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Forouzanfar MH, Alexander L, Anderson HR, Bachman VF, Biryukov S, Brauer M, Burnett R, Casey D, Coates MM, Cohen A, Delwiche K, Estep K, Frostad JJ, Astha KC, Kyu HH, Moradi-Lakeh M, Ng M, Slepak EL, Thomas BA, Wagner J, Aasvang GM, Abbafati C, Abbasoglu Ozgoren A, Abd-Allah F, Abera SF, Aboyans V, Abraham B, Abraham JP, Abubakar I, Abu-Rmeileh NME, Aburto TC, Achoki T, Adelekan A, Adofo K, Adou AK, Adsuar JC, Afshin A, Agardh EE, Al Khabouri MJ, Al Lami FH, Alam SS, Alasfoor D, Albittar MI, Alegretti MA, Aleman AV, Alemu ZA, Alfonso-Cristancho R, Alhabib S, Ali R, Ali MK, Alla F, Allebeck P, Allen PJ, Alsharif U, Alvarez E, Alvis-Guzman N, Amankwaa AA, Amare AT, Ameh EA, Ameli O, Amini H, Ammar W, Anderson BO, Antonio CAT, Anwari P, Argeseanu Cunningham S, Arnlöv J, Arsenijevic VSA, Artaman A, Asghar RJ, Assadi R, Atkins LS, Atkinson C, Avila MA, Awuah B, Badawi A, Bahit MC, Bakfalouni T, Balakrishnan K, Balalla S, Balu RK, Banerjee A, Barber RM, Barker-Collo SL, Barquera S, Barregard L, Barrero LH, Barrientos-Gutierrez T, Basto-Abreu AC, Basu A, Basu S, Basulaiman MO, Batis Ruvalcaba C, Beardsley J, Bedi N, Bekele T, Bell ML, Benjet C, Bennett DA, Benzian H, Bernabé E, Beyene TJ, Bhala N, Bhalla A, Bhutta ZA, Bikbov B, Bin Abdulhak AA, Blore JD, Blyth FM, Bohensky MA, Bora Başara B, Borges G, Bornstein NM, Bose D, Boufous S, Bourne RR, Brainin M, Brazinova A, Breitborde NJ, Brenner H, Briggs ADM, Broday DM, Brooks PM, Bruce NG, Brugha TS, Brunekreef B, Buchbinder R, Bui LN, Bukhman G, Bulloch AG, Burch M, Burney PGJ, Campos-Nonato IR, Campuzano JC, Cantoral AJ, Caravanos J, Cárdenas R, Cardis E, Carpenter DO, Caso V, Castañeda-Orjuela CA, Castro RE, Catalá-López F, Cavalleri F, Çavlin A, Chadha VK, Chang JC, Charlson FJ, Chen H, Chen W, Chen Z, Chiang PP, Chimed-Ochir O, Chowdhury R, Christophi CA, Chuang TW, Chugh SS, Cirillo M, Claßen TKD, Colistro V, Colomar M, Colquhoun SM, Contreras AG, Cooper C, Cooperrider K, Cooper LT, Coresh J, Courville KJ, Criqui MH, Cuevas-Nasu L, Damsere-Derry J, Danawi H, Dandona L, Dandona R, Dargan PI, Davis A, Davitoiu DV, Dayama A, de Castro EF, De la Cruz-Góngora V, De Leo D, de Lima G, Degenhardt L, del Pozo-Cruz B, Dellavalle RP, Deribe K, Derrett S, Des Jarlais DC, Dessalegn M, deVeber GA, Devries KM, Dharmaratne SD, Dherani MK, Dicker D, Ding EL, Dokova K, Dorsey ER, Driscoll TR, Duan L, Durrani AM, Ebel BE, Ellenbogen RG, Elshrek YM, Endres M, Ermakov SP, Erskine HE, Eshrati B, Esteghamati A, Fahimi S, Faraon EJA, Farzadfar F, Fay DFJ, Feigin VL, Feigl AB, Fereshtehnejad SM, Ferrari AJ, Ferri CP, Flaxman AD, Fleming TD, Foigt N, Foreman KJ, Paleo UF, Franklin RC, Gabbe B, Gaffikin L, Gakidou E, Gamkrelidze A, Gankpé FG, Gansevoort RT, García-Guerra FA, Gasana E, Geleijnse JM, Gessner BD, Gething P, Gibney KB, Gillum RF, Ginawi IAM, Giroud M, Giussani G, Goenka S, Goginashvili K, Gomez Dantes H, Gona P, Gonzalez de Cosio