Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 (2024)

Abstract

Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. Findings Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9·3% (6·9–11·6) decline in deaths and a 10·8% (8·3–13·1) decrease in DALYs at the global level, while population ageing accounts for 14·9% (12·7–17·5) of deaths and 6·2% (3·9–8·7) of DALYs, and population growth for 12·4% (10·1–14·9) of deaths and 12·4% (10·1–14·9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27·3% (24·9–29·7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. Interpretation Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade. Funding The Bill & Melinda Gates Foundation, Bloomberg Philanthropies.

Original language	English
Pages (from-to)	1345-1422
Number of pages	78
Journal	The Lancet Global Health
Volume	390
Issue number	10100
DOIs	https://doi.org/10.1016/S0140-6736(17)32366-8
Publication status	Published - 16 Sept 2017

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Abajobir, A. A., Abate, K. H., Abbafati, C., Abbas, K. M., Abd-Allah, F., Abdulle, A. M., Abera, S. F., Aboyans, V., Abu-Raddad, L. J., Abu-Rmeileh, N. M. E., Abyu, G. Y., Adedeji, I. A., Adetokunboh, O., Afarideh, M., Afshin, A., Agrawal, A., Agrawal, S., Ahmadieh, H., Ahmed, M. B., ... Zodpey, S. (2017). Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Global Health, 390(10100), 1345-1422. https://doi.org/10.1016/S0140-6736(17)32366-8

Abajobir, Amanuel Alemu ; Abate, Kalkidan Hassen ; Abbafati, Cristiana et al. / Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. In: The Lancet Global Health. 2017 ; Vol. 390, No. 10100. pp. 1345-1422.

@article{deb7c5119e2f4e9cbbcb24446f1c67d1,

title = "Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016",

abstract = "Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. Findings Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9·3% (6·9–11·6) decline in deaths and a 10·8% (8·3–13·1) decrease in DALYs at the global level, while population ageing accounts for 14·9% (12·7–17·5) of deaths and 6·2% (3·9–8·7) of DALYs, and population growth for 12·4% (10·1–14·9) of deaths and 12·4% (10·1–14·9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27·3% (24·9–29·7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. Interpretation Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade. Funding The Bill & Melinda Gates Foundation, Bloomberg Philanthropies.",

