, Rasmus and Hijar, Martha and Horino, Masako and Hosgood, H. Dean and Hu, Guoqing and Jacobsen, Kathryn H. and Jakovljevic, Mihajlo B and Jayaraman, Sudha P. and Jha, Vivekanand and Jibat, Tariku and Johnson, Catherine O. and Jonas, Jost B. and Kasaeian, Amir and Kawakami, Norito and Keiyoro, Peter N and Khalil, Ibrahim and Khang, Young-Ho and Khubchandani, Jagdish and Ahmad Kiadaliri, Aliasghar A and Kieling, Christian and Kim, Daniel and Kissoon, Niranjan and Knibbs, Luke D. and Koyanagi, Ai and Krohn, Kristopher J and Kuate Defo, Barthelemy and Kucuk Bicer, Burcu and Kulikoff, Rachel and Kumar, G. Anil and Lal, Dharmesh Kumar and Lam, Hilton Y and Larson, Heidi J. and Larsson, Anders and Laryea, Dennis Odai and Leung, Janni and Lim, Stephen and Lo, Loon-Tzian and Huff, Warren D. and Looker, Katharine J. and Lotufo, Paulo A. and Magdy Abd, Hassan and Razek, Mohammed Magdy Abd El and Malekzadeh, Reza and Markos Shifti, Desalegn and Mazidi, Mohsen and Meaney, Peter A. and Meles, Kidanu Gebremariam and Memiah, Peter and Mendoza, Walter and Abera Mengistie, Mubarek and Mengistu, Gebremichael Welday and Mensah, George A and Miller, Ted R. and Mock, Charles N. and Mohammadi-Nodooshan, Alireza and Mohammed, Shafiu and Monasta, Lorenzo and Mueller, Ulrich O. and Nagata, Chie and Naheed, Aliya and Nguyen, Grant and Nguyen, Quyen Le and Nsoesie, Elaine and Oh, In-Hwan and Okoro, Anselm and Olusanya, Jacob Olusegun and Olusanya, Bolajoko O. and Ortiz, Alberto and Paudel, Deepak and Pereira, David M. and Perico, Norberto and Petzold, Max and Phillips, Michael Robert and Polanczyk, Guilherme V. and Pourmalek, Farshad and Qorbani, Mostafa and Rafay, Anwar and Rahimi-Movaghar, Vafa and Rahman, Mahfuzar and Rai, Rajesh Kumar and Ram, Usha and Rankin, Zane and Remuzzi, Giuseppe and Renzaho, Andre M N and Roba, Hirbo Shore and Rojas-Rueda, David and Ronfani, Luca and Sagar, Rajesh and Sanabria, Juan Ramon and Kedir Mohammed, Muktar Sano and Santos, Itamar S. and Satpathy, Maheswar and Sawhney, Monika and Schöttker, Ben and Schwebel, David C. and Scott, James G. and Sepanlou, Sadaf G. and Shaheen, Amira and Shaikh, Masood Ali and She, June and Shiri, Rahman and Shiue, Ivy and Sigfusdottir, Inga Dora and Singh, Jasvinder A. and Slipakit, Naris and Smith, Alison and Sreeramareddy, Chandrashekhar T. and Stanaway, Jeffrey D. and Stein, Dan J. and Steiner, Caitlyn and Sufiyan, Muawiyyah Babale and Swaminathan, Soumya and Tabarés-Seisdedos, Rafael and Tabb, Karen M. and Tadese, Fentaw and Tavakkoli, Mohammad and Taye, Bineyam and Teeple, Stephanie and Tegegne, Teketo Kassaw and Temam Shifa, Girma and Terkawi, Adbullah Sulieman and Thomas, Bernadette and Thomson, Alan J and Tobe-Gai, Ruoyan and Tonelli, Marcello and Tran, Bach Xuan and Troeger, Christopher and Ukwaja, Kingsley N. and Uthman, Olalekan A and Vasankari, Tommi J. and Venketasubramanian, Narayanaswamy and Vlassov, Vasiliy Victorovich and Weiderpass, Elisabete and Weintraub, Robert G. and Gebrehiwot, Solomon Weldemariam and Westerman, Ronny and Williams, Hywel C. and Wolfe, Charles D A and Woodbrook, Rachel and Yano, Yuichiro and Yonemoto, Naohiro and Yoon, Seok-Jun and Younis, Mustafa Z. and Yu, Chuanhua and Zaki, Maysaa El Sayed and Zegeye, Elias Asfaw and Zuhlke, Liesl Joanna and Murray, Christopher J. L. and Vos, Theo and , },
  issn         = {2168-6211},
  language     = {eng},
  month        = {04},
  number       = {6},
  pages        = {573--592},
  publisher    = {American Medical Association},
  series       = {JAMA Pediatrics},
  title        = {Child and Adolescent Health From 1990 to 2015 : Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study},
  url          = {http://dx.doi.org/10.1001/jamapediatrics.2017.0250},
  volume       = {171},
  year         = {2017},
}