. 2019 Jun 1;173(6):e190337.

doi: 10.1001/jamapediatrics.2019.0337. Epub 2019 Jun 3.

Diseases, Injuries, and Risk Factors in Child and Adolescent Health, 1990 to 2017: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study

GBD 2017 Child and Adolescent Health Collaborators; Robert C Reiner Jr^{1

2}, Helen Elizabeth Olsen¹, Chad Thomas Ikeda¹, Michelle M Echko¹, Katherine E Ballestreros¹, Helen Manguerra¹, Ira Martopullo¹, Anoushka Millear¹, Chloe Shields¹, Alison Smith¹, Bryan Strub¹, Molla Abebe³, Zegeye Abebe⁴, Beyene Meressa Adhena⁵, Tara Ballav Adhikari^{6

7}, Mohammed Akibu⁸, Rajaa M Al-Raddadi⁹, Nelson Alvis-Guzman^{10

11}, Carl Abelardo T Antonio^{12

13}, Olatunde Aremu¹⁴, Solomon Weldegebreal Asgedom¹⁵, Netsanet Abera Asseffa¹⁶, Leticia Avila-Burgos¹⁷, Aleksandra Barac^{18

19}, Till W Bärnighausen^{20

21}, Quique Bassat^{22

23}, Isabela M Bensenor²⁴, Zulfiqar A Bhutta^{25

26}, Ali Bijani²⁷, Nigus Bililign²⁸, Lucero Cahuana-Hurtado¹⁷, Deborah Carvalho Malta²⁹, Jung-Chen Chang³⁰, Fiona J Charlson^{31

32}, Samath Dhamminda Dharmaratne^{1

33}, David Teye Doku^{34

35}, Dumessa Edessa³⁶, Ziad El-Khatib³⁷, Holly E Erskine^{31

38}, Alize J Ferrari^{31

38}, Nancy Fullman¹, Rahul Gupta^{39

40}, Hamid Yimam Hassen^{41

42}, Simon I Hay^{1

2}, Olayinka Stephen Ilesanmi⁴³, Kathryn H Jacobsen⁴⁴, Amaha Kahsay⁴⁵, Amir Kasaeian^{46

47}, Tesfaye Dessale Kassa⁴⁸, Seifu Kebede⁴⁹, Yousef Saleh Khader⁵⁰, Ejaz Ahmad Khan⁵¹, Mohammed Nuruzzaman Khan^{52

53}, Young-Ho Khang^{54

55}, Jagdish Khubchandani⁵⁶, Yohannes Kinfu^{57

58}, Sonali Kochhar^{32

59}, Yoshihiro Kokubo⁶⁰, Ai Koyanagi⁶¹, Barthelemy Kuate Defo^{62

63}, Dharmesh Kumar Lal⁶⁴, Fekede Asefa Kumsa^{65

66}, Heidi J Larson^{1

67}, Janni Leung⁶⁸, Abdullah A Mamun⁶⁹, Suresh Mehata⁷⁰, Mulugeta Melku⁷¹, Walter Mendoza⁷², Haftay Berhane Mezgebe⁷³, Ted R Miller^{74

75}, Nurilign Abebe Moges⁷⁶, Shafiu Mohammed^{20

77}, Ali H Mokdad^{1

2}, Lorenzo Monasta⁷⁸, Subas Neupane⁷⁹, Huong Lan Thi Nguyen⁸⁰, Dina Nur Anggraini Ningrum^{81

82}, Yirga Legesse Nirayo⁴⁸, Vuong Minh Nong⁸⁰, Felix Akpojene Ogbo⁸³, Andrew T Olagunju^{84

85}, Bolajoko Olubukunola Olusanya⁸⁶, Jacob Olusegun Olusanya⁸⁶, George C Patton^{87

88}, David M Pereira^{89

90}, Farshad Pourmalek⁹¹, Mostafa Qorbani⁹², Anwar Rafay⁹³, Rajesh Kumar Rai^{94

95}, Usha Ram⁹⁶, Chhabi Lal Ranabhat⁹⁷, Andre M N Renzaho⁹⁸, Mohammad Sadegh Rezai⁹⁹, Luca Ronfani⁷⁸, Gregory A Roth^{1

