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. 2024 May 18;403(10440):1989-2056.
doi: 10.1016/S0140-6736(24)00476-8. Epub 2024 Mar 11.

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Collaborators

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

GBD 2021 Demographics Collaborators. Lancet. .

Abstract

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020-21 COVID-19 pandemic period.

Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution.

Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5-65·1] decline), and increased during the COVID-19 pandemic period (2020-21; 5·1% [0·9-9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98-5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50-6·01) in 2019. An estimated 131 million (126-137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7-17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8-24·8), from 49·0 years (46·7-51·3) to 71·7 years (70·9-72·5). Global life expectancy at birth declined by 1·6 years (1·0-2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67-8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4-52·7]) and south Asia (26·3% [9·0-44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations.

Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic.

Funding: Bill & Melinda Gates Foundation.

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Conflict of interest statement

Declaration of interests Olugbenga Olusola Abiodun reports payment or honoraria for lectures and presentations from Cardiocare Hospital, Servier, and AstraZeneca; support for attending meetings from Boehringer Ingelheim, Megalifesciences, and MSN; all outside the submitted work. Saira Afzal reports payment for educational events and webinars from King Edward Medical University and collaborative partners including University of Johns Hopkins, University of California, University of Massachusetts, University of Nebraska, Imperial College London, KEMCA-UK, KEMCAANA, and APPNA; participation on data safety monitoring boards or advisory boards for the National Bioethics Committee Pakistan, the King Edward Medical University institutional ethical review board, and the Fatima Jinnah Medical University and Sir Ganga Ram Hospital ethical review board; leadership or a fiduciary role in other board, society, committee, or advocacy groups, paid or unpaid, for the Pakistan Association of Medical Editors, fellow of Faculty of Public Health Royal Colleges UK, Society of Prevention, Advocacy And Research, King Edward Medical University, and Member Pakistan Society of Infectious Diseases; other financial or non-financial interest as a member Corona Experts Advisory Group, member of the Dengue Advisory Group, member of the Technical Working Group and Guidelines development for COVID-19, has provided expert opinion in National Command and Operation Committee Government of Pakistan, member of the Research and Journals Committee Pakistan Medical and Dental Council, member of the Higher Education Commission Research and Publications Committee on Quality Assurance Agency, dean of Public Health and Preventive Medicine King Edward Medical University, director of Quality Enhancement Cell King Edward Medical University, chief editor of Annals of King Edward Medical University, and Chief Editor History Book King Edward Medical University; all outside the submitted work. Robert Ancuceanu reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AbbVie, Sandoz, B Braun, Laropharm, and MagnaPharm, all outside the submitted work. Ruhai Bai reports support for the present manuscript from the Fundamental Research Funds for the Central Universities (grant number 30923011101) and the Social Science Fund of Jiangsu Province (grant number 21GLD008). Ovidiu Constantin Baltatu reports support for the present manuscript from the National Council for Scientific and Technological Development (grant number 304224/2022-7) and Anima Institute - AI research professor fellowship; leadership or a fiduciary role in other board, society, committee or advocacy group, paid or unpaid, as a board member of the Biotechnology Board at São José dos Campos Technology Park and an Academic Ambassador for Afya, outside the submitted work. Michelle L Bell reports grants or contracts from the US Environmental Protection Agency, National Institutes of Health, High Tide Foundation, Health Effects Institute Yale Women Faculty Forum Environmental Defense Fund, Wellcome Trust Foundation, Yale Climate Change and Health Center, Robert Wood Johnson Foundation, and the Hutchinson Postdoctoral Fellowship, all as payments to their institution; consulting fees from Clinique; honoraria for speakers bureaus from Colorado School of Public Health, Duke University, University of Texas, Data4Justice, Korea University, Organization of Teratology Information Specialists, UPenn, Boston University, honoraria for editing duties from IOP Publishing, honoraria for grant review from