Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensiv...

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Autores:: Abbas, Kaja M.
Abbasifard, Mitra
Abbasi Kangevari, Mohsen
Abbastabar, Hedayat
Abd Allah, Foad
Abdelalim, Ahmed
Abolhassani, Hassan
Abreu, Lucas Guimarães
Abrigo, Michael R. M.
Abushouk, Abdelrahman I.
Adabi, Maryam
Adair, Tim
Adebayo, Oladimeji M.
Adedeji, Isaac Akinkunmi
Adekanmbi, Victor
Adeoye, Abiodun Moshood
Adetokunboh, Olatunji O.
Advani, Shailesh M.
Afshin, Ashkan
Aghaali, Mohammad
Agrawal, Anurag
Ahmadi, Keivan
Ahmadieh, Hamid
Ahmed, Muktar Beshir
Al Aly, Ziyad
Alam, Khurshid
Alam, Tahiya
Alanezi, Fahad Mashhour
Alanzi, Turki M.
Alcalde Rabanal, Jacqueline Elizabeth
Ali, Muhammad
Alicandro, Gianfranco
Alijanzadeh, Mehran
Alinia, Cyrus
Alipour, Vahid
Alizade, Hesam
Aljunid, Syed Mohamed
Allebeck, Peter
Almadi, Majid Abdulrahman Hamad
Almasi Hashiani, Amir
Al Mekhlafi, Hesham M.
Altirkawi, Khalid A.
Alumran, Arwa Khalid
Alvis Guzman, Nelson
Amini Rarani, Mostafa
Aminorroaya, Arya
Ancuceanu, Robert
Andrei, Catalina Liliana
Androudi, Sofia
Angus, Colin
Anjomshoa, Mina
Ansari, Fereshteh
Ansari, Iman
Ansari Moghaddam, Alireza
Antonio, Carl Abelardo T.
Antony, Catherine M.
Anvari, Davood
Appiah, Seth Christopher Yaw
Arabloo, Jalal
Arab Zozani, Morteza
Aravkin, Aleksandr Y.
Aremu, Olatunde
Ärnlöv, Johan
Aryal, Krishna K.
Asadi Pooya, Ali A.
Asgari, Samaneh
Asghari Jafarabadi, Mohammad
Atteraya, Madhu Sudhan
Ausloos, Marcel
Avila Burgos, Leticia
Avokpaho, Euripide Frinel Gbenato Arthur
Ayala Quintanilla, Beatriz Paulina
Ayano, Getinet
Ayanore, Martin Amogre
Azarian, Ghasem
Babaee, Ebrahim
Badiye, Ashish D.
Bagli, Eleni
Bahrami, Mohammad Amin
Bakhtiari, Ahad
Balassyano, Shelly
Banach, Maciej
Banik, Palash Chandra
Barker Collo, Suzanne Lyn
Bärnighausen, Till Winfried
Barzegar, Akbar
Basu, Sanjay
Baune, Bernhard T.
Bayati, Mohsen
Bazmandegan, Gholamreza
Bedi, Neeraj
Bell, Michellr L.
Bennett, Derrick A.
Bensenor, Isabela M.
Berhe, Kidanemaryam
Berman, Adam E.
Bertolacci, Gregory J.
Bhageerathy, Reshmi
Bhala, Neeraj
Bhattacharyya, Krittika
Bhutta, Zulfiqar A.
Bijani, Ali
Biondi, Antonio
Bisanzio, Donal
Bisignano, Catherine
Biswas, Raaj Kishore
Bjørge, Tone
Bohlouli, Somayeh
Bohluli, Mehdi
Bolla, Srinivasa Rao Rao
Borzì, Antonio Maria
Borzouei, Shiva
Brady, Oliver J.
Braithwaite, Dejana
Brauer, Michael
Briko, Andrey Nikolaevich
Briko, Nikolay Ivanovich
Bumgarner, Blair R.
Burugina Nagaraja, Sharath
Butt, Zahid A.
Caetano dos Santos, Florentino Luciano
Cai, Tianji
Callender, Charlton SKH
Cámera, Luis LA Alberto
Campos Nonato, Ismael R.
Cárdenas, Rosario
Carreras, Giulia
Carrero, Juan J.
Carvalho, Felix
Castaldelli Maia, Joao Mauricio
Castelpietra, Giulio
Castro, Franz
Catalá López, Ferrán
Cederroth, Christopher R.
Cerin, Ester
Chattu, Vijay Kumar
Chin, Ken Lee
Chu, Dinh Toi
Ciobanu, Liliana G.
Cirillo, Massimo
