The University of Southampton
University of Southampton Institutional Repository

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019
Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Interpretation: Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Funding: Bill & Melinda Gates Foundation.

0140-6736
1160-1203
Sabour, S.
dae16302-03bf-4a88-aea8-e1fdacdfa8b3
Abdollahi, M.
96ec68db-6302-4216-9aaf-9951a44be8b8
Hassan, A.
58f15670-feea-49de-951b-729dabe89fbe
Sadeghi, M.
0336904c-8524-430b-a601-4a9ff5904081
Basu, S.
d80360e5-405e-4b71-b57b-73107ac46448
Park, J.
75e0be94-e514-428c-94d9-02ce59b98d5b
Stubbs, J. L.
6a9af10b-92df-49d9-8f54-3d945c3354ac
Almulhim, A. M.
1fc094e0-aa1e-45e6-8b11-b41118a969a9
Hay, S. I.
ad00c295-7b71-4d56-83d5-2c936e6b77d2
Lopez, A. D.
95f2efff-054e-4b95-834d-049019615a86
Wang, H.
2fecb0ee-0f16-4702-9566-5cba15561054
Lim, S. S.
81c90df4-acd4-4636-b491-55ae14394925
Murray, C. J.L.
aafef9e5-c983-43fa-b12e-c73ea8e4f3ae
Crowe, C. S.
b0a872fd-40c0-4988-a707-f0126597de4a
Anderson, J. A.
de426cca-2178-45a0-a322-99efbd59bad6
Cao, J.
5a41012f-2135-4dad-8a55-ecda5aa068ae
Fox, J. T.
6e455708-8ae3-4b81-a537-7d29f44a1515
Frank, T. D.
3d1aae1b-7dd5-4ee3-8f06-c5a7f0acbe6f
Fuller, J. E.
744264a8-5aa1-4444-82d0-9faf0fb751cc
Han, C.
241d5aec-42dc-412e-bbc7-828b6c0638d3
Harvey, J. D.
624a5cc9-d8b4-485b-8028-bf9019ea10a8
Henry, N. J.
2c4ab1d9-10d9-46d0-b032-d8eff2f3763c
James, S. L.
3a961f18-3802-4e9a-814a-c2aa77c72a39
Johnson, C. O.
c18377d8-3597-4811-8412-8ac5d3759d0a
Johnson, S. C.
a1e8b35f-5c86-45e2-b440-204499c5a532
Knight, M.
da926606-b5ef-48cb-8db8-8e4ddb85ed07
Lau, K. M.
2aaea8fa-2552-475d-a6fa-c65a544bc7c5
Liu, H.
c9560e2b-c593-4209-8578-39bd481ee456
Liu, Z.
802c4555-e10a-47d6-a508-ee84f0ed7ab2
Ma, J.
8f13f496-9cfa-46b9-85e3-fa9e6c5a5fd2
Marks, A.
be2ac240-094c-42ce-a77c-75014420efe6
May, E. A.
6d1c3d6b-6e0a-4b14-a405-24d8eb3f3123
Nguyen, M.
847e20f7-6599-4981-83e5-b9fe289d0ffa
Nichols, E.
6dd89d88-e812-45c2-b8e0-a0a108a8bdce
Nixon, M. R.
2b5b9804-5a81-462a-82e6-92ee5fa74e12
Pease, S. A.
125fbdb1-962d-4493-94d5-ecff9621e9fb
Roberts, S.
90ff2cc8-75cf-4336-9db8-3637c686705a
Roberts, N. L.S.
d2579c68-b5b3-48bf-99e4-c61740470c6d
Shaw, D. H.
b0cacd78-deb4-4d56-ba1a-2259f09110f5
Simpson, K. E.
1cc9c348-4f76-403a-97e3-63896b89d8c5
Smith, A.
96e04a08-2a75-4a81-93d7-1ccb2dafd27d
Spencer, C. N.
15ac1e0d-c238-4946-ad97-7133bb60adbe
Taylor, H. J.
da363353-af24-45f6-af9b-f9b4cafdcc91
Wang, J.
ff4ce13a-5f70-41e1-9723-cb24c5a2617b
Watson, A.
e6e342bb-dd1d-485c-8ba9-a1efec015392
Watson, S.
5e5131bb-a35d-42ca-aa53-44c5a8d2ecec
Wilson, S.
d93a7b1d-1d3a-4d98-abbd-b519e7ed57e9
Wu, J.
0e097344-32d7-425e-8437-142b4fca1d56
Xu, R.
df9a854a-861a-498a-b55b-f0b74f8b8cf6
York, H. W.
e29d0369-510a-4c69-92b7-72179d8539fd
Zhao, J. T.
009bf4af-ade0-4b7f-8ffe-02f7256b4c89
Zheng, P.
a46dbafc-a753-4f22-b825-a00fd36ebd44
Guo, Y.
6c6f0c1a-55f0-43f6-9315-248d09358f90
Li, S.
042818a6-77de-43be-a387-63a406a5a3be
Zhang, J.
6bad4e75-40e0-4ea3-866d-58c8018b225a
Ahmadi, A.
2f8bbfec-8bc9-4e5e-8a15-1d7c1480d5f4
Mills, E. J.
cc44a635-190e-4d07-a2da-ef993f6db8d6
Olagunju, A. T.
184f57c4-1034-40ef-8bde-12164d307e96
Ahmad, T.
3e8dcf34-da44-401d-8344-438923c56c60
Maleki, S.
5ddca73c-dbd7-40e3-88d7-3d34b9b6e022
Ahmed, M. B.
49451a9e-65f4-4242-a577-de7180b22e20
Wu, C.
e284a512-2ea2-426c-84a7-047465f5b715
Ji, J. S.
b8f18985-425b-4077-9242-9e624e80299c
Mitchell, P. B.
480c854d-5575-4a10-a357-647057173611
Alam, S.
2b6bdbe5-ddcc-4a88-9057-299360b93435