author = "Abajobir, {Amanuel Alemu} and Abate, {Kalkidan Hassen} and Cristiana Abbafati and Abbas, {Kaja M.} and Foad Abd-Allah and Abdulle, {Abdishakur M.} and Abera, {Semaw Ferede} and Victor Aboyans and Abu-Raddad, {Laith J.} and Abu-Rmeileh, {Niveen M E} and Abyu, {Gebre Yitayih} and Adedeji, {Isaac Akinkunmi} and Olatunji Adetokunboh and Mohsen Afarideh and Ashkan Afshin and Anurag Agrawal and Sutapa Agrawal and Hamid Ahmadieh and Ahmed, {Muktar Beshir} and Aichour, {Miloud Taki Eddine} and Aichour, {Amani Nidhal} and Ibtihel Aichour and Akinyemi, {Rufus Olusola} and Nadia Akseer and Fares Alahdab and Ziyad Al-Aly and Khurshid Alam and Noore Alam and Tahiya Alam and Deena Alasfoor and Alene, {Kefyalew Addis} and Komal Ali and Reza Alizadeh-Navaei and Ala'a Alkerwi and Fran{\c c}ois Alla and Peter Allebeck and Rajaa Al-Raddadi and Ubai Alsharif and Altirkawi, {Khalid A.} and Nelson Alvis-Guzman and Amare, {Azmeraw T} and Erfan Amini and Walid Ammar and Amoako, {Yaw Ampem} and Hossein Ansari and Ant{\'o}, {Josep M.} and Antonio, {Carl Abelardo T} and Palwasha Anwari and Nicholas Arian and Johan {\"A}rnl{\"o}v and Al Artaman and Aryal, {Krishna Kumar} and Hamid Asayesh and Asgedom, {Solomon Weldegebreal} and Atey, {Tesfay Mehari} and Leticia Avila-Burgos and Avokpaho, {Euripide Frinel G.Arthur} and Ashish Awasthi and Peter Azzopardi and Umar Bacha and Alaa Badawi and Kalpana Balakrishnan and Ballew, {Shoshana H.} and Aleksandra Barac and Barber, {Ryan M} and Barker-Collo, {Suzanne L} and Till B{\"a}rnighausen and Simon Barquera and Lars Barregard and Barrero, {Lope H} and Carolina Batis and Battle, {Katherine E.} and Baumgarner, {Blair R.} and Baune, {Bernhard T.} and Justin Beardsley and Neeraj Bedi and Ettore Beghi and Bell, {Michelle L} and Bennett, {Derrick A} and Bennett, {James R.} and Bensenor, {Isabela M.} and Adugnaw Berhane and Berhe, {Derbew Fikadu} and Eduardo Bernab{\'e} and Betsu, {Balem Demtsu} and Mircea Beuran and Beyene, {Addisu Shunu} and Anil Bhansali and Bhutta, {Zulfiqar A} and Bicer, {Burcu Kucuk} and Boris Bikbov and Charles Birungi and Stan Biryukov and Blosser, {Christopher D.} and Boneya, {Dube Jara} and Bou-Orm, {Ibrahim R.} and Michael Brauer and Breitborde, {Nicholas J.K.} and Hermann Brenner and Brugha, {Traolach S} and Bulto, {Lemma Negesa Bulto} and Butt, {Zahid A.} and Lucero Cahuana-Hurtado and Rosario C{\'a}rdenas and Carrero, {Juan Jesus} and Casta{\~n}eda-Orjuela, {Carlos A} and Ferr{\'a}n Catal{\'a}-L{\'o}pez and Kelly Cercy and Chang, {Hsing Yi} and Charlson, {Fiona J} and Odgerel Chimed-Ochir and Chisumpa, {Vesper Hichilombwe} and Chitheer, {Abdulaal A.} and Hanne Christensen and Christopher, {Devasahayam Jesudas} and Massimo Cirillo and Cohen, {Aaron J} and Haley Comfort and Cyrus Cooper and Josef Coresh and Leslie Cornaby and Cortesi, {Paolo Angelo} and Criqui, {Michael H} and Crump, {John A} and Lalit Dandona and Rakhi Dandona and {das Neves}, Jos{\'e} and Gail Davey and Davitoiu, {Dragos V} and Kairat Davletov and {de Courten}, Barbora and Defo, {Barthelemy Kuate} and Louisa Degenhardt and Selina Deiparine and Dellavalle, {Robert P} and Kebede Deribe and Aniruddha Deshpande and Dharmaratne, {Samath D} and Ding, {Eric L} and Shirin Djalalinia and Do, {Huyen Phuc} and Klara Dokova and Doku, {David Teye} and Donkelaar, {Aaron van} and Dorsey, {E Ray} and