Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016

GBD 2016 Causes of Death Collaborators

Abstract

Background: Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends.

Methods: We estimated cause-specific deaths and years of life lost (YLLs) by age, sex, geography, and year. YLLs were calculated from the sum of each death multiplied by the standard life expectancy at each age. We used the GBD cause of death database composed of: vital registration (VR) data corrected for under-registration and garbage coding; national and subnational verbal autopsy (VA) studies corrected for garbage coding; and other sources including surveys and surveillance systems for specific causes such as maternal mortality. To facilitate assessment of quality, we reported on the fraction of deaths assigned to GBD Level 1 or Level 2 causes that cannot be underlying causes of death (major garbage codes) by location and year. Based on completeness, garbage coding, cause list detail, and time periods covered, we provided an overall data quality rating for each location with scores ranging from 0 stars (worst) to 5 stars (best). We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to generate estimates for each location, year, age, and sex. We assessed observed and expected levels and trends of cause-specific deaths in relation to the Socio-demographic Index (SDI), a summary indicator derived from measures of average income per capita, educational attainment, and total fertility, with locations grouped into quintiles by SDI. Relative to GBD 2015, we expanded the GBD cause hierarchy by 18 causes of death for GBD 2016.

Findings: The quality of available data varied by location. Data quality in 25 countries rated in the highest category (5 stars), while 48, 30, 21, and 44 countries were rated at each of the succeeding data quality levels. Vital registration or verbal autopsy data were not available in 27 countries, resulting in the assignment of a zero value for data quality. Deaths from non-communicable diseases (NCDs) represented 72·3% (95% uncertainty interval [UI] 71·2-73·2) of deaths in 2016 with 19·3% (18·5-20·4) of deaths in that year occurring from communicable, maternal, neonatal, and nutritional (CMNN) diseases and a further 8·43% (8·00-8·67) from injuries. Although age-standardised rates of death from NCDs decreased globally between 2006 and 2016, total numbers of these deaths increased; both numbers and age-standardised rates of death from CMNN causes decreased in the decade 2006-16-age-standardised rates of deaths from injuries decreased but total numbers varied little. In 2016, the three leading global causes of death in children under-5 were lower respiratory infections, neonatal preterm birth complications, and neonatal encephalopathy due to birth asphyxia and trauma, combined resulting in 1·80 million deaths (95% UI 1·59 million to 1·89 million). Between 1990 and 2016, a profound shift toward deaths at older ages occurred with a 178% (95% UI 176-181) increase in deaths in ages 90-94 years and a 210% (208-212) increase in deaths older than age 95 years. The ten leading causes by rates of age-standardised YLL significantly decreased from 2006 to 2016 (median annualised rate of change was a decrease of 2·89%); the median annualised rate of change for all other causes was lower (a decrease of 1·59%) during the same interval. Globally, the five leading causes of total YLLs in 2016 were cardiovascular diseases; diarrhoea, lower respiratory infections, and other common infectious diseases; neoplasms; neonatal disorders; and HIV/AIDS and tuberculosis. At a finer level of disaggregation within cause groupings, the ten leading causes of total YLLs in 2016 were ischaemic heart disease, cerebrovascular disease, lower respiratory infections, diarrhoeal diseases, road injuries, malaria, neonatal preterm birth complications, HIV/AIDS, chronic obstructive pulmonary disease, and neonatal encephalopathy due to birth asphyxia and trauma. Ischaemic heart disease was the leading cause of total YLLs in 113 countries for men and 97 countries for women. Comparisons of observed levels of YLLs by countries, relative to the level of YLLs expected on the basis of SDI alone, highlighted distinct regional patterns including the greater than expected level of YLLs from malaria and from HIV/AIDS across sub-Saharan Africa; diabetes mellitus, especially in Oceania; interpersonal violence, notably within Latin America and the Caribbean; and cardiomyopathy and myocarditis, particularly in eastern and central Europe. The level of YLLs from ischaemic heart disease was less than expected in 117 of 195 locations. Other leading causes of YLLs for which YLLs were notably lower than expected included neonatal preterm birth complications in many locations in both south Asia and southeast Asia, and cerebrovascular disease in western Europe.

