Semantic Scholar Open Access 2024 412 sitasi

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Austin E. Schumacher H. Kyu Amirali Aali C. Abbafati Jaffar Abbas +495 lainnya

Abstrak

Summary Background Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. Funding Bill & Melinda Gates Foundation.

Topik & Kata Kunci

Penulis (500)

A

Austin E. Schumacher

H

H. Kyu

A

Amirali Aali

C

C. Abbafati

J

Jaffar Abbas

R

Rouzbeh Abbasgholizadeh

M

M. Abbasi

M

Mohammadreza Abbasian

S

S. ElHafeez

M

Michael Abdelmasseh

S

S. Abd-Elsalam

A

Ahmed Abdelwahab

M

Mohammad Abdollahi

M

M. Abdoun

A

Auwal Abdullahi

A

Ame Mehadi Abdurehman

M

Mesfin Abebe

A

Aidin Abedi

A

Armita Abedi

T

Tadesse M. Abegaz

R

R. Zuñiga

E

E. Abhilash

O

O. Abiodun

R

R. Aboagye

H

Hassan Abolhassani

M

M. Abouzid

L

Lucas Guimarães Abreu

W

Woldu Aberhe Abrha

M

M. R. Abrigo

D

Dariush Abtahi

S

Samir Abu Rumeileh

N

N. Abu-Rmeileh

S

Salahdein Aburuz

A

A. Abu-Zaid

J

J. M. Acuna

T

Tim Adair

I

Isaac Yeboah Addo

O

O. Adebayo

O

O. Adegboye

V

Victor Adekanmbi

B

Bashir Aden

A

Abiola Adepoju

C

C. Adetunji

T

T. Adeyeoluwa

O

O. Adeyomoye

R

Rishan Adha

A

Amin Adibi

W

W. Adikusuma

Q

Q. Adnani

S

Saryia Adra

A

Abel Afework

A

A. Afolabi

A

Ali Afraz

S

Shadi Afyouni

S

Saira Afzal

P

P. Agasthi

S

Shahin Aghamiri

A

A. Agodi

W

Williams Agyemang-Duah

B

B. Ahinkorah

A

Aqeel Ahmad

D

Danish Ahmad

F

Firdos Ahmad

M

Muayyad M. Ahmad

T

Tauseef Ahmad

K

K. Ahmadi

A

A. M. Ahmadzade

M

M. Ahmadzade

A

Ayman Ahmed

H

H. Ahmed

L

Luai A. Ahmed

M

M. Ahmed

S

Syed Anees Ahmed

M

Marjan Ajami

B

Budi Aji

O

O. Ajumobi

G

G. T. Akalu

E

E. Akara

K

K. Akinosoglou

S

Sreelatha Akkala

S

Samuel Akyirem

H

H. A. Hamad

S

S. M. Hasan

A

Ammar Al Homsi

M

M. Qadire

M

Moein Ala

T

Timothy Olukunle Aladelusi

T

T. AL-Ahdal

S

Samer O. Alalalmeh

Z

Z. Al-Aly

K

K. Alam

M

Manjurul Alam

Z

Zufishan Alam

R

Rasmieh M. Al-amer

F

F. Alanezi

T

Turki M. Alanzi

M

M. Albashtawy

M

Mohammad T. Albataineh

R

R. Aldridge

S

Sharifullah Alemi

A

A. Al-Eyadhy

A

A. Al-Gheethi

K

K. Alhabib

F

F. Alhalaiqa

M

M. K. Al-Hanawi

A

Abid Ali

A

Akhtar Ali

B

B. Ali

H

Hassam Ali

M

M. Ali

R

Rafat Ali

S

Syed Shujait Shujait Ali

Z

Zahid Ali

S

S. A. Samakkhah

G

G. Alicandro

S

S. M. Alif

M

Mohammad Aligol

R

Rasoul Alimi

A

Ahmednur Adem Aliyi

