TY - JOUR
T1 - Diseases, Injuries, and Risk Factors in Child and Adolescent Health, 1990 to 2017
T2 - Findings from the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study
AU - Luca Ronfani
AU - Kassebaum, Nicholas J.
AU - Reiner, Robert C.
AU - Olsen, Helen Elizabeth
AU - Ikeda, Chad Thomas
AU - Echko, Michelle M.
AU - Ballestreros, Katherine E.
AU - Manguerra, Helen
AU - Martopullo, Ira
AU - Millear, Anoushka
AU - Shields, Chloe
AU - Smith, Alison
AU - Strub, Bryan
AU - Abebe, Molla
AU - Abebe, Zegeye
AU - Adhikari, Tara Ballav
AU - Adhikari, Tara Ballav
AU - Akibu, Mohammed
AU - Al-Raddadi, Rajaa M.
AU - Alvis-Guzman, Nelson
AU - Antonio, Carl Abelardo T.
AU - Aremu, Olatunde
AU - Asgedom, Solomon Weldegebreal
AU - Asseffa, Netsanet Abera
AU - Avila-Burgos, Leticia
AU - Barac, Aleksandra
AU - Bärnighausen, Till W.
AU - Bassat, Quique
AU - Bensenor, Isabela M.
AU - Bhutta, Zulfiqar A.
AU - Bijani, Ali
AU - Bililign, Nigus
AU - Cahuana-Hurtado, Lucero
AU - Malta, Deborah Carvalho
AU - Chang, Jung Chen
AU - Charlson, Fiona J.
AU - Dharmaratne, Samath Dhamminda
AU - Doku, David Teye
AU - Edessa, Dumessa
AU - El-Khatib, Ziad
AU - Erskine, Holly E.
AU - Ferrari, Alize J.
AU - Fullman, Nancy
AU - Gupta, Rahul
AU - Hassen, Hamid Yimam
AU - Hay, Simon I.
AU - Ilesanmi, Olayinka Stephen
AU - Jacobsen, Kathryn H.
AU - Kahsay, Amaha
AU - Monasta, Lorenzo
AU - Ronfani, Luca
PY - 2019/6
Y1 - 2019/6
N2 - Importance: Understanding causes and correlates of health loss among children and adolescents can identify areas of success, stagnation, and emerging threats and thereby facilitate effective improvement strategies. Objective: To estimate mortality and morbidity in children and adolescents from 1990 to 2017 by age and sex in 195 countries and territories. Design, Setting, and Participants: This study examined levels, trends, and spatiotemporal patterns of cause-specific mortality and nonfatal health outcomes using standardized approaches to data processing and statistical analysis. It also describes epidemiologic transitions by evaluating historical associations between disease indicators and the Socio-Demographic Index (SDI), a composite indicator of income, educational attainment, and fertility. Data collected from 1990 to 2017 on children and adolescents from birth through 19 years of age in 195 countries and territories were assessed. Data analysis occurred from January 2018 to August 2018. Exposures: Being under the age of 20 years between 1990 and 2017. Main Outcomes and Measures: Death and disability. All-cause and cause-specific deaths, disability-adjusted life years, years of life lost, and years of life lived with disability. Results: Child and adolescent deaths decreased 51.7% from 13.77 million (95% uncertainty interval [UI], 13.60-13.93 million) in 1990 to 6.64 million (95% UI, 6.44-6.87 million) in 2017, but in 2017, aggregate disability increased 4.7% to a total of 145 million (95% UI, 107-190 million) years lived with disability globally. Progress was uneven, and inequity increased, with low-SDI and low-middle-SDI locations experiencing 82.2% (95% UI, 81.6%-82.9%) of deaths, up from 70.9% (95% UI, 70.4%-71.4%) in 1990. The leading disaggregated causes of disability-adjusted life years in 2017 in the low-SDI quintile were neonatal disorders, lower respiratory infections, diarrhea, malaria, and congenital birth defects, whereas neonatal disorders, congenital birth defects, headache, dermatitis, and anxiety were highest-ranked in the high-SDI quintile. Conclusions and Relevance: Mortality reductions over this 27-year period mean that children are more likely than ever to reach their 20th birthdays. The concomitant expansion of nonfatal health loss and epidemiological transition in children and adolescents, especially in low-SDI and middle-SDI countries, has the potential to increase already overburdened health systems, will affect the human capital potential of societies, and may influence the trajectory of socioeconomic development. Continued monitoring of child and adolescent health loss is crucial to sustain the progress of the past 27 years.
AB - Importance: Understanding causes and correlates of health loss among children and adolescents can identify areas of success, stagnation, and emerging threats and thereby facilitate effective improvement strategies. Objective: To estimate mortality and morbidity in children and adolescents from 1990 to 2017 by age and sex in 195 countries and territories. Design, Setting, and Participants: This study examined levels, trends, and spatiotemporal patterns of cause-specific mortality and nonfatal health outcomes using standardized approaches to data processing and statistical analysis. It also describes epidemiologic transitions by evaluating historical associations between disease indicators and the Socio-Demographic Index (SDI), a composite indicator of income, educational attainment, and fertility. Data collected from 1990 to 2017 on children and adolescents from birth through 19 years of age in 195 countries and territories were assessed. Data analysis occurred from January 2018 to August 2018. Exposures: Being under the age of 20 years between 1990 and 2017. Main Outcomes and Measures: Death and disability. All-cause and cause-specific deaths, disability-adjusted life years, years of life lost, and years of life lived with disability. Results: Child and adolescent deaths decreased 51.7% from 13.77 million (95% uncertainty interval [UI], 13.60-13.93 million) in 1990 to 6.64 million (95% UI, 6.44-6.87 million) in 2017, but in 2017, aggregate disability increased 4.7% to a total of 145 million (95% UI, 107-190 million) years lived with disability globally. Progress was uneven, and inequity increased, with low-SDI and low-middle-SDI locations experiencing 82.2% (95% UI, 81.6%-82.9%) of deaths, up from 70.9% (95% UI, 70.4%-71.4%) in 1990. The leading disaggregated causes of disability-adjusted life years in 2017 in the low-SDI quintile were neonatal disorders, lower respiratory infections, diarrhea, malaria, and congenital birth defects, whereas neonatal disorders, congenital birth defects, headache, dermatitis, and anxiety were highest-ranked in the high-SDI quintile. Conclusions and Relevance: Mortality reductions over this 27-year period mean that children are more likely than ever to reach their 20th birthdays. The concomitant expansion of nonfatal health loss and epidemiological transition in children and adolescents, especially in low-SDI and middle-SDI countries, has the potential to increase already overburdened health systems, will affect the human capital potential of societies, and may influence the trajectory of socioeconomic development. Continued monitoring of child and adolescent health loss is crucial to sustain the progress of the past 27 years.
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U2 - 10.1001/jamapediatrics.2019.0337
DO - 10.1001/jamapediatrics.2019.0337
M3 - Article
C2 - 31034019
AN - SCOPUS:85065307750
VL - 173
JO - JAMA Pediatrics
JF - JAMA Pediatrics
SN - 2168-6203
IS - 6
ER -