Worldwide mortality in adults

Adult deaths and causes of adult death are a crucial priority for global health. Yet, adult mortality has received little policy attention, resources, or monitoring studies.
This study aimed to estimate worldwide mortality in men and women aged 15-59 years.
A database of 3889 measurements of adult mortality for 187 countries from 1970 to 2010 used 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.
Yearly estimates of the probability of death between the ages of 15 years and 60 years for men and women for every country were constructed.
These showed that 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 is 65 per 1000; in Cyprus, female is 38 per 1000.
Highest risk of mortality in 2010 for men is found in Swaziland with 765 per 1000 and for women Zambia for women 606 per 1000.
Between 1970 and 2010, there were substantial increases in adult mortality 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.

Rajaratnam et al 2010 Worldwide mortality in men and women aged 15-59 years from 1970 to 2010: a systematic analysis . The Lancet vol 375 pp 1704-20

Martin Eastwood
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