Interpretation: The past 37 years have featured declining rates of communicable, maternal, neonatal, and nutritional diseases across all quintiles of SDI, with faster than expected gains for many locations relative to their SDI. A global shift towards deaths at older ages suggests success in reducing many causes of early death. YLLs have increased globally for causes such as diabetes mellitus or some neoplasms, and in some locations for causes such as drug use disorders, and conflict and terrorism. Increasing levels of YLLs might reflect outcomes from conditions that required high levels of care but for which effective treatments remain elusive, potentially increasing costs to health systems.

Funding: Bill & Melinda Gates Foundation.

Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Figures

Figure 1
Figure 1
Percent of garbage coded deaths in GBD levels 1 and 2 for all ages by country and year, 1980–2016 Cells are colour-coded by percent of data redistributed in a given country-year from garbage coding to a likely underlying cause of death. Blank white cells indicate lack of vital registration. Major garbage codes are causes of death that are redistributed onto Level 1 or 2 of the GBD cause hierarchy. Countries without vital registration for 1980–2016 are not listed. High percentages of vaguely coded deaths highlight the importance of improvements in accurate reporting of mortality data to avoid redistribution of deaths to broad level causes.
Figure 1
Figure 1
Percent of garbage coded deaths in GBD levels 1 and 2 for all ages by country and year, 1980–2016 Cells are colour-coded by percent of data redistributed in a given country-year from garbage coding to a likely underlying cause of death. Blank white cells indicate lack of vital registration. Major garbage codes are causes of death that are redistributed onto Level 1 or 2 of the GBD cause hierarchy. Countries without vital registration for 1980–2016 are not listed. High percentages of vaguely coded deaths highlight the importance of improvements in accurate reporting of mortality data to avoid redistribution of deaths to broad level causes.
Figure 2
Figure 2
Classification of national time series of vital registration and verbal autopsy data, 1980–2016, on the basis of the fraction of deaths well certified and assigned to a detailed GBD cause Only vital registration data and verbal autopsy data were considered for this metric, and a country with no data in this form received 0 stars. Verbal autopsy data were down-weighted as a whole, to represent lower accuracy in cause of death ascertainment, and studies which were not nationally representative were significantly down-weighted for the star rating. Stars were assigned in proportion to completeness, percentage of deaths assigned to major garbage codes, time series availability, age and sex coverage, and geographical coverage. GBD=Global Burden of Disease. ATG=Antigua and Barbuda. FSM=Federated States of Micronesia. LCA=Saint Lucia. TLS=Timor-Leste. TTO=Trinidad and Tobago. VCT=Saint Vincent and the Grenadines.
Figure 3
Figure 3
Global composition of number of deaths by Level 2 causes for 23 GBD age groups, both sexes combined, 1990 versus 2016 Composition of Level 2 causes of death globally for males and females combined, by age group, showing difference in composition between 1990 and 2016. Number of total deaths due to Level 2 causes is indicated by height of bar; causes are colour-coded to highlight the relative number of total deaths due to a specific cause. GBD=Global Burden of Disease.
Figure 4
Figure 4
Deaths due to fatal discontinuities by category (A, conflict and terrorism; B, epidemics; C, famine; D, natural disasters; E, other injuries) and region from 1980 to 2016, both sexes combined Number of deaths due to fatal discontinuities are presented by region for each of the shock cause groups. Results are shown every year from 1980 to 2016; regions are colour-coded by super-region. Regions for which data were unavailable for specific causes are not presented. Specific events that cause a disproportionate number of deaths are identified. Conflict and terrorism includes military operations, civil conflicts, and terrorist attacks. Epidemics include outbreaks of cholera, meningococcal meningitis, and Ebola virus disease. Famine includes deaths due to protein-energy malnutrition. Natural disasters include exposure to forces of nature. Other injuries includes other transport injuries, fire, heat, and hot substances, poisonings, and other exposure to mechanical forces.