Martin, R. V.
056af022-7532-4352-966e-24a8117d728e
Ali, M.
71dd6748-6797-4734-a908-677587e8cac8
Ali, S.
2d9041fa-9a51-4415-b5cf-eb97850e8169
Khan, M.
6b96e823-7483-4688-87a7-8dc82a6e69b0
Hasan, M.
fdb892ba-7f72-4e59-98c1-f070733840c9
McGrath, J. J.
e5b8f781-2556-43f7-947a-3bd87e21749a
Erskine, H. E.
2f0af480-4e20-450d-9016-9e1dc3b172a8
Angus, C.
7a190f2d-9816-4960-8695-e694c39f099c
Lee, P. H.
f47c6d5d-2d1f-4f03-a3ff-03658812d80b
Aremu, O.
0be4f104-f548-477e-929d-dbc3be016939
Islam, M.
75039414-5023-4a48-b1e9-f51b21aa083c
Rahman, M.
f55a7a1e-04d9-44fe-9253-3044ffdb4b3b
Gething, P. W.
2cacb985-6234-4d1f-9aa1-1dc7bee7da14
Briggs, A. M.
385ce64b-7639-4ecc-b3ed-d699dd836259
Miller, T. R.
dd762152-c2fc-4924-8d02-16fc393906ad
Shetty, R. S.
1f641a80-d586-4bf0-919f-08aa1414a7bd
Joshi, A.
5dda640b-fe5f-4675-9995-3b7ee7c700f6
Balakrishnan, S.
7d221752-b7bc-4405-84eb-783ce35157b6
Mohammed, A. S.
c0348c6f-0911-457b-8a04-ff568591941e
Roberts, S.
90ff2cc8-75cf-4336-9db8-3637c686705a
Stokes, M. A.
71730503-70ce-4e67-b7ea-a3e54579717f
Ball, K.
b9f5b1bd-02b6-4c82-86dc-335a08738be6
Islam, S.
5be24bb8-751c-42c2-8fe7-a1bb8916dd58
Davis, A. C.
c4f510e8-50b1-42e1-8ae6-c45ca22620d8
West, J.
f1c2e060-16c3-44c0-af70-242a1c58b968
Bell, M. L.
7bdee58a-47bb-4c4a-83ca-77409deb8a98
Collins, E. L.
578521e8-ebc1-460e-b181-5b46b0fe3299
Zhao, Y.
14a0a855-59b4-47c6-8d72-0a06ab2a8084
Bennett, D. A.
b8187d5d-b4f0-4fbb-b6bc-879a04e5a322
Wang, Y.
9678f8f9-a06f-41e0-9c92-e1fbd1afcf00
Liu, Y.
cf8d307b-0983-416d-81a7-eed75f930e39
Khan, G.
074c43d0-6e37-45d8-863c-7c3333997ef1
Das, J. K.
1568dc82-cece-47dc-9385-47cf5073bade
Hassan, S.
2b39f311-7364-427c-91e7-f4a1d2b6762d
Fisher, J. L.
d0b71217-39c4-418d-8ca3-27b12cc93947
Castro, F.
8b7b046c-f9c6-4755-b4ce-6f41c19ac0f9
Cai, T.
6347e9ac-66ad-4207-a959-0c77df96c498
Hall, B. J.
828e6e5e-4364-4504-9785-62c2f8eb519b
Santos, J. V.
099caf8f-657e-437e-b1e2-8a562ca2f329
Chang, J.
ad3977b8-4c64-4d9c-8c79-055fb2b14244
Chang, K.
4a4a15be-862b-4cd2-a229-bc4562f6b47e
Kumar, M.
4b3bfd7e-146c-4d0c-81d9-d1434061b9f8
Ward, J. L.
2f3a681d-6f37-4cfb-812c-5990bf405fb4
Chung, M. T.
f6bb2904-ec3a-4986-9624-95f5fed6ec91
Schmidt, M. I.
8515ec8d-eb84-4721-93b2-11ce69444d72
Leigh, J.
00643551-3e27-49a0-a125-b80fe40eee1c
Cross, M.
d68d9834-d04b-402b-8972-e6c438ca1a39
Ferreira, M. L.
9ab7385b-55a3-418b-8671-cf9c16434a6e
Smith, E. U.R.
9c3b65f0-14d1-4d96-8fa2-89e206f698e9
Cross, D. H.
bdabaad5-a6a2-4139-993b-58fbb8f7c3a6
Dai, H.
214c9368-7f1b-41c9-b3e9-5715d1ba21c5
Pandey, A.
f9d7fe21-b053-4679-9c42-53f9657e00a0
Davey, G.
75ca6560-fb27-45a8-ade4-f6ee114bfdb2
Nguyen, T. H.
f2efcd9d-14ad-450d-a7ad-5630e910aaa1
Do, H. T.
ea3f13a4-2572-4f4a-be34-dc0f6f3e73d5
Robinson, S. R.
7a6999c0-13e3-431e-9f5e-3fd5edbc13f2
Liu, X.
1a86e4d4-ce3e-4e54-83fe-6f4704a551db
Franklin, R. C.
7a218367-2550-458f-99ea-c6da4657859b
Hameed, S.
759b4b50-adbf-468a-9a77-ffc4ff8759c6
Milne, G. J.
83bb44a0-dcf4-445f-8745-44652cff0df0
Gupta, S. S.
596611db-ddae-45a2-a0ec-266a19c9a1c0
Phillips, M. R.
4eee155f-4130-43c6-8431-4f5a402441e2
Nguyen, C. T.
c3d1ec16-957b-4130-aa1a-83a34ba8e3b5
Nguyen, H. L.T.
de43b885-f2f4-4315-b5e9-c7d9f19f02a4
Hussain, R.
7cf1fabd-1faa-4793-89a1-659f8d9fadf6
Yamada, T.
81c66c35-0e2b-4342-80fa-cbee6ff9ce5f
Kumar, M.
4b3bfd7e-146c-4d0c-81d9-d1434061b9f8
Khan, E. A.
9882c703-d28b-4faa-a4cc-e74843e9ba33
Kim, Y.
ad29833d-48e4-4080-8614-ff02fd530402
Yoon, S.
0d1ab085-3ab2-4d59-aab8-8d0748043345
Shin, M.
2c911163-f027-4c79-8a7b-368f326c46e7