NIH, Health Canada, PAC- 10, UK Research and Innovation, AXA Research Fund Fellowship, and honoraria for external advisory committee from Harvard University and University of Montana; travel reimbursement from Colorado School of Public Health, University of Texas, Duke University, Boston University, UPenn, Harvard University, American Journal of Public Health; leadership or a fiduciary role in other board, society, committee or advocacy group, unpaid, with the Fifth National Climate Assessment, Lancet Countdown, Johns Hopkins EHE Advisory Board, Harvard external advisory committee for training grant, WHO Global Air Pollution and Health Technical Advisory group, and National Academies Panels and Committees, and paid roles with the US EPA Clean Air Scientific Advisory Committee; all outside the submitted work. Paulo J G Bettencourt reports other financial or non-financial interests with the Botnar Foundation as project reviewer, outside the submitted work. Pra Bhardwaj reports stock options in Doximity in 2020 and 2021 for being a Doximity fellow, outside the submitted work. Sonu Bhaskar reports grants or contracts from the Japan Society for the Promotion of Science (JSPS) through grants-in-aid for Scientific Research KAKENH and a JSPS International Fellowship (2023–25); leadership or a fiduciary role in other board, society, committee or advocacy group, paid or unpaid, as chair of the Global Health and Migration Hub Community for Global Health Hub Germany, Berlin, district chair; Diversity, Equity, and Inclusion for Rotary District 9675, Australia; and as editorial board member with Frontiers in Stroke, Frontiers in Neurology, PLOS One, BMC Medical Research Methodology, BMC Neurology, and Frontiers in Public Health; all outside the submitted work. Zulfiqar A Bhutta reports leadership or a fiduciary role in other board, society, committee or advocacy group, paid or unpaid, as member and chair of the Board of Governors of the National Institutes of Health, Pakistan, outside the submitted work. Boris Bikbov reports grants or contracts from the European Commission; support for attending meetings or travel expenses from the European Renal Association; an unpaid leadership role in the advocacy group International Society of Nephrology; and other non-financial interests in Scientific-Tools.org for a public health consultancy; all outside the submitted work. Atanu Biswas reports consulting fees from INTAS Pharmaceuticals, Lupin Pharmaceuticals, and Alkem Laboratories; and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Roche Diagnostic; all outside the submitted work. Edward J Boyko reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from the Korean Diabetes Association, Diabetes Association (Taiwan), and the American Diabetes Association, all outside the submitted work. Márcia Carvalho reports other financial or non-financial interests in LAQV-REQUIMTE and the Faculty of Science and Technology under the scope of the project UIDP/50006/2020, outside the submitted work. Joao Conde reports grants or contracts from the European Research Council (starting grant ERC-StG-2019-848325; €1·5 million funding), outside the submitted work. Saswati Das reports leadership or a fiduciary role in other board, society, committee or advocacy group, unpaid, with the Association for Diagnostics and Laboratory Medicine, and the Women in Global Health India Chapter, outside the submitted work. 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Andre Faro reports support for the present manuscript from Coordination of Superior Level Staff Improvement (Brazil), Productivity in Research Scholarship (PQ Scholarship). Irina Filip and Amir Radfar report support for the present manuscript from Avicenna Medical and Clinical Research Institute. Artem Alekseevich Fomenkov reports support for the present manuscript from Ministry of Science and Higher Education of the Russian Federation (theme number 121050500047-5). Lisa M Force reports support for the present manuscript from the Gates Foundation; grants or contracts from Conquer Cancer Foundation, St Jude Children's Research Hospital, St Baldrick's Foundation, and NIH Loan Repayment Program; leadership or a fiduciary role in other board, society, committee or advocacy group, unpaid, with the Lancet Oncology International Advisory Board; all outside the submitted work. 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Quan Gan reports other financial or non-financial interest in the International Agency for Research on Cancer, WHO; the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy or views of the International Agency for Research on Cancer or WHO. Paramjit Singh Gill reports support for the present manuscript from the NIHR as senior investigator with payments to their institution; the views expressed in this publication are those of the authors and not necessarily those of the NIHR or the UK Department of Health and Social Care. Avirup Guha reports grants or contracts from the American Heart Association and Department of Defense; consulting fees from Pfizer, Novartis, and Myovant; and a leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, with ZERO Prostate Cancer Health Equity Task Force; all outside the submitted work. 