Figure 4
Figure 4
Deaths due to fatal discontinuities by category (A, conflict and terrorism; B, epidemics; C, famine; D, natural disasters; E, other injuries) and region from 1980 to 2016, both sexes combined Number of deaths due to fatal discontinuities are presented by region for each of the shock cause groups. Results are shown every year from 1980 to 2016; regions are colour-coded by super-region. Regions for which data were unavailable for specific causes are not presented. Specific events that cause a disproportionate number of deaths are identified. Conflict and terrorism includes military operations, civil conflicts, and terrorist attacks. Epidemics include outbreaks of cholera, meningococcal meningitis, and Ebola virus disease. Famine includes deaths due to protein-energy malnutrition. Natural disasters include exposure to forces of nature. Other injuries includes other transport injuries, fire, heat, and hot substances, poisonings, and other exposure to mechanical forces.
Figure 4
Figure 4
Deaths due to fatal discontinuities by category (A, conflict and terrorism; B, epidemics; C, famine; D, natural disasters; E, other injuries) and region from 1980 to 2016, both sexes combined Number of deaths due to fatal discontinuities are presented by region for each of the shock cause groups. Results are shown every year from 1980 to 2016; regions are colour-coded by super-region. Regions for which data were unavailable for specific causes are not presented. Specific events that cause a disproportionate number of deaths are identified. Conflict and terrorism includes military operations, civil conflicts, and terrorist attacks. Epidemics include outbreaks of cholera, meningococcal meningitis, and Ebola virus disease. Famine includes deaths due to protein-energy malnutrition. Natural disasters include exposure to forces of nature. Other injuries includes other transport injuries, fire, heat, and hot substances, poisonings, and other exposure to mechanical forces.
Figure 5
Figure 5
Annualised rate of change in age-standardised YLLs from 2006 to 2016 versus global age-standardised YLLs per 100 000 due to each Level 3 cause Causes with 100 000 YLLs or more are presented. YLLs are represented on a logarithmic scale. Italicised causes highlight changes that are not statistically significant. Level 3 causes related to fatal discontinuities (conflict and terrorism, executions and police conflict, and exposures to forces of nature) are excluded. Not shown in figure: Afr tryp: YLL=1·69 ARC=-15·23, Measles: YLL=80·99 ARC=–13·32, Zika virus disease: YLL=0·01 ARC=48·47, Ebola virus disease: YLL=0·003 ARC=32·57, Diphtheria: YLL=1·23 ARC=-11·58, Otitus: YLL=0·7 ARC=–7·32, tetanus: YLL=33·52 ARC=–10·24, Leish: YLL=9·73 ARC=–9·44. ARC=annualised rate of change. A fib=atrial fibrillation and flutter. Afr tryp=African trypanosomiasis. AGN=acute glomerulonephritis. Alcohol=alcohol use disorders. ALS=motor neuron disease. Alzheimer=Alzheimer's disease and other dementias. Animal=animal contact. Aort an=aortic aneurysm. Appendicit=appendicitis. Bladder C=bladder cancer. Brain C=brain and nervous system cancer. Breast C=breast cancer. Cervix C=cervical cancer. Chagas=Chagas disease. Cirr alc=cirrhosis and other chronic liver diseases due to alcohol use. Cirr HepB=cirrhosis and other chronic liver diseases due to hepatitis B. Cirr hep C=cirrhosis and other chronic liver diseases due to hepatitis C. CKD=chronic kidney disease. CMP=cardiomyopathy and myocarditis. Colorect C=colon and rectum cancer. Comp abort=maternal abortion, miscarriage, and ectopic pregnancy. Congenital=congenital birth defects. COPD=chronic obstructive pulmonary disease. Cysticer=cysticercosis. Diabetes=diabetes mellitus. Diarrhoea=diarrhoeal diseases. Disaster=exposure to forces of nature. Drown=drowning. Drugs=drug use disorders. Eating=eating disorders. Echino=cystic echinococcosis. Encepha=encephalitis. Endocar=endocarditis. Endocrine=endocrine, metabolic, blood, and immune disorders. Oesophag C=oesophageal cancer. F body=foreign body. Fire=fire, heat, and hot substances. Gall bile=gallbladder and biliary diseases. Gallblad C=gallbladder and biliary tract cancer. Gastritis=gastritis and