100}, Saeid Safiri¹⁰¹, Benn Sartorius¹⁰², James G Scott^{31

103}, Katya Anne Shackelford¹, Karen Sliwa¹⁰⁴, Chandrashekhar Sreeramareddy¹⁰⁵, Mu'awiyyah Bable Sufiyan¹⁰⁶, Abdullah Sulieman Terkawi^{107

108}, Roman Topor-Madry^{109

110}, Bach Xuan Tran¹¹¹, Kingsley Nnanna Ukwaja¹¹², Olalekan A Uthman¹¹³, Stein Emil Vollset^{1

2}, Kidu Gidey Weldegwergs⁴⁸, Andrea Werdecker^{114

115}, Harvey A Whiteford^{1

116}, Tissa Wijeratne^{117

118}, Naohiro Yonemoto¹¹⁹, Marcel Yotebieng^{120

121}, Liesl J Zuhlke^{104

122}, Hmwe Hmwe Kyu^{1

2}, Mohsen Naghavi^{1

2}, Theo Vos^{1

2}, Christopher J L Murray^{1

2}, Nicholas J Kassebaum^{1

123}

Affiliations

¹ Institute for Health Metrics and Evaluation, Seattle, Washington.
² Department of Health Metrics Sciences, University of Washington, Seattle.
³ Department of Clinical Chemistry, University of Gondar, Gondar, Ethiopia.
⁴ Department of Human Nutrition, University of Gondar, Gondar, Ethiopia.
⁵ School of Public Health, Mekelle University, Tigray, Ethiopia.
⁶ Nepal Health Research Environment, Center for Social Science and Public Health Research Nepal, Lalitpur, Nepal.
⁷ Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark.
⁸ Department of Midwifery, Debre Berhan University, Debre Berhan, Ethiopia.
⁹ Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
¹⁰ Research Group on Health Economics, University of Cartagena, Cartagena, Colombia.
¹¹ Research Group on Hospital Management and Health Policies, University of the Coast, Barranquilla, Colombia.
¹² Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines.
¹³ Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong.
¹⁴ School of Health Sciences, Birmingham City University, Birmingham, United Kingdom.
¹⁵ School of Pharmacy, Mekelle University, Mekelle, Ethiopia.
¹⁶ School of Public Health, Wolaita Sodo University, Wolaita Dofo, Ethiopia.
¹⁷ Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico.
¹⁸ Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade, Serbia.
¹⁹ Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
²⁰ Institute of Public Health, Heidelberg University, Heidelberg, Germany.
²¹ Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
²² Barcelona Institute for Global Health, Barcelona, Spain.
²³ Catalan Institution for Research and Advanced Studies, Manhiça Health Research Center, Manhiça, Mozambique.
²⁴ Department of Internal Medicine, University of São Paulo, São Paulo, Brazil.
²⁵ The Centre for Global Child Health, University of Toronto, Toronto, Canada.
²⁶ Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
²⁷ Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran.
²⁸ Woldia University, Woldia, Ethiopia.
²⁹ Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Minas Gerais, Brazil.
³⁰ College of Medicine, National Taiwan University, Taipei, Taiwan.
³¹ School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
³² Department of Global Health, University of Washington, Seattle.
³³ Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
³⁴ Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
³⁵ Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland.
³⁶ School of Pharmacy, Haramaya University, Harar, Ethiopia.
³⁷ Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
³⁸ Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia.
³⁹ West Virginia Bureau for Public Health, Charleston, West Virginia.
⁴⁰ Department of Health Policy, Management, and Leadership, West Virginia University, Morgantown.
⁴¹ Public Health Department, Mizan-Tepi University, Teppi, Ethiopia.
⁴² Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Antwerp, Belgium.
⁴³ Department of Public Health and Community Medicine, University of Liberia, Monrovia, Liberia.
⁴⁴ Department of Global and Community Health, George Mason University, Fairfax, Virginia.
⁴⁵ Department of Nutrition and Dietetics, Mekelle University, Tigray, Ethiopia.
⁴⁶ Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁴⁷ Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁴⁸ Clinical Pharmacy Unit, Mekelle University, Mekelle, Ethiopia.
⁴⁹ Midwifery Program, Salale University, Fiche, Ethiopia.
⁵⁰ Department of Public Health and Community Medicine, Jordan University of Science and Technology, Ramtha, Jordan.
⁵¹ Department of Epidemiology and Biostatistics, Health Services Academy, Islamabad, Pakistan.
⁵² School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
⁵³ Department of Population Sciences, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh.
⁵⁴ Department of Health Policy and Management, Seoul National University, Seoul, South Korea.
⁵⁵ Institute of Health Policy and Management, Seoul National University, Seoul, South Korea.
⁵⁶ Department of Nutrition and Health Science, Ball State University, Muncie, Indiana.
⁵⁷ Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia.
