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

DOI: 10.1016/S0140-6736(25)01330-3

Authors - 107

Rana Kamal Abu Farha

56283149600

Cristiana Abbafati

54917122400

Faezeh Abbaspour

60175308900

Nadin M.I. Abdel Razeq

57188590773

Mohammed Altigani Abdalla

57217676700

Abdallah H.A. Abd Al Magied

59128864400

Reda Abdel-Hameed

54883057400

Arash Abdollahi

58736039900

Wael M. Abdel-Rahman

6603240889

Ahmed Abu-Zaid

45861125100

Aminu Kende Abubakar

58880268300

Eman Abu-Gharbieh

24586714800

Isaac Ayodeji Adesina

57215413364

Aanuoluwapo Adeyimika Afolabi

57219351723

Giuseppina Affinito

57220067141

Kamoru Ademola Adedokun

57207983240

Nurudeen A. Adegoke

57196007299

Habtamu Abebe Getahun

59135717500

Lisa C. Adams

57192991712

Armita Abedi

57204607249

Usha Adiga

14057674100

Peng Zheng

57213707656

Mitra Abbasifard

37053407900

Austin E. Schumacher

60005948200

Faisal Ahmad

59452625300

A. Bhoomadevi

57208576447

Mohammad Amin Aalipour

57221831253

Hazim S. Ababneh

57371604000

Ukachukwu O. Abaraogu

56119041500

Ryan M. Barber

57202560423

Omar Ahmed Abdelwahab

57194482197

Dariush Abtahi

18036750600

Abdullahi Salahudeen Abdulraheem

59516292000

Ripon Kumar Adhikary

55847469100

Rizwan Suliankatchi Abdulkader

57226205764

Mohd Adnan

36022136700

Tanin Adl Parvar

58494468100

Mahdi Aghaalikhani

60211450000

Williams Agyemang-Duah

57190228903

Feleke Doyore Agide

57204329765

Danish Ahmad

57202805842

Alemwork Abie

58020591000

Hana J. Abukhadijah

57865346000

Nasir Abbas

59847373500

Rotimi Felix Afolabi

57190673952

Habtamu Abebe Getahun

57222307044

Tanin Adl Parvar

59905754300

César Agostinis Sobrinho

58962500300

Rana Kamal Abu Farha

60215296500

Ahmed Abu Zaid

57370271400

Saira Afzal

7004381116

Gizachew Beykaso Agafari

57790095900

Emad M. Abdallah

16644652400

Samar Abd ElHafeez

55551273300

Navidha Aggarwal

57224993442

Tim Adair

24480317900

Mahdi Aghaalikhani

57195330812

Oladimeji Muritala Adebayo

57194329853

César Agostinis Sobrinho

56968193400

Sepehr Aghajanian

57221371799

Anurag Agrawal

35214460700

Rabbiya Ahmad

57214801544

Seyed Mohammad Kazem Aghamir

6508244234

Mary Dada Agoi

58099684600

Meriem Abdoun

20336514800

Salahdein Aburuz

59755057900

Lucas Guimarães Abreu

55937631400

Qorinah Estiningtyas Sakilah Adnani

57211604149

Bright Opoku Ahinkorah

57194684030

Sherief Abd-Elsalam

57189845325

Samar Abd ElHafeez

59158131500

Deldar Morad Abdulah

57200190808

Asrat Agalu Abejew

55204820500

Dmitry Abramov

25623078100

Fuad Hamdi A. Abuadas

57193453829

Bilyaminu Abubakar

56389502700

Sawsan Abuhammad

57205384547

Olatunji O. Adetokunboh

56598104300

Meshack Achore

57204045088

Parisa Abedi

57219860997

Olugbenga Olusola Abiodun

54386552600

Shady Abohashem

57194703660

Nagah M. Abourashed

57450956800

Mohamed Abouzid

57204445082

David Adedia

57207309355

Roberto Ariel Abeldaño Zuñiga

57737618600

Anirudh Balakrishna Acharya

35751874500

Juan Manuel Acuna

56473433400

Arman Abdous

57263159900

Auwal Abdullahi

56102934500

David Adzrago

57327792200

Hasan Aalruz

57216547615

Kishor Adhikari

57852466400

Syed Hani Abidi

59663694600

Olumide Abiodun

7003859089

Richard Gyan Aboagye

57221438826

Ulric Sena Abonie

57214797230

Parsa Abdi

58143779200

Leticia Akua Adzigbli

57899326600

Ahmad Y. Abuhelwa

56588047800

Dina Abushanab

57205329983

Tajudeen Adesanmi Adebisi

59997997500

Oluwatobi E. Adegbile

58998875200

Olumide Thomas Adeleke

57204237787

Miracle Ayomikun Adesina

57212196361

Temitayo Esther Adeyeoluwa

57218094241

Mache Tsadik Adhana

57219360973