Austin E. Schumacher
60005948200
Publications - 1
Global age-sex-specific all-cause mortality and life expectancy estimates for 204 countries and territories and 660 subnational locations, 1950–2023: a demographic analysis for the Global Burden of Disease Study 2023
Rana Kamal Abu Farha
Cristiana Abbafati
Faezeh Abbaspour
Nadin M.I. Abdel Razeq
Mohammed Altigani Abdalla
Abdallah H.A. Abd Al Magied
Reda Abdel-Hameed
Arash Abdollahi
Wael M. Abdel-Rahman
Ahmed Abu-Zaid
Aminu Kende Abubakar
Eman Abu-Gharbieh
Isaac Ayodeji Adesina
Aanuoluwapo Adeyimika Afolabi
Giuseppina Affinito
Kamoru Ademola Adedokun
Nurudeen A. Adegoke
Habtamu Abebe Getahun
Lisa C. Adams
Armita Abedi
Usha Adiga
Peng Zheng
Mitra Abbasifard
Austin E. Schumacher
Faisal Ahmad
A. Bhoomadevi
Mohammad Amin Aalipour
Hazim S. Ababneh
Ukachukwu O. Abaraogu
Ryan M. Barber
Omar Ahmed Abdelwahab
Dariush Abtahi
Abdullahi Salahudeen Abdulraheem
Ripon Kumar Adhikary
Rizwan Suliankatchi Abdulkader
Mohd Adnan
Tanin Adl Parvar
Mahdi Aghaalikhani
Williams Agyemang-Duah
Feleke Doyore Agide
Danish Ahmad
Alemwork Abie
Hana J. Abukhadijah
Nasir Abbas
Rotimi Felix Afolabi
Habtamu Abebe Getahun
Tanin Adl Parvar
César Agostinis Sobrinho
Rana Kamal Abu Farha
Ahmed Abu Zaid
Saira Afzal
Gizachew Beykaso Agafari
Emad M. Abdallah
Samar Abd ElHafeez
Navidha Aggarwal
Tim Adair
Mahdi Aghaalikhani
Oladimeji Muritala Adebayo
César Agostinis Sobrinho
Sepehr Aghajanian
Anurag Agrawal
Rabbiya Ahmad
Seyed Mohammad Kazem Aghamir
Mary Dada Agoi
Meriem Abdoun
Salahdein Aburuz
Lucas Guimarães Abreu
Qorinah Estiningtyas Sakilah Adnani
Bright Opoku Ahinkorah
Sherief Abd-Elsalam
Samar Abd ElHafeez
Deldar Morad Abdulah
Asrat Agalu Abejew
Dmitry Abramov
Fuad Hamdi A. Abuadas
Bilyaminu Abubakar
Sawsan Abuhammad
Olatunji O. Adetokunboh
Meshack Achore
Parisa Abedi
Olugbenga Olusola Abiodun
Shady Abohashem
Nagah M. Abourashed
Mohamed Abouzid
David Adedia
Roberto Ariel Abeldaño Zuñiga
Anirudh Balakrishna Acharya
Juan Manuel Acuna
Arman Abdous
Auwal Abdullahi
David Adzrago
Hasan Aalruz
Kishor Adhikari
Syed Hani Abidi
Olumide Abiodun
Richard Gyan Aboagye
Ulric Sena Abonie
Parsa Abdi
Leticia Akua Adzigbli
Ahmad Y. Abuhelwa
Dina Abushanab
Tajudeen Adesanmi Adebisi
Oluwatobi E. Adegbile
Olumide Thomas Adeleke
Miracle Ayomikun Adesina
Temitayo Esther Adeyeoluwa
Mache Tsadik Adhana
Publication Name: Lancet
Publication Date: 2025-10-18
Volume: 406
Issue: 10513
Page Range: 1731-1810
Description:
Comprehensive, comparable, and timely estimates of demographic metrics—including life expectancy and age-specific mortality—are essential for evaluating, understanding, and addressing trends in population health. The COVID-19 pandemic highlighted the importance of timely and all-cause mortality estimates for being able to respond to changing trends in health outcomes, showing a strong need for demographic analysis tools that can produce all-cause mortality estimates more rapidly with more readily available all-age vital registration (VR) data. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) is an ongoing research effort that quantifies human health by estimating a range of epidemiological quantities of interest across time, age, sex, location, cause, and risk. This study—part of the latest GBD release, GBD 2023—aims to provide new and updated estimates of all-cause mortality and life expectancy for 1950 to 2023 using a novel statistical model that accounts for complex correlation structures in demographic data across age and time. We used 24 025 data sources from VR, sample registration, surveys, censuses, and other sources to estimate all-cause mortality for males, females, and all sexes combined across 25 age groups in 204 countries and territories as well as 660 subnational units in 20 countries and territories, for the years 1950–2023. For the first time, we used complete birth history data for ages 5–14 years, age-specific sibling history data for ages 15–49 years, and age-specific mortality data from Health and Demographic Surveillance Systems. We developed a single statistical model that incorporates both parametric and non-parametric methods, referred to as OneMod, to produce estimates of all-cause mortality for each age-sex-location group. OneMod includes two main steps: a detailed regression analysis with a generalised linear modelling tool that accounts for age-specific covariate