⁵⁸ Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
⁵⁹ Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands.
⁶⁰ Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan.
⁶¹ Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Barcelona.
⁶² Department of Demography, University of Montreal, Montreal, Quebec, Canada.
⁶³ Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada.
⁶⁴ Public Health Foundation of India, Gurugram, India.
⁶⁵ Center for Midwifery, Child, and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia.
⁶⁶ School of Public Health, Haramaya University, Harar, Ethiopia.
⁶⁷ Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
⁶⁸ Center for Youth Substance Abuse Research, The University of Queensland, St Lucia, Queensland, Australia.
⁶⁹ Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia.
⁷⁰ Research, Monitoring, and Evaluation, Ipas Nepal, Kathmandu, Nepal.
⁷¹ Institute of Public Health, University of Gondar, Gondar, Ethiopia.
⁷² Peru Country Office, United Nations Population Fund, Lima, Peru.
⁷³ Department of Pharmacy, Ethiopian Academy of Medical Science, Tigray, Ethiopia.
⁷⁴ Pacific Institute for Research and Evaluation, Calverton, Maryland.
⁷⁵ School of Public Health, Curtin University, Perth, Western Australia, Australia.
⁷⁶ Department of Public Health, Debre Markos University, Debre Markos, Ethiopia.
⁷⁷ Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria.
⁷⁸ Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy.
⁷⁹ Faculty of Health Sciences, University of Tampere, Tampere, Finland.
⁸⁰ Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam.
⁸¹ Department of Public Health Science, State University of Semarang, Kota Semarang, Indonesia.
⁸² Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan.
⁸³ Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.
⁸⁴ Department of Psychiatry,University of Adelaide, Adelaide, South Australia, Australia.
⁸⁵ Department of Psychiatry, University of Lagos, Lagos, Nigeria.
⁸⁶ Centre for Healthy Start Initiative, Lagos, Nigeria.
⁸⁷ Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
⁸⁸ Population Health Group, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
⁸⁹ Rede de Química e Tecnologia/Laboratório Asociado do Química Verde, University of Porto, Oporto, Portugal.
⁹⁰ Cartagena University, Cartagena, Colombia.
⁹¹ School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
⁹² Noncommunicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
⁹³ Department of Epidemiology and Biostatistics, Contech School of Public Health, Lahore, Pakistan.
⁹⁴ Society for Health and Demographic Surveillance, Suri, India.
⁹⁵ Department of Economics, University of Göttingen, Göttingen, Germany.
⁹⁶ Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India.
⁹⁷ Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, South Korea.
⁹⁸ School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia.
⁹⁹ Department of Pediatrics, Mazandaran University of Medical Sciences, Sari, Iran.
¹⁰⁰ Division of Cardiology, University of Washington, Seattle.
¹⁰¹ Managerial Epidemiology Research Center, Maragheh University of Medical Sciences, Maragheh, Iran.
¹⁰² Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa.
¹⁰³ Child and Youth Mental Health, Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia.
¹⁰⁴ Department of Medicine, University of Cape Town, Cape Town, Western Cape, South Africa.
¹⁰⁵ Division of Community Medicine, International Medical University, Kuala Lumpur, Malaysia.
¹⁰⁶ Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria.
¹⁰⁷ Department of Anesthesiology, University of Virginia, Charlottesville.
¹⁰⁸ Syrian Expatriate Medical Association, Charlottesville, Virginia.
¹⁰⁹ Institute for Public Health, Jagiellonian University Medical College, Krakow, Poland.
¹¹⁰ Agency for Health Technology Assessment and Tariff System, Warszawa, Poland.
¹¹¹ Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam.
¹¹² Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Nigeria.
¹¹³ Division of Health Sciences, University of Warwick, Coventry, United Kingdom.
¹¹⁴ Demographic Change and Ageing Research Area, Federal Institute for Population Research, Wiesbaden, Germany.
¹¹⁵ Independent Consultant, Staufenberg, Germany.
¹¹⁶ The University of Queensland, Brisbane, Queensland, Australia.
¹¹⁷ Department of Medicine, University of Melbourne, St Albans, Victoria, Australia.
¹¹⁸ Department of Psychology, La Trobe University, Melbourne, Victoria, Australia.
¹¹⁹ Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan.
¹²⁰ College of Public Health, The Ohio State University, Columbus.
¹²¹ School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
¹²² Department of Paediatrics and Child Health, University of Cape Town, Cape Town, Western Cape, South Africa.
¹²³ Department of Anesthesiology and Pain Medicine, University of Washington, Seattle.

