@article{22932,
  keywords = {Female, Humans, Male, Risk Factors, Adolescent, Age Factors, Pregnancy, Child, Sex Factors, Global Health, Cause of Death, Wounds and Injuries, Adolescent Health, Child Health, Child Mortality, Disabled Children, Global Burden of Disease, Pregnancy Complications},
  author = {Tonelli Marcello and Liang Xiaofeng and Amare Azmeraw and Bedi Neeraj and Catalá-Lopéz Ferrán and Dandona Lalit and Dandona Rakhi and Ding Eric and Farzadfar Farshad and Fijabi Daniel and Geleijnse Johanna and Gona Philimon and Goto Atsushi and Gugnani Harish and H Hosgood Dean and Jiang Guohong and Khang Young-Ho and Kim Daniel and Kinfu Yohannes and G Kumar Anil and Larsson Anders and Lim Stephen and Lotufo Paulo and Mendoza Walter and Mensah George and Miller Ted and Mokdad Ali and Monasta Lorenzo and Naghavi Mohsen and Rojas-Rueda David and Ronfani Luca and Salomon Joshua and Santos Itamar and Sawhney Monika and Shiue Ivy and Sigfusdottir Inga and Tabb Karen and Terkawi Abdullah and Thomson Alan and Vlassov Vasiliy and Vollset Stein and Vos Theo and Weiderpass Elisabete and Westerman Ronny and Williams Hywel and Yonemoto Naohiro and Yu Chuanhua and Murray Christopher and Jha V. and Gupta Rajeev and Thomas Bernadette and Ärnlöv Johan and Bikbov Boris and Ortiz Alberto and Perico Norberto and Remuzzi Giuseppe and Schöttker Ben and Werdecker Andrea and Yano Yuichiro and Zaki Maysaa and Naheed Aliya and Asayesh Hamid and Awasthi Ashish and Barac Aleksandra and Malta Deborah and Dubey Manisha and Hailu Gessessew and Havmoeller Rasmus and Hay Simon and Horino Masako and Jonas Jost and Kasaeian Amir and Khubchandani Jagdish and Krohn Kristopher and Lal Dharmesh and Lopez Alan and Malekzadeh Reza and Mazidi Mohsen and Meles Kidanu and Mohammed Shafiu and Nguyen Grant and Qorbani Mostafa and Rai Rajesh and Sartorius Benn and Shaikh Masood and Swaminathan Soumya and Tabarés-Seisdedos Rafael and Topor-Madry Roman and Uthman Olalekan and Vasankari Tommi and Weintraub Robert and Global Burden of Disease Child and Adolescent Health Collaboration and Kassebaum Nicholas and Kyu Hmwe and Zoeckler Leo and Olsen Helen and Thomas Katie and Pinho Christine and Bhutta Zulfiqar and Ferrari Alize and Ghiwot Tsegaye and Patton George and Whiteford Harvey and Abate Kalkidan and Abbas Kaja and Damtew Solomon and Ahmed Muktar and Akseer Nadia and Al-Raddadi Rajaa and Alemayohu Mulubirhan and Altirkawi Khalid and Abajobir Amanuel and Antonio Carl and Artaman Al and Avokpaho Euripide and Quintanilla Beatriz and Bacha Umar and Betsu Balem and Bärnighausen Till and Baye Estifanos and Bensenor Isabela and Berhane Adugnaw and Bernabe Eduardo and Bernal Oscar and Beyene Addisu and Biadgilign Sibhatu and Boyce Cheryl and Brazinova Alexandra and Carter Austin and Castañeda-Orjuela Carlos and Charlson Fiona and Chitheer Abdulaal and Choi Jee-Young and Ciobanu Liliana and Crump John and Dellavalle Robert and Deribew Amare and deVeber Gabrielle and Dicker Daniel and Endries Amanuel and Erskine Holly and Faraon Emerito and Faro Andre and Fernandes Joao and Fitzmaurice Christina and Fleming Thomas and Flor Luisa and Foreman Kyle and Franklin Richard and Fraser Maya and Frostad Joseph and Fullman Nancy and Gebregergs Gebremedhin and Gebru Alemseged and Gibney Katherine and Yihdego Mahari and Ginawi Ibrahim and Gishu Melkamu and Gizachew Tessema and Glaser Elizabeth and Gold Audra and Goldberg Ellen and Tesfay Fisaha and Hankey Graeme and Hijar Martha and Hu Guoqing and Jacobsen Kathryn and Jakovljevic Mihajlo and Jayaraman Sudha and Jibat Tariku and Johnson Catherine and Kawakami Norito and Keiyoro Peter and Khalil Ibrahim and Kiadaliri Aliasghar and Kieling Christian and Kissoon Niranjan and Knibbs Luke and Koyanagi Ai and Defo Barthelemy and Bicer Burcu and Kulikoff Rachel and Lam Hilton and Larson Heidi and Laryea Dennis and Leung Janni and Lo Loon-Tzian and Lo Warren and Looker Katharine and Razek Hassan and Shifti Desalegn and Meaney Peter and Memiah Peter and Mengistie Mubarek and Mengistu Gebremichael and Mock Charles and Mohammadi Alireza and Mueller Ulrich and Nagata Chie and Le Nguyen Quyen and Nsoesie Elaine and Oh In-Hwan and Okoro Anselm and Olusanya Jacob and Olusanya Bolajoko and Paudel Deepak and Pereira David and Petzold Max and Phillips Michael and Polanczyk Guilherme and Pourmalek Farshad and Rafay Anwar and Rahimi-Movaghar Vafa and Rahman Mahfuzar and Ram Usha and Rankin Zane and Renzaho Andre and Roba Hirbo and Sagar Rajesh and Sanabria Juan and Mohammed Muktar and Satpathy Maheswar and Schwebel David and Scott James and Sepanlou Sadaf and Shaheen Amira and She June and Shiri Rahman and Singh Jasvinder and Silpakit Naris and Smith Alison and Sreeramareddy Chandrashekhar and Stanaway Jeffrey and Stein Dan and Steiner Caitlyn and Sufiyan Muawiyyah and Tadese Fentaw and Tavakkoli Mohammad and Taye Bineyam and Teeple Stephanie and Tegegne Teketo and Shifa Girma and Tobe-Gai Ruoyan and Tran Bach and Troeger Christopher and Ukwaja Kingsley and Venketasubramanian Narayanaswamy and Gebrehiwot Solomon and Wolfe Charles and Woodbrook Rachel and Yoon Seok-Jun and Younis Mustafa and Zegeye Elias and Zuhlke Liesl},
  title = {Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study.},
  abstract = {<p><b>Importance: </b>Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health.</p><p><b>Objective: </b>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.</p><p><b>Evidence Review: </b>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.</p><p><b>Findings: </b>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.</p><p><b>Conclusions and Relevance: </b>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.</p>},
  year = {2017},
  journal = {JAMA Pediatr},
  volume = {171},
  pages = {573-592},
  issn = {2168-6211},
  doi = {10.1001/jamapediatrics.2017.0250},
  language = {eng},
}