Comfort, Haley
Costa, Vera Marisa
Cowden, Richard G.
Cromwell, Elizabeth A.
Croneberger, Andrew J.
Cunningham, Matthew
Dahlawi, Saad M. A.
Damiani, Giovanni
D'Amico, Emanuele
Dandona, Lalit
Dandona, Rakhi
Dargan, Paul I.
Darwesh, Aso Mohammad
Daryani, Ahmad
Das Gupta, Rajat
das Neves, José
Davletov, Kairat
De Leo, Diego
Denova Gutiérrez, Edgar
Deribe, Kebede
Dervenis, Nikolaos
Desai, Rupak
Dhungana, Govinda Prasad
Dias da Silva, Diana
Diaz, Daniel
Dippenaar, Ilse N.
Djalalinia, Shirin
Do, Hoa Thi
Dokova, Klara
Doku, David Teye
Dorostkar, Fariba
Doshi, Chirag P.
Doshmangir, Leila
Doyle, Kerrie E.
Dubljanin, Eleonora
Duraes, Andre Rodrigues
Edvardsson, David
Effiong, Andem
El Sayed, Iman
El Tantawi, Maha
Elbarazi, Iffat
El Jaafary, Shaimaa I.
Emamian, Mohammad Hassan
Eskandarieh, Sharareh
Esmaeilzadeh, Firooz
Estep, Kara
Farahmand, Mohammad
Faraj, Anwar
Fareed, Mohammad
Faridnia, Roghiyeh
Faro, Andre
Farzadfar, Farshad
Fattahi, Nazir
Fazaeli, Ali Akbar
Fazlzadeh, Mehdi
Feigin, Valery L.
Fereshtehnejad, Seyed Mohammad
Fernandes, Eduarda
Ferreira, Manuela L.
Filip, Irina
Fischer, Florian
Flohr, Carsten
Foigt, Nataliya A.
Folayan, Morenike Oluwatoyin
Fomenkov, Artem Alekseevich
Freitas, Marisa
Fukumoto, Takeshi
Fuller, John E.
Furtado, João M.
Gad, Mohamed M.
Gakidou, Emmanuela
Gallus, Silvano
Gebrehiwot, Abiyu Mekonnen
Gebremedhin, Ketema Bizuwork
Gething, Peter W.
Ghamari, Farhad
Ghashghaee, Ahmad
Gholamian, Asadollah
Gilani, Syed Amir
Gitimoghaddam, Mojgan
Glushkova, Ekaterina Vladimirovna
Gnedovskaya, Elena V.
Gopalani, Sameer Vali
Goulart, Alessandra C.
Gugnani, Harish Chander
Guo, Yuming
Gupta, Rajeev
Gupta, Subodh Sharan
Haagsma, Juanita A.
Haj Mirzaian, Arvin
Haj Mirzaian, Arya
Halvaei, Iman
Hamadeh, Randah R.
Hamagharib Abdullah, Kanaan
Han, Chieh
Handiso, Demelash Woldeyohannes
Hankey, Graeme J.
Haririan, Hamidreza
Haro, Josep Maria
Hasaballah, Ahmed I.
Hassanipour, Soheil
Hassankhani, Hadi
Hay, Simon I.
Heibati, Behzad
Heidari Soureshjani, Reza
Henny, Kiana
Henry, Nathaniel J.
Herteliu, Claudiu
Heydarpour, Fatemeh
Hole, Michael K.
Hoogar, Praveen
Hosgood, H. Dean
Hossain, Naznin
Hosseinzadeh, Mehdi
Hostiuc, Mihaela
Hostiuc, Sorin
Househ, Mowafa
Hoy, Damian G.
Hu, Guoqing
Huda, Tanvir M.
Ibitoye, Segun Emmanuel
Ikuta, Kevin S.
Ilesanmi, Olayinka Stephen
Ilic, Irena M.
Ilic, Milena D.
Imani Nasab, Mohammad Hasan
Islam, MdMohaimenul
Iso, Hiroyasu
Iwu, Chinwe Juliana
Jaafari, Jalil
Jacobsen, Kathryn H.
Jahagirdar, Deepa
Jahanmehr, Nader
Jalali, Amir
Jalilian, Farzad
James, Spencer L.
Janjani, Hosna
Jenabi, Ensiyeh
Jha, Ravi Prakash
Jha, Vivekanand
Ji, John S.
Jonas, Jost B.
Joukar, Farahnaz
Jozwiak, Jacek Jerzy
Jürisson, Mikk
Kabir, Zubair
Kalani, Hamed
Kalankesh, Leila R.
Kamiab, Zahra
Kanchan, Tanuj
Kapoor, Neeti
Karch, André
Karimi, Salah Eddin
Karimi, Seyed Asaad
Kassebaum, Nicholas J.
Katikireddi, Srinivasa Vittal
Kawakami, Norito