PMID: 31034019
PMCID: PMC6547084
DOI: 10.1001/jamapediatrics.2019.0337

Diseases, Injuries, and Risk Factors in Child and Adolescent Health, 1990 to 2017: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study

GBD 2017 Child and Adolescent Health Collaborators et al. JAMA Pediatr. 2019.

. 2019 Jun 1;173(6):e190337.

doi: 10.1001/jamapediatrics.2019.0337. Epub 2019 Jun 3.

Authors

Affiliations

¹ Institute for Health Metrics and Evaluation, Seattle, Washington.
² Department of Health Metrics Sciences, University of Washington, Seattle.
³ Department of Clinical Chemistry, University of Gondar, Gondar, Ethiopia.
⁴ Department of Human Nutrition, University of Gondar, Gondar, Ethiopia.
⁵ School of Public Health, Mekelle University, Tigray, Ethiopia.
⁶ Nepal Health Research Environment, Center for Social Science and Public Health Research Nepal, Lalitpur, Nepal.
⁷ Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark.
⁸ Department of Midwifery, Debre Berhan University, Debre Berhan, Ethiopia.
⁹ Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
¹⁰ Research Group on Health Economics, University of Cartagena, Cartagena, Colombia.
¹¹ Research Group on Hospital Management and Health Policies, University of the Coast, Barranquilla, Colombia.
¹² Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines.
¹³ Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong.
¹⁴ School of Health Sciences, Birmingham City University, Birmingham, United Kingdom.
¹⁵ School of Pharmacy, Mekelle University, Mekelle, Ethiopia.
¹⁶ School of Public Health, Wolaita Sodo University, Wolaita Dofo, Ethiopia.
¹⁷ Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico.
¹⁸ Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade, Serbia.
¹⁹ Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
²⁰ Institute of Public Health, Heidelberg University, Heidelberg, Germany.
²¹ Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
²² Barcelona Institute for Global Health, Barcelona, Spain.
²³ Catalan Institution for Research and Advanced Studies, Manhiça Health Research Center, Manhiça, Mozambique.
²⁴ Department of Internal Medicine, University of São Paulo, São Paulo, Brazil.
²⁵ The Centre for Global Child Health, University of Toronto, Toronto, Canada.
²⁶ Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
²⁷ Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran.
²⁸ Woldia University, Woldia, Ethiopia.
²⁹ Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Minas Gerais, Brazil.
³⁰ College of Medicine, National Taiwan University, Taipei, Taiwan.
³¹ School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
³² Department of Global Health, University of Washington, Seattle.
³³ Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
³⁴ Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
³⁵ Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland.
³⁶ School of Pharmacy, Haramaya University, Harar, Ethiopia.
³⁷ Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
³⁸ Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia.
³⁹ West Virginia Bureau for Public Health, Charleston, West Virginia.
⁴⁰ Department of Health Policy, Management, and Leadership, West Virginia University, Morgantown.
⁴¹ Public Health Department, Mizan-Tepi University, Teppi, Ethiopia.
⁴² Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Antwerp, Belgium.
⁴³ Department of Public Health and Community Medicine, University of Liberia, Monrovia, Liberia.
⁴⁴ Department of Global and Community Health, George Mason University, Fairfax, Virginia.
⁴⁵ Department of Nutrition and Dietetics, Mekelle University, Tigray, Ethiopia.
⁴⁶ Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁴⁷ Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁴⁸ Clinical Pharmacy Unit, Mekelle University, Mekelle, Ethiopia.
⁴⁹ Midwifery Program, Salale University, Fiche, Ethiopia.
⁵⁰ Department of Public Health and Community Medicine, Jordan University of Science and Technology, Ramtha, Jordan.
⁵¹ Department of Epidemiology and Biostatistics, Health Services Academy, Islamabad, Pakistan.
⁵² School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
⁵³ Department of Population Sciences, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh.
⁵⁴ Department of Health Policy and Management, Seoul National University, Seoul, South Korea.
⁵⁵ Institute of Health Policy and Management, Seoul National University, Seoul, South Korea.
⁵⁶ Department of Nutrition and Health Science, Ball State University, Muncie, Indiana.
⁵⁷ Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia.
⁵⁸ Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
⁵⁹ Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands.