Kim, C.
c7f1180e-8f6a-4f48-a2e2-73b1ad2f8de7
Kim, Y.
ad29833d-48e4-4080-8614-ff02fd530402
Kim, D.
c4e820fe-d29a-4594-9a51-9cee28cc8038
Kumar, P.
63c79684-5e70-4733-926f-4bb516dfad1e
Singh, P.
95d5e721-2fc5-4aaf-95da-a71aa4a06b92
Li, B.
ff6006d5-9415-4ddd-b641-005ab8fc18d9
Lim, L.
4e6f0941-4777-4319-bd11-79916998b054
Liu, S.
741afc1b-31b1-4fac-a2cb-38855fe8d6a3
Mahmoudi, M.
f6a55246-399e-4f81-944e-a4b169786e8a
Mapoma, C.
08f0b4b9-d4cd-48e9-bec9-95f0773e2ed8
Mukhopadhyay, S.
a12b9e01-549d-4fab-b45f-e7df03340156
Nagel, G.
802314b0-95c5-4c78-b250-0778913c0d9b
Singh, J. A.
1c38b7cc-d483-4644-a595-93142122052e
Nair, S.
4e14be3f-3063-4c57-88ff-af113291ccbb
Ong, S.
882b1ec7-d864-4c00-81dc-2d5a2cbf8889
Patel, S. K.
445f8b27-2e51-467e-aa31-7c7f87199970
Pathak, M.
6eaf4b66-9d21-4b9b-ad64-cb5c9088848f
Paudel, S.
eb090ec4-899b-4448-b3f8-913ffec84781
Rao, S.
0823e42a-7524-4702-89f3-8347900d6a8d
Ullah, S.
dc11df8b-6dea-4b5c-a100-998b36212621
Salomon, J. A.
af51ebe8-275d-44a2-9bc6-2afc10a09d7c
Sharma, R.
cc5d88a9-3704-4c36-a37f-223fbc05b66e
Shin, J.
0cae2cda-8fcb-4979-b082-4fac20bedc4f
Silva, D. A.S.
7f9d09a4-51cc-42ca-be73-58e1d7774baf
Singh, A.
f019ba98-48fd-4e2a-a0b9-300df27acb06
Thomas, N.
a66e197d-4184-4640-8b37-c6937ebc99db
Ullah, I.
15653bbb-6bcc-4f9e-b1af-54145ad92cdb
Wang, F.
d78b15ef-f08b-482b-8651-f89e02ae8103
Zhao, X. G.
70e12f26-5ece-46cd-a186-3cac70e99a6f
Wang, Y.
9678f8f9-a06f-41e0-9c92-e1fbd1afcf00
Yu, C.
0ffaac60-4999-4bbf-ac6d-d3d4cecad0b3
Zhang, Z.
695332f3-2d6f-44d0-a4fc-405ef2482d59
Wang, H.
2fecb0ee-0f16-4702-9566-5cba15561054
Wu, A.
42b1ddc4-34ec-4353-ad82-903eef91b3c3
Xie, Y.
2a6c1811-972a-4aba-8843-292b8c80478c
Yu, Y.
a46f1df6-fa8f-475c-b1aa-b98205266f6c
Zaidi, S.
52ccc64d-89e9-4d44-afb0-29a131204907
Zhang, J.
6bad4e75-40e0-4ea3-866d-58c8018b225a
Zhang, Y.
52bebb1d-3de2-427b-ae79-88199c6afa7e
Zhu, C.
67a1c085-5e0b-4dcf-8770-b99c520115fc
GBD 2019 Demographics Collaborators
Sabour, S.
dae16302-03bf-4a88-aea8-e1fdacdfa8b3
Abdollahi, M.
96ec68db-6302-4216-9aaf-9951a44be8b8
Hassan, A.
58f15670-feea-49de-951b-729dabe89fbe
Sadeghi, M.
0336904c-8524-430b-a601-4a9ff5904081
Basu, S.
d80360e5-405e-4b71-b57b-73107ac46448
Park, J.
75e0be94-e514-428c-94d9-02ce59b98d5b
Stubbs, J. L.
6a9af10b-92df-49d9-8f54-3d945c3354ac
Almulhim, A. M.
1fc094e0-aa1e-45e6-8b11-b41118a969a9
Hay, S. I.
ad00c295-7b71-4d56-83d5-2c936e6b77d2
Lopez, A. D.
95f2efff-054e-4b95-834d-049019615a86
Wang, H.
2fecb0ee-0f16-4702-9566-5cba15561054
Lim, S. S.
81c90df4-acd4-4636-b491-55ae14394925
Murray, C. J.L.
aafef9e5-c983-43fa-b12e-c73ea8e4f3ae
Crowe, C. S.
b0a872fd-40c0-4988-a707-f0126597de4a
Anderson, J. A.
de426cca-2178-45a0-a322-99efbd59bad6
Cao, J.
5a41012f-2135-4dad-8a55-ecda5aa068ae
Fox, J. T.
6e455708-8ae3-4b81-a537-7d29f44a1515
Frank, T. D.
3d1aae1b-7dd5-4ee3-8f06-c5a7f0acbe6f
Fuller, J. E.
744264a8-5aa1-4444-82d0-9faf0fb751cc
Han, C.
241d5aec-42dc-412e-bbc7-828b6c0638d3
Harvey, J. D.
624a5cc9-d8b4-485b-8028-bf9019ea10a8
Henry, N. J.
2c4ab1d9-10d9-46d0-b032-d8eff2f3763c
James, S. L.
3a961f18-3802-4e9a-814a-c2aa77c72a39
Johnson, C. O.
c18377d8-3597-4811-8412-8ac5d3759d0a
Johnson, S. C.
a1e8b35f-5c86-45e2-b440-204499c5a532
Knight, M.
da926606-b5ef-48cb-8db8-8e4ddb85ed07
Lau, K. M.
2aaea8fa-2552-475d-a6fa-c65a544bc7c5
Liu, H.
c9560e2b-c593-4209-8578-39bd481ee456
Liu, Z.
802c4555-e10a-47d6-a508-ee84f0ed7ab2
Ma, J.
8f13f496-9cfa-46b9-85e3-fa9e6c5a5fd2
Marks, A.
be2ac240-094c-42ce-a77c-75014420efe6
May, E. A.
6d1c3d6b-6e0a-4b14-a405-24d8eb3f3123