Driscoll, {Tim R} and Manisha Dubey and Duncan, {Bruce Bartholow} and Sarah Duncan and Hedyeh Ebrahimi and El-Khatib, {Ziad Ziad} and Ahmadali Enayati and Endries, {Aman Yesuf} and Ermakov, {Sergey Petrovich} and Erskine, {Holly E} and Babak Eshrati and Sharareh Eskandarieh and Alireza Esteghamati and Kara Estep and Faraon, {Emerito Jose Aquino} and Farinha, {Carla Sofia e.Sa} and Andr{\'e} Faro and Farshad Farzadfar and Kairsten Fay and Feigin, {Valery L} and Seyed-Mohammad Fereshtehnejad and Fernandes, {Jo{\~a}o C.} and Ferrari, {Alize J} and Feyissa, {Tesfaye Regassa} and Irina Filip and Florian Fischer and Christina Fitzmaurice and Flaxman, {Abraham D} and Nataliya Foigt and Foreman, {Kyle J} and Frostad, {Joseph J} and Nancy Fullman and Thomas F{\"u}rst and Furtado, {Joao M.} and Emmanuela Gakidou and Morsaleh Ganji and Garcia-Basteiro, {Alberto L.} and Gebrehiwot, {Tsegaye Tewelde} and Geleijnse, {Johanna M.} and Ayele Geleto and Gemechu, {Bikila Lencha} and Gesesew, {Hailay Abrha} and Gething, {Peter W.} and Alireza Ghajar and Gibney, {Katherine B} and Gill, {Paramjit Singh} and Gillum, {Richard F} and Giref, {Ababi Zergaw} and Gishu, {Melkamu Dedefo} and Giorgia Giussani and Godwin, {William W.} and Gona, {Philimon N.} and Amador Goodridge and Gopalani, {Sameer Vali} and Yevgeniy Goryakin and Goulart, {Alessandra Carvalho} and Nicholas Graetz and Gugnani, {Harish Chander} and Jingwen Guo and Rajeev Gupta and Tanush Gupta and Vipin Gupta and Guti{\'e}rrez, {Reyna A} and Vladimir Hachinski and Nima Hafezi-Nejad and Hailu, {Gessessew Bugssa} and Hamadeh, {Randah Ribhi} and Samer Hamidi and Mouhanad Hammami and Handal, {Alexis J.} and Hankey, {Graeme J.} and Hanson, {Sarah Wulf} and Harb, {Hilda L} and Hareri, {Habtamu Abera} and Hassanvand, {Mohammad Sadegh} and Rasmus Havmoeller and Caitlin Hawley and Hay, {Simon I} and Hedayati, {Mohammad T} and Delia Hendrie and Heredia-Pi, {Ileana Beatriz} and Hernandez, {Julio Cesar Monta{\~n}ez} and Hoek, {Hans W} and Nobuyuki Horita and Hosgood, {H. Dean} and Sorin Hostiuc and Hoy, {Damian G} and Mohamed Hsairi and Guoqing Hu and Huang, {John J} and Hsiang Huang and Ibrahim, {Norlinah Mohamed} and Iburg, {Kim Moesgaard} and Chad Ikeda and Manami Inoue and Irvine, {Caleb Mackay Salpeter} and Jackson, {Maria Delores} and Jacobsen, {Kathryn H} and Nader Jahanmehr and Jakovljevic, {Mihajlo B.} and Alejandra Jauregui and Mehdi Javanbakht and Panniyammakal Jeemon and Johansson, {Lars R.K.} and Johnson, {Catherine O.} and Jonas, {Jost B} and Mikk J{\"u}risson and Zubair Kabir and Rajendra Kadel and Amaha Kahsay and Ritul Kamal and Andr{\'e} Karch and Karema, {Corine Kakizi} and Amir Kasaeian and Kassebaum, {Nicholas J.} and Anshul Kastor and Katikireddi, {Srinivasa Vittal} and Norito Kawakami and Keiyoro, {Peter Njenga} and Kelbore, {Sefonias Getachew} and Laura Kemmer and Kengne, {Andre Pascal} and Kesavachandran, {Chandrasekharan Nair} and Khader, {Yousef Saleh} and Khalil, {Ibrahim A.} and Khan, {Ejaz Ahmad} and Young-Ho Khang and 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and Rafael Lozano and Raimundas Lunevicius and Macarayan, {Erlyn Rachelle King} and {Magdy Abd El Razek}, Hassan and {Magdy Abd El Razek}, Mohammed and Marek Majdan and Reza Majdzadeh and Azeem Majeed and Reza Malekzadeh and Rajesh Malhotra and Malta, {Deborah Carvalho} and Mamun, {Abdullah A.