T, González-Castell D, Gotay CC, Goto A, Gouda HN, Guerrant RL, Gugnani HC, Guillemin F, Gunnell D, Gupta R, Gupta R, Gutiérrez RA, Hafezi-Nejad N, Hagan H, Hagstromer M, Halasa YA, Hamadeh RR, Hammami M, Hankey GJ, Hao Y, Harb HL, Haregu TN, Haro JM, Havmoeller R, Hay SI, Hedayati MT, Heredia-Pi IB, Hernandez L, Heuton KR, Heydarpour P, Hijar M, Hoek HW, Hoffman HJ, Hornberger JC, Hosgood HD, Hoy DG, Hsairi M, Hu G, Hu H, Huang C, Huang JJ, Hubbell BJ, Huiart L, Husseini A, Iannarone ML, Iburg KM, Idrisov BT, Ikeda N, Innos K, Inoue M, Islami F, Ismayilova S, Jacobsen KH, Jansen HA, Jarvis DL, Jassal SK, Jauregui A, Jayaraman S, Jeemon P, Jensen PN, Jha V, Jiang F, Jiang G, Jiang Y, Jonas JB, Juel K, Kan H, Kany Roseline SS, Karam NE, Karch A, Karema CK, Karthikeyan G, Kaul A, Kawakami N, Kazi DS, Kemp AH, Kengne AP, Keren A, Khader YS, Khalifa SEAH, Khan EA, Khang YH, Khatibzadeh S, Khonelidze I, Kieling C, Kim D, Kim S, Kim Y, Kimokoti RW, Kinfu Y, Kinge JM, Kissela BM, Kivipelto M, Knibbs LD, Knudsen AK, Kokubo Y, Kose MR, Kosen S, Kraemer A, Kravchenko M, Krishnaswami S, Kromhout H, Ku T, Kuate Defo B, Kucuk Bicer B, Kuipers EJ, Kulkarni C, Kulkarni VS, Kumar GA, Kwan GF, Lai T, Lakshmana Balaji A, Lalloo R, Lallukka T, Lam H, Lan Q, Lansingh VC, Larson HJ, Larsson A, Laryea DO, Lavados PM, Lawrynowicz AE, Leasher JL, Lee JT, Leigh J, Leung R, Levi M, Li Y, Li Y, Liang J, Liang X, Lim SS, Lindsay MP, Lipshultz SE, Liu S, Liu Y, Lloyd BK, Logroscino G, London SJ, Lopez N, Lortet-Tieulent J, Lotufo PA, Lozano R, Lunevicius R, Ma J, Ma S, Machado VMP, MacIntyre MF, Magis-Rodriguez C, Mahdi AA, Majdan M, Malekzadeh R, Mangalam S, Mapoma CC, Marape M, Marcenes W, Margolis DJ, Margono C, Marks GB, Martin RV, Marzan MB, Mashal MT, Masiye F, Mason-Jones AJ, Matsushita K, Matzopoulos R, Mayosi BM, Mazorodze TT, McKay AC, McKee M, McLain A, Meaney PA, Medina C, Mehndiratta MM, Mejia-Rodriguez F, Mekonnen W, Melaku YA, Meltzer M, Memish ZA, Mendoza W, Mensah GA, Meretoja A, Mhimbira FA, Micha R, Miller TR, Mills EJ, Misganaw A, Mishra S, Mohamed Ibrahim N, Mohammad KA, Mokdad AH, Mola GL, Monasta L, Montañez Hernandez JC, Montico M, Moore AR, Morawska L, Mori R, Moschandreas J, Moturi WN, Mozaffarian D, Mueller UO, Mukaigawara M, Mullany EC, Murthy KS, Naghavi M, Nahas Z, Naheed A, Naidoo KS, Naldi L, Nand D, Nangia V, Narayan KMV, Nash D, Neal B, Nejjari C, Neupane SP, Newton CR, Ngalesoni FN, Ngirabega JDD, Nguyen G, Nguyen NT, Nieuwenhuijsen MJ, Nisar MI, Nogueira JR, Nolla JM, Nolte S, Norheim OF, Norman RE, Norrving B, Nyakarahuka L, Oh IH, Ohkubo T, Olusanya BO, Omer SB, Opio JN, Orozco R, Pagcatipunan RS, Pain AW, Pandian JD, Panelo CIA, Papachristou C, Park EK, Parry CD, Paternina Caicedo AJ, Patten SB, Paul VK, Pavlin BI, Pearce N, Pedraza LS, Pedroza A, Pejin Stokic L, Pekericli A, Pereira DM, Perez-Padilla R, Perez-Ruiz F, Perico N, Perry SAL, Pervaiz A, Pesudovs K, Peterson CB, Petzold M, Phillips MR, Phua