A

Adel Al-Jumaily

S

S. Aljunid

W

W. Almahmeed

S

Sabah Al-Marwani

S

S. Al-Maweri

J

Joseph Almazan

H

Hesham M Al-Mekhlafi

O

Omar Almidani

M

Mahmoud A. Alomari

N

Nivaldo Alonso

J

J. Alqahtani

A

A. Alqutaibi

S

Salman Khalifah Al-Sabah

A

Awais Altaf

J

J. Al-Tawfiq

K

K. Altirkawi

F

F. J. Alvi

H

H. Alwafi

Y

Y. Al-Worafi

H

Hany Aly

K

K. Alzoubi

A

A. Amare

E

E. Ameyaw

A

A. F. Amhare

T

T. Amin

A

Alireza Amindarolzarbi

J

J. A. Dehkordi

S

Sohrab Amiri

H

Hubert Amu

D

D. Amugsi

J

J. Amzat

R

R. Ancuceanu

D

D. Anderlini

P

Pedro Prata Andrade

C

C. Andrei

T

Tudorel Andrei

D

Dhanalakshmi Angappan

A

Abhishek Anil

A

Afifa Anjum

C

C. Antony

E

E. Antriyandarti

I

Iyadunni A. Anuoluwa

S

S. Anwar

A

A. Anyasodor

S

Seth Christopher Yaw Appiah

M

M. Aqeel

J

J. Arabloo

R

R. Bahri

M

M. Arab-Zozani

M

M. Arafat

A

Ana Margarida Araújo

A

Aleksandr Y. Aravkin

A

A. Aremu

H

Hany Ariffin

T

T. Aripov

B

B. Armocida

M

Mahwish Arooj

A

A. Artamonov

K

K. D. Artanti

J

Judie Arulappan

I

Idowu Aruleba

R

R. T. Aruleba

A

Ashokan Arumugam

M

Malke Asaad

S

Saeed Asgary

M

Mubarek Yesse Ashemo

M

M. Ashraf

M

M. O. Asika

S

S. Athari

M

M. Atout

A

A. Atreya

S

Sameh Attia

A

A. Aujayeb

A

Abolfazl Avan

A

A. Awotidebe

B

B. Quintanilla

M

M. Ayanore

G

Getnet Melaku Ayele

J

J. Ayuso-Mateos

S

S. M. Ayyoubzadeh

S

S. Azadnajafabad

G

G. Azhar

S

Shahkaar Aziz

A

A. Azzam

M

Mina Babashahi

A

Abraham Samuel Babu

M

Muhammad Badar

A

A. Badawi

A

A. Badiye

S

Soroush Baghdadi

N

Nasser Bagheri

S

S. Bagherieh

S

S. Bah

S

S. Bahadorikhalili

J

Jianjun Bai

R

Ruhai Bai

J

Jennifer L. Baker

S

Shankar M. Bakkannavar

A

A. T. Bako

S

Senthilkumar Balakrishnan

S

Saliu A Balogun

O

Ovidiu Constantin Baltatu

K

Kiran Bam

M

Maciej Banach

S

Soham Bandyopadhyay

B

B. Banik

P

Palash Chandra Banik

H

Hansi Bansal

S

S. Barati

M

M. Barchitta

M

Mainak Bardhan

S

S. Barker-Collo

F

Francesco Barone-Adesi

H

H. Barqawi

R

Ronald D Barr

L

L. Barrero

Z

Zarrin Basharat

A

Asma'u I J Bashir

H

H. Bashiru

P

P. Baskaran

B

Buddha Basnyat

Q

Q. Bassat

J

João Diogo Basso

S

S. Basu

K

Kavita Batra

R

Ravi Batra

B

B. Baune

M

M. Bayati

N

N. Bayileyegn

T

Thomas Beaney

N

Neeraj Bedi

T

Tahmina Begum

E

Emad Behboudi

A

A. Behnoush

M

Maryam Beiranvand

D

Diana Fernanda Bejarano Ramirez