Nguyen, M.
847e20f7-6599-4981-83e5-b9fe289d0ffa
Nichols, E.
6dd89d88-e812-45c2-b8e0-a0a108a8bdce
Nixon, M. R.
2b5b9804-5a81-462a-82e6-92ee5fa74e12
Pease, S. A.
125fbdb1-962d-4493-94d5-ecff9621e9fb
Roberts, S.
90ff2cc8-75cf-4336-9db8-3637c686705a
Roberts, N. L.S.
d2579c68-b5b3-48bf-99e4-c61740470c6d
Shaw, D. H.
b0cacd78-deb4-4d56-ba1a-2259f09110f5
Simpson, K. E.
1cc9c348-4f76-403a-97e3-63896b89d8c5
Smith, A.
96e04a08-2a75-4a81-93d7-1ccb2dafd27d
Spencer, C. N.
15ac1e0d-c238-4946-ad97-7133bb60adbe
Taylor, H. J.
da363353-af24-45f6-af9b-f9b4cafdcc91
Wang, J.
ff4ce13a-5f70-41e1-9723-cb24c5a2617b
Watson, A.
e6e342bb-dd1d-485c-8ba9-a1efec015392
Watson, S.
5e5131bb-a35d-42ca-aa53-44c5a8d2ecec
Wilson, S.
d93a7b1d-1d3a-4d98-abbd-b519e7ed57e9
Wu, J.
0e097344-32d7-425e-8437-142b4fca1d56
Xu, R.
df9a854a-861a-498a-b55b-f0b74f8b8cf6
York, H. W.
e29d0369-510a-4c69-92b7-72179d8539fd
Zhao, J. T.
009bf4af-ade0-4b7f-8ffe-02f7256b4c89
Zheng, P.
a46dbafc-a753-4f22-b825-a00fd36ebd44
Guo, Y.
6c6f0c1a-55f0-43f6-9315-248d09358f90
Li, S.
042818a6-77de-43be-a387-63a406a5a3be
Zhang, J.
6bad4e75-40e0-4ea3-866d-58c8018b225a
Ahmadi, A.
2f8bbfec-8bc9-4e5e-8a15-1d7c1480d5f4
Mills, E. J.
cc44a635-190e-4d07-a2da-ef993f6db8d6
Olagunju, A. T.
184f57c4-1034-40ef-8bde-12164d307e96
Ahmad, T.
3e8dcf34-da44-401d-8344-438923c56c60
Maleki, S.
5ddca73c-dbd7-40e3-88d7-3d34b9b6e022
Ahmed, M. B.
49451a9e-65f4-4242-a577-de7180b22e20
Wu, C.
e284a512-2ea2-426c-84a7-047465f5b715
Ji, J. S.
b8f18985-425b-4077-9242-9e624e80299c
Mitchell, P. B.
480c854d-5575-4a10-a357-647057173611
Alam, S.
2b6bdbe5-ddcc-4a88-9057-299360b93435
Martin, R. V.
056af022-7532-4352-966e-24a8117d728e
Ali, M.
71dd6748-6797-4734-a908-677587e8cac8
Ali, S.
2d9041fa-9a51-4415-b5cf-eb97850e8169
Khan, M.
6b96e823-7483-4688-87a7-8dc82a6e69b0
Hasan, M.
fdb892ba-7f72-4e59-98c1-f070733840c9
McGrath, J. J.
e5b8f781-2556-43f7-947a-3bd87e21749a
Erskine, H. E.
2f0af480-4e20-450d-9016-9e1dc3b172a8
Angus, C.
7a190f2d-9816-4960-8695-e694c39f099c
Lee, P. H.
f47c6d5d-2d1f-4f03-a3ff-03658812d80b
Aremu, O.
0be4f104-f548-477e-929d-dbc3be016939
Islam, M.
75039414-5023-4a48-b1e9-f51b21aa083c
Rahman, M.
f55a7a1e-04d9-44fe-9253-3044ffdb4b3b
Gething, P. W.
2cacb985-6234-4d1f-9aa1-1dc7bee7da14
Briggs, A. M.
385ce64b-7639-4ecc-b3ed-d699dd836259
Miller, T. R.
dd762152-c2fc-4924-8d02-16fc393906ad
Shetty, R. S.
1f641a80-d586-4bf0-919f-08aa1414a7bd
Joshi, A.
5dda640b-fe5f-4675-9995-3b7ee7c700f6
Balakrishnan, S.
7d221752-b7bc-4405-84eb-783ce35157b6
Mohammed, A. S.
c0348c6f-0911-457b-8a04-ff568591941e
Roberts, S.
90ff2cc8-75cf-4336-9db8-3637c686705a
Stokes, M. A.
71730503-70ce-4e67-b7ea-a3e54579717f
Ball, K.
b9f5b1bd-02b6-4c82-86dc-335a08738be6
Islam, S.
5be24bb8-751c-42c2-8fe7-a1bb8916dd58
Davis, A. C.
c4f510e8-50b1-42e1-8ae6-c45ca22620d8
West, J.
f1c2e060-16c3-44c0-af70-242a1c58b968
Bell, M. L.
7bdee58a-47bb-4c4a-83ca-77409deb8a98
Collins, E. L.
578521e8-ebc1-460e-b181-5b46b0fe3299
Zhao, Y.
14a0a855-59b4-47c6-8d72-0a06ab2a8084
Bennett, D. A.
b8187d5d-b4f0-4fbb-b6bc-879a04e5a322
Wang, Y.
9678f8f9-a06f-41e0-9c92-e1fbd1afcf00
Liu, Y.
cf8d307b-0983-416d-81a7-eed75f930e39
Khan, G.
074c43d0-6e37-45d8-863c-7c3333997ef1
Das, J. K.
1568dc82-cece-47dc-9385-47cf5073bade
Hassan, S.
2b39f311-7364-427c-91e7-f4a1d2b6762d
Fisher, J. L.
d0b71217-39c4-418d-8ca3-27b12cc93947
Castro, F.
8b7b046c-f9c6-4755-b4ce-6f41c19ac0f9
Cai, T.
6347e9ac-66ad-4207-a959-0c77df96c498
Hall, B. J.
828e6e5e-4364-4504-9785-62c2f8eb519b
Santos, J. V.
