Global Burden of Disease Visualisations Mortality

We estimated separately under-5 mortality
(ages 0-4) and adult mortality (ages 15-59)
rates for 195 countries and territories using all
available data sources including surveys,
censuses, sample registration systems, disease
surveillance, and vital registration systems.
Summary birth history data from surveys and
censuses have been analyzed using updated
formal demographic methods developed for the
Global Burden of Disease study. Death reporting
from vital registration and censuses were
evaluated for completeness using improved
death distribution methods. We also applied an
improved sibling survival method to survey data
on sibling survival modules to correct for
survivor bias, zero-survivor bias, and recall bias.
Estimates of under-5 and adult mortality were
generated using the state-of-the-art data
synthesis methods: a combination of spatio-
temporal and Gaussian Process regressions.

The final estimates of under-5 and adult
mortality rates, together with crude death rates
due to HIV/AIDS, were used as entry
parameters to a relational model life table
system. In this model life table system, we have
a flexible standard life table selection process to
account for similarities in life tables based on
levels of under-5 and adult mortality rates and
distance between two life tables in terms of time
and geographic location. Impacts of conflict and
natural disasters on age patterns of mortality
are modeled separately. Age- and sex-specific
deaths for 195 countries and territories for
years 1950-2017 are then generated together
with population estimates. Uncertainty has been
propagated throughout the entire process and
95% uncertainty intervals have been provided
for each metric we generate.

Shapes

Colors and pa erns

Child Mortality

Adult Mortality

Life Tables

HIV Adjustment

Results

CBH microdata

CBH tabulated data

SBH microdata

SBH tabulated data

Under-5 age

pa erns from VR/

SRS/DSP

Empirical life

table database

VR/SRS/DSP

HH death recall

Sibling survival

histories

Under-5 age

pa erns from CBH

Live births

Under-5 popula ons

Adult popula ons

VR/SRS/DSP

Iden fy VR

underenumera on

for bias correc on

Biennial 5q0

es mates

SBH to 5q0 me

series method

5q0 data synthesis,

model running, and

bias correc on

5q0

es mates

(with and

without HIV)

Under-5 death

number es ma on

Sibling survival

method

DDM

Completeness

synthesis

45q15 data

synthesis and model

running

Iden fy and remove

outliers

45q15

es mates

(with and

without HIV)

GBD rela onal

model life table

system

Extending age-

speciﬁc mortality to

age 100+

Quality review and

removal of poor-

quality life tables

HIV-free

mortality

rates

Age-speciﬁc

mortality

rates (with

HIV/AIDS)

EPP (Group 1 only)

and Spectrum

HIV/mortality

reckoning

(including ensemble

model for Group 1)

Add fatal

discon nui es

Age-speciﬁc

deaths with

discon nui es

and HIV/AIDS

Iden fy and remove

outliers

Under-5 age-sex

spli ng model

applica on

On- and oﬀ-ART

cohort mortality

data

HIV-free

survival rates

(for

Spectrum)

Program data

HIV prevalence data

Demographic data

(migra on, fer lity,

popula ons)

On- and oﬀ-ART

mortality es ma on

and CD4 progression

parameters for oﬀ-ART

Life tables with

HIV/AIDS and

fatal

discon nui es

Input

Process

Results

Database

2. Adult mortality

es ma on

3. Age- and sex-

speciﬁc all-cause

mortality genera on

4. HIV/AIDS

es ma on

5. Re-es ma ng all-

cause mortality with

HIV/AIDS and fatal

discon nui es

1. Under-5 mortality

es ma on

Input updated

when process

repeats

*Because of the very large and changing eﬀects of HIV/AIDS on

all-cause mortality in a number of countries with large HIV

epidemics and limited data on all-cause mortality, the es ma on

of HIV/AIDS and all-cause mortality are closely linked and

presented jointly here.

Abbrevia ons:

5q0: Probability of death between birth and exact age 5

45q15: Probability of death between age 15 and exact age 60

ART: An -retroviral therapy

CBH: Complete birth history

CDR: Crude death rate

CoD: Causes of death

DSP: Disease Surveillance Points

EPP: Es ma on and Projec on Package

GBD: Global Burden of Disease

SBH: Summary birth history

SRS: Sample Registra on System

VR: Vital registra on

Age-speciﬁc

mortality

without

discon nui es

(with HIV/AIDS)

Institute for Health Metrics and Evaluation

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