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Morteza Mahmoudi reports other financial or non-financial interests as co-founder and director of the Academic Parity Movement, a non-profit organisation dedicated to addressing academic discrimination, violence and incivility; as a cofounder of and shareholder in Targets' Tip; and from royalties or honoraria for published books, plenary lectures, and licensed patents; outside the submitted work. Hamid Reza Marateb reports support for the present manuscript from The Beatriu de Pinós post-doctoral programme from the Office of the Secretary of Universities and Research from the Ministry of Business and Knowledge of the Government of Catalonia (programme number 2020 BP 00261); and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Universitat Politècnica de Catalunya; outside the submitted work. 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Colm McAlinden reports grants or contracts as a co-applicant on an awarded Welsh Government research grant related to diabetic eye disease (unpaid role); consulting fees from Acufocus, Atia Vision, Bausch and Lomb, BVI, Coopervision, Cutting Edge, Fudan University, Hoya, Knowledge Gate Group, Johnson & Johnson Surgical Vision, Keio University, Ludwig-Maximilians-University, Medevise Consulting SAS, Ophtec BV, SightGlass vision, Science in Vision, Scope, SpyGlass, Sun Yat-sen University, Targomed GmbH, University of São Paulo, and Vold Vision; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Scope, Thea pharmaceuticals; support for travel expenses from Bayer, British Society of Refractive Surgery, Portuguese Society of Ophthalmology, Royal College of Ophthalmologists, Scope, Thea pharmaceuticals; a leadership or fiduciary role in other board, society, committee or advocacy group, unpaid as a council member of the British Society for Refractive Surgery, unpaid as a PROM advisor to the Royal College of Ophthalmologists, an editorial board member for Graefe's Archive for Clinical and Experimental Ophthalmology, Eye and Vision, Archives of Medical Science, Journal of Clinical Medicine, Journal of Ophthalmology, and Journal of Clinical and Experimental Ophthalmology, and as an associate editor for Frontiers in Medicine – Ophthalmology; and other financial interests from developing the Quality of Vision questionnaire and the Orthokeratology and Contact Lens Quality of Life Questionnaire, and consultancy fees on topics including Rasch analysis, questionnaires, statistical analyses, and clinical and surgical ophthalmology topics, and paid peer reviews for Research Square; all outside the submitted work. 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Simona Sacco reports grants or contracts from Novartis and Uriach; consulting fees from Novartis, Allergan-AbbVie, Teva, Lilly, Lundbeck, Pfizer, NovoNordisk, Abbott, AstraZeneca; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Novartis, Allergan-AbbVie, Teva, Lilly, Lundbeck, Pfizer, NovoNordisk, Abbott, AstraZeneca; support for attending meetings or travel from Lilly, Novartis, Teva, Lundbeck; a leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as the president elect of the European Stroke Organization, and the second vice-president of the European Headache Federation; and receipt of equipment, materials, drugs, medical writing, gifts or other services from Allergan-AbbVie, NovoNordisk; all outside the submitted work. Juan Sanabria reports support for attending meetings or travel from the Marshall University Medical School; three patents pending; participation in quality assessment and assurance for surgeries of his Marshall University Department of Surgery; a leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid with ASTS, SSO, and AASLD; all outside the submitted work. Chinmoy Sarkar reports other financial interests as a Global Health Leadership Fellow from National Academy of Medicine, outside the submitted work. Nikolas Scarmeas reports grants or contracts with Novo Nordisc as the local principal investigator of a recruitment site for multinational, multicenter industry sponsored phase 3 treatment trial for Alzheimer's disease with funding paid to the institution; participation on a data safety monitoring board or advisory board with Albert Einstein College of Medicine (NIH funded study) as the chair of data safety monitoring board; all outside the submitted work. Benedikt Michael Schaarschmidt reports research grants from Else Kröner-Fresenius Foundatuin, DFG, and PharmaCept; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca; support for attending meetings or travel from Bayer AG; all outside the submitted work. Nilay S Shah reports