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

doi:10.1001/jamapediatrics.2017.0250

. 2017 Jun 1;171(6):573-592.

doi: 10.1001/jamapediatrics.2017.0250.

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

Global Burden of Disease Child and Adolescent Health Collaboration; Nicholas Kassebaum¹, Hmwe Hmwe Kyu¹, Leo Zoeckler¹, Helen Elizabeth Olsen¹, Katie Thomas¹, Christine Pinho¹, Zulfiqar A Bhutta², Lalit Dandona^{1

3}, Alize Ferrari⁴, Tsegaye Tewelde Ghiwot⁵, Simon I Hay^{1

6}, Yohannes Kinfu⁷, Xiaofeng Liang⁸, Alan Lopez⁹, Deborah Carvalho Malta¹⁰, Ali H Mokdad¹, Mohsen Naghavi¹, George C Patton¹¹, Joshua Salomon¹², Benn Sartorius¹³, Roman Topor-Madry¹⁴, Stein Emil Vollset¹⁵, Andrea Werdecker¹⁶, Harvey A Whiteford⁴, Kalkidan Hasen Abate⁵, Kaja Abbas¹⁷, Solomon Abrha Damtew¹⁸, Muktar Beshir Ahmed⁵, Nadia Akseer¹⁹, Rajaa Al-Raddadi²⁰, Mulubirhan Assefa Alemayohu²¹, Khalid Altirkawi²², Amanuel Alemu Abajobir⁴, Azmeraw T Amare²³, Carl A T Antonio²⁴, Johan Arnlov^{25

26}, Al Artaman²⁷, Hamid Asayesh²⁸, Euripide Frinel G Arthur Avokpaho²⁹, Ashish Awasthi³⁰, Beatriz Paulina Ayala Quintanilla³¹, Umar Bacha³², Balem Demtsu Betsu²¹, Aleksandra Barac³³, Till Winfried Bärnighausen¹², Estifanos Baye³⁴, Neeraj Bedi³⁵, Isabela M Bensenor³⁶, Adugnaw Berhane³⁷, Eduardo Bernabe³⁸, Oscar Alberto Bernal³⁹, Addisu Shunu Beyene⁴⁰, Sibhatu Biadgilign⁴¹, Boris Bikbov⁴², Cheryl Anne Boyce⁴³, Alexandra Brazinova⁴⁴, Gessessew Bugssa Hailu²¹, Austin Carter¹, Carlos A Castañeda-Orjuela⁴⁵, Ferrán Catalá-López^{46

47}, Fiona J Charlson⁴, Abdulaal A Chitheer⁴⁸, Jee-Young Jasmine Choi⁴⁹, Liliana G Ciobanu²³, John Crump⁵⁰, Rakhi Dandona⁵¹, Robert P Dellavalle⁵², Amare Deribew⁵³, Gabrielle deVeber¹⁹, Daniel Dicker¹, Eric L Ding¹², Manisha Dubey⁵⁴, Amanuel Yesuf Endries⁵⁵, Holly E Erskine⁵⁶, Emerito Jose Aquino Faraon²⁴, Andre Faro⁵⁷, Farshad Farzadfar⁵⁸, Joao C Fernandes⁵⁹, Daniel Obadare Fijabi⁶⁰, Christina Fitzmaurice¹, Thomas D Fleming¹, Luisa Sorio Flor⁶¹, Kyle J Foreman¹, Richard C Franklin⁶², Maya S Fraser¹, Joseph J Frostad¹, Nancy Fullman¹, Gebremedhin Berhe Gebregergs²¹, Alemseged Aregay Gebru²¹, Johanna M Geleijnse⁶³, Katherine B Gibney⁶⁴, Mahari Gidey Yihdego^{65

66}, Ibrahim Abdelmageem Mohamed Ginawi⁶⁷, Melkamu Dedefo Gishu⁴¹, Tessema Assefa Gizachew²³, Elizabeth Glaser⁶⁰, Audra L Gold¹, Ellen Goldberg¹, Philimon Gona⁶⁸, Atsushi Goto⁶⁹, Harish Chander Gugnani⁷⁰, Guohong Jiang⁷¹, Rajeev Gupta⁷², Fisaha Haile Tesfay²¹, Graeme J Hankey⁷³, Rasmus Havmoeller⁷⁴, Martha Hijar⁷⁵, Masako Horino⁷⁶, H Dean Hosgood⁷⁷, Guoqing Hu⁷⁸, Kathryn H Jacobsen⁷⁹, Mihajlo B Jakovljevic⁸⁰, Sudha P Jayaraman⁸¹, Vivekanand Jha^{82

83}, Tariku Jibat^{63

65}, Catherine O Johnson¹, Jost Jonas⁸⁴, Amir Kasaeian⁵⁸, Norito Kawakami⁸⁵, Peter N Keiyoro⁸⁶, Ibrahim Khalil¹, Young-Ho Khang⁴⁹, Jagdish Khubchandani⁸⁷, Aliasghar A Ahmad Kiadaliri⁸⁸, Christian Kieling^{89