} and Helena Manguerra and Mantovani, {Lorenzo G.} and Mapoma, {Chabila C.} and Martin, {Randall V} and Jose Martinez-Raga and Martins-Melo, {Francisco Rogerl{\^a}ndio} and Mathur, {Manu Raj} and Kunihiro Matsush*ta and Richard Matzopoulos and Mohsen Mazidi and Colm McAlinden and McGrath, {John W} and Suresh Mehata and Mehndiratta, {Man Mohan} and Toni Meier and Melaku, {Yohannes Adama} and Peter Memiah and Memish, {Ziad A.} and Walter Mendoza and Mengesha, {Melkamu Merid} and Mensah, {George A} and Mensink, {Gert B.M.} and Mereta, {Seid Tiku} and Meretoja, {Tuomo J.} and Atte Meretoja and Mezgebe, {Haftay Berhane} and Renata Micha and Anoushka Millear and Miller, {Ted R} and Shawn Minnig and Mojde Mirarefin and Mirrakhimov, {Erkin M.} and Awoke Misganaw and Mishra, {Shiva Raj} and Mohammad, {Karzan Abdulmuhsin} and Mohammed, {Kedir Endris} and Shafiu Mohammed and Mohan, {Murali B.V.} and Mokdad, {Ali H} and Lorenzo Monasta and Marcella Montico and Maziar Moradi-Lakeh and Paula Moraga and Lidia Morawska and Morrison, {Shane D.} and Cliff Mountjoy-Venning and Mueller, {Ulrich O} and Mullany, {Erin C} and Kate Muller and Murray, {Christopher J L} and Murthy, {Gudlavalleti Venkata Satyanarayana} and Musa, {Kamarul Imran} and Mohsen Naghavi and Aliya Naheed and Vinay Nangia and Gopalakrishnan Natarajan and Negoi, {Ruxandra Irina} and Ionut Negoi and Nguyen, {Cuong Tat} and Nguyen, {Quyen Le} and Nguyen, {Trang Huyen} and Grant Nguyen and Nguyen, {Minh Hao} and Emma Nichols and Ningrum, {Dina Nur Anggraini} and Marika Nomura and Nong, {Vuong Minh} and Norheim, {Ole F} and Bo Norrving and Noubiap, {Jean Jacques N.} and Obermeyer, {Carla Makhlouf} and Ogbo, {Felix Akpojene} and 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S.} and Ornwipa Thamsuwan and Thankappan, {Kavumpurathu Raman} and Theis, {Andrew M.} and Thomas, {Matthew Lloyd} and Thomson, {Alan J.} and Thrift, {Amanda G} and Taavi Tillmann and Ruoyan Tobe-Gai and Myriam Tobollik and Tollanes, {Mette C.} and Marcello Tonelli and Roman Topor-Madry and Anna Torre and Miguel Tortajada and Mathilde Touvier and Tran, {Bach Xuan} and Thomas Truelsen and Tuem, {Kald Beshir} and Tuzcu, {Emin Murat} and Stefanos Tyrovolas and Ukwaja, {Kingsley Nnanna} and Uneke, {Chigozie Jesse} and Rachel Updike and Uthman, {Olalekan A.} and {van Boven}, {Job F.M.} and Santosh Varughese and Vasankari, {Tommi J} and Veerman, {Lennert J} and Vidhya Venkateswaran and Narayanaswamy Venketasubramanian and Violante, {Francesco S} and Vladimirov, {Sergey K.} and Vlassov, {Vasiliy Victorovich} and Vollset, {Stein Emil} and Theo Vos and Fiseha Wadilo and Tolassa Wakayo and Wallin, {Mitchell T} and Wang, {Yuan Pang} and Scott Weichenthal and Elisabete Weiderpass and Weintraub, {Robert G} and Weiss, {Daniel J.} and Andrea Werdecker and Ronny Westerman and Whiteford, {Harvey A} and Wiysonge, {Charles Shey} and Woldeyes, {Belete Getahun} and Wolfe, {Charles D A} and Rachel Woodbrook and Abdulhalik Workicho and Denis Xavier and Gelin Xu and Simon Yadgir and Bereket Yakob and Yan, {Lijing L} and Mehdi Yaseri and Yimam, {Hassen Hamid} and Paul Yip and Naohiro Yonemoto and Seok-Jun Yoon and Marcel Yotebieng and Younis, {Mustafa Z} and Zoubida Zaidi and Zaki, {Maysaa El Sayed} and Luis Zavala-Arciniega and Xueying Zhang and Zimsen, {Stephanie Raman M.} and Ben Zipkin and Sanjay Zodpey",