support for the present manuscript from the National Heart, Lung, and Blood Institute (grant number K23HL157766). Amin Sharifan reports leadership or fiduciary roles in other board, society, committee or advocacy group, unpaid as a steering member of the Cochrane Early Career Professionals Network; and receipt of equipment, materials, drugs, medical writing, gifts or other services from Elsevier; outside the submitted work. Saurab Sharma reports support for the present manuscript from the John J Bonica Postdoctoral Fellowship from the International Association for the Study of Pain (IASP; 2021–23); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from giving an online lecture and a travel grant for delivering a talk conducted by the Pain Education special interest group of the IASP at the World Pain Congress in Toronto (2022); support for attending meetings or travel from the International Association for the Study of Pain to attend its biennial meeting in Toronto (September 2022); outside the submitted work. Velizar Shivarov reports one issue patent in Bulgaria and one issue utility model in Bulgaria; restricted stock units for ICON; and other financial interests from Iconplc/PRAHS (salary), outside the submitted work. Sunil Shrestha reports other financial interests from the Graduate Research Merit Scholarship from the School of Pharmacy at Monash University Malaysia, outside the submitted work. João Pedro Silva reports support for the present manuscript from the Portuguese Foundation for Science and Technology. Luís Manuel Lopes Rodrigues Silva reports grants or contracts from CENTRO-04-3559-FSE-000162, Fundo Social Europeu, outside the submitted work. Colin R Simpson reports grants or contracts from Ministry of Business, Innovation, & Employement (New Zealand), Health Research Council (New Zealand), Ministry of Health (New Zealand), UK Medical Research Council, Health Data Research UK, and CSO (UK); a leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid with the New Zealand Government Data Ethics Advisory Group as the chair; outside the submitted work. Marco Solmi reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AbbVie and Otsuka, outside the submitted work. Dan J Stein reports consulting fees from Discovery Vitality, Johnson & Johnson, Kanna, L'Oreal, Lundbeck, Orion, Sanofi, Servier, Takeda, and Vistagen, outside the submitted work. Stefan Stortecky reports grants or contracts paid to their institution from Edwards Lifesciences, Medtronic, Abbott, and Boston Scientific; consulting fees from Boston Scientific/BTG and Teleflex; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Boston Scientific/BTG; outside the submitted work. Katharina S Sunnerhagen reports a leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as the chair of the scientific committee for the Swedish stroke association; outside the submitted work. Luis M Taborda-Barata reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Sanofi, AstraZeneca, and LETI Laboratories; outside the submitted work. Amanda G Thrift reports grants or contracts paid to their institution from the Australian National Health & Medical Research Council (grant numbers 1171966 and 1182071) and the Medical Research Future Fund (Australian Government; grant number 2015976); outside the submitted work. Samuel Joseph Tromans reports grants or contracts from the 2023 Adult Psychiatric Morbidity Survey team, collecting epidemiological data on community-based adults living in England; this is a contracted study from NHS Digital, via the Department of Health and Social Care; outside the submitted work. Tissa Wijeratne reports leadership or fiduciary roles in other board, society, committee or advocacy group, paid or unpaid as the president of the Asian Regional Consortium of Headaches, co-chair of both World Brain Day and Public Awareness and Advocacy with the World Federation of Neurology; and other financial or non-financial interests as the chair of the Migraine Foundation; outside the submitted work. Siddhesh Zadey reports payment or honoraria for writing for Think Global Health, Harvard Public Health Magazine, The Wire Science; a leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as a cofounding Director of the Association for Socially Applicable Research, a permanent council member for the The G4 Alliance, chair of the SOTA Care in South Asia Working Group (G4 Alliance), and a drafting Committee member for Maharashtra State Mental Health Policy; outside the submitted work. Giulia Zamagni reports support for the present manuscript from the Italian Ministry of Health (Ricerca Corrente 34/2017), as payments made to the Institute for Maternal and Child Health IRCCS Burlo Garofolo. Ha Zhang reports grants or contract funding from WHO, outside the submitted work. Magdalena Zielińska reports other financial interest as an AstraZeneca employee, outside the submitted work. All other authors declare no competing interests.