90}, Daniel Kim⁹¹, Niranjan Kissoon⁹², Luke D Knibbs⁴, Ai Koyanagi⁹³, Kristopher J Krohn¹, Barthelemy Kuate Defo⁹⁴, Burcu Kucuk Bicer⁹⁵, Rachel Kulikoff¹, G Anil Kumar⁵¹, Dharmesh Kumar Lal⁵¹, Hilton Y Lam⁹⁶, Heidi J Larson^{4

97}, Anders Larsson²⁵, Dennis Odai Laryea⁹⁸, Janni Leung⁴, Stephen S Lim¹, Loon-Tzian Lo^{99

100}, Warren D Lo¹⁰¹, Katharine J Looker¹⁰², Paulo A Lotufo³⁷, Hassan Magdy Abd El Razek¹⁰³, Reza Malekzadeh⁵⁸, Desalegn Markos Shifti¹⁰⁴, Mohsen Mazidi¹⁰⁵, Peter A Meaney¹⁰⁶, Kidanu Gebremariam Meles²¹, Peter Memiah¹⁰⁷, Walter Mendoza¹⁰⁸, Mubarek Abera Mengistie⁵, Gebremichael Welday Mengistu²¹, George A Mensah⁴³, Ted R Miller¹⁰⁹, Charles Mock¹¹⁰, Alireza Mohammadi¹¹¹, Shafiu Mohammed¹¹², Lorenzo Monasta¹¹³, Ulrich Mueller¹⁶, Chie Nagata¹¹⁴, Aliya Naheed¹¹⁵, Grant Nguyen¹, Quyen Le Nguyen¹¹⁶, Elaine Nsoesie¹, In-Hwan Oh¹¹⁷, Anselm Okoro¹¹⁸, Jacob Olusegun Olusanya¹¹⁹, Bolajoko O Olusanya¹²⁰, Alberto Ortiz¹²⁰, Deepak Paudel¹²¹, David M Pereira¹²², Norberto Perico¹²³, Max Petzold¹²⁴, Michael Robert Phillips¹²⁵, Guilherme V Polanczyk³⁶, Farshad Pourmalek⁹², Mostafa Qorbani¹²⁶, Anwar Rafay¹²⁷, Vafa Rahimi-Movaghar⁵⁸, Mahfuzar Rahman¹²⁸, Rajesh Kumar Rai¹²⁹, Usha Ram⁵⁴, Zane Rankin¹, Giuseppe Remuzzi¹³⁰, Andre M N Renzaho¹³¹, Hirbo Shore Roba⁴⁰, David Rojas-Rueda¹³², Luca Ronfani¹¹³, Rajesh Sagar¹³³, Juan Ramon Sanabria¹³⁴, Muktar Sano Kedir Mohammed⁶⁶, Itamar S Santos³⁶, Maheswar Satpathy¹³³, Monika Sawhney¹³⁴, Ben Schöttker^{135

136}, David C Schwebel¹³⁷, James G Scott¹³⁸, Sadaf G Sepanlou⁵⁸, Amira Shaheen¹³⁹, Masood Ali Shaikh¹⁴⁰, June She¹⁴¹, Rahman Shiri¹⁴², Ivy Shiue¹⁴³, Inga Dora Sigfusdottir¹⁴⁴, Jasvinder Singh¹³⁷, Naris Silpakit¹, Alison Smith¹, Chandrashekhar Sreeramareddy¹⁴⁵, Jeffrey D Stanaway¹, Dan J Stein¹⁴⁶, Caitlyn Steiner¹, Muawiyyah Babale Sufiyan¹¹¹, Soumya Swaminathan¹⁴⁷, Rafael Tabarés-Seisdedos⁴⁶, Karen M Tabb¹⁴⁸, Fentaw Tadese¹⁴⁹, Mohammad Tavakkoli¹⁵⁰, Bineyam Taye¹⁵¹, Stephanie Teeple¹, Teketo Kassaw Tegegne¹⁴⁹, Girma Temam Shifa⁵⁵, Abdullah Sulieman Terkawi¹⁵², Bernadette Thomas¹, Alan J Thomson¹⁵³, Ruoyan Tobe-Gai¹¹⁴, Marcello Tonelli¹⁵⁴, Bach Xuan Tran¹⁵⁵, Christopher Troeger¹, Kingsley N Ukwaja¹⁵⁶, Olalekan Uthman¹⁵⁷, Tommi Vasankari¹⁵⁸, Narayanaswamy Venketasubramanian¹⁵⁹, Vasiliy Victorovich Vlassov¹⁶⁰, Elisabete Weiderpass^{161

162}, Robert Weintraub¹⁶³, Solomon Weldemariam Gebrehiwot²¹, Ronny Westerman¹⁶, Hywel C Williams¹⁶⁴, Charles D A Wolfe³⁹, Rachel Woodbrook¹, Yuichiro Yano¹⁶⁵, Naohiro Yonemoto¹⁶⁶, Seok-Jun Yoon¹⁶⁷, Mustafa Z Younis¹⁶⁸, Chuanhua Yu¹⁶⁹, Maysaa El Sayed Zaki¹⁰³, Elias Asfaw Zegeye¹⁷⁰, Liesl Joanna Zuhlke¹⁷¹, Christopher J L Murray¹, Theo Vos¹