U

U. Belgaumi

M

Michelle L. Bell

A

A. Bello

M

M. Bello

O

O. Bello

L

Luis Belo

A

Apostolos Beloukas

S

S. Bendak

D

Derrick A. Bennett

I

I. Benseñor

H

Habib Benzian

Z

Z. Berezvai

A

Adam E. Berman

A

A. N. Bermudez

P

P. J. Bettencourt

H

Habtamu B. Beyene

K

Kebede A. Beyene

D

D. Bhagat

A

A. Bhagavathula

N

N. Bhala

A

Ashish Bhalla

D

Dinesh Bhandari

N

Nikha Bhardwaj

P

Pankaj Bhardwaj

P

Prarthna V. Bhardwaj

A

A. Bhargava

S

Sonu M M Bhaskar

V

Vivek Bhat

G

G. K. Bhatti

J

Jasvinder Singh Bhatti

M

M. Bhatti

R

Rajbir Bhatti

Z

Z. Bhutta

B

B. Bikbov

N

Nada Binmadi

B

B. S. Bintoro

A

A. Biondi

C

C. Bisignano

F

F. Bisulli

A

Atanu Biswas

R

R. Biswas

S

Saeid Bitaraf

T

T. Bjørge

A

A. Bleyer

M

M. S. Boampong

V

V. Bodolica

A

Aadam Olalekan Bodunrin

O

Obasanjo Afolabi Bolarinwa

M

Milad Hashemi

A

A. Bonny

K

Kaustubh Bora

B

B. Basara

S

S. B. Borodo

R

Rohan Borschmann

A

A. B. Carvajal

S

S. Bouaoud

S

S. Boudalia

E

Edward J. Boyko

N

N. Bragazzi

D

Dejana Braithwaite

H

H. Brenner

G

Gabrielle Britton

A

A. Browne

A

A. Brunoni

N

Norma B. Bulamu

L

L. Bulto

D

Danilo Buonsenso

K

Katrin Burkart

R

Richard A. Burns

S

S. Nagaraja

R

Reinhard Busse

Y

Yasser K. Bustanji

Z

Z. Butt

F

F. C. Santos

T

Tianji Cai

D

D. Calina

L

L. Cámera

L

L. A. Campos

I

Ismael Campos-Nonato

C

Chao Cao

C

C. Cardenas

R

Rosario Cárdenas

S

Sinclair Carr

G

G. Carreras

J

J. Carrero

A

A. Carugno

F

F. Carvalho

M

M. Carvalho

J

J. Castaldelli-Maia

C

C. Castañeda-Orjuela

G

G. Castelpietra

F

F. Catalá-López

A

A. Catapano

M

M. Cattaruzza

A

A. Caye

C

Christopher R. Cederroth

F

Francieli Cembranel

M

Muthia Cenderadewi

K

Kelly M. Cercy

E

Ester Cerin

M

Muge Cevik

P

P. R. Chacón-Uscamaita

Y

Yaacoub Chahine

C

C. Chakraborty

J

Jeffrey Shi Kai Chan

C

Chin-Kuo Chang

P

P. Charalampous

J

J. Charan

V

Vijay Kumar Chattu

V

V. Chatzimavridou-Grigoriadou

M

M. P. Chavula

H

H. Cheema

A

An-Tian Chen

H

Haowei Chen

L

Lingxiao Chen

M

M. Chen

S

Simiao Chen

N

N. Cherbuin

D

Derek S. Chew

G

Gerald Chi

J

Jesus Lorenzo Chirinos-Caceres

A

Abdulaal Chitheer

S

So Mi Jemma Cho

W

William C. S. Cho

B

Bryan Chong

H

Hitesh Chopra

R

Rahul Choudhary

R

Rajiv Chowdhury

D

D. Chu

I

I. Chukwu

E

Eric Chung

E

Eunice Chung

S

S. Chung

K

K. Cini

C

Cain C T Clark