year = "2017",

month = sep,

day = "16",

doi = "10.1016/S0140-6736(17)32366-8",

language = "English",

volume = "390",

pages = "1345--1422",

journal = "The Lancet Global Health",

issn = "2214-109X",

publisher = "Elsevier BV",

number = "10100",

}

Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abdulle, AM, Abera, SF, Aboyans, V, Abu-Raddad, LJ, Abu-Rmeileh, NME, Abyu, GY, Adedeji, IA, Adetokunboh, O, Afarideh, M, Afshin, A, Agrawal, A, Agrawal, S, Ahmadieh, H, Ahmed, MB, Aichour, MTE, Aichour, AN, Aichour, I, Akinyemi, RO, Akseer, N, Alahdab, F, Al-Aly, Z, Alam, K, Alam, N, Alam, T, Alasfoor, D, Alene, KA, Ali, K, Alizadeh-Navaei, R, Alkerwi, A, Alla, F, Allebeck, P, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Amoako, YA, Ansari, H, Antó, JM, Antonio, CAT, Anwari, P, Arian, N, Ärnlöv, J, Artaman, A, Aryal, KK, Asayesh, H, Asgedom, SW, Atey, TM, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Azzopardi, P, Bacha, U, Badawi, A, Balakrishnan, K, Ballew, SH, Barac, A, Barber, RM, Barker-Collo, SL, Bärnighausen, T, Barquera, S, Barregard, L, Barrero, LH, Batis, C, Battle, KE, Baumgarner, BR, Baune, BT, Beardsley, J, Bedi, N, Beghi, E, Bell, ML, Bennett, DA, Bennett, JR, Bensenor, IM, Berhane, A, Berhe, DF, Bernabé, E, Betsu, BD, Beuran, M, Beyene, AS, Bhansali, A, Bhutta, ZA, Bicer, BK, Bikbov, B, Birungi, C, Biryukov, S, Blosser, CD, Boneya, DJ, Bou-Orm, IR, Brauer, M, Breitborde, NJK, Brenner, H, Brugha, TS, Bulto, LNB, Butt, ZA, Cahuana-Hurtado, L, Cárdenas, R, Carrero, JJ, Castañeda-Orjuela, CA, Catalá-López, F, Cercy, K, Chang, HY, Charlson, FJ, Chimed-Ochir, O, Chisumpa, VH, Chitheer, AA, Christensen, H, Christopher, DJ, Cirillo, M, Cohen, AJ, Comfort, H, Cooper, C, Coresh, J, Cornaby, L, Cortesi, PA, Criqui, MH, Crump, JA, Dandona, L, Dandona, R, das Neves, J, Davey, G, Davitoiu, DV, Davletov, K, de Courten, B, Defo, BK, Degenhardt, L, Deiparine, S, Dellavalle, RP, Deribe, K, Deshpande, A, Dharmaratne, SD, Ding, EL, Djalalinia, S, Do, HP, Dokova, K, Doku, DT, Donkelaar, AV, Dorsey, ER, Driscoll, TR, Dubey, M, Duncan, BB, Duncan, S, Ebrahimi, H, El-Khatib, ZZ, Enayati, A, Endries, AY, Ermakov, SP, Erskine, HE, Eshrati, B, Eskandarieh, S, Esteghamati, A, Estep, K, Faraon, EJA, Farinha, CSES, Faro, A, Farzadfar, F, Fay, K, Feigin, VL, Fereshtehnejad, S-M, Fernandes, JC, Ferrari, AJ, Feyissa, TR, Filip, I, Fischer, F, Fitzmaurice, C, Flaxman, AD, Foigt, N, Foreman, KJ, Frostad, JJ, Fullman, N, Fürst, T, Furtado, JM, Gakidou, E, Ganji, M, Garcia-Basteiro, AL, Gebrehiwot, TT, Geleijnse, JM, Geleto, A, Gemechu, BL, Gesesew, HA, Gething, PW, Ghajar, A, Gibney, KB, Gill, PS, Gillum, RF, Giref, AZ, Gishu, MD, Giussani, G, Godwin, WW, Gona, PN, Goodridge, A, Gopalani, SV, Goryakin, Y, Goulart, AC, Graetz, N, Gugnani, HC, Guo, J, Gupta, R, Gupta, T, Gupta, V, Gutiérrez, RA, Hachinski, V, Hafezi-Nejad, N, Hailu, GB, Hamadeh, RR, Hamidi, S, Hammami, M, Handal, AJ, Hankey, GJ, Hanson, SW, Harb, HL, Hareri, HA, Hassanvand, MS, Havmoeller, R, Hawley, C, Hay, SI, Hedayati, MT, Hendrie, D, Heredia-Pi, IB, Hernandez, JCM, Hoek, HW, Horita, N, Hosgood, HD, Hostiuc, S, Hoy, DG, Hsairi, M, Hu, G, Huang, JJ, Huang, H, Ibrahim, NM, Iburg, KM, Ikeda, C, Inoue, M, Irvine, CMS, Jackson, MD, Jacobsen, KH, Jahanmehr, N, Jakovljevic, MB, Jauregui, A, Javanbakht, M, Jeemon, P, Johansson, LRK, Johnson, CO, Jonas, JB, Jürisson, M, Kabir, Z, Kadel, R, Kahsay, A, Kamal, R, Karch, A, Karema, CK, Kasaeian, A, Kassebaum, NJ, Kastor, A, Katikireddi, SV, Kawakami, N, Keiyoro, PN, Kelbore, SG, Kemmer, L, Kengne, AP, Kesavachandran, CN, Khader, YS, Khalil, IA, Khan, EA, Khang, Y-H, Khosravi, A, Khubchandani, J, Kiadaliri, AA, Kieling, C, Kim, JY, Kim, YJ, Kim, D, Kimokoti, RW, Kinfu, Y, Kisa, A, Kissimova-Skarbek, KA, Kivimaki, M, Knibbs, LD, Knudsen, AK, Kopec, JA, Kosen, S, Koul, PA, Koyanagi, A, Kravchenko, M, Krohn, KJ, Kromhout, H, Kumar, GA, Kutz, M, Kyu, HH, Lal, DK, Lalloo, R, Lallukka, T, Lan, Q, Lansingh, VC, Larsson, A, Lee, PH, Lee, A, Leigh, J, Leung, J, Levi, M, Levy, TS, Li, Y, Li, Y, Liang, X, Liben, ML, Lim, SS, Linn, S, Liu, P, Lodha, R, Logroscino, G, Looker, KJ, Lopez, AD, Lorkowski, S, Lotufo, PA, Lozano, R, Lunevicius, R, Macarayan, ERK, Magdy