duodenitis. Gyne=Gynecological diseases. Heat + cold=environmental heat and cold exposure. Haemog=haemoglobinopathies and haemolytic anaemias. Hep=hepatitis. Hernia=inguinal, femoral, and abdominal hernia. HIV=HIV/AIDS. Hodgkin=Hodgkin's lymphoma. HTN HD=hypertensive heart disease. IBD=inflammatory bowel disease. IHD=ischaemic heart disease. ILD=interstitial lung disease and pulmonary sarcoidosis. Ileus=paralytic ileus and intestinal obstruction. Intest inf=intestinal infectious diseases. Iodine=iodine deficiency. Iron=iron-deficiency anaemia. Kidney C=kidney cancer. Larynx C=larynx cancer. Leish=leishmaniasis. Lip oral C=lip and oral cavity cancer. Liver C=liver cancer. LRI=lower respiratory infections. Lung C=tracheal, bronchus, and lung cancer. Lymphoma=non-Hodgkin lymphoma. Mat haem=maternal haemorrhage. Mat HIV=maternal deaths aggravated by HIV/AIDS. Mat HTN=maternal hypertensive disorders. Mat indir=indirect maternal deaths. Mat late=late maternal deaths. Mat sepsis=maternal sepsis and other maternal infections. Mech=exposure to mechanical forces. Med treat=adverse effects of medical treatment. Melanoma=malignant skin melanoma. Mesothel=mesothelioma. MS=multiple sclerosis. Myeloma=multiple myeloma. Nasoph C=nasopharynx cancer. Nematode=intestinal nematode infections. NN enceph=neonatal encephalopathy due to birth asphyxia and trauma. NN haemol=haemolytic disease and other neonatal jaundice. NN Preterm=neonatal preterm birth complications. NN sepsis=neonatal sepsis and other neonatal infections. Obst labor=maternal obstructed labor and uterine ruptures. Oth cardio=other cardiovascular and circulatory diseases. Oth cirr=cirrhosis and other chronic liver diseases due to other causes. Other digest=other digestive diseases. Oth inf=other infectious diseases. Oth mat=other maternal disorders. Oth MSK=other musculoskeletal disorders. Oth neopla=other neoplasms. Oth neuro=other neurological disorders. Oth NN=other neonatal disorders. Oth NTD=other neglected tropical diseases. Oth nutr =other nutritional deficiencies. Oth phar C=other pharynx cancer. Oth resp=other chronic respiratory diseases. Oth trans=other transport injuries. Oth unint=other unintentional injuries. Otitis=otitis media. Ovary C=ovarian cancer. PAD=peripheral artery disease. Pancreas C=pancreatic cancer. Pancreatit=pancreatitis. Parkinson's=Parkinson's disease. PEM=protein-energy malnutrition. Pneumocon=pneumoconiosis. Poison=poisonings. Prostate C=prostate cancer. PUD=peptic ulcer disease. RHD=rheumatic heart disease. Rheu arth=rheumatoid arthritis. Road inj=road injuries. Schisto=schistosomiasis. SIDS=sudden infant death syndrome. Skin=skin and subcutaneous diseases. Skin C=non-melanoma skin cancer. State viol=executions and police conflict. STD=sexually transmitted diseases excluding HIV. Stomach C=stomach cancer. Stroke=cerebrovascular disease. TB=tuberculosis. Testis C=testicular cancer. Thyroid C=thyroid cancer. URI=upper respiratory infections. Urinary=urinary diseases and male infertility. Uterus C=uterine cancer. Varicella=varicella and herpes zoster. Vasc intest=vascular intestinal disorders. Violence=interpersonal violence. Whooping=whooping cough. YLLs=years of life lost.
Figure 6
Figure 6
Trends of (A) total YLLs and (B) age-standardised YLL rates from 1980 to 2016, by GBD Level 1 cause, by SDI quintile Shaded areas show 95% uncertainty intervals. GBD=Global Burden of Disease. SDI=Socio-demographic Index. YLLs=years of life lost.
Figure 7
Figure 7
Leading 30 Level 3 causes of total YLLs by SDI grouping (high, A; high-middle, B; middle, C; low-middle, D; low, E) for 1990, 2006, and 2016, with percent change in number of YLLs, and all-age and age-standardised rates Causes are connected by arrows between time periods; solid lines are increases and dashed lines are decreases. For the time period 1990–2006 and for 2006–16, three measures of change are shown: percent change in the number of YLLs, percent change in the all-age YLL rate, and percent change in the age-standardised YLL rate. Statistically significant changes are shown in bold. COPD=chronic obstructive pulmonary disease. STDs=sexually transmitted diseases. SDI=Socio-demographic Index. YLLs=years of life lost.