K

Kaleb Coberly

A

A. Columbus

H

H. Comfort

J

J. Conde

S

Sara Conti

P

P. Cortesi

V

V. M. Costa

E

Ewerton Cousin

R

R. Cowden

M

M. Criqui

N

N. Cruz-Martins

G

Garland T Culbreth

P

Patricia Cullen

M

Matthew Cunningham

D

D. P. D. Silva

S

Sriharsha Dadana

O

O. Dadras

Z

Zhaoli Dai

K

K. Dalal

L

Lachlan L. Dalli

G

G. Damiani

E

Emanuele D’Amico

S

Sara Daneshvar

A

A. Darwesh

J

Jai K Das

S

Saswati Das

N

N. Dash

M

M. Dashti

C

C. Dávila-Cervantes

N

N. Weaver

K

K. Davletov

D

Diego De Leo

A

Aklilu Tamire Debele

L

L. Degenhardt

R

Reza Dehbandi

L

Lee Deitesfeld

I

Iván Delgado-Enciso

L

Laura Delgado-Ortiz

D

Daniel Demant

B

Berecha Hundessa Demessa

A

A. K. Demetriades

X

Xinlei Deng

E

E. Denova-Gutiérrez

K

Kebede Deribe

N

Nikolaos Dervenis

D

D. C. Jarlais

H

Hardik D. Desai

R

Rupak Desai

K

K. Deuba

V

Vinoth Gnana Chellaiyan Devanbu

S

Sourav Dey

A

A. Dhali

K

K. Dhama

M

M. Dhimal

M

M. Dhimal

S

Sameer Dhingra

D

D. Silva

D

Daniel Diaz

A

Adriana Dima

D

Delaney D. Ding

M

M. Dirac

A

Abhinav Dixit

S

S. Dixit

T

T. Do

T

Thao Phuong Do

C

C. Prado

M

Masoud Dodangeh

K

K. Dokova

C

C. Dolecek

E

E. Dorsey

W

Wendel Mombaque dos Santos

R

Rajkumar Doshi

L

L. Doshmangir

A

Abdel Douiri

R

Robert Kokou Dowou

T

T. Driscoll

H

Haneil Larson Dsouza

J

John Dube

S

S. Dumith

S

S. Dunachie

B

Bruce B Duncan

A

A. Durães

S

Senbagam Duraisamy

O

O. Durojaiye

S

S. Dutta

P

Paulina A. Dzianach

A

Arkadiusz Marian Dziedzic

O

Oluwakemi Ebenezer

E

E. Eboreime

A

Alireza Ebrahimi

C

C. Echieh

A

Abdelaziz Ed-Dra

H

H. Edinur

D

D. Edvardsson

K

Kristina Edvardsson

D

Defi Efendi

F

Ferry Efendi

S

Shayan Eghdami

T

T. Eikemo

E

E. Eini

M

Michael Ekholuenetale

E

Emmanuel Ekpor

T

T. Ekundayo

R

Rabie Adel El Arab

D

Doaa Abdel Wahab El Morsi

M

M. Zaki

M

M. Tantawi

I

I. Elbarazi

N

N. Elemam

F

F. Elgar

Format Sitasi

Schumacher, A.E., Kyu, H., Aali, A., Abbafati, C., Abbas, J., Abbasgholizadeh, R. et al. (2024). Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. https://doi.org/10.1016/S0140-6736(24)00476-8

Akses Cepat

PDF tidak tersedia langsung

Cek di sumber asli →
Lihat di Sumber doi.org/10.1016/S0140-6736(24)00476-8
Informasi Jurnal
Tahun Terbit
2024
Bahasa
en
Total Sitasi
412×
Sumber Database
Semantic Scholar
DOI
10.1016/S0140-6736(24)00476-8
Akses
Open Access ✓