Kayode, Gbenga A.
Keiyoro, Peter Njenga
Keller, Cathleen
Khader, Yousef Saleh
Khalid, Nauman
Khan, Ejaz Ahmad
Khan, Maseer
Khang, Young Ho
Khater, Amir M.
Khater, Mona M.
Khazaei, Salman
Khazaie, Habibolah
Khodayari, Mohammad Taghi
Khubchandani, Jagdish
Kianipour, Neda
Kim, Cho il
Kim, Young Eun
Kim, Yun Jin
Kinfu, Yohannes
Kisa, Adnan
Kisa, Sezer
Kissimova Skarbek, Katarzyna
Kivimäki, Mika
Komaki, Hamidreza
Kopec, Jacek A.
Kosen, Soewarta
Koul, Parvaiz A.
Koyanagi, Ai
Kravchenko, Michael A.
Krishan, Kewal
Krohn, Kris J.
Kuate Defo, Barthelemy
Kumar, G. Anil
Kumar, Manasi
Kumar, Pushpendra
Kumar, Vivek
Kusuma, Dian
Kyu, Hmwe Hmwe
La Vecchia, Carlo
Lacey, Ben
Lal, Dharmesh Kumar
Lalloo, Ratilal
Lami, Faris Hasan
Lansky, Sonia
Larson, Samantha Leigh
Larsson, Anders O.
Lasrado, Savita
Lassi, Zohra S.
Lazarus, Jeffrey V.
Lee, Paul H.
Lee, Shaun Wen Huey
Leever, Andrew T.
LeGrand, Kate E.
Leonardi, Matilde
Li, Shanshan
Lim, Lee Ling
Lim, Stephen S.
Linn, Shai
Lodha, Rakesh
Logroscino, Giancarlo
Lopez, Alan D.
Lopukhov, Platon D.
Lotufo, Paulo A.
Lozano, Rafael
Lu, Alton
Lunevicius, Raimundas
Madadin, Mohammed
Maddison, Emilie R.
Magdy Abd El Razek, Hassan
Magdy Abd El Razek, Muhammed
Mahasha, Phetole Walter
Mahdavi, Mokhtar Mahdavi
Malekzadeh, Reza
Mamun, Abdullah A.
Manafi, Navid
Mansour Ghanaei, Fariborz
Mansouri, Borhan
Mansournia, Mohammad Ali
Mapoma, Chabila Christopher
Martini, Santi
Martins Melo, Francisco Rogerlândio
Masaka, Anthony
Mastrogiacomo, Claudia I.
Mathur, Manu Raj
May, Erin A.
McAlinden, Colm
McGrath, John J.
McKee, Martin
Mehndiratta, Man Mohan
Mehri, Fereshteh
Mehta, Kala M.
Meitei, Wahengbam Bigyananda
Memiah, Peter T. N.
Mendoza, Walter
Menezes, Ritesh G.
Mengesha, Endalkachew Worku
Mensah, George A.
Meretoja, Atte
Meretoja, Tuomo J.
Mestrovic, Tomislav
Michalek, Irmina Maria
Mihretie, Kebadnew Mulatu
Miller, Ted R.
Mills, Edward J.
Milne, George J.
Mirrakhimov, Erkin M.
Mirzaei, Hamed
Mirzaei, Maryam
Mirzaei Alavijeh, Mehdi
Misganaw, Awoke Temesgen
Moazen, Babak
Moghadaszadeh, Masoud
Mohamadi, Efat
Mohammad, Dara K.
Mohammad, Yousef
Mohammad Gholi Mezerji, Naser
Mohammadbeigi, Abolfazl
Mohammadian Hafshejani, Abdollah
Mohammadpourhodki, Reza
Mohammed, Hussen
Mohammed, Shafiu
Mohebi, Farnam
Mohseni Bandpei, Mohammad A.
Mokari, Amin
Mokdad, Ali H.
Momen, Natalie C.
Monasta, Lorenzo
Mooney, Meghan D.
Moradi, Ghobad
Moradi, Masoud
Moradi Joo, Mohammad
Moradi Lakeh, Maziar
Moradzadeh, Rahmatollah
Moraga, Paula
Moreno Velásquez, Ilais
Morgado da Costa, Joana
Morrison, Shane Douglas
Mosser, Jonathan F.
Mouodi, Simin
Mousavi, Seyyed Meysam
Mousavi Khaneghah, Amin
Mueller, Ulrich Otto
Musa, Kamarul Imran
Muthupandian, Saravanan
Nabavizadeh, Behnam
Naderi, Mehdi
Nagarajan, Ahamarshan Jayaraman
Naghavi, Mohsen
Naghshtabrizi, Behshad
Naik, Gurudatta
Najafi, Farid
Nangia, Vinay
Nansseu, Jobert Richie
Ndwandwe, Duduzile Edith