Figure 7
Figure 7
Leading 30 Level 3 causes of total YLLs by SDI grouping (high, A; high-middle, B; middle, C; low-middle, D; low, E) for 1990, 2006, and 2016, with percent change in number of YLLs, and all-age and age-standardised rates Causes are connected by arrows between time periods; solid lines are increases and dashed lines are decreases. For the time period 1990–2006 and for 2006–16, three measures of change are shown: percent change in the number of YLLs, percent change in the all-age YLL rate, and percent change in the age-standardised YLL rate. Statistically significant changes are shown in bold. COPD=chronic obstructive pulmonary disease. STDs=sexually transmitted diseases. SDI=Socio-demographic Index. YLLs=years of life lost.
Figure 7
Figure 7
Leading 30 Level 3 causes of total YLLs by SDI grouping (high, A; high-middle, B; middle, C; low-middle, D; low, E) for 1990, 2006, and 2016, with percent change in number of YLLs, and all-age and age-standardised rates Causes are connected by arrows between time periods; solid lines are increases and dashed lines are decreases. For the time period 1990–2006 and for 2006–16, three measures of change are shown: percent change in the number of YLLs, percent change in the all-age YLL rate, and percent change in the age-standardised YLL rate. Statistically significant changes are shown in bold. COPD=chronic obstructive pulmonary disease. STDs=sexually transmitted diseases. SDI=Socio-demographic Index. YLLs=years of life lost.
Figure 8
Figure 8
Leading Level 3 causes of total YLLs by country, for all ages, females (A) and males (B) ATG=Antigua and Barbuda. FSM=Federated States of Micronesia. Marshall Isl=Marshall Islands. Solomon Isl=Solomon Islands. LCA=Saint Lucia. TLS=Timor-Leste. TTO=Trinidad and Tobago. VCT=Saint Vincent and the Grenadines. YLLs=years of life lost.
Figure 9
Figure 9
Leading 10 causes of total YLLs with the ratio of observed YLLs to YLLs expected on the basis of SDI in 2016, by location, with data quality rating Values shown in brackets represent the ratio of observed YLLs to predicted YLLs on the basis of SDI, rounded to two digits. Colour ranges were calculated to place a roughly equal number of cells into each bin. Alcohol=alcohol use disorders. Alzheimer=Alzheimer's disease and other dementias. Asthma=asthma. Breast C=breast cancer. Cirr Alc=cirrhosis and other chronic liver diseases due to alcohol use. Cirr HepB=cirrhosis and other chronic liver diseases due to hepatitis B. Cirr HepC=cirrhosis and other chronic liver diseases due to hepatitis C. CKD=chronic kidney disease. CMP=cardiomyopathy and myocarditis. Colorect C=colon and rectum cancer. Conflict terror=conflict and terrorism. Congenital=congenital birth defects. COPD=chronic obstructive pulmonary disease. Diabetes=diabetes mellitus. Diarrhoea=diarrhoeal diseases. Disaster=exposure to forces of nature. Drown=drowning. Drugs=drug use disorders. Endocrine=endocrine, metabolic, blood, and immune disorders. F Body=foreign body. HIV=HIV/AIDS. HTN HD=hypertensive heart disease. IHD=ischaemic heart disease. Intest Inf=intestinal infectious diseases. Leukemia=leukaemia. Liver C=liver cancer. LRI=lower respiratory infections. Lung C=tracheal, bronchus, and lung cancer. Mech=exposure to mechanical forces. NN Enceph=neonatal encephalopathy due to birth asphyxia and trauma. NN Preterm=neonatal preterm birth complications. NN Sepsis=neonatal sepsis and other neonatal infections. Oth Cardio=other cardiovascular and circulatory diseases. Oesophag C=oesophageal cancer. Oth Cirr=cirrhosis and other chronic liver diseases due to other causes. Oth Inf=other infectious diseases. Oth NN=other neonatal disorders. Pancreas C=pancreatic cancer. PEM=protein-energy malnutrition. Prostate C=prostate cancer. Road Inj=road injuries. SDI=Socio-demographic Index. Self Harm=self-harm. STD=sexually transmitted diseases excluding HIV. Stomach C=stomach cancer. Stroke=cerebrovascular disease. TB=tuberculosis. Violence=interpersonal violence. YLL=year of life lost.
