article · JAMA Pediatrics
This study estimated mortality and morbidity in children and adolescents aged 0 to 19 years across 195 countries and territories from 1990 to 2017. Researchers used standardised methods to analyse cause-specific mortality and non-fatal health outcomes, also examining trends in relation to the Socio-Demographic Index (SDI). Findings show that child and adolescent deaths decreased by 51.7% globally during this period. However, aggregate disability increased by 4.7%, totalling 145 million years lived with disability in 2017. Progress was uneven, with low and low-middle SDI regions experiencing a greater proportion of deaths. The leading causes of disability-adjusted life years differed significantly between low and high SDI countries.
Understanding global health trends in children and adolescents is vital for public health planning. This research highlights a critical shift from mortality to disability, especially in lower-income regions. This has significant implications for health systems, resource allocation, and the long-term human capital potential of societies worldwide.
The abstract provides epidemiological data crucial for public health policy and resource allocation. It does not indicate a direct commercialisation pathway for a specific product or service. However, understanding these trends could inform the development of targeted health interventions, diagnostic tools, or support services by organisations aiming to address specific disease burdens or disabilities in children and adolescents. This is early-stage insight for strategic planning.
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Importance: Understanding causes and correlates of health loss among children and adolescents can identify areas of success, stagnation, and emerging threats and thereby facilitate effective improvement strategies. Objective: To estimate mortality and morbidity in children and adolescents from 1990 to 2017 by age and sex in 195 countries and territories. Design, Setting, and Participants: This study examined levels, trends, and spatiotemporal patterns of cause-specific mortality and nonfatal health outcomes using standardized approaches to data processing and statistical analysis. It also describes epidemiologic transitions by evaluating historical associations between disease indicators and the Socio-Demographic Index (SDI), a composite indicator of income, educational attainment, and fertility. Data collected from 1990 to 2017 on children and adolescents from birth through 19 years of age in 195 countries and territories were assessed. Data analysis occurred from January 2018 to August 2018. Exposures: Being under the age of 20 years between 1990 and 2017. Main Outcomes and Measures: Death and disability. All-cause and cause-specific deaths, disability-adjusted life years, years of life lost, and years of life lived with disability. Results: Child and adolescent deaths decreased 51.7% from 13.77 million (95% uncertainty interval [UI], 13.60-13.93 million) in 1990 to 6.64 million (95% UI, 6.44-6.87 million) in 2017, but in 2017, aggregate disability increased 4.7% to a total of 145 million (95% UI, 107-190 million) years lived with disability globally. Progress was uneven, and inequity increased, with low-SDI and low-middle-SDI locations experiencing 82.2% (95% UI, 81.6%-82.9%) of deaths, up from 70.9% (95% UI, 70.4%-71.4%) in 1990. The leading disaggregated causes of disability-adjusted life years in 2017 in the low-SDI quintile were neonatal disorders, lower respiratory infections, diarrhea, malaria, and congenital birth defects, whereas neonatal disorders, congenital birth defects, headache, dermatitis, and anxiety were highest-ranked in the high-SDI quintile. Conclusions and Relevance: Mortality reductions over this 27-year period mean that children are more likely than ever to reach their 20th birthdays. The concomitant expansion of nonfatal health loss and epidemiological transition in children and adolescents, especially in low-SDI and middle-SDI countries, has the potential to increase already overburdened health systems, will affect the human capital potential of societies, and may influence the trajectory of socioeconomic development. Continued monitoring of child and adolescent health loss is crucial to sustain the progress of the past 27 years.
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DOI: 10.1001/jamapediatrics.2019.0337
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