Negoi, Ionut
Negoi, Ruxandra Irina
Ngunjiri, Josephine W.
Nguyen, Huong Lan Thi
Nguyen, Trang Huyen
Nigatu, Yeshambel T.
Nikbakhsh, Rajan
Nikpoor, Amin Reza
Nixon, Molly R.
Nnaji, Chukwudi A.
Nomura, Shuhei
Noubiap, Jean Jacques
Nouraei Motlagh, Soraya
Nowak, Christoph
Oţoiu, Adrian
Odell, Christopher M.
Oh, In Hwan
Oladnabi, Morteza
Olagunju, Andrew T.
Olusanya, Bolajoko Olubukunola
Olusanya, Jacob Olusegun
Omar Bali, Ahmed
Ong, Kanyin L.
Onwujekwe, Obinna E.
Ortiz, Alberto
Otstavnov, Nikita
Otstavnov, Stanislav S.
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P. A., Mahesh
Padubidri, Jagadish Rao
Pakshir, Keyvan
Palladino, Raffaele
Pana, Adrian
Panda Jonas, Songhomitra
Park, James
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Patel, Jenil R.
Patel, Sangram Kishor
Patton, George C.
Paulson, Katherine R.
Pazoki Toroudi, Hamidreza
Pease, Spencer A.
Peden, Amy E.
Pepito, Veincent Christian Filipino
Peprah, Emmanuel K.
Pereira, Alexandre
Pereira, David M.
Perico, Norberto
Pigott, David M.
Pilgrim, Thomas
Pilz, Tessa M.
Piradov, Michael A.
Pirsaheb, Meghdad
Pokhrel, Khem Narayan
Postma, Maarten J.
Pourjafar, Hadi
Pourmalek, Farshad
Pourshams, Akram
Poznańska, Anna
Prada, Sergio I.
Prakash, Sanjay
Preotescu, Liliana
Quazi Syed, Zahiruddin
Rabiee, Mohammad
Rabiee, Navid
Radfar, Amir
Rafiei, Alireza
Raggi, Alberto
Rahman, Muhammad Aziz
Rajabpour Sanati, Ali
Ram, Pradhum
Ranabhat, Chhabi Lal
Rao, Sowmya J.
Rasella, Davide
Rashedi, Vahid
Rastogi, Prateek
Rathi, Priya
Rawal, Lal
Remuzzi, Giuseppe
Renjith, Vishnu
Renzaho, Andre M. N.
Resnikoff, Serge
Rezaei, Nima
Rezai, Mohammad sadegh
Rezapour, Aziz
Rickard, Jennifer
Roever, Leonardo
Ronfani, Luca
Roshandel, Gholamreza
Rostamian, Morteza
Rubagotti, Enrico
Rwegerera, Godfrey M.
Sabour, Siamak
Saddik, Basema
Sadeghi, Ehsan
Sadeghi, Masoumeh
Saeedi Moghaddam, Sahar
Safari, Yahya
Safi, Sare
Safiri, Saeid
Sagar, Rajesh
Sahebkar, Amirhossein
Sahraian, Mohammad Ali
Sajadi, S. Mohammad
Salahshoor, Mohammad Reza
Salama, Joseph S.
Salamati, Payman
Salem, Marwa R. Rashad
Salimi, Yahya
Salomon, Joshua A.
Salz, Inbal
Samad, Zainab
Samy, Abdallah M.
Sanabria, Juan
Santric Milicevic, Milena M.
Saraswathy, Sivan Yegnanarayana Iyer
Sartorius, Benn
Sarveazad, Arash
Sathian, Brijesh
Sathish, Thirunavukkarasu
Sattin, Davide
Saylan, Mete
Schaeffer, Lauren E.
Schiavolin, Silvia
Schwebel, David C.
Schwendicke, Falk
Sekerija, Mario
Senbeta, Anbissa Muleta
Senthilkumaran, Subramanian
Sepanlou, Sadaf G.
Serván Mori, Edson
Shabani, Mahsima
Shahabi, Saeed
Shahbaz, Mohammad
Shaheen, Amira A.
Shaikh, Masood Ali
Shalash, Ali S.
Shams Beyranvand, Mehran
Shamsi, MohammadBagher
Shamsizadeh, Morteza
Shannawaz, Mohammed
Sharafi, Kiomars
Sharafi, Zeinab
Sharara, Fablina
Sharma, Rajesh
Shaw, David H.
Sheikh, Aziz
Shin, Jae Il
Shiri, Rahman
Shrime, Mark G.
Shuval, Kerem
Siabani, Soraya
Sigfusdottir, Inga Dora