Figure 9
Figure 9
Leading 10 causes of total YLLs with the ratio of observed YLLs to YLLs expected on the basis of SDI in 2016, by location, with data quality rating Values shown in brackets represent the ratio of observed YLLs to predicted YLLs on the basis of SDI, rounded to two digits. Colour ranges were calculated to place a roughly equal number of cells into each bin. Alcohol=alcohol use disorders. Alzheimer=Alzheimer's disease and other dementias. Asthma=asthma. Breast C=breast cancer. Cirr Alc=cirrhosis and other chronic liver diseases due to alcohol use. Cirr HepB=cirrhosis and other chronic liver diseases due to hepatitis B. Cirr HepC=cirrhosis and other chronic liver diseases due to hepatitis C. CKD=chronic kidney disease. CMP=cardiomyopathy and myocarditis. Colorect C=colon and rectum cancer. Conflict terror=conflict and terrorism. Congenital=congenital birth defects. COPD=chronic obstructive pulmonary disease. Diabetes=diabetes mellitus. Diarrhoea=diarrhoeal diseases. Disaster=exposure to forces of nature. Drown=drowning. Drugs=drug use disorders. Endocrine=endocrine, metabolic, blood, and immune disorders. F Body=foreign body. HIV=HIV/AIDS. HTN HD=hypertensive heart disease. IHD=ischaemic heart disease. Intest Inf=intestinal infectious diseases. Leukemia=leukaemia. Liver C=liver cancer. LRI=lower respiratory infections. Lung C=tracheal, bronchus, and lung cancer. Mech=exposure to mechanical forces. NN Enceph=neonatal encephalopathy due to birth asphyxia and trauma. NN Preterm=neonatal preterm birth complications. NN Sepsis=neonatal sepsis and other neonatal infections. Oth Cardio=other cardiovascular and circulatory diseases. Oesophag C=oesophageal cancer. Oth Cirr=cirrhosis and other chronic liver diseases due to other causes. Oth Inf=other infectious diseases. Oth NN=other neonatal disorders. Pancreas C=pancreatic cancer. PEM=protein-energy malnutrition. Prostate C=prostate cancer. Road Inj=road injuries. SDI=Socio-demographic Index. Self Harm=self-harm. STD=sexually transmitted diseases excluding HIV. Stomach C=stomach cancer. Stroke=cerebrovascular disease. TB=tuberculosis. Violence=interpersonal violence. YLL=year of life lost.
Figure 9
Figure 9
Leading 10 causes of total YLLs with the ratio of observed YLLs to YLLs expected on the basis of SDI in 2016, by location, with data quality rating Values shown in brackets represent the ratio of observed YLLs to predicted YLLs on the basis of SDI, rounded to two digits. Colour ranges were calculated to place a roughly equal number of cells into each bin. Alcohol=alcohol use disorders. Alzheimer=Alzheimer's disease and other dementias. Asthma=asthma. Breast C=breast cancer. Cirr Alc=cirrhosis and other chronic liver diseases due to alcohol use. Cirr HepB=cirrhosis and other chronic liver diseases due to hepatitis B. Cirr HepC=cirrhosis and other chronic liver diseases due to hepatitis C. CKD=chronic kidney disease. CMP=cardiomyopathy and myocarditis. Colorect C=colon and rectum cancer. Conflict terror=conflict and terrorism. Congenital=congenital birth defects. COPD=chronic obstructive pulmonary disease. Diabetes=diabetes mellitus. Diarrhoea=diarrhoeal diseases. Disaster=exposure to forces of nature. Drown=drowning. Drugs=drug use disorders. Endocrine=endocrine, metabolic, blood, and immune disorders. F Body=foreign body. HIV=HIV/AIDS. HTN HD=hypertensive heart disease. IHD=ischaemic heart disease. Intest Inf=intestinal infectious diseases. Leukemia=leukaemia. Liver C=liver cancer. LRI=lower respiratory infections. Lung C=tracheal, bronchus, and lung cancer. Mech=exposure to mechanical forces. NN Enceph=neonatal encephalopathy due to birth asphyxia and trauma. NN Preterm=neonatal preterm birth complications. NN Sepsis=neonatal sepsis and other neonatal infections. Oth Cardio=other cardiovascular and circulatory diseases. Oesophag C=oesophageal cancer. Oth Cirr=cirrhosis and other chronic liver diseases due to other causes. Oth Inf=other infectious diseases. Oth NN=other neonatal disorders. Pancreas C=pancreatic cancer. PEM=protein-energy malnutrition. Prostate C=prostate cancer. Road Inj=road injuries. SDI=Socio-demographic Index. Self Harm=self-harm. STD=sexually transmitted diseases excluding HIV. Stomach C=stomach cancer. Stroke=cerebrovascular disease. TB=tuberculosis. Violence=interpersonal violence. YLL=year of life lost.