099caf8f-657e-437e-b1e2-8a562ca2f329
Chang, J.
ad3977b8-4c64-4d9c-8c79-055fb2b14244
Chang, K.
4a4a15be-862b-4cd2-a229-bc4562f6b47e
Kumar, M.
4b3bfd7e-146c-4d0c-81d9-d1434061b9f8
Ward, J. L.
2f3a681d-6f37-4cfb-812c-5990bf405fb4
Chung, M. T.
f6bb2904-ec3a-4986-9624-95f5fed6ec91
Schmidt, M. I.
8515ec8d-eb84-4721-93b2-11ce69444d72
Leigh, J.
00643551-3e27-49a0-a125-b80fe40eee1c
Cross, M.
d68d9834-d04b-402b-8972-e6c438ca1a39
Ferreira, M. L.
9ab7385b-55a3-418b-8671-cf9c16434a6e
Smith, E. U.R.
9c3b65f0-14d1-4d96-8fa2-89e206f698e9
Cross, D. H.
bdabaad5-a6a2-4139-993b-58fbb8f7c3a6
Dai, H.
214c9368-7f1b-41c9-b3e9-5715d1ba21c5
Pandey, A.
f9d7fe21-b053-4679-9c42-53f9657e00a0
Davey, G.
75ca6560-fb27-45a8-ade4-f6ee114bfdb2
Nguyen, T. H.
f2efcd9d-14ad-450d-a7ad-5630e910aaa1
Do, H. T.
ea3f13a4-2572-4f4a-be34-dc0f6f3e73d5
Robinson, S. R.
7a6999c0-13e3-431e-9f5e-3fd5edbc13f2
Liu, X.
1a86e4d4-ce3e-4e54-83fe-6f4704a551db
Franklin, R. C.
7a218367-2550-458f-99ea-c6da4657859b
Hameed, S.
759b4b50-adbf-468a-9a77-ffc4ff8759c6
Milne, G. J.
83bb44a0-dcf4-445f-8745-44652cff0df0
Gupta, S. S.
596611db-ddae-45a2-a0ec-266a19c9a1c0
Phillips, M. R.
4eee155f-4130-43c6-8431-4f5a402441e2
Nguyen, C. T.
c3d1ec16-957b-4130-aa1a-83a34ba8e3b5
Nguyen, H. L.T.
de43b885-f2f4-4315-b5e9-c7d9f19f02a4
Hussain, R.
7cf1fabd-1faa-4793-89a1-659f8d9fadf6
Yamada, T.
81c66c35-0e2b-4342-80fa-cbee6ff9ce5f
Kumar, M.
4b3bfd7e-146c-4d0c-81d9-d1434061b9f8
Khan, E. A.
9882c703-d28b-4faa-a4cc-e74843e9ba33
Kim, Y.
ad29833d-48e4-4080-8614-ff02fd530402
Yoon, S.
0d1ab085-3ab2-4d59-aab8-8d0748043345
Shin, M.
2c911163-f027-4c79-8a7b-368f326c46e7
Kim, C.
c7f1180e-8f6a-4f48-a2e2-73b1ad2f8de7
Kim, Y.
ad29833d-48e4-4080-8614-ff02fd530402
Kim, D.
c4e820fe-d29a-4594-9a51-9cee28cc8038
Kumar, P.
63c79684-5e70-4733-926f-4bb516dfad1e
Singh, P.
95d5e721-2fc5-4aaf-95da-a71aa4a06b92
Li, B.
ff6006d5-9415-4ddd-b641-005ab8fc18d9
Lim, L.
4e6f0941-4777-4319-bd11-79916998b054
Liu, S.
741afc1b-31b1-4fac-a2cb-38855fe8d6a3
Mahmoudi, M.
f6a55246-399e-4f81-944e-a4b169786e8a
Mapoma, C.
08f0b4b9-d4cd-48e9-bec9-95f0773e2ed8
Mukhopadhyay, S.
a12b9e01-549d-4fab-b45f-e7df03340156
Nagel, G.
802314b0-95c5-4c78-b250-0778913c0d9b
Singh, J. A.
1c38b7cc-d483-4644-a595-93142122052e
Nair, S.
4e14be3f-3063-4c57-88ff-af113291ccbb
Ong, S.
882b1ec7-d864-4c00-81dc-2d5a2cbf8889
Patel, S. K.
445f8b27-2e51-467e-aa31-7c7f87199970
Pathak, M.
6eaf4b66-9d21-4b9b-ad64-cb5c9088848f
Paudel, S.
eb090ec4-899b-4448-b3f8-913ffec84781
Rao, S.
0823e42a-7524-4702-89f3-8347900d6a8d
Ullah, S.
dc11df8b-6dea-4b5c-a100-998b36212621
Salomon, J. A.
af51ebe8-275d-44a2-9bc6-2afc10a09d7c
Sharma, R.
cc5d88a9-3704-4c36-a37f-223fbc05b66e
Shin, J.
0cae2cda-8fcb-4979-b082-4fac20bedc4f
Silva, D. A.S.
7f9d09a4-51cc-42ca-be73-58e1d7774baf
Singh, A.
f019ba98-48fd-4e2a-a0b9-300df27acb06
Thomas, N.
a66e197d-4184-4640-8b37-c6937ebc99db
Ullah, I.
15653bbb-6bcc-4f9e-b1af-54145ad92cdb
Wang, F.
d78b15ef-f08b-482b-8651-f89e02ae8103
Zhao, X. G.
70e12f26-5ece-46cd-a186-3cac70e99a6f
Wang, Y.
9678f8f9-a06f-41e0-9c92-e1fbd1afcf00
Yu, C.
0ffaac60-4999-4bbf-ac6d-d3d4cecad0b3
Zhang, Z.
695332f3-2d6f-44d0-a4fc-405ef2482d59
Wang, H.
2fecb0ee-0f16-4702-9566-5cba15561054
Wu, A.
42b1ddc4-34ec-4353-ad82-903eef91b3c3
Xie, Y.
2a6c1811-972a-4aba-8843-292b8c80478c
Yu, Y.
a46f1df6-fa8f-475c-b1aa-b98205266f6c
Zaidi, S.
52ccc64d-89e9-4d44-afb0-29a131204907
Zhang, J.
6bad4e75-40e0-4ea3-866d-58c8018b225a
Zhang, Y.
52bebb1d-3de2-427b-ae79-88199c6afa7e
Zhu, C.
67a1c085-5e0b-4dcf-8770-b99c520115fc