Sigurvinsdottir, Rannveig
Silva, Diego Augusto Santos
Simonetti, Biagio
Simpson, Kyle E.
Singh, Jasvinder A.
Skiadaresi, Eirini
Skryabin, Valentin Yurievich
Soheili, Amin
Sokhan, Anton
Sorensen, Reed J. D.
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Sorrie, Muluken Bekele
Soyiri, Ireneous N.
Spurlock, Emma Elizabeth
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Stokes, Mark A.
Stubbs, Jacob L.
Sudaryanto, Agus
Sufiyan, Mu'awiyyah Babale
Suliankatchi Abdulkader, Rizwan
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Tabarés Seisdedos, Rafael
Tabb, Karen M.
Tadakamadla, Santosh Kumar
Taherkhani, Amir
Tang, Muming
Taveira, Nuno
Taylor, Heather Jean
Teagle, Whitney L.
Tehrani Banihashemi, Arash
Teklehaimanot, Berhane Fseha
Tessema, Zemenu Tadesse
Thankappan, Kavumpurathu Raman
Thomas, Nihal
Thrift, Amanda G.
Titova, Mariya Vladimirovna
Tohidinik, Hamid Reza
Tonelli, Marcello
Topor Madry, Roman
Topouzis, Fotis
Tovani Palone, Marcos Roberto Roberto
Traini, Eugenio
Tran, Bach Xuan
Travillian, Ravensara
Trias Llimós, Sergi
Truelsen, Thomas Clement
Tudor Car, Lorainne
Unnikrishnan, Bhaskaran
Upadhyay, Era
Vacante, Marco
Vakilian, Alireza
Valdez, Pascual R.
Valli, Alessandro
Vardavas, Constantine
Vasankari, Tommi Juhani
Vasconcelos, Ana Maria Nogales
Vasseghian, Yasser
Veisani, Yousef
Venketasubramanian, Narayanaswamy
Vidale, Simone
Violante, Francesco S.
Vlassov, Vasily
Vollset, Stein Emil
Vos, Theo
Vujcic, Isidora S.
Vukovic, Ana
Vukovic, Rade
Waheed, Yasir
Wallin, Mitchell Taylor
Walters, Magdalene K.
Wang, Hongbo
Wang, Haidong
Wang, Yuan Pang
Watson, Stefanie
Wei, Jingkai
Weiss, Jordan
Weldesamuel, Girmay Teklay
Werdecker, Andrea
Westerman, Ronny
Whiteford, Harvey A.
Wiangkham, Taweewat
Wiens, Kirsten E.
Wijeratne, Tissa
Wiysonge, Charles Shey
Wojtyniak, Bogdan
Wolfe, Charles D. A.
Wondmieneh, Adam Belay
Wool, Eve E.
Wu, Ai Min
Wu, Junjie
Xu, Gelin
Yamada, Tomohide
Yamagishi, Kazumasa
Yano, Yuichiro
Yaya, Sanni
Yazdi Feyzabadi, Vahid
Yearwood, Jamal A.
Yeheyis, Tomas Y.
Yilgwan, Christopher Sabo
Yip, Paul
Yonemoto, Naohiro
Yoon, Seok Jun
Yoosefi Lebni, Javad
York, Hunter W.
Younis, Mustafa Z.
Younker, Theodore Patrick
Yousefi, Zabihollah
Yousefinezhadi, Taraneh
Yousuf, Abdilahi Yousuf
Yusefzadeh, Hasan
Zahirian Moghadam, Telma
Zakzuk, Josefina
Zaman, Sojib Bin
Zamani, Mohammad
Zamanian, Maryam
Zandian, Hamed
Zhang, Zhi Jiang
Zheng, Peng
Zhou, Maigeng
Ziapour, Arash
Murray, Christopher J. L.

Tipo de recurso:: Article of journal

Fecha de publicación:: 2021

Institución:: Universidad El Bosque

Repositorio:: Repositorio U. El Bosque

Idioma:: eng

Description
Summary:	Background Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Interpretation Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring.

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019

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