HP, Plass D, Poenaru D, Polanczyk GV, Polinder S, Pond CD, Pope CA, Pope D, Popova S, Pourmalek F, Powles J, Prabhakaran D, Prasad NM, Qato DM, Quezada AD, Quistberg DAA, Racapé L, Rafay A, Rahimi K, Rahimi-Movaghar V, Rahman SU, Raju M, Rakovac I, Rana SM, Rao M, Razavi H, Reddy KS, Refaat AH, Rehm J, Remuzzi G, Ribeiro AL, Riccio PM, Richardson L, Riederer A, Robinson M, Roca A, Rodriguez A, Rojas-Rueda D, Romieu I, Ronfani L, Room R, Roy N, Ruhago GM, Rushton L, Sabin N, Sacco RL, Saha S, Sahathevan R, Sahraian MA, Salomon JA, Salvo D, Sampson UK, Sanabria JR, Sanchez LM, Sánchez-Pimienta TG, Sanchez-Riera L, Sandar L, Santos IS, Sapkota A, Satpathy M, Saunders JE, Sawhney M, Saylan MI, Scarborough P, Schmidt JC, Schneider IJC, Schöttker B, Schwebel DC, Scott JG, Seedat S, Sepanlou SG, Serdar B, Servan-Mori EE, Shaddick G, Shahraz S, Levy TS, Shangguan S, She J, Sheikhbahaei S, Shibuya K, Shin HH, Shinohara Y, Shiri R, Shishani K, Shiue I, Sigfusdottir ID, Silberberg DH, Simard EP, Sindi S, Singh A, Singh GM, Singh JA, Skirbekk V, Sliwa K, Soljak M, Soneji S, Søreide K, Soshnikov S, Sposato LA, Sreeramareddy CT, Stapelberg NJC, Stathopoulou V, Steckling N, Stein DJ, Stein MB, Stephens N, Stöckl H, Straif K, Stroumpoulis K, Sturua L, Sunguya BF, Swaminathan S, Swaroop M, Sykes BL, Tabb KM, Takahashi K, Talongwa RT, Tandon N, Tanne D, Tanner M, Tavakkoli M, Te Ao BJ, Teixeira CM, Téllez Rojo MM, Terkawi AS, Texcalac-Sangrador JL, Thackway SV, Thomson B, Thorne-Lyman AL, Thrift AG, Thurston GD, Tillmann T, Tobollik M, Tonelli M, Topouzis F, Towbin JA, Toyoshima H, Traebert J, Tran BX, Trasande L, Trillini M, Trujillo U, Dimbuene ZT, Tsilimbaris M, Tuzcu EM, Uchendu US, Ukwaja KN, Uzun SB, van de Vijver S, Van Dingenen R, van Gool CH, van Os J, Varakin YY, Vasankari TJ, Vasconcelos AMN, Vavilala MS, Veerman LJ, Velasquez-Melendez G, Venketasubramanian N, Vijayakumar L, Villalpando S, Violante FS, Vlassov VV, Vollset SE, Wagner GR, Waller SG, Wallin MT, Wan X, Wang H, Wang J, Wang L, Wang W, Wang Y, Warouw TS, Watts CH, Weichenthal S, Weiderpass E, Weintraub RG, Werdecker A, Wessells KR, Westerman R, Whiteford HA, Wilkinson JD, Williams HC, Williams TN, Woldeyohannes SM, Wolfe CDA, Wong JQ, Woolf AD, Wright JL, Wurtz B, Xu G, Yan LL, Yang G, Yano Y, Ye P, Yenesew M, Yentür GK, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Younoussi Z, Yu C, Zaki ME, Zhao Y, Zheng Y, Zhou M, Zhu J, Zhu S, Zou X, Zunt JR, Lopez AD, Vos T, Murray CJ. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 386:2287-323. [PMID: 26364544 PMCID: PMC4685753 DOI: 10.1016/s0140-6736(15)00128-2] [Citation(s) in RCA: 1719] [Impact Index Per Article: 191.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. METHODS Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. FINDINGS All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa. INTERPRETATION Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks. FUNDING Bill & Melinda Gates Foundation.