effects such as the Socio-demographic Index (SDI) and a population attributable fraction (PAF) for all risk factors combined; and a non-parametric analysis of residuals using a multivariate kernel regression model that smooths across age and time to adaptably follow trends in the data without overfitting. We calibrated asymptotic uncertainty estimates using Pearson residuals to produce 95% uncertainty intervals (UIs) and corresponding 1000 draws. Life expectancy was calculated from age-specific mortality rates with standard demographic methods. For each measure, 95% UIs were calculated with the 25th and 975th ordered values from a 1000-draw posterior distribution. In 2023, 60·1 million (95% UI 59·0–61·1) deaths occurred globally, of which 4·67 million (4·59–4·75) were in children younger than 5 years. Due to considerable population growth and ageing since 1950, the number of annual deaths globally increased by 35·2% (32·2–38·4) over the 1950–2023 study period, during which the global age-standardised all-cause mortality rate declined by 66·6% (65·8–67·3). Trends in age-specific mortality rates between 2011 and 2023 varied by age group and location, with the largest decline in under-5 mortality occurring in east Asia (67·7% decrease); the largest increases in mortality for those aged 5–14 years, 25–29 years, and 30–39 years occurring in high-income North America (11·5%, 31·7%, and 49·9%, respectively); and the largest increases in mortality for those aged 15–19 years and 20–24 years occurring in Eastern Europe (53·9% and 40·1%, respectively). We also identified higher than previously estimated mortality rates in sub-Saharan Africa for all sexes combined aged 5–14 years (87·3% higher in GBD 2023 than GBD 2021 on average across countries and territories over the 1950–2021 period) and for females aged 15–29 years (61·2% higher), as well as lower than previously estimated mortality rates in sub-Saharan Africa for all sexes combined aged 50 years and older (13·2% lower), reflecting advances in our modelling approach. Global life expectancy followed three distinct trends over the study period. First, between 1950 and 2019, there were considerable improvements, from 51·2 (50·6–51·7) years for females and 47·9 (47·4–48·4) years for males in 1950 to 76·3 (76·2–76·4) years for females and 71·4 (71·3–71·5) years for males in 2019. Second, this period was followed by a decrease in life expectancy during the COVID-19 pandemic, to 74·7 (74·6–74·8) years for females and 69·3 (69·2–69·4) years for males in 2021. Finally, the world experienced a period of post-pandemic recovery in 2022 and 2023, wherein life expectancy generally returned to pre-pandemic (2019) levels in 2023 (76·3 [76·0–76·6] years for females and 71·5 [71·2–71·8] years for males). 194 (95·1%) of 204 countries and territories experienced at least partial post-pandemic recovery in age-standardised mortality rates by 2023, with 61·8% (126 of 204) recovering to or falling below pre-pandemic levels. There were several mortality trajectories during and following the pandemic across countries and territories. Long-term mortality trends also varied considerably between age groups and locations, demonstrating the diverse landscape of health outcomes globally. This analysis identified several key differences in mortality trends from previous estimates, including higher rates of adolescent mortality, higher rates of young adult mortality in females, and lower rates of mortality in older age groups in much of sub-Saharan Africa. The findings also highlight stark differences across countries and territories in the timing and scale of changes in all-cause mortality trends during and following the COVID-19 pandemic (2020–23). Our estimates of evolving trends in mortality and life expectancy across locations, ages, sexes, and SDI levels in recent years as well as over the entire 1950–2023 study period provide crucial information for governments, policy makers, and the public to ensure that health-care systems, economies, and societies are prepared to address the world's health needs, particularly in populations with higher rates of mortality than previously known. The estimates from this study provide a robust framework for GBD and a valuable foundation for policy development, implementation, and evaluation around the world. Gates Foundation.
Open Access: Yes