⁶⁰ Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan.
⁶¹ Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Barcelona.
⁶² Department of Demography, University of Montreal, Montreal, Quebec, Canada.
⁶³ Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada.
⁶⁴ Public Health Foundation of India, Gurugram, India.
⁶⁵ Center for Midwifery, Child, and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia.
⁶⁶ School of Public Health, Haramaya University, Harar, Ethiopia.
⁶⁷ Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
⁶⁸ Center for Youth Substance Abuse Research, The University of Queensland, St Lucia, Queensland, Australia.
⁶⁹ Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia.
⁷⁰ Research, Monitoring, and Evaluation, Ipas Nepal, Kathmandu, Nepal.
⁷¹ Institute of Public Health, University of Gondar, Gondar, Ethiopia.
⁷² Peru Country Office, United Nations Population Fund, Lima, Peru.
⁷³ Department of Pharmacy, Ethiopian Academy of Medical Science, Tigray, Ethiopia.
⁷⁴ Pacific Institute for Research and Evaluation, Calverton, Maryland.
⁷⁵ School of Public Health, Curtin University, Perth, Western Australia, Australia.
⁷⁶ Department of Public Health, Debre Markos University, Debre Markos, Ethiopia.
⁷⁷ Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria.
⁷⁸ Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy.
⁷⁹ Faculty of Health Sciences, University of Tampere, Tampere, Finland.
⁸⁰ Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam.
⁸¹ Department of Public Health Science, State University of Semarang, Kota Semarang, Indonesia.
⁸² Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan.
⁸³ Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.
⁸⁴ Department of Psychiatry,University of Adelaide, Adelaide, South Australia, Australia.
⁸⁵ Department of Psychiatry, University of Lagos, Lagos, Nigeria.
⁸⁶ Centre for Healthy Start Initiative, Lagos, Nigeria.
⁸⁷ Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
⁸⁸ Population Health Group, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
⁸⁹ Rede de Química e Tecnologia/Laboratório Asociado do Química Verde, University of Porto, Oporto, Portugal.
⁹⁰ Cartagena University, Cartagena, Colombia.
⁹¹ School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
⁹² Noncommunicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
⁹³ Department of Epidemiology and Biostatistics, Contech School of Public Health, Lahore, Pakistan.
⁹⁴ Society for Health and Demographic Surveillance, Suri, India.
⁹⁵ Department of Economics, University of Göttingen, Göttingen, Germany.
⁹⁶ Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India.
⁹⁷ Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, South Korea.
⁹⁸ School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia.
⁹⁹ Department of Pediatrics, Mazandaran University of Medical Sciences, Sari, Iran.
¹⁰⁰ Division of Cardiology, University of Washington, Seattle.
¹⁰¹ Managerial Epidemiology Research Center, Maragheh University of Medical Sciences, Maragheh, Iran.
¹⁰² Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa.
¹⁰³ Child and Youth Mental Health, Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia.
¹⁰⁴ Department of Medicine, University of Cape Town, Cape Town, Western Cape, South Africa.
¹⁰⁵ Division of Community Medicine, International Medical University, Kuala Lumpur, Malaysia.
¹⁰⁶ Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria.
¹⁰⁷ Department of Anesthesiology, University of Virginia, Charlottesville.
¹⁰⁸ Syrian Expatriate Medical Association, Charlottesville, Virginia.
¹⁰⁹ Institute for Public Health, Jagiellonian University Medical College, Krakow, Poland.
¹¹⁰ Agency for Health Technology Assessment and Tariff System, Warszawa, Poland.
¹¹¹ Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam.
¹¹² Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Nigeria.
¹¹³ Division of Health Sciences, University of Warwick, Coventry, United Kingdom.
¹¹⁴ Demographic Change and Ageing Research Area, Federal Institute for Population Research, Wiesbaden, Germany.
¹¹⁵ Independent Consultant, Staufenberg, Germany.
¹¹⁶ The University of Queensland, Brisbane, Queensland, Australia.
¹¹⁷ Department of Medicine, University of Melbourne, St Albans, Victoria, Australia.
¹¹⁸ Department of Psychology, La Trobe University, Melbourne, Victoria, Australia.
¹¹⁹ Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan.
¹²⁰ College of Public Health, The Ohio State University, Columbus.
¹²¹ School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
¹²² Department of Paediatrics and Child Health, University of Cape Town, Cape Town, Western Cape, South Africa.
¹²³ Department of Anesthesiology and Pain Medicine, University of Washington, Seattle.