Abd El Razek, H, Magdy Abd El Razek, M, Majdan, M, Majdzadeh, R, Majeed, A, Malekzadeh, R, Malhotra, R, Malta, DC, Mamun, AA, Manguerra, H, Mantovani, LG, Mapoma, CC, Martin, RV, Martinez-Raga, J, Martins-Melo, FR, Mathur, MR, Matsush*ta, K, Matzopoulos, R, Mazidi, M, McAlinden, C, McGrath, JW, Mehata, S, Mehndiratta, MM, Meier, T, Melaku, YA, Memiah, P, Memish, ZA, Mendoza, W, Mengesha, MM, Mensah, GA, Mensink, GBM, Mereta, ST, Meretoja, TJ, Meretoja, A, Mezgebe, HB, Micha, R, Millear, A, Miller, TR, Minnig, S, Mirarefin, M, Mirrakhimov, EM, Misganaw, A, Mishra, SR, Mohammad, KA, Mohammed, KE, Mohammed, S, Mohan, MBV, Mokdad, AH, Monasta, L, Montico, M, Moradi-Lakeh, M, Moraga, P, Morawska, L, Morrison, SD, Mountjoy-Venning, C, Mueller, UO, Mullany, EC, Muller, K, Murray, CJL, Murthy, GVS, Musa, KI, Naghavi, M, Naheed, A, Nangia, V, Natarajan, G, Negoi, RI, Negoi, I, Nguyen, CT, Nguyen, QL, Nguyen, TH, Nguyen, G, Nguyen, MH, Nichols, E, Ningrum, DNA, Nomura, M, Nong, VM, Norheim, OF, Norrving, B, Noubiap, JJN, Obermeyer, CM, Ogbo, FA, Oh, I-H, Oladimeji, O, Olagunju, AT, Olagunju, TO, Olivares, PR, Olsen, HE, Olusanya, BO, Olusanya, JO, Opio, JN, Oren, E, Ortiz, A, Ota, E, Owolabi, MO, PA, M, Pacella, RE, Pana, A, Panda, BK, Panda-Jonas, S, Pandian, JD, Papachristou, C, Park, E-K, Parry, CD, Patten, SB, Patton, GC, Pereira, DM, Perico, N, Pesudovs, K, Petzold, M, Phillips, MR, Pillay, JD, Piradov, MA, Pishgar, F, Plass, D, Pletcher, MA, Polinder, S, Popova, S, Poulton, RG, Pourmalek, F, Prasad, N, Purcell, C, Qorbani, M, Radfar, A, Rafay, A, Rahimi-Movaghar, A, Rahimi-Movaghar, V, Rahman, MHU, Rahman, MA, Rahman, M, Rai, RK, Rajsic, S, Ram, U, Rawaf, S, Rehm, CD, Rehm, J, Reiner, RC, Reitsma, MB, Remuzzi, G, Renzaho, AMN, Resnikoff, S, Reynales-Shigematsu, LM, Rezaei, S, Ribeiro, AL, Rivera, JA, Roba, KT, Rojas-Rueda, D, Roman, Y, Room, R, Roshandel, G, Roth, GA, Rothenbacher, D, Rubagotti, E, Rushton, L, Sadat, N, Safdarian, M, Safi, S, Safiri, S, Sahathevan, R, Salama, J, Salomon, JA, Samy, AM, Sanabria, JR, Sanchez-Niño, MD, Sánchez-Pimienta, TG, Santomauro, D, Santos, IS, Santric Milicevic, MM, Sartorius, B, Satpathy, M, Sawhney, M, Saxena, S, Schmidt, MI, Schneider, IJC, Schutte, AE, Schwebel, DC, Schwendicke, F, Seedat, S, Sepanlou, SG, Serdar, B, Servan-Mori, EE, Shaddick, G, Shaheen, A, Shahraz, S, Shaikh, MA, Shamsipour, M, Shamsizadeh, M, Shariful Islam, SM, Sharma, J, Sharma, R, She, J, Shen, J, Shi, P, Shibuya, K, Shields, C, Shiferaw, MS, Shigematsu, M, Shin, MJ, Shiri, R, Shirkoohi, R, Shishani, K, Shoman, H, Shrime, MG, Sigfusdottir, ID, Silva, DAS, Silva, JP, Silveira, DGA, Singh, JA, Singh, V, Sinha, DN, Skiadaresi, E, Slepak, EL, Smith, DL, Smith, M, Sobaih, BHA, Sobngwi, E, Soneji, S, Sorensen, RJD, Sposato, LA, Sreeramareddy, CT, Srinivasan, V, Steel, N, Stein, DJ, Steiner, C, Steinke, S, Stokes, MA, Strub, B, Subart, M, Sufiyan, MB, Suliankatchi, RA, Sur, PJ, Swaminathan, S, Sykes, BL, Szoeke, CEI, Tabarés-Seisdedos, R, Tadakamadla, SK, Takahashi, K, Takala, JS, Tandon, N, Tanner, M, Tarekegn, YL, Tavakkoli, M, Tegegne, TK, Tehrani-Banihashemi, A, Terkawi, AS, Tesssema, B, Thakur, JS, Thamsuwan, O, Thankappan, KR, Theis, AM, Thomas, ML, Thomson, AJ, Thrift, AG, Tillmann, T, Tobe-Gai, R, Tobollik, M, Tollanes, MC, Tonelli, M, Topor-Madry, R, Torre, A, Tortajada, M, Touvier, M, Tran, BX, Truelsen, T, Tuem, KB, Tuzcu, EM, Tyrovolas, S, Ukwaja, KN, Uneke, CJ, Updike, R, Uthman, OA, van Boven, JFM, Varughese, S, Vasankari, TJ, Veerman, LJ, Venkateswaran, V, Venketasubramanian, N, Violante, FS, Vladimirov, SK, Vlassov, VV, Vollset, SE, Vos, T, Wadilo, F, Wakayo, T, Wallin, MT, Wang, YP, Weichenthal, S, Weiderpass, E, Weintraub, RG, Weiss, DJ, Werdecker, A, Westerman, R, Whiteford, HA, Wiysonge, CS, Woldeyes, BG, Wolfe, CDA, Woodbrook, R, Workicho, A, Xavier, D, Xu, G, Yadgir, S, Yakob, B, Yan, LL, Yaseri, M, Yimam, HH, Yip, P, Yonemoto, N, Yoon, S-J, Yotebieng, M, Younis, MZ, Zaidi, Z, Zaki, MES, Zavala-Arciniega, L, Zhang, X, Zimsen, SRM, Zipkin, B & Zodpey, S 2017, 'Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016', The Lancet Global Health, vol. 390, no. 10100, pp. 1345-1422. https://doi.org/10.1016/S0140-6736(17)32366-8

