Child and adolescent health from 1990 to 2015

Findings from the global burden of diseases, injuries, and risk factors 2015 study

The Global Burden of Disease Child and Adolescent Health Collaboration

Research output: Contribution to journalReview article

70 Citations (Scopus)

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 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.

Original languageEnglish (US)
Pages (from-to)573-592
Number of pages20
JournalJAMA Pediatrics
Volume171
Issue number6
DOIs
StatePublished - Jun 1 2017

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Wounds and Injuries
Demography
Mortality
Health
Uncertainty
Deaf-Blind Disorders
Age Groups
Nutrition Disorders
Hemoglobinopathies
Child Mortality
Developmental Disabilities
Geography
Child Health
Global Burden of Disease
Adolescent Health
Africa South of the Sahara
Population Growth
Reproductive Health
Malnutrition
Intellectual Disability

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Child and adolescent health from 1990 to 2015 : Findings from the global burden of diseases, injuries, and risk factors 2015 study. / The Global Burden of Disease Child and Adolescent Health Collaboration.

In: JAMA Pediatrics, Vol. 171, No. 6, 01.06.2017, p. 573-592.

Research output: Contribution to journalReview article

The Global Burden of Disease Child and Adolescent Health Collaboration. / Child and adolescent health from 1990 to 2015 : Findings from the global burden of diseases, injuries, and risk factors 2015 study. In: JAMA Pediatrics. 2017 ; Vol. 171, No. 6. pp. 573-592.
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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 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.",
author = "{The Global Burden of Disease Child and Adolescent Health Collaboration} and Nicholas Kassebaum and Kyu, {Hmwe Hmwe} and Leo Zoeckler and Olsen, {Helen Elizabeth} and Katie Thomas and Christine Pinho and Bhutta, {Zulfiqar A.} and Lalit Dandona and Alize Ferrari and Ghiwot, {Tsegaye Tewelde} and Hay, {Simon I.} and Yohannes Kinfu and Xiaofeng Liang and Alan Lopez and Malta, {Deborah Carvalho} and Mokdad, {Ali H.} and Mohsen Naghavi and Patton, {George C.} and Joshua Salomon and Benn Sartorius and Roman Topor-Madry and Vollset, {Stein Emil} and Andrea Werdecker and Whiteford, {Harvey A.} and Abate, {Kalkidan Hasen} and Kaja Abbas and Damtew, {Solomon Abrha} and Ahmed, {Muktar Beshir} and Nadia Akseer and Rajaa Al-Raddadi and Alemayohu, {Mulubirhan Assefa} and Khalid Altirkawi and Abajobir, {Amanuel Alemu} and Amare, {Azmeraw T.} and Antonio, {Carl A.T.} and Johan Arnlov and Al Artaman and Hamid Asayesh and Avokpaho, {Euripide Frinel G.Arthur} and Ashish Awasthi and Quintanilla, {Beatriz Paulina Ayala} and Umar Bacha and Betsu, {Balem Demtsu} and Aleksandra Barac and Barnighausen, {Till Winfried} and Estifanos Baye and Neeraj Bedi and Bensenor, {Isabela M.} and Adugnaw Berhane and Hosgood, {Howard D.}",
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TY - JOUR

T1 - Child and adolescent health from 1990 to 2015

T2 - Findings from the global burden of diseases, injuries, and risk factors 2015 study

AU - The Global Burden of Disease Child and Adolescent Health Collaboration

AU - Kassebaum, Nicholas

AU - Kyu, Hmwe Hmwe

AU - Zoeckler, Leo

AU - Olsen, Helen Elizabeth

AU - Thomas, Katie

AU - Pinho, Christine

AU - Bhutta, Zulfiqar A.

AU - Dandona, Lalit

AU - Ferrari, Alize

AU - Ghiwot, Tsegaye Tewelde

AU - Hay, Simon I.

AU - Kinfu, Yohannes

AU - Liang, Xiaofeng

AU - Lopez, Alan

AU - Malta, Deborah Carvalho

AU - Mokdad, Ali H.

AU - Naghavi, Mohsen

AU - Patton, George C.

AU - Salomon, Joshua

AU - Sartorius, Benn

AU - Topor-Madry, Roman

AU - Vollset, Stein Emil

AU - Werdecker, Andrea

AU - Whiteford, Harvey A.

AU - Abate, Kalkidan Hasen

AU - Abbas, Kaja

AU - Damtew, Solomon Abrha

AU - Ahmed, Muktar Beshir

AU - Akseer, Nadia

AU - Al-Raddadi, Rajaa

AU - Alemayohu, Mulubirhan Assefa

AU - Altirkawi, Khalid

AU - Abajobir, Amanuel Alemu

AU - Amare, Azmeraw T.

AU - Antonio, Carl A.T.

AU - Arnlov, Johan

AU - Artaman, Al

AU - Asayesh, Hamid

AU - Avokpaho, Euripide Frinel G.Arthur

AU - Awasthi, Ashish

AU - Quintanilla, Beatriz Paulina Ayala

AU - Bacha, Umar

AU - Betsu, Balem Demtsu

AU - Barac, Aleksandra

AU - Barnighausen, Till Winfried

AU - Baye, Estifanos

AU - Bedi, Neeraj

AU - Bensenor, Isabela M.

AU - Berhane, Adugnaw

AU - Hosgood, Howard D.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - 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.

AB - 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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U2 - 10.1001/jamapediatrics.2017.0250

DO - 10.1001/jamapediatrics.2017.0250

M3 - Review article

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SP - 573

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JO - JAMA Pediatrics

JF - JAMA Pediatrics

SN - 2168-6203

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