GBD 2019 Demographics Collaborators (2020) Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. The Lancet, 396 (10258), 1160-1203. (doi:10.1016/S0140-6736(20)30977-6).

Record type: Article

Abstract

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Interpretation: Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Funding: Bill & Melinda Gates Foundation.

Text
1-s2.0-S0140673620309776-main - Version of Record
Available under License Creative Commons Attribution.
Download (3MB)

More information

Accepted/In Press date: 15 October 2020
Published date: 17 October 2020
Additional Information: Funding Information: Research reported in this publication was supported by the Bill & Melinda Gates Foundation, the University of Melbourne, Public Health England, the Norwegian Institute of Public Health, the National Institute on Aging of the National Institutes of Health (NIH; award P30AG047845), and the National Institute of Mental Health of the NIH (award R01MH110163). This analysis uses data or information from the Longitudinal Aging Study in India (LASI) pilot micro data and documentation. The development and release of the LASI pilot study was funded by the National Institute on Aging of the NIH (R21AG032572, R03AG043052, and R01AG030153). The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with license number SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law, 2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data. Data were included from the Russia Longitudinal Monitoring survey, conducted by the National Research University Higher School of Economics and ZAO Demoscope together with Carolina Population Center, University of North Carolina at Chapel Hill and the Institute of Sociology, Russia Academy of Sciences. The United States Aging, Demographics, and Memory Study is a supplement to the Health and Retirement Study, which is sponsored by the National Institute of Aging (grant number NIA U01AG009740). It was conducted jointly by Duke University and the University of Michigan. L G Abreu acknowledges support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Brazil; finance code 001) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, a Brazilian funding agency). O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. A Agrawal acknowledges the Wellcome Trust DBT India Alliance Senior Fellowship. S Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. M Ausloos, C Herteliu, and A Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. T Bärnighausen acknowledges support from the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. D Bennett acknowledges support by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the UK Department of Health and Social Care. J J Carrero was supported by the Swedish Research Council (2019-01059). F Caravlho and E Fernandes acknowledge support from UID/MULTI/04378/2019 and UID/QUI/50006/2019 with funding from FCT/MCTES through national funds. V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia, IP, under the Norma Transitória DL57/2016/CP1334/CT0006. K Deribe acknowledges support by the Wellcome Trust (201900/Z/16/Z) as part of his International Intermediate Fellowship. M Ferreira acknowledges her research fellowship from the National Health and Medical Research Council (NHMRC) of Australia. C Flohr acknowledges support by the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust. M Freitas acknowledges financial support from the EU (European Regional Development Fund [FEDER] funds through COMPETE POCI-01-0145-FEDER-029248) and National Funds (Fundação para a Ciência e Tecnologia) through project PTDC/NAN-MAT/29248/2017. C Herteliu was partially supported by a grant co-funded by FEDER through Operational Competitiveness Program (project ID P_40_382). P Hoogar acknowledges the Bio Cultural Studies, Manipal Academy of Higher Education, and Manipal and Centre for Holistic Development and Research, Kalaghatgi. S V Katikireddi acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13, MC_UU_12017/15), and the Scottish Government Chief Scientist Office (SPHSU13, SPHSU15). Y J Kim was supported by Research Management Office, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/0001). K Krishan is supported by the UCG Centre of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar acknowledges the Fogarty International Centre and NIH for the K43 award (K43 TW 010716-03). B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. J V Lazarus was supported by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III [ISCIII]/ESF, the EU [CP18/00074]). J McGrath acknowledges support by the Danish National Research Foundation (Niels Bohr Professorship). W Mendoza acknowledges the Population and Development department at the UN Population Fund Country Office in Peru, which does not necessarily endorse this study. George Milne acknowledges support provided by The University of Western Australia. I Moreno Velásquez acknowledges support by the Sistema Nacional de Investigación (SENACYT, Panamá). U O Mueller acknowledges funding by the German National Cohort Study (BMBF grant number 01ER1801D). S Nomura acknowledges the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). A Ortiz was supported by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. G C Patton was supported by a NHMRC fellowship. A Raggi, D Sattin, and S Schiavolin were supported by a grant from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4—Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). A M Samy was supported by a fellowship from the Egyptian Fulbright Mission Program. D F Santomauro is affiliated with the Queensland Centre for Mental Health Research, which receives core funding from the Queensland Department of Health. M M Santric-Milicevic acknowledges the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). A Sheikh was supported by Health Data Research UK. J B Soriano is funded by the Centro de Investigación en Red de Enfermedades Respiratorias, ISCIII. R Tabarés-Seisdedos was supported in part by the national grant PI17/00719 from ISCIII–FEDER. S Tadakamadla was supported by an NHMRC Early Career Fellowship. N Taveira was partially supported by the European & Developing Countries Clinical Trials Partnership, the EU (LIFE project, reference RIA2016MC-1615). M Tonelli acknowledges the David Freeze Chair in Health Services Research at the University of Calgary. C S Wiysonge was supported by the South African Medical Research Council. S B Zaman received a scholarship from the Australian Government research training programme in support of his academic career. Editorial note: the Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations. Funding Information: Research reported in this publication was supported by the Bill & Melinda Gates Foundation, the University of Melbourne, Public Health England, the Norwegian Institute of Public Health, the National Institute on Aging of the National Institutes of Health (NIH; award P30AG047845), and the National Institute of Mental Health of the NIH (award R01MH110163). This analysis uses data or information from the Longitudinal Aging Study in India (LASI) pilot micro data and documentation. The development and release of the LASI pilot study was funded by the National Institute on Aging of the NIH (R21AG032572, R03AG043052, and R01AG030153). The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with license number SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law, 2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data. Data were included from the Russia Longitudinal Monitoring survey, conducted by the National Research University Higher School of Economics and ZAO Demoscope together with Carolina Population Center, University of North Carolina at Chapel Hill and the Institute of Sociology, Russia Academy of Sciences. The United States Aging, Demographics, and Memory Study is a supplement to the Health and Retirement Study, which is sponsored by the National Institute of Aging (grant number NIA U01AG009740). It was conducted jointly by Duke University and the University of Michigan. L G Abreu acknowledges support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Brazil; finance code 001) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, a Brazilian funding agency). O Adetokunboh acknowledges the South African Department of Science and Innovation and the National Research Foundation. A Agrawal acknowledges the Wellcome Trust DBT