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. / Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbafati, Cristiana et al.
In: The Lancet Global Health, Vol. 390, No. 10100, 16.09.2017, p. 1345-1422.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

AU - Abajobir, Amanuel Alemu

AU - Abate, Kalkidan Hassen

AU - Abbafati, Cristiana

AU - Abbas, Kaja M.

AU - Abd-Allah, Foad

AU - Abdulle, Abdishakur M.

AU - Abera, Semaw Ferede

AU - Aboyans, Victor

AU - Abu-Raddad, Laith J.

AU - Abu-Rmeileh, Niveen M E

AU - Abyu, Gebre Yitayih

AU - Adedeji, Isaac Akinkunmi

AU - Adetokunboh, Olatunji

AU - Afarideh, Mohsen

AU - Afshin, Ashkan

AU - Agrawal, Anurag

AU - Agrawal, Sutapa

AU - Ahmadieh, Hamid

AU - Ahmed, Muktar Beshir

AU - Aichour, Miloud Taki Eddine

AU - Aichour, Amani Nidhal

AU - Aichour, Ibtihel

AU - Akinyemi, Rufus Olusola

AU - Akseer, Nadia

AU - Alahdab, Fares

AU - Al-Aly, Ziyad

AU - Alam, Khurshid

AU - Alam, Noore

AU - Alam, Tahiya

AU - Alasfoor, Deena

AU - Alene, Kefyalew Addis

AU - Ali, Komal

AU - Alizadeh-Navaei, Reza

AU - Alkerwi, Ala'a

AU - Alla, François

AU - Allebeck, Peter

AU - Al-Raddadi, Rajaa

AU - Alsharif, Ubai

AU - Altirkawi, Khalid A.

AU - Alvis-Guzman, Nelson

AU - Amare, Azmeraw T

AU - Amini, Erfan

AU - Ammar, Walid

AU - Amoako, Yaw Ampem

AU - Ansari, Hossein

AU - Antó, Josep M.

AU - Antonio, Carl Abelardo T

AU - Anwari, Palwasha

AU - Arian, Nicholas

AU - Ärnlöv, Johan

AU - Artaman, Al

AU - Aryal, Krishna Kumar

AU - Asayesh, Hamid

AU - Asgedom, Solomon Weldegebreal

AU - Atey, Tesfay Mehari

AU - Avila-Burgos, Leticia

AU - Avokpaho, Euripide Frinel G.Arthur

AU - Awasthi, Ashish

AU - Azzopardi, Peter

AU - Bacha, Umar

AU - Badawi, Alaa

AU - Balakrishnan, Kalpana

AU - Ballew, Shoshana H.

AU - Barac, Aleksandra

AU - Barber, Ryan M

AU - Barker-Collo, Suzanne L

AU - Bärnighausen, Till

AU - Barquera, Simon

AU - Barregard, Lars

AU - Barrero, Lope H

AU - Batis, Carolina

AU - Battle, Katherine E.

AU - Baumgarner, Blair R.

AU - Baune, Bernhard T.

AU - Beardsley, Justin

AU - Bedi, Neeraj

AU - Beghi, Ettore

AU - Bell, Michelle L

AU - Bennett, Derrick A

AU - Bennett, James R.

AU - Bensenor, Isabela M.

AU - Berhane, Adugnaw

AU - Berhe, Derbew Fikadu

AU - Bernabé, Eduardo

AU - Betsu, Balem Demtsu

AU - Beuran, Mircea

AU - Beyene, Addisu Shunu

AU - Bhansali, Anil

AU - Bhutta, Zulfiqar A

AU - Bicer, Burcu Kucuk

AU - Bikbov, Boris

AU - Birungi, Charles

AU - Biryukov, Stan

AU - Blosser, Christopher D.

AU - Boneya, Dube Jara

AU - Bou-Orm, Ibrahim R.

AU - Brauer, Michael

AU - Breitborde, Nicholas J.K.

AU - Brenner, Hermann

AU - Brugha, Traolach S

AU - Bulto, Lemma Negesa Bulto

AU - Butt, Zahid A.

AU - Cahuana-Hurtado, Lucero

AU - Cárdenas, Rosario

AU - Carrero, Juan Jesus

AU - Castañeda-Orjuela, Carlos A

AU - Catalá-López, Ferrán

AU - Cercy, Kelly

AU - Chang, Hsing Yi

AU - Charlson, Fiona J

AU - Chimed-Ochir, Odgerel

AU - Chisumpa, Vesper Hichilombwe

AU - Chitheer, Abdulaal A.

AU - Christensen, Hanne

AU - Christopher, Devasahayam Jesudas

AU - Cirillo, Massimo

AU - Cohen, Aaron J

AU - Comfort, Haley

AU - Cooper, Cyrus

AU - Coresh, Josef

AU - Cornaby, Leslie

AU - Cortesi, Paolo Angelo

AU - Larsson, Anders

AU - Lee, Paul H.

AU - Lee, Alexander

AU - Leigh, James

AU - Leung, Janni

AU - Levi, Miriam

AU - Levy, Teresa Shamah

AU - Li, Yichong

AU - Li, Yongmei

AU - Liang, Xiaofeng

AU - Liben, Misgan Legesse

AU - Lim, Stephen S

AU - Linn, Shai

AU - Liu, Patrick

AU - Lodha, Rakesh

AU - Logroscino, Giancarlo

AU - Looker, Katherine J.