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Newton JN, Briggs ADM, Murray CJL, Dicker D, Foreman KJ, Wang H, Naghavi M, Forouzanfar MH, Ohno SL, Barber RM, Vos T, Stanaway JD, Schmidt JC, Hughes AJ, Fay DFJ, Ecob R, Gresser C, McKee M, Rutter H, Abubakar I, Ali R, Anderson HR, Banerjee A, Bennett DA, Bernabé E, Bhui KS, Biryukov SM, Bourne RR, Brayne CEG, Bruce NG, Brugha TS, Burch M, Capewell S, Casey D, Chowdhury R, Coates MM, Cooper C, Critchley JA, Dargan PI, Dherani MK, Elliott P, Ezzati M, Fenton KA, Fraser MS, Fürst T, Greaves F, Green MA, Gunnell DJ, Hannigan BM, Hay RJ, Hay SI, Hemingway H, Larson HJ, Looker KJ, Lunevicius R, Lyons RA, Marcenes W, Mason-Jones AJ, Matthews FE, Moller H, Murdoch ME, Newton CR, Pearce N, Piel FB, Pope D, Rahimi K, Rodriguez A, Scarborough P, Schumacher AE, Shiue I, Smeeth L, Tedstone A, Valabhji J, Williams HC, Wolfe CDA, Woolf AD, Davis ACJ. Changes in health in England, with analysis by English regions and areas of deprivation, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 386:2257-74. [PMID: 26382241 PMCID: PMC4672153 DOI: 10.1016/s0140-6736(15)00195-6] [Citation(s) in RCA: 261] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND In the Global Burden of Disease Study 2013 (GBD 2013), knowledge about health and its determinants has been integrated into a comparable framework to inform health policy. Outputs of this analysis are relevant to current policy questions in England and elsewhere, particularly on health inequalities. We use GBD 2013 data on mortality and causes of death, and disease and injury incidence and prevalence to analyse the burden of disease and injury in England as a whole, in English regions, and within each English region by deprivation quintile. We also assess disease and injury burden in England attributable to potentially preventable risk factors. England and the English regions are compared with the remaining constituent countries of the UK and with comparable countries in the European Union (EU) and beyond. METHODS We extracted data from the GBD 2013 to compare mortality, causes of death, years of life lost (YLLs), years lived with a disability (YLDs), and disability-adjusted life-years (DALYs) in England, the UK, and 18 other countries (the first 15 EU members [apart from the UK] and Australia, Canada, Norway, and the USA [EU15+]). We extended elements of the analysis to English regions, and subregional areas defined by deprivation quintile (deprivation areas). We used data split by the nine English regions (corresponding to the European boundaries of the Nomenclature for Territorial Statistics level 1 [NUTS 1] regions), and by quintile groups within each English region according to deprivation, thereby making 45 regional deprivation areas. Deprivation quintiles were defined by area of residence ranked at national level by Index of Multiple Deprivation score, 2010. Burden due to various risk factors is described for England using new GBD methodology to estimate independent and overlapping attributable risk for five tiers of behavioural, metabolic, and environmental risk factors. We present results for 306 causes and 2337 sequelae, and 79 risks or risk clusters. FINDINGS Between 1990 and 2013, life expectancy from birth in England increased by 5·4 years (95% uncertainty interval 5·0-5·8) from 75·9 years (75·9-76·0) to 81·3 years (80·9-81·7); gains were greater for men than for women. Rates of age-standardised YLLs reduced by 41·1% (38·3-43·6), whereas DALYs were reduced by 23·8% (20·9-27·1), and YLDs by 1·4% (0·1-2·8). For these measures, England ranked better than the UK and the EU15+ means. Between 1990 and 2013, the range in life expectancy among 45 regional deprivation areas remained 8·2 years for men and decreased from 7·2 years in 1990 to 6·9 years in 2013 for women. In 2013, the leading cause of YLLs was ischaemic heart disease, and the leading cause of DALYs was low back and neck pain. Known risk factors accounted for 39·6% (37·7-41·7) of DALYs; leading behavioural risk factors were suboptimal diet (10·8% [9·1-12·7]) and tobacco (10·7% [9·4-12·0]). INTERPRETATION Health in England is improving although substantial opportunities exist for further reductions in the burden of preventable disease. The gap in mortality rates between men and women has reduced, but marked health inequalities between the least deprived and most deprived areas remain. Declines in mortality have not been matched by similar declines in morbidity, resulting in people living longer with diseases. Health policies must therefore address the causes of ill health as well as those of premature mortality. Systematic action locally and nationally is needed to reduce risk exposures, support healthy behaviours, alleviate the severity of chronic disabling disorders, and mitigate the effects of socioeconomic deprivation. FUNDING Bill & Melinda Gates Foundation and Public Health England.