Affiliations

¹ Institute for Health Metrics and Evaluation, University of Washington, Seattle.
² Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
³ Public Health Foundation of India, Gurgaon-122002, National Capital Region, India.
⁴ School of Public Health, University of Queensland, Brisbane, Queensland, Australia.
⁵ Jimma University, Jimma, Ethiopia.
⁶ Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom.
⁷ Centre for Research & Action in Public Health, University of Canberra, Canberra, Australia.
⁸ Chinese Center for Disease Control and Prevention, Beijing, China.
⁹ Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
¹⁰ Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
¹¹ Murdoch Childrens Research Institute, University of Melbourne, Victoria, Australia.
¹² Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
¹³ School of Nursing and Public Health, University of KwaZulu-Natal, South African Medical Research Council/University of KwaZulu-Natal Gastrointestinal Cancer Research Center, Durban, South Africa.
¹⁴ Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
¹⁵ Center for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway.
¹⁶ Federal Institute for Population Research, Wiesbaden, Germany.
¹⁷ Department of Population Health, Virginia Tech, Blacksburg.
¹⁸ Wolaita Soda University, Wolaita Soda, Ethiopia.
¹⁹ The Hospital for Sick Children, Centre for Child Health, Toronto, Ontario, Canada.
²⁰ Ministry of Health, Jeddah, Saudi Arabia.
²¹ Mekelle University, Mekelle, Ethiopia.
²² King Saud University, Riyadh, Saudi Arabia.
²³ University of Adelaide, Adelaide, Australia.
²⁴ Department of Health Policy and Administration, University of Philippines-Manila, Manila, Philippines.
²⁵ Department of Medical Services, Uppsala University, Uppsala, Sweden.
²⁶ Dalarna University, Uppsala, Sweden.
²⁷ University of Manitoba, Winnipeg, Manitoba, Canada.
²⁸ Qom University of Medical Sciences, Qom, Iran.
²⁹ Institute de Recherche Clinique du Bénin, Cotonou, Benin.
³⁰ Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
³¹ The Judith Lumley Centre for Mother, Infant, and Family Health Research, La Trobe University, Melbourne, Victoria, Australia.
³² School of Health Sciences, University of Management and Technology, Lahore, Pakistan.
³³ Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
³⁴ Monash University, Melbourne, Victoria, Australia.
³⁵ College of Public Health and Tropical Medicine, Jazan, Saudi Arabia.
³⁶ University of Sao Paulo, Sao Paulo, Brazil.
³⁷ College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia.
³⁸ King's College London, London, United Kingdom.
³⁹ University Andes, Bogota, Columbia.
⁴⁰ Haramaya University, Dire Dawa, Ethiopia.
⁴¹ Independent Public Health Consultants, Addis Ababa, Ethiopia.
⁴² Department of Nephrology Issues of Transplanted Kidney, V. I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russia.
⁴³ National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
⁴⁴ Faculty of Health Sciences and Social Work, Department of Public Health, Trnava University, Trnava, Slovakia.
⁴⁵ Instituto Nacional de Salud, Bogotá, Colombia.
⁴⁶ University of Valencia, Valencia, Spain.
⁴⁷ Health Research Institute and CIBERSAM, Valencia, Spain.
⁴⁸ Ministry of Health, Baghdad, Iraq.
⁴⁹ Seoul National University, Seoul, South Korea.
⁵⁰ Departmentà Centre for International Health, University of Otago, Dunedin, New Zealand.
⁵¹ Public Health Foundation of India, New Delhi, India.
⁵² School of Medicine, School of Public Health, University of Colorado, Aurora.
⁵³ Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
⁵⁴ International Institute for Population Sciences, Mumbai, India.
⁵⁵ Arba Minch University, Arba Minch, Ethiopia.
⁵⁶ Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia.
⁵⁷ Federal University of Sergipe, Aracaju, Brazil.
⁵⁸ Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁵⁹ Center for Biotechnology and Fine Chemistry, Catholic University of Portugal, Porto, Portugal.
⁶⁰ Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
⁶¹ Escola Nacional de Saúde Pública Sergio Arouca/Fiocruz, Rio De Janeiro, Brazil.
⁶² James Cook University, Townsville, Queensland, Australia.
⁶³ Wageningen University, Wageningen, Netherlands.
⁶⁴ The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.
⁶⁵ Addis Ababa University, Addis Ababa, Ethiopia.
⁶⁶ Department of Public Health, Mizan-Tepi University, Ethiopia.
⁶⁷ College of Medicine, University of Hail, Hail, Saudi Arabia.
⁶⁸ University of Massachusetts-Boston.
⁶⁹ National Cancer Center, Tokyo, Japan.
⁷⁰ Department of Microbiology, Departments of Epidemiology and Biostatistics, St James School of Medicine, the Quarter, Anguilla.
⁷¹ School of Public Health, Tianjin Medical University, Tianjin, China.
⁷² Eternal Heart Care Centre and Research Institute, Jaipur, India.
⁷³ School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
⁷⁴ Karolinska Institutet, Stockholm, Sweden.
⁷⁵ Fundacion Entornos, Cuernavaca, Morelos, Mexico.
⁷⁶ Nevada Division of Public and Behavioral Health, Carson City, Nevada.
⁷⁷ Albert Einstein College of Medicine, Bronx, New York.
⁷⁸ Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China.
⁷⁹ Department of Global and Community Health, George Mason University, Fairfax, Virginia.
⁸⁰ University of Kragujevac, Kragujevac, Serbia.
⁸¹ Virginia Commonwealth University, Richmond.
⁸² George Institute for Global Health, New Delhi, India.
⁸³ University of Oxford, Oxford, United Kingdom.
⁸⁴ Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karlas University, Heidelberg, Germany.
⁸⁵ School of Public Health, University of Tokyo, Tokyo, Japan.
