When compiling the third annual global report detailing the levels, trends, causes, and correlates of health loss in pediatric patients, researchers found that in 2017, children and adolescents in every country in the world were more likely to reach their 20th birthday than ever before, according to study results published in JAMA Pediatrics. This decline in mortality is largely due to decreased deaths from infectious diseases.

The Global Burden of Disease 2017 used a geographic hierarchy of 195 countries and territories and 359 diseases arranged in a 4-level case hierarchy analyzed as causing both death and disability. Estimates of mortality were produced for males and females separately in 23 standard age groups: 0 to 6 days, 7 to 27 days, 28 to364 days, 1 to 4 years, 5 to 9 years, 10 to 14 years, and 15 to 19 years.

Outcomes included all-cause mortality, cause-specific mortality, and years of life lost (YLLs). Cause-specific years lived with disability (YLDs) and disability-adjusted life years (DALYs) were also calculated.

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In 1990, child and adolescent deaths totaled 13.77 million; the number of deaths decreased by 51.7% (6.64 million) in 2017, with more than half (60.1%) of deaths occurring in children age ≤1 year. Total DALYs in children and adolescents decreased by 46%, from 1.31 billion in 1990 to 709 million in 2017. Rates of YLDs decreased only slightly between 1990 and 2017 for a total of 4.7% (145 million) in children and adolescents; iron-deficient anemia was the top cause of global YLDs.

Of note, low and middle socio-demographic index (SDI) locations (ie, North Africa, the Middle East, and Latin America) experienced 82.2% of deaths in 2017 compared with 70.9% in 1990. The leading cause of DALYs in low SDI countries included neonatal disorders, lower respiratory infections, diarrhea, malaria, and congenital birth defects.

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“The global community must commit to creating systematic accounting of drivers and consequences of long-lasting negative health outcomes beginning in childhood and the effects of long-term morbidity on health systems and human capital and ensuring that no populations are left behind,” the researchers concluded. “Only then will we be able to accelerate progress to 2030 and beyond.”


Reiner RC Jr, Olsen HE, Ikeda CT; GBD 2017 Child and Adolescent Health Collaborators. Diseases, injuries, and risk factors in child and adolescent health, 1990 to 2017: findings from the global burden of diseases, injuries, and risk factors 2017 study [published online April 29, 2019]. JAMA Pediatr. doi:10.1001/jamapediatrics.2019.0337