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Affiliation(s)
- John N Newton
- Public Health England, London, UK; University of Manchester, Manchester, UK.
| | | | | | - Daniel Dicker
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Kyle J Foreman
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Haidong Wang
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | | | - Ryan M Barber
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | | | | | | | | | | | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Harry Rutter
- London School of Hygiene & Tropical Medicine, Oxford Martin School, University of Oxford, Oxford, UK
| | - Ibrahim Abubakar
- Public Health England, London, UK; Centre for Infectious Disease Epidemiology and MRC Clinical Trials Unit, London, UK
| | - Raghib Ali
- INDOX Cancer Research Network, Oxford, UK; John Radcliffe Hospital, Oxford, UK; Green-Templeton College, University of Oxford, Oxford, UK
| | - H Ross Anderson
- Population Health Research Institute, Hamilton, ON, Canada; MRC-PHE Centre for Environment and Health, London, UK; St George's, University of London, London, UK
| | | | - Derrick A Bennett
- Clinical Trials Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Kamaldeep S Bhui
- Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London, UK
| | | | - Rupert R Bourne
- Vision & Eye Research Unit, Anglia Ruskin University, Cambridge, UK
| | - Carol E G Brayne
- Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | | | | | - Michael Burch
- Great Ormond Street Hospital for Children, London, UK
| | | | - Daniel Casey
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | | | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southhampton, UK
| | | | - Paul I Dargan
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Paul Elliott
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Majid Ezzati
- MRC-PHE Centre for Population Health, School of Public Health, Imperial College London, London, UK
| | | | - Maya S Fraser
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Thomas Fürst
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Felix Greaves
- Public Health England, London, UK; Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Mark A Green
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - David J Gunnell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | | | - Simon I Hay
- Institute for Health Metrics and Evaluation, Seattle, WA, USA; Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Harry Hemingway
- University College London, London, UK; Farr Institute of Health Informatics Research, London, UK
| | - Heidi J Larson
- Institute for Health Metrics and Evaluation, Seattle, WA, USA; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Katharine J Looker
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Raimundas Lunevicius
- University of Liverpool, Liverpool, UK; Aintree University Hospital NHS Foundation Trust, University of Liverpool, Liverpool, UK
| | - Ronan A Lyons
- Farr Institute, College of Medicine, Swansea University, Swansea, UK
| | | | - Amanda J Mason-Jones
- Department of Health Sciences, University of York, York, UK; Adolescent Health Research Unit, University of Cape Town, Cape Town, South Africa
| | - Fiona E Matthews
- Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK; Institute of Health and Society, Newcastle University, Newcastle, UK
| | - Henrik Moller
- Cancer Epidemiology and Population Health, King's College London, London, UK
| | | | | | - Neil Pearce
- London School of Hygiene & Tropical Medicine, Oxford Martin School, University of Oxford, Oxford, UK
| | | | | | - Kazem Rahimi
- George Institute for Global Health and Division of Cardiovascular Medicine, Oxford Martin School, University of Oxford, Oxford, UK
| | - Alina Rodriguez
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK; Mid Sweden University, Sundsvall, Sweden
| | - Peter Scarborough
- British Heart Foundation Centre on Population Approaches for NCD Prevention, University of Oxford, Oxford, UK
| | | | - Ivy Shiue
- University of Edinburgh, Edinburgh, Scotland; Northumbria University, Newcastle upon Tyne
| | - Liam Smeeth
- Farr Institute of Health Informatics Research, London, UK; London School of Hygiene & Tropical Medicine, Oxford Martin School, University of Oxford, Oxford, UK
| | | | - Jonathan Valabhji
- NHS England, Leeds, UK; Imperial College Healthcare NHS Trust, London, UK; Imperial College London, London, UK
| | | | | | | | - Adrian C J Davis
- Public Health England, London, UK; London School of Economics, London, UK; University College London, London, UK