⁸⁶ University of Nairobi, Nairobi, Kenya.
⁸⁷ Ball State University, Muncie, Indiana.
⁸⁸ Department of Clinical Sciences, Lund University, Lund, Sweden.
⁸⁹ Federal University of Rio Grande de Sul, Porto Alegre, Brazil.
⁹⁰ Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
⁹¹ Department of Health Sciences, Northeastern University, Boston, Massachusetts.
⁹² University of British Columbia, Vancouver, British Columbia, Canada.
⁹³ Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain.
⁹⁴ University of Montreal, Montreal, Quebec, Canada.
⁹⁵ Institute of Public Health, Hacettepe University, Ankara, Turkey.
⁹⁶ Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines.
⁹⁷ Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
⁹⁸ Komfo Anokye Teaching Hospital, Kumasi, Ghana.
⁹⁹ UnionHealth Associates LLC, St Louis, Missouri.
¹⁰⁰ Alton Mental Health Center, Alton, Illinois.
¹⁰¹ Department of Pediatrics, Department of Neurology, The Ohio State University, Columbus.
¹⁰² University of Bristol, Bristol, United Kingdom.
¹⁰³ Faculty of Medicine, Mansoura University, Mansoura, Egypt.
¹⁰⁴ Madda Walabu University, Robe, Ethiopia.
¹⁰⁵ Institute of Genetics and Developmental Biology, Key State Laboratory of Molecular Developmental Biology, Chinese Academy of Sciences, Beijing, China.
¹⁰⁶ Perelman School of Medicine, University of Pennsylvania, Philadelphia.
¹⁰⁷ University of West Florida, Pensacola.
¹⁰⁸ United Nations Population Fund, Lima, Peru.
¹⁰⁹ Pacific Institute for Research and Evaluation, Calverton, Maryland.
¹¹⁰ School of Medicine, School of Global Health, University of Washington, Seattle.
¹¹¹ Baqiyatallah University of Medical Sciences, Tehran, Iran.
¹¹² Ahmadu Bello University, Zaria, Kaduna, Nigeria.
¹¹³ Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
¹¹⁴ National Center for Child Health and Development, Tokyo, Japan.
¹¹⁵ International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.
¹¹⁶ Institute for Global Health, Duy Tan University, Da Nang, Vietnam.
¹¹⁷ Department of Preventive Medicine, College of Medicine, Kyung Hee University, Seoul, South Korea.
¹¹⁸ Society for Family Health, Abuja, Nigeria.
¹¹⁹ Center for Healthy Start Initiative, Lagos, Nigeria.
¹²⁰ IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain.
¹²¹ UK Department for International Development, Lalitpur, Nepal.
¹²² Universidade do Porto, Porto, Portugal.
¹²³ Istituto di Richerche Farmacologiche Mario Negri, Bergamo, Italy.
¹²⁴ Health Metrics Unit, University of Gothenburg, Gothenburg, Sweden.
¹²⁵ School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
¹²⁶ School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
¹²⁷ Contect International Health Consultants, Lahore, Punjab, Pakistan.
¹²⁸ Research and Evaluation Division, Building Resources Access Communities, Dhaka, Bangladesh.
¹²⁹ Society for Health and Demographic Surveillance, Suri, India.
¹³⁰ International Society of Nephrology, Brussels, Belgium.
¹³¹ Western Sydney University, Penrith, Australia.
¹³² ISGlobal Instituto de Salud Global de Barcelona, Barcelona, Spain.
¹³³ All India Institute of Medical Sciences, New Delhi, India.
¹³⁴ Marshall University, Huntington, West Virginia.
¹³⁵ Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.
¹³⁶ Institute of Health Care and Social Sciences, FOM University, Essen, Germany.
¹³⁷ University of Alabama at Birmingham.
¹³⁸ Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia.
¹³⁹ Department of Public Health, An-Najah University, Nablus, Palestine.
¹⁴⁰ Independent Consultant, Karachi, Pakistan.
¹⁴¹ Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
¹⁴² Finnish Institute of Occupational Health, Work Organizations, Disability Program, University of Helsinki, Helsinki, Finland.
¹⁴³ Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, United Kingdom.
¹⁴⁴ Reykjavik University, Reykjavik, Iceland.
¹⁴⁵ Department of Community Medicine, International Medical University, Kuala Lumpur, Selangor, Malaysia.
¹⁴⁶ Department of Psychiatry, University of Cape Town, Cape Town, South Africa.
¹⁴⁷ Indian Council of Medical Research, Chennai, India.
¹⁴⁸ University of Illinois at Urbana-Champaign, Champaign.
¹⁴⁹ Debre Markos University, Debre Markos, Ethiopia.
¹⁵⁰ New York Medical Center, Valhalla.
¹⁵¹ Department of Biology, Colgate University, Hamilton, New York.
¹⁵² University of Virginia, Charlottesville.
¹⁵³ Adaptive Knowledge Management, Victoria, British Columbia, Canada.
¹⁵⁴ University of Calgary, Calgary, Alberta, Canada.
¹⁵⁵ The Johns Hopkins University, Baltimore, Maryland.
¹⁵⁶ Federal Teaching Hospital, Abakaliki, Nigeria.
¹⁵⁷ University of Warwick, Coventry, United Kingdom.
¹⁵⁸ Institute for Health Promotion Research, Tampere, Finland.
¹⁵⁹ Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore.
¹⁶⁰ National Research University Higher School of Economics, Moscow, Russia.
¹⁶¹ Department of Medical Epidemiology and Biostatistics, Karolinska Insitutet, Stockholm, Sweden.
¹⁶² Institute of Population-based Cancer Research, Cancer Registry of Norway, Oslo, Norway.
¹⁶³ Royal Children's Hospital, Melbourne, Victoria, Australia.
¹⁶⁴ University of Nottingham, Nottingham, United Kingdom.
¹⁶⁵ Department of Preventive Medicine, Northwestern University, Chicago, Illinois.
¹⁶⁶ Kyoto University, Kyoto, Japan.
¹⁶⁷ Department of Preventive Medicine, School of Medicine, Korea University, Seoul, South Korea.
¹⁶⁸ Jackson State University, Jackson, Missouri.
¹⁶⁹ Wuhan University, Wuhan, China.
¹⁷⁰ University of KwaZulu-Natal, Durban, South Africa.
¹⁷¹ Red Cross War Memorial Children's Hospital, Cape Town, South Africa.

