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      2017                            d10aFemale10aHumans10aMale10aRisk Factors10aAdolescent10aAge Factors10aPregnancy10aChild10aSex Factors10aGlobal Health10aCause of Death10aWounds and Injuries10aAdolescent Health10aChild Health10aChild Mortality10aDisabled Children10aGlobal Burden of Disease10aPregnancy Complications1 aTonelli Marcello1 aLiang Xiaofeng1 aAmare Azmeraw1 aBedi Neeraj1 aCatalá-Lopéz Ferrán1 aDandona Lalit1 aDandona Rakhi1 aDing Eric1 aFarzadfar Farshad1 aFijabi Daniel1 aGeleijnse Johanna1 aGona Philimon1 aGoto Atsushi1 aGugnani Harish1 aH Hosgood Dean1 aJiang Guohong1 aKhang Young-Ho1 aKim Daniel1 aKinfu Yohannes1 aG Kumar Anil1 aLarsson Anders1 aLim Stephen1 aLotufo Paulo1 aMendoza Walter1 aMensah George1 aMiller Ted1 aMokdad Ali1 aMonasta Lorenzo1 aNaghavi Mohsen1 aRojas-Rueda David1 aRonfani Luca1 aSalomon Joshua1 aSantos Itamar1 aSawhney Monika1 aShiue Ivy1 aSigfusdottir Inga1 aTabb Karen1 aTerkawi Abdullah1 aThomson Alan1 aVlassov Vasiliy1 aVollset Stein1 aVos Theo1 aWeiderpass Elisabete1 aWesterman Ronny1 aWilliams Hywel1 aYonemoto Naohiro1 aYu Chuanhua1 aMurray Christopher1 aJha V.1 aGupta Rajeev1 aThomas Bernadette1 aÄrnlöv Johan1 aBikbov Boris1 aOrtiz Alberto1 aPerico Norberto1 aRemuzzi Giuseppe1 aSchöttker Ben1 aWerdecker Andrea1 aYano Yuichiro1 aZaki Maysaa1 aNaheed Aliya1 aAsayesh Hamid1 aAwasthi Ashish1 aBarac Aleksandra1 aMalta Deborah1 aDubey Manisha1 aHailu Gessessew1 aHavmoeller Rasmus1 aHay Simon1 aHorino Masako1 aJonas Jost1 aKasaeian Amir1 aKhubchandani Jagdish1 aKrohn Kristopher1 aLal Dharmesh1 aLopez Alan1 aMalekzadeh Reza1 aMazidi Mohsen1 aMeles Kidanu1 aMohammed Shafiu1 aNguyen Grant1 aQorbani Mostafa1 aRai Rajesh1 aSartorius Benn1 aShaikh Masood1 aSwaminathan Soumya1 aTabarés-Seisdedos Rafael1 aTopor-Madry Roman1 aUthman Olalekan1 aVasankari Tommi1 aWeintraub Robert1 aGlobal Burden of Disease Child and Adolescent Health Collaboration1 aKassebaum Nicholas1 aKyu Hmwe1 aZoeckler Leo1 aOlsen Helen1 aThomas Katie1 aPinho Christine1 aBhutta Zulfiqar1 aFerrari Alize1 aGhiwot Tsegaye1 aPatton George1 aWhiteford Harvey1 aAbate Kalkidan1 aAbbas Kaja1 aDamtew Solomon1 aAhmed Muktar1 aAkseer Nadia1 aAl-Raddadi Rajaa1 aAlemayohu Mulubirhan1 aAltirkawi Khalid1 aAbajobir Amanuel1 aAntonio Carl1 aArtaman Al1 aAvokpaho Euripide1 aQuintanilla Beatriz1 aBacha Umar1 aBetsu Balem1 aBärnighausen Till1 aBaye Estifanos1 aBensenor Isabela1 aBerhane Adugnaw1 aBernabe Eduardo1 aBernal Oscar1 aBeyene Addisu1 aBiadgilign Sibhatu1 aBoyce Cheryl1 aBrazinova Alexandra1 aCarter Austin1 aCastañeda-Orjuela Carlos1 aCharlson Fiona1 aChitheer Abdulaal1 aChoi Jee-Young1 aCiobanu Liliana1 aCrump John1 aDellavalle Robert1 aDeribew Amare1 adeVeber Gabrielle1 aDicker Daniel1 aEndries Amanuel1 aErskine Holly1 aFaraon Emerito1 aFaro Andre1 aFernandes Joao1 aFitzmaurice Christina1 aFleming Thomas1 aFlor Luisa1 aForeman Kyle1 aFranklin Richard1 aFraser Maya1 aFrostad Joseph1 aFullman Nancy1 aGebregergs Gebremedhin1 aGebru Alemseged1 aGibney Katherine1 aYihdego Mahari1 aGinawi Ibrahim1 aGishu Melkamu1 aGizachew Tessema1 aGlaser Elizabeth1 aGold Audra1 aGoldberg Ellen1 aTesfay Fisaha1 aHankey Graeme1 aHijar Martha1 aHu Guoqing1 aJacobsen Kathryn1 aJakovljevic Mihajlo1 aJayaraman Sudha1 aJibat Tariku1 aJohnson Catherine1 aKawakami Norito1 aKeiyoro Peter1 aKhalil Ibrahim1 aKiadaliri Aliasghar1 aKieling Christian1 aKissoon Niranjan1 aKnibbs Luke1 aKoyanagi Ai1 aDefo Barthelemy1 aBicer Burcu1 aKulikoff Rachel1 aLam Hilton1 aLarson Heidi1 aLaryea Dennis1 aLeung Janni1 aLo Loon-Tzian1 aLo Warren1 aLooker Katharine1 aRazek Hassan1 aShifti Desalegn1 aMeaney Peter1 aMemiah Peter1 aMengistie Mubarek1 aMengistu Gebremichael1 aMock Charles1 aMohammadi Alireza1 aMueller Ulrich1 aNagata Chie1 aLe Nguyen Quyen1 aNsoesie Elaine1 aOh In-Hwan1 aOkoro Anselm1 aOlusanya Jacob1 aOlusanya Bolajoko1 aPaudel Deepak1 aPereira David1 aPetzold Max1 aPhillips Michael1 aPolanczyk Guilherme1 aPourmalek Farshad1 aRafay Anwar1 aRahimi-Movaghar Vafa1 aRahman Mahfuzar1 aRam Usha1 aRankin Zane1 aRenzaho Andre1 aRoba Hirbo1 aSagar Rajesh1 aSanabria Juan1 aMohammed Muktar1 aSatpathy Maheswar1 aSchwebel David1 aScott James1 aSepanlou Sadaf1 aShaheen Amira1 aShe June1 aShiri Rahman1 aSingh Jasvinder1 aSilpakit Naris1 aSmith Alison1 aSreeramareddy Chandrashekhar1 aStanaway Jeffrey1 aStein Dan1 aSteiner Caitlyn1 aSufiyan Muawiyyah1 aTadese Fentaw1 aTavakkoli Mohammad1 aTaye Bineyam1 aTeeple Stephanie1 aTegegne Teketo1 aShifa Girma1 aTobe-Gai Ruoyan1 aTran Bach1 aTroeger Christopher1 aUkwaja Kingsley1 aVenketasubramanian Narayanaswamy1 aGebrehiwot Solomon1 aWolfe Charles1 aWoodbrook Rachel1 aYoon Seok-Jun1 aYounis Mustafa1 aZegeye Elias1 aZuhlke Liesl00aChild and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study.  a573-5920 v1713 a<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>  a2168-6211