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Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, Abraham JP, Abu-Rmeileh NME, Achoki T, AlBuhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guzman NA, Ammar W, Anwari P, Banerjee A, Barquera S, Basu S, Bennett DA, Bhutta Z, Blore J, Cabral N, Nonato IC, Chang JC, Chowdhury R, Courville KJ, Criqui MH, Cundiff DK, Dabhadkar KC, Dandona L, Davis A, Dayama A, Dharmaratne SD, Ding EL, Durrani AM, Esteghamati A, Farzadfar F, Fay DFJ, Feigin VL, Flaxman A, Forouzanfar MH, Goto A, Green MA, Gupta R, Hafezi-Nejad N, Hankey GJ, Harewood HC, Havmoeller R, Hay S, Hernandez L, Husseini A, Idrisov BT, Ikeda N, Islami F, Jahangir E, Jassal SK, Jee SH, Jeffreys M, Jonas JB, Kabagambe EK, Khalifa SEAH, Kengne AP, Khader YS, Khang YH, Kim D, Kimokoti RW, Kinge JM, Kokubo Y, Kosen S, Kwan G, Lai T, Leinsalu M, Li Y, Liang X, Liu S, Logroscino G, Lotufo PA, Lu Y, Ma J, Mainoo NK, Mensah GA, Merriman TR, Mokdad AH, Moschandreas J, Naghavi M, Naheed A, Nand D, Narayan KMV, Nelson EL, Neuhouser ML, Nisar MI, Ohkubo T, Oti SO, Pedroza A, Prabhakaran D, Roy N, Sampson U, Seo H, Sepanlou SG, Shibuya K, Shiri R, Shiue I, Singh GM, Singh JA, Skirbekk V, Stapelberg NJC, Sturua L, Sykes BL, Tobias M, Tran BX, Trasande L, Toyoshima H, van de Vijver S, Vasankari TJ, Veerman JL, Velasquez-Melendez G, Vlassov VV, Vollset SE, Vos T, Wang C, Wang X, Weiderpass E, Werdecker A, Wright JL, Yang YC, Yatsuya H, Yoon J, Yoon SJ, Zhao Y, Zhou M, Zhu S, Lopez AD, Murray CJL, Gakidou E. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384:766-81. [PMID: 24880830 PMCID: PMC4624264 DOI: 10.1016/s0140-6736(14)60460-8] [Citation(s) in RCA: 7556] [Impact Index Per Article: 755.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. METHODS We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). FINDINGS Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. INTERPRETATION Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Marie Ng
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Tom Fleming
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Blake Thomson
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Nicholas Graetz
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Erin C Mullany
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Stan Biryukov
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Semaw Ferede Abera
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Jerry P Abraham
- University of Texas School of Medicine, San Antonio, TX, USA
| | - Niveen M E Abu-Rmeileh
- Institute of Community and Public Health, Birzeti University, Ramallah, West Bank, Occupied Palestinian Territory
| | - Tom Achoki
- Institute for Health Metrics and Evaluation, Seattle, WA, USA; Ministry of Health, Gaborone, Botswana
| | - Fadia S AlBuhairan
- King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Simon Barquera
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | | | | | - Jed Blore
- University of Melbourne, Melbourne, VIC, Australia
| | | | | | | | | | | | | | | | | | - Lalit Dandona
- Institute for Health Metrics and Evaluation, Seattle, WA, USA; Public Health Foundation of India, New Delhi, India
| | | | | | | | - Eric L Ding
- Harvard School of Public Health, Boston, MA USA
| | - Adnan M Durrani
- National Institutes of Health, Bethesda and Montgomery, MD, USA
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Valery L Feigin
- National Institute for Stroke and Applied Neurosciences, AUT University, Auckland, New Zealand
| | - Abraham Flaxman
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Atsushi Goto
- Department of Diabetes Research, National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Nima Hafezi-Nejad
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Graeme J Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
| | | | | | | | - Lucia Hernandez
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | | | - Nayu Ikeda
- National Institute of Health and Nutrition, Tokyo, Japan
| | | | | | - Simerjot K Jassal
- VA San Diego, University of California San Diego, San Diego, CA, USA
| | - Sun Ha Jee
- Graduate School of Public Health, Yonsei University, Seoul, Korea
| | | | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | | | | | | | - Young-Ho Khang
- Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Daniel Kim
- Northeastern University, Boston, MA, USA
| | | | - Jonas M Kinge
- The Norwegian Institute of Public Health, Oslo, Norway
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Soewarta Kosen
- Center for Community Empowerment, Health Policy & Informatics, NIHRD, Jakarta, Indonesia