PMID: 28384795
PMCID: PMC5540012
DOI: 10.1001/jamapediatrics.2017.0250

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

Global Burden of Disease Child and Adolescent Health Collaboration et al. JAMA Pediatr. 2017.

. 2017 Jun 1;171(6):573-592.

doi: 10.1001/jamapediatrics.2017.0250.

Authors

Affiliations

¹ Institute for Health Metrics and Evaluation, University of Washington, Seattle.
² Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
³ Public Health Foundation of India, Gurgaon-122002, National Capital Region, India.
⁴ School of Public Health, University of Queensland, Brisbane, Queensland, Australia.
⁵ Jimma University, Jimma, Ethiopia.
⁶ Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom.
⁷ Centre for Research & Action in Public Health, University of Canberra, Canberra, Australia.
⁸ Chinese Center for Disease Control and Prevention, Beijing, China.
⁹ Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
¹⁰ Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
¹¹ Murdoch Childrens Research Institute, University of Melbourne, Victoria, Australia.
¹² Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
¹³ School of Nursing and Public Health, University of KwaZulu-Natal, South African Medical Research Council/University of KwaZulu-Natal Gastrointestinal Cancer Research Center, Durban, South Africa.
¹⁴ Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
¹⁵ Center for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway.
¹⁶ Federal Institute for Population Research, Wiesbaden, Germany.
¹⁷ Department of Population Health, Virginia Tech, Blacksburg.
¹⁸ Wolaita Soda University, Wolaita Soda, Ethiopia.
¹⁹ The Hospital for Sick Children, Centre for Child Health, Toronto, Ontario, Canada.
²⁰ Ministry of Health, Jeddah, Saudi Arabia.
²¹ Mekelle University, Mekelle, Ethiopia.
²² King Saud University, Riyadh, Saudi Arabia.
²³ University of Adelaide, Adelaide, Australia.
²⁴ Department of Health Policy and Administration, University of Philippines-Manila, Manila, Philippines.
²⁵ Department of Medical Services, Uppsala University, Uppsala, Sweden.
²⁶ Dalarna University, Uppsala, Sweden.
²⁷ University of Manitoba, Winnipeg, Manitoba, Canada.
²⁸ Qom University of Medical Sciences, Qom, Iran.
²⁹ Institute de Recherche Clinique du Bénin, Cotonou, Benin.
³⁰ Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
³¹ The Judith Lumley Centre for Mother, Infant, and Family Health Research, La Trobe University, Melbourne, Victoria, Australia.
³² School of Health Sciences, University of Management and Technology, Lahore, Pakistan.
³³ Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
³⁴ Monash University, Melbourne, Victoria, Australia.
³⁵ College of Public Health and Tropical Medicine, Jazan, Saudi Arabia.
³⁶ University of Sao Paulo, Sao Paulo, Brazil.
³⁷ College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia.
³⁸ King's College London, London, United Kingdom.
³⁹ University Andes, Bogota, Columbia.
⁴⁰ Haramaya University, Dire Dawa, Ethiopia.
⁴¹ Independent Public Health Consultants, Addis Ababa, Ethiopia.
⁴² Department of Nephrology Issues of Transplanted Kidney, V. I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russia.
⁴³ National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
⁴⁴ Faculty of Health Sciences and Social Work, Department of Public Health, Trnava University, Trnava, Slovakia.
⁴⁵ Instituto Nacional de Salud, Bogotá, Colombia.
⁴⁶ University of Valencia, Valencia, Spain.
⁴⁷ Health Research Institute and CIBERSAM, Valencia, Spain.
⁴⁸ Ministry of Health, Baghdad, Iraq.
⁴⁹ Seoul National University, Seoul, South Korea.
⁵⁰ Departmentà Centre for International Health, University of Otago, Dunedin, New Zealand.
⁵¹ Public Health Foundation of India, New Delhi, India.
⁵² School of Medicine, School of Public Health, University of Colorado, Aurora.