Figures

Figure 1
Figure 1
Completeness of VR systems in GBD super-regions, 1975–2021 Completeness is defined as the total number of deaths registered in all VR systems within a super-region during a 5-year period divided by the total number of estimated deaths within that super-region and period, with 100% completeness indicating that all deaths were registered. The size of the datapoints represents the number of estimated deaths. The solid black line shows the global completeness, the dashed black line indicates global completeness, excluding China and India, and other coloured lines indicate GBD super-regions. The green box indicates complete registration (defined as >95%). GBD=Global Burden of Diseases, Injuries, and Risk Factors Study. VR=vital registration.
Figure 2
Figure 2
Global and GBD super-region all-cause mortality rates across the lifespan in females (A) and males (B), 1950–2021 Mortality rates are expressed as the number of deaths per 1000 population. Fatal discontinuities are indicated by the following letters: A=HIV epidemic; B=conflicts in the Middle East; C=war and genocide in India, Pakistan, and Bangladesh in 1971; D=war and genocide in Cambodia in the 1970s; E=Rwandan genocide in 1994; F=earthquake in Haiti in 2010; G=famine between 1959 and 1961. GBD=Global Burden of Diseases, Injuries, and Risk Factors Study.
Figure 3
Figure 3
Distribution of the mortality sex ratio by age in 1970, 2000, 2019, and 2021 The distributions are for the mortality sex ratio calculated across all 204 countries and territories included in this study. The boxes represent the middle 50% of the distribution (25th and 75th percentiles), the horizontal line in boxes indicates the mean, and the whiskers show the middle 95% of the distribution (2·5th and 97·5th percentiles). *The ratio of male to female mortality rates, computed by dividing the male mortality rate by the female mortality rate for each age group and year.
Figure 4
Figure 4
Annual change in all-cause deaths by GBD super-region across three age groups, 1970–2021 Annual change is defined as the difference between the number of deaths in the current year and the preceding year. The y-axes scales differ by age groups. The large change in the 5–24 years group between 1994 and 1995 was due to deaths during the Rwandan genocide. Different colours show GBD super-regions. GBD=Global Burden of Diseases, Injuries, and Risk Factors Study.
Figure 5
Figure 5
Life expectancy at birth across GBD super-regions and SDI quintiles in females and males, 1950–2021 The different colours represent GBD super-regions in the top row and SDI quintiles in the bottom row. The decline in life expectancy in 1960 for the southeast Asia, east Asia, and Oceania super-region was due to famine. GBD=Global Burden of Diseases, Injuries, and Risk Factors Study. SDI=Socio-demographic Index.
Figure 6
Figure 6
Global distribution of age-standardised excess mortality rates due to the COVID-19 pandemic, 2020 and 2021 combined Mortality rates are expressed as the number of deaths per 100 000 population. Excess mortality rates are negative in countries and territories where fewer deaths occurred than predicted.
Figure 7
Figure 7
National life expectancy at birth versus SDI, and expected life expectancy based on SDI, in females and males in 1950, 1990, and 2021 Life expectancy at birth is shown for 204 countries and territories coloured by GBD super-region. Transparent points in all plots show every fifth year between 1950 and 2015, and 2021 in the first two columns. The black line represents the expected life expectancy at birth based on SDI, and the shaded area corresponds to 95% uncertainty intervals. GBD=Global Burden of Diseases, Injuries, and Risk Factors Study. SDI=Socio-demographic Index.
Figure 8
Figure 8
National age-standardised rates of excess mortality due to the COVID-19 pandemic versus SDI, and expected rates of excess mortality based on SDI, 2020 and 2021 combined Mortality rates are expressed as the number of deaths per 100 000 and are shown for 204 countries and territories coloured by GBD super-region. The size of the datapoints indicates the number of excess deaths. The black line represents expected age-standardised excess mortality rates based on SDI, and the shaded area indicates the 95% uncertainty intervals. GBD=Global Burden of Diseases, Injuries, and Risk Factors Study. SDI=Socio-demographic Index.
Figure 9
Figure 9
Annual change in global total population by GBD super-region, 1950–2021 Annual change is defined as the difference between the population size in the current year and the preceding year. Different colours show GBD super-regions. GBD=Global Burden of Diseases, Injuries, and Risk Factors Study.
Figure 10
Figure 10
Rate of natural increase in population, 2010–19 versus 2000–09 Rate of natural increase is shown for 204 countries and territories coloured by GBD super-region. The rate of natural increase is calculated as the number of births minus the number of deaths divided by the person-years during the time period. The shape of the datapoints represents the year that peak population was reached. Purple shading indicates a higher rate of natural increase between 2010 and 2019 than between 2000 and 2009; green shading denotes a higher rate between 2000 and 2009 than between 2010 and 2019; yellow shading indicates a negative rate between 2010 and 2019 and a positive rate between 2000 and 2009; blue shading denotes a negative rate across all years that was most pronounced between 2010 and 2019; orange shading indicates a negative rate across all years that was most pronounced between 2000 and 2009; white shading denotes a negative rate between 2000 and 2009 and a positive rate between 2010 and 2019. The years 2020 and 2021 were omitted due to the impact of the COVID-19 pandemic on deaths. GBD=Global Burden of Diseases, Injuries, and Risk Factors Study.
Figure 11
Figure 11
Ratio of the number of individuals older than 65 years to those younger than 15 years, 2000 versus 2021 This ratio is shown for 204 countries and territories coloured by GBD super-region. The size of the datapoints indicates the annualised rate of change in total population from 2000 to 2021, and the black dotted line represents the line of equality. GBD=Global Burden of Diseases, Injuries, and Risk Factors Study.

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