Figure 9
Figure 9
Leading 10 causes of total YLLs with the ratio of observed YLLs to YLLs expected on the basis of SDI in 2016, by location, with data quality rating Values shown in brackets represent the ratio of observed YLLs to predicted YLLs on the basis of SDI, rounded to two digits. Colour ranges were calculated to place a roughly equal number of cells into each bin. Alcohol=alcohol use disorders. Alzheimer=Alzheimer's disease and other dementias. Asthma=asthma. Breast C=breast cancer. Cirr Alc=cirrhosis and other chronic liver diseases due to alcohol use. Cirr HepB=cirrhosis and other chronic liver diseases due to hepatitis B. Cirr HepC=cirrhosis and other chronic liver diseases due to hepatitis C. CKD=chronic kidney disease. CMP=cardiomyopathy and myocarditis. Colorect C=colon and rectum cancer. Conflict terror=conflict and terrorism. Congenital=congenital birth defects. COPD=chronic obstructive pulmonary disease. Diabetes=diabetes mellitus. Diarrhoea=diarrhoeal diseases. Disaster=exposure to forces of nature. Drown=drowning. Drugs=drug use disorders. Endocrine=endocrine, metabolic, blood, and immune disorders. F Body=foreign body. HIV=HIV/AIDS. HTN HD=hypertensive heart disease. IHD=ischaemic heart disease. Intest Inf=intestinal infectious diseases. Leukemia=leukaemia. Liver C=liver cancer. LRI=lower respiratory infections. Lung C=tracheal, bronchus, and lung cancer. Mech=exposure to mechanical forces. NN Enceph=neonatal encephalopathy due to birth asphyxia and trauma. NN Preterm=neonatal preterm birth complications. NN Sepsis=neonatal sepsis and other neonatal infections. Oth Cardio=other cardiovascular and circulatory diseases. Oesophag C=oesophageal cancer. Oth Cirr=cirrhosis and other chronic liver diseases due to other causes. Oth Inf=other infectious diseases. Oth NN=other neonatal disorders. Pancreas C=pancreatic cancer. PEM=protein-energy malnutrition. Prostate C=prostate cancer. Road Inj=road injuries. SDI=Socio-demographic Index. Self Harm=self-harm. STD=sexually transmitted diseases excluding HIV. Stomach C=stomach cancer. Stroke=cerebrovascular disease. TB=tuberculosis. Violence=interpersonal violence. YLL=year of life lost.