⁵³ Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
⁵⁴ International Institute for Population Sciences, Mumbai, India.
⁵⁵ Arba Minch University, Arba Minch, Ethiopia.
⁵⁶ Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia.
⁵⁷ Federal University of Sergipe, Aracaju, Brazil.
⁵⁸ Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁵⁹ Center for Biotechnology and Fine Chemistry, Catholic University of Portugal, Porto, Portugal.
⁶⁰ Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
⁶¹ Escola Nacional de Saúde Pública Sergio Arouca/Fiocruz, Rio De Janeiro, Brazil.
⁶² James Cook University, Townsville, Queensland, Australia.
⁶³ Wageningen University, Wageningen, Netherlands.
⁶⁴ The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.
⁶⁵ Addis Ababa University, Addis Ababa, Ethiopia.
⁶⁶ Department of Public Health, Mizan-Tepi University, Ethiopia.
⁶⁷ College of Medicine, University of Hail, Hail, Saudi Arabia.
⁶⁸ University of Massachusetts-Boston.
⁶⁹ National Cancer Center, Tokyo, Japan.
⁷⁰ Department of Microbiology, Departments of Epidemiology and Biostatistics, St James School of Medicine, the Quarter, Anguilla.
⁷¹ School of Public Health, Tianjin Medical University, Tianjin, China.
⁷² Eternal Heart Care Centre and Research Institute, Jaipur, India.
⁷³ School of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
⁷⁴ Karolinska Institutet, Stockholm, Sweden.
⁷⁵ Fundacion Entornos, Cuernavaca, Morelos, Mexico.
⁷⁶ Nevada Division of Public and Behavioral Health, Carson City, Nevada.
⁷⁷ Albert Einstein College of Medicine, Bronx, New York.
⁷⁸ Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China.
⁷⁹ Department of Global and Community Health, George Mason University, Fairfax, Virginia.
⁸⁰ University of Kragujevac, Kragujevac, Serbia.
⁸¹ Virginia Commonwealth University, Richmond.
⁸² George Institute for Global Health, New Delhi, India.
⁸³ University of Oxford, Oxford, United Kingdom.
⁸⁴ Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karlas University, Heidelberg, Germany.
⁸⁵ School of Public Health, University of Tokyo, Tokyo, Japan.
⁸⁶ University of Nairobi, Nairobi, Kenya.
⁸⁷ Ball State University, Muncie, Indiana.
⁸⁸ Department of Clinical Sciences, Lund University, Lund, Sweden.
⁸⁹ Federal University of Rio Grande de Sul, Porto Alegre, Brazil.
⁹⁰ Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
⁹¹ Department of Health Sciences, Northeastern University, Boston, Massachusetts.
⁹² University of British Columbia, Vancouver, British Columbia, Canada.
⁹³ Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain.
⁹⁴ University of Montreal, Montreal, Quebec, Canada.
⁹⁵ Institute of Public Health, Hacettepe University, Ankara, Turkey.
⁹⁶ Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines.
⁹⁷ Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
⁹⁸ Komfo Anokye Teaching Hospital, Kumasi, Ghana.
⁹⁹ UnionHealth Associates LLC, St Louis, Missouri.
¹⁰⁰ Alton Mental Health Center, Alton, Illinois.
¹⁰¹ Department of Pediatrics, Department of Neurology, The Ohio State University, Columbus.
¹⁰² University of Bristol, Bristol, United Kingdom.
¹⁰³ Faculty of Medicine, Mansoura University, Mansoura, Egypt.
¹⁰⁴ Madda Walabu University, Robe, Ethiopia.
¹⁰⁵ Institute of Genetics and Developmental Biology, Key State Laboratory of Molecular Developmental Biology, Chinese Academy of Sciences, Beijing, China.
¹⁰⁶ Perelman School of Medicine, University of Pennsylvania, Philadelphia.
¹⁰⁷ University of West Florida, Pensacola.
¹⁰⁸ United Nations Population Fund, Lima, Peru.
¹⁰⁹ Pacific Institute for Research and Evaluation, Calverton, Maryland.
¹¹⁰ School of Medicine, School of Global Health, University of Washington, Seattle.
¹¹¹ Baqiyatallah University of Medical Sciences, Tehran, Iran.
¹¹² Ahmadu Bello University, Zaria, Kaduna, Nigeria.