| | - Gene Kwan
- Boston Medical Center, Boston, MA, USA
| | - Taavi Lai
- Fourth View Consulting, Tallinn, Estonia
| | - Mall Leinsalu
- The National Institute for Health Development, Tallinn, Estonia
| | - Yichong Li
- National Center for Chronic and Non-communicable Disease Control and Prevention, Beijing, China
| | - Xiaofeng Liang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shiwei Liu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | | | | | - Yuan Lu
- Harvard School of Public Health, Boston, MA USA
| | - Jixiang Ma
- Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - George A Mensah
- Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute, Bethesda and Montgomery, MD, USA
| | | | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Aliya Naheed
- International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | | | | | | | | | | | | | - Samuel O Oti
- African Population and Health Research Center, Nairobi, Kenya
| | - Andrea Pedroza
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | | | | | - Hyeyoung Seo
- Department of Public Health, Graduate School, Seoul, Korea
| | - Sadaf G Sepanlou
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Rahman Shiri
- Finnish institute of Occupational Health, Helsinki, Finland
| | - Ivy Shiue
- Heriot-Watt University, Edinburgh, Scotland, UK
| | | | | | | | | | - Lela Sturua
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | | | - Martin Tobias
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Bach X Tran
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | | | | | | | - Stein Emil Vollset
- The Norwegian Institute of Public Health, Oslo, Norway; University of Bergen, Bergen, Norway
| | - Theo Vos
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - XiaoRong Wang
- Shandong University affiliated Jinan Central Hospital, Jinan, China
| | | | - Andrea Werdecker
- Institute of Medical Sociology and Social Medicine, Marburg, Hessen, Germany
| | | | | | | | - Jihyun Yoon
- Department of Preventive Medicine, Seoul, Korea
| | | | - Yong Zhao
- Chongqing Medical University, Chongqing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Beijing, China
| | - Shankuan Zhu
- Zhejiang University School of Public Health, Hangzhou, China
| | - Alan D Lopez
- University of Melbourne, Melbourne, VIC, Australia
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Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, Abraham JP, Abu-Rmeileh NME, Achoki T, AlBuhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guzman NA, Ammar W, Anwari P, Banerjee A, Barquera S, Basu S, Bennett DA, Bhutta Z, Blore J, Cabral N, Nonato IC, Chang JC, Chowdhury R, Courville KJ, Criqui MH, Cundiff DK, Dabhadkar KC, Dandona L, Davis A, Dayama A, Dharmaratne SD, Ding EL, Durrani AM, Esteghamati A, Farzadfar F, Fay DFJ, Feigin VL, Flaxman A, Forouzanfar MH, Goto A, Green MA, Gupta R, Hafezi-Nejad N, Hankey GJ, Harewood HC, Havmoeller R, Hay S, Hernandez L, Husseini A, Idrisov BT, Ikeda N, Islami F, Jahangir E, Jassal SK, Jee SH, Jeffreys M, Jonas JB, Kabagambe EK, Khalifa SEAH, Kengne AP, Khader YS, Khang YH, Kim D, Kimokoti RW, Kinge JM, Kokubo Y, Kosen S, Kwan G, Lai T, Leinsalu M, Li Y, Liang X, Liu S, Logroscino G, Lotufo PA, Lu Y, Ma J, Mainoo NK, Mensah GA, Merriman TR, Mokdad AH, Moschandreas J, Naghavi M, Naheed A, Nand D, Narayan KMV, Nelson EL, Neuhouser ML, Nisar MI, Ohkubo T, Oti SO, Pedroza A, Prabhakaran D, Roy N, Sampson U, Seo H, Sepanlou SG, Shibuya K, Shiri R, Shiue I, Singh GM, Singh JA, Skirbekk V, Stapelberg NJC, Sturua L, Sykes BL, Tobias M, Tran BX, Trasande L, Toyoshima H, van de Vijver S, Vasankari TJ, Veerman JL, Velasquez-Melendez G, Vlassov VV, Vollset SE, Vos T, Wang C, Wang X, Weiderpass E, Werdecker A, Wright JL, Yang YC, Yatsuya H, Yoon J, Yoon SJ, Zhao Y, Zhou M, Zhu S, Lopez AD, Murray CJL, Gakidou E. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014. [PMID: 24880830 DOI: 10.1016/s0140-6736(14)60460] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. METHODS We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). FINDINGS Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. INTERPRETATION Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Marie Ng
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Tom Fleming
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Blake Thomson
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Nicholas Graetz
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Erin C Mullany
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Stan Biryukov
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Semaw Ferede Abera