India Alliance Senior Fellowship. S Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. M Ausloos, C Herteliu, and A Pana acknowledge partial support by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. T Bärnighausen acknowledges support from the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. D Bennett acknowledges support by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the UK Department of Health and Social Care. J J Carrero was supported by the Swedish Research Council (2019-01059). F Caravlho and E Fernandes acknowledge support from UID/MULTI/04378/2019 and UID/QUI/50006/2019 with funding from FCT/MCTES through national funds. V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia, IP, under the Norma Transitória DL57/2016/CP1334/CT0006. K Deribe acknowledges support by the Wellcome Trust (201900/Z/16/Z) as part of his International Intermediate Fellowship. M Ferreira acknowledges her research fellowship from the National Health and Medical Research Council (NHMRC) of Australia. C Flohr acknowledges support by the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust. M Freitas acknowledges financial support from the EU (European Regional Development Fund [FEDER] funds through COMPETE POCI-01-0145-FEDER-029248) and National Funds (Fundação para a Ciência e Tecnologia) through project PTDC/NAN-MAT/29248/2017. C Herteliu was partially supported by a grant co-funded by FEDER through Operational Competitiveness Program (project ID P_40_382). P Hoogar acknowledges the Bio Cultural Studies, Manipal Academy of Higher Education, and Manipal and Centre for Holistic Development and Research, Kalaghatgi. S V Katikireddi acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13, MC_UU_12017/15), and the Scottish Government Chief Scientist Office (SPHSU13, SPHSU15). Y J Kim was supported by Research Management Office, Xiamen University Malaysia (XMUMRF/2018-C2/ITCM/0001). K Krishan is supported by the UCG Centre of Advanced Study awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar acknowledges the Fogarty International Centre and NIH for the K43 award (K43 TW 010716-03). B Lacey acknowledges support from the NIHR Oxford Biomedical Research Centre and the BHF Centre of Research Excellence, Oxford. J V Lazarus was supported by a Spanish Ministry of Science, Innovation and Universities Miguel Servet grant (Instituto de Salud Carlos III [ISCIII]/ESF, the EU [CP18/00074]). J McGrath acknowledges support by the Danish National Research Foundation (Niels Bohr Professorship). W Mendoza acknowledges the Population and Development department at the UN Population Fund Country Office in Peru, which does not necessarily endorse this study. George Milne acknowledges support provided by The University of Western Australia. I Moreno Velásquez acknowledges support by the Sistema Nacional de Investigación (SENACYT, Panamá). U O Mueller acknowledges funding by the German National Cohort Study (BMBF grant number 01ER1801D). S Nomura acknowledges the Ministry of Education, Culture, Sports, Science, and Technology of Japan (18K10082). A Ortiz was supported by ISCIII PI19/00815, DTS18/00032, ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM. These funding sources had no role in the writing of the manuscript or the decision to submit it for publication. G C Patton was supported by a NHMRC fellowship. A Raggi, D Sattin, and S Schiavolin were supported by a grant from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C Besta, Linea 4—Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). A M Samy was supported by a fellowship from the Egyptian Fulbright Mission Program. D F Santomauro is affiliated with the Queensland Centre for Mental Health Research, which receives core funding from the Queensland Department of Health. M M Santric-Milicevic acknowledges the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). A Sheikh was supported by Health Data Research UK. J B Soriano is funded by the Centro de Investigación en Red de Enfermedades Respiratorias, ISCIII. R Tabarés-Seisdedos was supported in part by the national grant PI17/00719 from ISCIII–FEDER. S Tadakamadla was supported by an NHMRC Early Career Fellowship. N Taveira was partially supported by the European & Developing Countries Clinical Trials Partnership, the EU (LIFE project, reference RIA2016MC-1615). M Tonelli acknowledges the David Freeze Chair in Health Services Research at the University of Calgary. C S Wiysonge was supported by the South African Medical Research Council. S B Zaman received a scholarship from the Australian Government research training programme in support of his academic career. Funding Information: R Ancuceanu reports consultancy and speakers' fees from UCB Pharmaceuticals, Sandoz, Abbvie, Zentiva, Teva, Laropharm, and Cegedim, outside of the submitted work. M Bell reports grants from the US Environmental Protection Agency, National Institutes of Health (NIH), and Wellcome, during the conduct of the study; and Honorarium or travel reimbursement from the NIH (for review of grant proposals), American Journal of Public Health (participation as editor), Global Research Laboratory and Seoul National University, Royal Society, Ohio University, Atmospheric Chemistry Gordon Research Conference, Johns Hopkins Bloomberg School of Public Health, Arizona State University, Ministry of the Environment Japan, Hong Kong Polytechnic University, University of Illinois—Champaign, and the University of Tennessee—Knoxville, outside of the submitted work. S James reports grants from Sanofi Pasteur, and employment from Genentech, outside of the submitted work. V Jha reports grants from Baxter Healthcare, GlaxoSmithKline, Zydus Cadilla, and Biocon, and personal fees from NephroPlus, outside of the submitted work. J J Jozwiak reports personal fees from Amgen, ALAB Laboratoria, Teva, Synexus, and Boehringer Ingelheim, outside of the submitted work. S Katikireddi reports grants from NRS Senior Clinical Fellowship, UK Medical Research Council, and Scottish Government Chief Scientist Office, during the conduct of the study. J Mosser reports grants from Bill & Melinda Gates Foundation, during the conduct of the study. S Nomura reports grants from the Ministry of Education, Culture, Sports, Science, and Technology, both during the conduct of the study and outside of the submitted work. T Pilgrim reports grants and personal fees from Biotronik and from Boston Scientific, and grants from Edwards Lifesciences, outside of the submitted work. M Postma reports grants from BioMerieux, WHO, EU, FIND, Antilope, DIKTI, LPDP, Bayer, and Budi; personal fees from Quintiles, Novartis, and Pharmerit; grants and personal fees from IQVIA, Bristol Myers Squibb, AstraZeneca, Seqirus, Sanofi, Merck Sharp & Dohme, GlaxoSmithKline, Pfizer, Boehringer Ingelheim, and Novavax; stocks from Ingress Health, and PAG; and acting as advisor to Asc Academics, all outside of the submitted work. M Şaylan reports employment with Bayer, during the conduct of the study. M Shrime reports grants from Mercy Ships, and Damon Runyon Cancer Research Foundation, outside of the submitted work. J Singh reports personal fees from Crealta/Horizon, Medisys, Fidia, UBM, Trio Health, Medscape, WebMD, Clinical Care Options, Clearview Healthcare Partners, Putnam Associates, Spherix, Practice Point Communications, NIH, and the American College of Rheumatology; personal fees from Simply Speaking; stock options in Amarin Pharmaceuticals and Viking Pharmaceuticals; membership in the steering committee of OMERACT (an international organisation that develops measures for clinical trials and receives arm's length funding from 12 pharmaceutical companies), US Food and Drug Administration Arthritis Advisory Committee, and the Veterans Affairs Rheumatology Field Advisory Committee; and non-financial support from UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis, outside of the submitted work. A Thrift reports grants from National Health and Medical Research Council Australia, outside of the submitted work. F Topouzis reports grants from Pfizer, Thea, Novartis, Rheon, Omikron, Pharmaten, Bayer, and Bausch & Lomb, and personal fees from Novartis, and Omikron, outside of the submitted work. M Wallin reports serving as a consultant on grants from Rand Corporation, outside of the submitted work. All other authors declare no competing interests. Publisher Copyright: © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