¹¹³ Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
¹¹⁴ National Center for Child Health and Development, Tokyo, Japan.
¹¹⁵ International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.
¹¹⁶ Institute for Global Health, Duy Tan University, Da Nang, Vietnam.
¹¹⁷ Department of Preventive Medicine, College of Medicine, Kyung Hee University, Seoul, South Korea.
¹¹⁸ Society for Family Health, Abuja, Nigeria.
¹¹⁹ Center for Healthy Start Initiative, Lagos, Nigeria.
¹²⁰ IIS-Fundacion Jimenez Diaz-UAM, Madrid, Spain.
¹²¹ UK Department for International Development, Lalitpur, Nepal.
¹²² Universidade do Porto, Porto, Portugal.
¹²³ Istituto di Richerche Farmacologiche Mario Negri, Bergamo, Italy.
¹²⁴ Health Metrics Unit, University of Gothenburg, Gothenburg, Sweden.
¹²⁵ School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
¹²⁶ School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
¹²⁷ Contect International Health Consultants, Lahore, Punjab, Pakistan.
¹²⁸ Research and Evaluation Division, Building Resources Access Communities, Dhaka, Bangladesh.
¹²⁹ Society for Health and Demographic Surveillance, Suri, India.
¹³⁰ International Society of Nephrology, Brussels, Belgium.
¹³¹ Western Sydney University, Penrith, Australia.
¹³² ISGlobal Instituto de Salud Global de Barcelona, Barcelona, Spain.
¹³³ All India Institute of Medical Sciences, New Delhi, India.
¹³⁴ Marshall University, Huntington, West Virginia.
¹³⁵ Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.
¹³⁶ Institute of Health Care and Social Sciences, FOM University, Essen, Germany.
¹³⁷ University of Alabama at Birmingham.
¹³⁸ Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia.
¹³⁹ Department of Public Health, An-Najah University, Nablus, Palestine.
¹⁴⁰ Independent Consultant, Karachi, Pakistan.
¹⁴¹ Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
¹⁴² Finnish Institute of Occupational Health, Work Organizations, Disability Program, University of Helsinki, Helsinki, Finland.
¹⁴³ Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, United Kingdom.
¹⁴⁴ Reykjavik University, Reykjavik, Iceland.
¹⁴⁵ Department of Community Medicine, International Medical University, Kuala Lumpur, Selangor, Malaysia.
¹⁴⁶ Department of Psychiatry, University of Cape Town, Cape Town, South Africa.
¹⁴⁷ Indian Council of Medical Research, Chennai, India.
¹⁴⁸ University of Illinois at Urbana-Champaign, Champaign.
¹⁴⁹ Debre Markos University, Debre Markos, Ethiopia.
¹⁵⁰ New York Medical Center, Valhalla.
¹⁵¹ Department of Biology, Colgate University, Hamilton, New York.
¹⁵² University of Virginia, Charlottesville.
¹⁵³ Adaptive Knowledge Management, Victoria, British Columbia, Canada.
¹⁵⁴ University of Calgary, Calgary, Alberta, Canada.
¹⁵⁵ The Johns Hopkins University, Baltimore, Maryland.
¹⁵⁶ Federal Teaching Hospital, Abakaliki, Nigeria.
¹⁵⁷ University of Warwick, Coventry, United Kingdom.
¹⁵⁸ Institute for Health Promotion Research, Tampere, Finland.
¹⁵⁹ Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore.
¹⁶⁰ National Research University Higher School of Economics, Moscow, Russia.
¹⁶¹ Department of Medical Epidemiology and Biostatistics, Karolinska Insitutet, Stockholm, Sweden.
¹⁶² Institute of Population-based Cancer Research, Cancer Registry of Norway, Oslo, Norway.
¹⁶³ Royal Children's Hospital, Melbourne, Victoria, Australia.
¹⁶⁴ University of Nottingham, Nottingham, United Kingdom.
¹⁶⁵ Department of Preventive Medicine, Northwestern University, Chicago, Illinois.
¹⁶⁶ Kyoto University, Kyoto, Japan.
¹⁶⁷ Department of Preventive Medicine, School of Medicine, Korea University, Seoul, South Korea.
¹⁶⁸ Jackson State University, Jackson, Missouri.
¹⁶⁹ Wuhan University, Wuhan, China.
¹⁷⁰ University of KwaZulu-Natal, Durban, South Africa.
¹⁷¹ Red Cross War Memorial Children's Hospital, Cape Town, South Africa.

