Worldwide mortality in men and women aged 15-59 years from 1970 to 2010: a systematic analysis.
ABSTRACT Adult deaths are a crucial priority for global health. Causes of adult death are important components of Millennium Development Goals 5 and 6. However, adult mortality has received little policy attention, resources, or monitoring efforts. This study aimed to estimate worldwide mortality in men and women aged 15-59 years.
We compiled a database of 3889 measurements of adult mortality for 187 countries from 1970 to 2010 using vital registration data and census and survey data for deaths in the household corrected for completeness, and sibling history data from surveys corrected for survival bias. We used Gaussian process regression to generate yearly estimates of the probability of death between the ages of 15 years and 60 years (45q15) for men and women for every country with uncertainty intervals that indicate sampling and non-sampling error. We showed that these analytical methods have good predictive validity for countries with missing data.
Adult mortality varied substantially across countries and over time. In 2010, the countries with the lowest risk of mortality for men and women are Iceland and Cyprus, respectively. In Iceland, male 45q15 is 65 (uncertainty interval 61-69) per 1000; in Cyprus, female 45q15 is 38 (36-41) per 1000. Highest risk of mortality in 2010 is seen in Swaziland for men (45q15 of 765 [692-845] per 1000) and Zambia for women (606 [518-708] per 1000). Between 1970 and 2010, substantial increases in adult mortality occurred in sub-Saharan Africa because of the HIV epidemic and in countries in or related to the former Soviet Union. Other regional trends were also seen, such as stagnation in the decline of adult mortality for large countries in southeast Asia and a striking decline in female mortality in south Asia.
The prevention of premature adult death is just as important for global health policy as the improvement of child survival. Routine monitoring of adult mortality should be given much greater emphasis.
Bill & Melinda Gates Foundation.
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ABSTRACT: Amartya Sen started a debate about gender bias in mortality by estimating the number of "missing women," which refers to the number of females of any age who have presumably died as a result of discriminatory treatment. Depending on the assumptions made, the combined estimates for countries exhibiting the presence of such gender bias varied between 60 and 107 million. As new population data have become available for these countries, this article examines whether the number of "missing women" has changed in the past decade. The combined estimate of the number of missing women has risen in absolute terms but has fallen slightly in relation to overall population. Considerable improvement is evident in West Asia, North Africa, and parts of South Asia, while only small improvements have occurred in India and a deterioration took place in China. Analyses of the underlying causes of gender bias in mortality suggest that improvements are largely related to improved female education and employment opportunities and rising overall incomes, while deterioration is mostly attributable to the rising incidence of sex-selective abortions. Copyright 2002 by The Population Council, Inc..Population and Development Review 02/2002; 28(2):285-312. · 2.22 Impact Factor
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ABSTRACT: Using a two-year panel of 1,422 Kenyan households surveyed in 1997 and 2000, we measure how working-age adult mortality affects rural households’ size and composition, crop production, asset levels, and off-farm income. We also use adult mortality rates from available data on an HIV-negative sample to predict the proportion of deaths observed during 1997–2000 due to AIDS. Difference-in-differences estimations indicate that the effects of adult mortality are highly sensitive to the gender and position of the deceased family member in the household and to the household’s initial asset levels. Results indicate that relatively poor households do not recover quickly from head-of-household adult mortality; effects on crop and nonfarm incomes do not decay at least over the three-year survey interval.World Development. 02/2004; 32(1):91-119.
- Bulletin of the World Health Organization. 83(March):171-177.