Identifiers

Local EPrints ID: 472569
URI: http://eprints.soton.ac.uk/id/eprint/472569
ISSN: 0140-6736
PURE UUID: d33ea372-a90d-48eb-801d-a07820e9b527
ORCID for S. Sabour: ORCID iD orcid.org/0000-0003-2697-2994
ORCID for T. D. Frank: ORCID iD orcid.org/0000-0003-4677-4055
ORCID for E. Nichols: ORCID iD orcid.org/0000-0002-9729-1830
ORCID for M. R. Nixon: ORCID iD orcid.org/0000-0002-9174-5934
ORCID for Y. Guo: ORCID iD orcid.org/0000-0002-6207-4975
ORCID for M. B. Ahmed: ORCID iD orcid.org/0000-0003-3234-2788
ORCID for M. A. Stokes: ORCID iD orcid.org/0000-0002-4204-0890
ORCID for K. Ball: ORCID iD orcid.org/0000-0003-2628-0891
ORCID for J. West: ORCID iD orcid.org/0000-0002-5709-6790
ORCID for M. L. Ferreira: ORCID iD orcid.org/0000-0002-2428-0284
ORCID for T. Yamada: ORCID iD orcid.org/0000-0002-5090-7239
ORCID for M. Mahmoudi: ORCID iD orcid.org/0000-0003-1293-8461
ORCID for D. A.S. Silva: ORCID iD orcid.org/0000-0001-7430-3037
ORCID for X. G. Zhao: ORCID iD orcid.org/0000-0002-9714-3176
ORCID for C. Zhu: ORCID iD orcid.org/0000-0002-2145-0559

Catalogue record

Date deposited: 08 Dec 2022 17:37
Last modified: 18 Mar 2024 03:36

Export record

Altmetrics

Contributors

Author: S. Sabour ORCID iD
Author: M. Abdollahi
Author: A. Hassan
Author: M. Sadeghi
Author: S. Basu
Author: J. Park
Author: J. L. Stubbs
Author: A. M. Almulhim
Author: S. I. Hay
Author: A. D. Lopez
Author: H. Wang
Author: S. S. Lim
Author: C. J.L. Murray
Author: C. S. Crowe
Author: J. A. Anderson
Author: J. Cao
Author: J. T. Fox
Author: T. D. Frank ORCID iD
Author: J. E. Fuller
Author: C. Han
Author: J. D. Harvey
Author: N. J. Henry
Author: S. L. James
Author: C. O. Johnson
Author: S. C. Johnson
Author: M. Knight
Author: K. M. Lau
Author: H. Liu
Author: Z. Liu
Author: J. Ma
Author: A. Marks
Author: E. A. May
Author: M. Nguyen
Author: E. Nichols ORCID iD
Author: M. R. Nixon ORCID iD
Author: S. A. Pease
Author: S. Roberts
Author: N. L.S. Roberts
Author: D. H. Shaw
Author: K. E. Simpson
Author: A. Smith
Author: C. N. Spencer
Author: H. J. Taylor
Author: J. Wang
Author: A. Watson
Author: S. Watson
Author: S. Wilson
Author: J. Wu
Author: R. Xu
Author: H. W. York
Author: J. T. Zhao
Author: P. Zheng
Author: Y. Guo ORCID iD
Author: S. Li
Author: J. Zhang
Author: A. Ahmadi
Author: E. J. Mills
Author: A. T. Olagunju
Author: T. Ahmad
Author: S. Maleki
Author: M. B. Ahmed ORCID iD
Author: C. Wu
Author: J. S. Ji
Author: P. B. Mitchell
Author: S. Alam
Author: R. V. Martin
Author: M. Ali
Author: S. Ali
Author: M. Khan
Author: M. Hasan
Author: J. J. McGrath
Author: H. E. Erskine
Author: C. Angus
Author: P. H. Lee
Author: O. Aremu
Author: M. Islam
Author: M. Rahman
Author: P. W. Gething
Author: A. M. Briggs
Author: T. R. Miller
Author: R. S. Shetty
Author: A. Joshi
Author: S. Balakrishnan
Author: A. S. Mohammed
Author: S. Roberts
Author: M. A. Stokes ORCID iD
Author: K. Ball ORCID iD
Author: S. Islam
Author: A. C. Davis
Author: J. West ORCID iD
Author: M. L. Bell
Author: E. L. Collins
Author: Y. Zhao
Author: D. A. Bennett
Author: Y. Wang
Author: Y. Liu
Author: G. Khan
Author: J. K. Das
Author: S. Hassan
Author: J. L. Fisher
Author: F. Castro
Author: T. Cai
Author: B. J. Hall
Author: J. V. Santos
Author: J. Chang
Author: K. Chang
Author: M. Kumar
Author: J. L. Ward
Author: M. T. Chung
Author: M. I. Schmidt
Author: J. Leigh
Author: M. Cross
Author: M. L. Ferreira ORCID iD
Author: E. U.R. Smith
Author: D. H. Cross
Author: H. Dai
Author: A. Pandey
Author: G. Davey
Author: T. H. Nguyen
Author: H. T. Do
Author: S. R. Robinson
Author: X. Liu
Author: R. C. Franklin
Author: S. Hameed
Author: G. J. Milne
Author: S. S. Gupta
Author: M. R. Phillips
Author: C. T. Nguyen
Author: H. L.T. Nguyen
Author: R. Hussain
Author: T. Yamada ORCID iD
Author: M. Kumar
Author: E. A. Khan
Author: Y. Kim
Author: S. Yoon
Author: M. Shin
Author: C. Kim
Author: Y. Kim
Author: D. Kim
Author: P. Kumar
Author: P. Singh
Author: B. Li
Author: L. Lim
Author: S. Liu
Author: M. Mahmoudi ORCID iD
Author: C. Mapoma
Author: S. Mukhopadhyay
Author: G. Nagel
Author: J. A. Singh
Author: S. Nair
Author: S. Ong
Author: S. K. Patel
Author: M. Pathak
Author: S. Paudel
Author: S. Rao
Author: S. Ullah
Author: J. A. Salomon
Author: R. Sharma
Author: J. Shin
Author: D. A.S. Silva ORCID iD
Author: A. Singh
Author: N. Thomas
Author: I. Ullah
Author: F. Wang
Author: X. G. Zhao ORCID iD
Author: Y. Wang
Author: C. Yu
Author: Z. Zhang
Author: H. Wang
Author: A. Wu
Author: Y. Xie
Author: Y. Yu
Author: S. Zaidi
Author: J. Zhang
Author: Y. Zhang
Author: C. Zhu ORCID iD
Corporate Author: GBD 2019 Demographics Collaborators

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×