PMID: 28384795
PMCID: PMC5540012
DOI: 10.1001/jamapediatrics.2017.0250

Erratum in

Errors in Author Names and Affiliations.
[No authors listed] [No authors listed] JAMA Pediatr. 2017 Jun 1;171(6):602. doi: 10.1001/jamapediatrics.2017.1667. JAMA Pediatr. 2017. PMID: 28586793 Free PMC article. No abstract available.
Addition of Open Access, Funding/Support, and Role of Funder/Sponsor Information.
[No authors listed] [No authors listed] JAMA Pediatr. 2017 Oct 1;171(10):1019. doi: 10.1001/jamapediatrics.2017.2732. JAMA Pediatr. 2017. PMID: 28806443 Free PMC article. No abstract available.

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.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Larson reported that her research group at the London School of Hygiene and Tropical Medicine has received funding from GlaxoSmithKline and Merck to convene research symposia, that she has received funding from GlaxoSmithKline for advising on issues related to vaccine hesitancy, and that she has have served on the Merck Vaccines Strategy Advisory Board. No other disclosures were reported.

Figures

**Figure 1.. Ranking of the Top 25 Global Causes of Death in 2015 by 5 Socio-demographic Index (SDI) Quintiles and 21 Regions in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD)**
Ranking of causes of death in females and males. Global causes, SDI quintiles, and GBD regions appear in columns, sorted in order of decreasing SDI status. The causes are sorted according to their ranking at the global level. The color coding indicates the relative ranking of each cause, with red the highest and green the lowest. The numbers appearing in each column indicate the geography-specific ranking of that cause in 2015. Blanks indicate causes that were not contracted in that geographical area. HIV indicates human immunodeficiency virus.

**Figure 2.. Leading Level 3 Causes of Global Disability-Adjusted Life Years (DALYs) in the Global Burden of Diseases, Injuries, and Risk Factors Study**
This figure shows the rankings for the top 25 causes of global disability-adjusted life years among children and adolescents 19 years or younger at the global level in 1990, 2005, and 2015. Lines connecting the boxes illustrate changes in ranking. Any cause that appears in the top 25 in any year is listed, along with its ranking during each year. Group I causes (infectious, neonatal, nutritional, and maternal) are shown in gray, noncommunicable diseases in red, and injuries in green. Changes in total DALYs are in the first column next to 2005, followed by changes in all-ages rates of DALYs, and age-standardized rates of DALYs. Statistically significant differences appear in bold. HIV indicates human immunodeficiency virus, and STI, sexually transmitted infection.

Figure 3.. Expected Association Between Rates of Years of Life Lost (YLL) and Years Lived With Disability (YLD) Rates With Socio-demographic Index (SDI) for 21 Level 2 Causes in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD)
A, Expected association between rates of YLL and YLD with SDI for the 21 GBD level 2 causes in children and adolescents 19 years or younger, both sexes, 1990-2015. Each geography is assigned an SDI value for each year, and nonlinear spline regressions are used to find the average relationship between SDI and cause-specific burden rates. B, Expected association between rates of YLL and YLD and SDI for the 21 GBD level 2 causes as a proportion of total rates of YLL and YLD in children and adolescents 19 years or younger, both sexes, 1990-2015. Each geographical area is assigned an SDI value for each year, and nonlinear spline regressions are used to find the mean association between SDI and cause-specific rates of disease burden. HIV indicates human immunodeficiency virus.

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Comment in

Importance of Innovations in Neonatal and Adolescent Health in Reaching the Sustainable Development Goals by 2030.
Sudfeld CR, Fawzi WW. Sudfeld CR, et al. JAMA Pediatr. 2017 Jun 1;171(6):521-522. doi: 10.1001/jamapediatrics.2017.0261. JAMA Pediatr. 2017. PMID: 28384685 No abstract available.

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References

1. The United Nations Convention on the Rights of the Child. New York, NY: United Nations; 1989. Treaty Series; 1577, 3.
1. United Nations Millennium Development Goals and beyond 2015. http://www.un.org/millenniumgoals/. Published October 29, 2015. Accessed October 29, 2015.
1. United Nations Sustainable Development Goals. http://www.un.org/sustainabledevelopment/sustainable-development-goals/. Accessed October 29, 2015.
1. Wang H, Bhutta ZA, Coates MM, et al. . Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1725-1774. - PMC - PubMed
1. Patton GC, Sawyer SM, Santelli JS, et al. . Our future: a Lancet commission on adolescent health and wellbeing. Lancet. 2016;387(10036):2423-2478. - PMC - PubMed

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[1] The United Nations Convention on the Rights of the Child. New York, NY: United Nations; 1989. Treaty Series; 1577, 3.

[2] The United Nations Convention on the Rights of the Child. New York, NY: United Nations; 1989. Treaty Series; 1577, 3.

[3] United Nations Millennium Development Goals and beyond 2015. http://www.un.org/millenniumgoals/. Published October 29, 2015. Accessed October 29, 2015.

[4] United Nations Millennium Development Goals and beyond 2015. http://www.un.org/millenniumgoals/. Published October 29, 2015. Accessed October 29, 2015.

[5] United Nations Sustainable Development Goals. http://www.un.org/sustainabledevelopment/sustainable-development-goals/. Accessed October 29, 2015.

[6] United Nations Sustainable Development Goals. http://www.un.org/sustainabledevelopment/sustainable-development-goals/. Accessed October 29, 2015.

[7] Wang H, Bhutta ZA, Coates MM, et al. . Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1725-1774. - PMC - PubMed

[8] Wang H, Bhutta ZA, Coates MM, et al. . Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1725-1774. - PMC - PubMed

[9] Patton GC, Sawyer SM, Santelli JS, et al. . Our future: a Lancet commission on adolescent health and wellbeing. Lancet. 2016;387(10036):2423-2478. - PMC - PubMed

[10] Patton GC, Sawyer SM, Santelli JS, et al. . Our future: a Lancet commission on adolescent health and wellbeing. Lancet. 2016;387(10036):2423-2478. - PMC - PubMed

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

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

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