PMID: 31034019
PMCID: PMC6547084
DOI: 10.1001/jamapediatrics.2019.0337

Abstract

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.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Yotebieng reports grants from National Institute of Health during the conduct of the study. Dr Kassebaum reports personal fees from Vifor Pharmaceuticals LLC, outside the submitted work. Dr Larson reports grants from GlaxoSmithKline, outside the submitted work. No other disclosures were reported.

Figures

Figure 1.. Decomposition of the Probability of Death Globally and in the Socio-Demographic Index (SDI) Quintiles and Global Burden of Disease Regions for Individuals Younger Than 20 Years of Both Sexes, From 1990 to 2017
Probability of death is plotted globally by SDI quintile and Global Disease Burden study region for 1990 (dashed vertical line) and 2017 (solid vertical line). The relative contribution of that change owing to different causes is indicated by different color bars. The SDI quintiles are sorted from lowest probability of death in 2017 to highest, and GBD regions are sorted from highest probability of death in 2017 to lowest.

**Figure 2.. Trends of Disability-Adjusted Life Years From 1990 to 2017 for Global and Socio-Demographic Index (SDI) Quintiles for Children and Adolescents Younger Than 20 Years**
Temporal trends in disability adjusted life-years (DALYs) are plotted for children and adolescents younger than 20 years. Global trends are plotted in the top left subpanel, and the corresponding trends for each SDI quintile are plotted in the next 5 subpanels. Shaded areas show 95% uncertainty intervals. Communicable, maternal, neonatal, and nutritional disorders are shown in orange, noncommunicable disease causes in blue, and injuries in gray.

**Figure 3.. Percentage Change From 1990 to 2017 in Observed-to-Expected (O:E) Disability-Adjusted Life-Years Ratio in Children and Adolescents of Both Sexes, Aged 0 to 19 Years**
Percentage changes in observed-to-expected disability-adjusted life-years (DALYs) are plotted for 1990 to 2017 for all children and adolescents younger than 20 years. Both sexes are combined. Subnational differentiation occurs within each country’s Global Burden of Disease models at the subnational level. Inset plots provided for detailed inspection of small or clustered regions. ATG indicates Antigua and Barbuda; BRB, Barbados; COM, Comoros; DMA, Dominica; E Med, Eastern Mediterranean; FJI, Fiji; FSM, Federated States of Micronesia; GRD, Grenada; KIR, Kiribati; LCA, St Lucia; MDV, Maldives; MHL, Marshall Islands; MLT, Malta; MUS, Mauritius; SGP, Singapore; SLB, Solomon Islands; SYC, Seychelles; TLS, Timor-Leste; TON, Tonga; TTO, Trinidad and Tobago; W Africa, West Africa; WSM, Samoa; VCT, St Vincent and the Grenadines; and VUT, Vanuatu.

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References

1. Dicker D, Nguyen G, Abate D, et al. ; GBD 2017 Mortality Collaborators . Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):-. doi:10.1016/S0140-6736(18)31891-9 - DOI - PMC - PubMed
1. Keats EC, Ngugi A, Macharia W, et al. . Progress and priorities for reproductive, maternal, newborn, and child health in Kenya: a countdown to 2015 country case study. Lancet Glob Health. 2017;5(8):e782-e795. doi:10.1016/S2214-109X(17)30246-2 - DOI - PMC - PubMed
1. Victora CG, Adair L, Fall C, et al. ; Maternal and Child Undernutrition Study Group . Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008;371(9609):340-357. doi:10.1016/S0140-6736(07)61692-4 - DOI - PMC - PubMed
1. GBD 2016 SDG Collaborators Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1423-1459. doi:10.1016/S0140-6736(17)32336-X - DOI - PMC - PubMed
1. United Nations SDG Indicators: global indicator framework for the Sustainable Development Goals and targets of the 2030 Agenda for Sustainable Development. https://unstats.un.org/sdgs/indicators/indicators-list/. Published 2018. Accessed February 13, 2018.

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Diseases, Injuries, and Risk Factors in Child and Adolescent Health, 1990 to 2017: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study

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Diseases, Injuries, and Risk Factors in Child and Adolescent Health, 1990 to 2017: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study

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