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Jerry P Abraham
- University of Texas School of Medicine, San Antonio, TX, USA
| | - Niveen M E Abu-Rmeileh
- Institute of Community and Public Health, Birzeti University, Ramallah, West Bank, Occupied Palestinian Territory
| | - Tom Achoki
- Institute for Health Metrics and Evaluation, Seattle, WA, USA; Ministry of Health, Gaborone, Botswana
| | - Fadia S AlBuhairan
- King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Simon Barquera
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | | | | | - Jed Blore
- University of Melbourne, Melbourne, VIC, Australia
| | | | | | | | | | | | | | | | | | - Lalit Dandona
- Institute for Health Metrics and Evaluation, Seattle, WA, USA; Public Health Foundation of India, New Delhi, India
| | | | | | | | - Eric L Ding
- Harvard School of Public Health, Boston, MA USA
| | - Adnan M Durrani
- National Institutes of Health, Bethesda and Montgomery, MD, USA
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Valery L Feigin
- National Institute for Stroke and Applied Neurosciences, AUT University, Auckland, New Zealand
| | - Abraham Flaxman
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Atsushi Goto
- Department of Diabetes Research, National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Nima Hafezi-Nejad
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Graeme J Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
| | | | | | | | - Lucia Hernandez
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | | | - Nayu Ikeda
- National Institute of Health and Nutrition, Tokyo, Japan
| | | | | | - Simerjot K Jassal
- VA San Diego, University of California San Diego, San Diego, CA, USA
| | - Sun Ha Jee
- Graduate School of Public Health, Yonsei University, Seoul, Korea
| | | | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | | | | | | | - Young-Ho Khang
- Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Daniel Kim
- Northeastern University, Boston, MA, USA
| | | | - Jonas M Kinge
- The Norwegian Institute of Public Health, Oslo, Norway
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Soewarta Kosen
- Center for Community Empowerment, Health Policy & Informatics, NIHRD, Jakarta, Indonesia
| | - Gene Kwan
- Boston Medical Center, Boston, MA, USA
| | - Taavi Lai
- Fourth View Consulting, Tallinn, Estonia
| | - Mall Leinsalu
- The National Institute for Health Development, Tallinn, Estonia
| | - Yichong Li
- National Center for Chronic and Non-communicable Disease Control and Prevention, Beijing, China
| | - Xiaofeng Liang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shiwei Liu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | | | | | - Yuan Lu
- Harvard School of Public Health, Boston, MA USA
| | - Jixiang Ma
- Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - George A Mensah
- Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute, Bethesda and Montgomery, MD, USA
| | | | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Aliya Naheed
- International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | | | | | | | | | | | | | - Samuel O Oti
- African Population and Health Research Center, Nairobi, Kenya
| | - Andrea Pedroza
- National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | | | | | - Hyeyoung Seo
- Department of Public Health, Graduate School, Seoul, Korea
| | - Sadaf G Sepanlou
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Rahman Shiri
- Finnish institute of Occupational Health, Helsinki, Finland
| | - Ivy Shiue
- Heriot-Watt University, Edinburgh, Scotland, UK
| | | | | | | | | | - Lela Sturua
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | | | - Martin Tobias
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - Bach X Tran
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | | | | | | | - Stein Emil Vollset
- The Norwegian Institute of Public Health, Oslo, Norway; University of Bergen, Bergen, Norway
| | - Theo Vos
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | | | - XiaoRong Wang
- Shandong University affiliated Jinan Central Hospital, Jinan, China
| | | | - Andrea Werdecker
- Institute of Medical Sociology and Social Medicine, Marburg, Hessen, Germany
| | | | | | | | - Jihyun Yoon
- Department of Preventive Medicine, Seoul, Korea
| | | | - Yong Zhao
- Chongqing Medical University, Chongqing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Beijing, China
| | - Shankuan Zhu
- Zhejiang University School of Public Health, Hangzhou, China
| | - Alan D Lopez
- University of Melbourne, Melbourne, VIC, Australia
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