Figure 9
Figure 9
Leading 10 causes of total YLLs with the ratio of observed YLLs to YLLs expected on the basis of SDI in 2016, by location, with data quality rating Values shown in brackets represent the ratio of observed YLLs to predicted YLLs on the basis of SDI, rounded to two digits. Colour ranges were calculated to place a roughly equal number of cells into each bin. Alcohol=alcohol use disorders. Alzheimer=Alzheimer's disease and other dementias. Asthma=asthma. Breast C=breast cancer. Cirr Alc=cirrhosis and other chronic liver diseases due to alcohol use. Cirr HepB=cirrhosis and other chronic liver diseases due to hepatitis B. Cirr HepC=cirrhosis and other chronic liver diseases due to hepatitis C. CKD=chronic kidney disease. CMP=cardiomyopathy and myocarditis. Colorect C=colon and rectum cancer. Conflict terror=conflict and terrorism. Congenital=congenital birth defects. COPD=chronic obstructive pulmonary disease. Diabetes=diabetes mellitus. Diarrhoea=diarrhoeal diseases. Disaster=exposure to forces of nature. Drown=drowning. Drugs=drug use disorders. Endocrine=endocrine, metabolic, blood, and immune disorders. F Body=foreign body. HIV=HIV/AIDS. HTN HD=hypertensive heart disease. IHD=ischaemic heart disease. Intest Inf=intestinal infectious diseases. Leukemia=leukaemia. Liver C=liver cancer. LRI=lower respiratory infections. Lung C=tracheal, bronchus, and lung cancer. Mech=exposure to mechanical forces. NN Enceph=neonatal encephalopathy due to birth asphyxia and trauma. NN Preterm=neonatal preterm birth complications. NN Sepsis=neonatal sepsis and other neonatal infections. Oth Cardio=other cardiovascular and circulatory diseases. Oesophag C=oesophageal cancer. Oth Cirr=cirrhosis and other chronic liver diseases due to other causes. Oth Inf=other infectious diseases. Oth NN=other neonatal disorders. Pancreas C=pancreatic cancer. PEM=protein-energy malnutrition. Prostate C=prostate cancer. Road Inj=road injuries. SDI=Socio-demographic Index. Self Harm=self-harm. STD=sexually transmitted diseases excluding HIV. Stomach C=stomach cancer. Stroke=cerebrovascular disease. TB=tuberculosis. Violence=interpersonal violence. YLL=year of life lost.
Figure 9
Figure 9
Leading 10 causes of total YLLs with the ratio of observed YLLs to YLLs expected on the basis of SDI in 2016, by location, with data quality rating Values shown in brackets represent the ratio of observed YLLs to predicted YLLs on the basis of SDI, rounded to two digits. Colour ranges were calculated to place a roughly equal number of cells into each bin. Alcohol=alcohol use disorders. Alzheimer=Alzheimer's disease and other dementias. Asthma=asthma. Breast C=breast cancer. Cirr Alc=cirrhosis and other chronic liver diseases due to alcohol use. Cirr HepB=cirrhosis and other chronic liver diseases due to hepatitis B. Cirr HepC=cirrhosis and other chronic liver diseases due to hepatitis C. CKD=chronic kidney disease. CMP=cardiomyopathy and myocarditis. Colorect C=colon and rectum cancer. Conflict terror=conflict and terrorism. Congenital=congenital birth defects. COPD=chronic obstructive pulmonary disease. Diabetes=diabetes mellitus. Diarrhoea=diarrhoeal diseases. Disaster=exposure to forces of nature. Drown=drowning. Drugs=drug use disorders. Endocrine=endocrine, metabolic, blood, and immune disorders. F Body=foreign body. HIV=HIV/AIDS. HTN HD=hypertensive heart disease. IHD=ischaemic heart disease. Intest Inf=intestinal infectious diseases. Leukemia=leukaemia. Liver C=liver cancer. LRI=lower respiratory infections. Lung C=tracheal, bronchus, and lung cancer. Mech=exposure to mechanical forces. NN Enceph=neonatal encephalopathy due to birth asphyxia and trauma. NN Preterm=neonatal preterm birth complications. NN Sepsis=neonatal sepsis and other neonatal infections. Oth Cardio=other cardiovascular and circulatory diseases. Oesophag C=oesophageal cancer. Oth Cirr=cirrhosis and other chronic liver diseases due to other causes. Oth Inf=other infectious diseases. Oth NN=other neonatal disorders. Pancreas C=pancreatic cancer. PEM=protein-energy malnutrition. Prostate C=prostate cancer. Road Inj=road injuries. SDI=Socio-demographic Index. Self Harm=self-harm. STD=sexually transmitted diseases excluding HIV. Stomach C=stomach cancer. Stroke=cerebrovascular disease. TB=tuberculosis. Violence=interpersonal violence. YLL=year of life lost.

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