AU - Lopez, Alan D

AU - Lorkowski, Stefan

AU - Lotufo, Paulo A

AU - Lozano, Rafael

AU - Lunevicius, Raimundas

AU - Macarayan, Erlyn Rachelle King

AU - Magdy Abd El Razek, Hassan

AU - Magdy Abd El Razek, Mohammed

AU - Majdan, Marek

AU - Majdzadeh, Reza

AU - Majeed, Azeem

AU - Malekzadeh, Reza

AU - Malhotra, Rajesh

AU - Malta, Deborah Carvalho

AU - Mamun, Abdullah A.

AU - Manguerra, Helena

AU - Mantovani, Lorenzo G.

AU - Mapoma, Chabila C.

AU - Martin, Randall V

AU - Martinez-Raga, Jose

AU - Martins-Melo, Francisco Rogerlândio

AU - Mathur, Manu Raj

AU - Matsush*ta, Kunihiro

AU - Matzopoulos, Richard

AU - Mazidi, Mohsen

AU - McAlinden, Colm

AU - McGrath, John W

AU - Mehata, Suresh

AU - Mehndiratta, Man Mohan

AU - Meier, Toni

AU - Melaku, Yohannes Adama

AU - Memiah, Peter

AU - Memish, Ziad A.

AU - Mendoza, Walter

AU - Mengesha, Melkamu Merid

AU - Mensah, George A

AU - Mensink, Gert B.M.

AU - Mereta, Seid Tiku

AU - Meretoja, Tuomo J.

AU - Meretoja, Atte

AU - Mezgebe, Haftay Berhane

AU - Micha, Renata

AU - Millear, Anoushka

AU - Miller, Ted R

AU - Minnig, Shawn

AU - Mirarefin, Mojde

AU - Mirrakhimov, Erkin M.

AU - Misganaw, Awoke

AU - Mishra, Shiva Raj

AU - Mohammad, Karzan Abdulmuhsin

AU - Mohammed, Kedir Endris

AU - Mohammed, Shafiu

AU - Mohan, Murali B.V.

AU - Mokdad, Ali H

AU - Monasta, Lorenzo

AU - Montico, Marcella

AU - Moradi-Lakeh, Maziar

AU - Moraga, Paula

AU - Morawska, Lidia

AU - Morrison, Shane D.

AU - Mountjoy-Venning, Cliff

AU - Mueller, Ulrich O

AU - Mullany, Erin C

AU - Muller, Kate

AU - Murray, Christopher J L

AU - Murthy, Gudlavalleti Venkata Satyanarayana

AU - Musa, Kamarul Imran

AU - Naghavi, Mohsen

AU - Naheed, Aliya

AU - Nangia, Vinay

AU - Natarajan, Gopalakrishnan

AU - Negoi, Ruxandra Irina

AU - Negoi, Ionut

AU - Nguyen, Cuong Tat

AU - Nguyen, Quyen Le

AU - Nguyen, Trang Huyen

AU - Nguyen, Grant

AU - Nguyen, Minh Hao

AU - Nichols, Emma

AU - Ningrum, Dina Nur Anggraini

AU - Nomura, Marika

AU - Nong, Vuong Minh

AU - Norheim, Ole F

AU - Norrving, Bo

AU - Noubiap, Jean Jacques N.

AU - Obermeyer, Carla Makhlouf

AU - Ogbo, Felix Akpojene

AU - Oh, In-Hwan

AU - Oladimeji, Olanrewaju

AU - Olagunju, Andrew Toyin

AU - Olagunju, Tinuke Oluwasefunmi

AU - Olivares, Pedro R.

AU - Olsen, Helen E.

AU - Olusanya, Bolajoko Olubukunola

AU - Olusanya, Jacob Olusegun

AU - Opio, John Nelson

AU - Oren, Eyal

AU - Ortiz, Alberto

AU - Ota, Erika

AU - Owolabi, Mayowa O.

AU - PA, Mahesh

AU - Pacella, Rosana E.

AU - Pana, Adrian

AU - Panda, Basant Kumar

AU - Panda-Jonas, Songhomitra

AU - Pandian, Jeyaraj D

AU - Papachristou, Christina

AU - Park, Eun-Kee

AU - Parry, Charles D

AU - Patten, Scott B

AU - Patton, George C.

AU - Pereira, David M

AU - Perico, Norberto

AU - Pesudovs, Konrad

AU - Petzold, Max

AU - Phillips, Michael Robert

AU - Pillay, Julian David

AU - Piradov, Michael A.

AU - Pishgar, Farhad

AU - Plass, Dietrich

AU - Pletcher, Martin A.

AU - Polinder, Suzanne

AU - Popova, Svetlana

AU - Poulton, Richie G.

AU - Pourmalek, Farshad

AU - Prasad, Narayan

AU - Purcell, Carrie

AU - Qorbani, Mostafa

AU - Radfar, Amir

AU - Rafay, Anwar

AU - Rahimi-Movaghar, Afarin

AU - Rahimi-Movaghar, Vafa

AU - Rahman, Mohammad Hifz Ur

AU - Rahman, Muhammad Aziz

AU - Rahman, Mahfuzar

AU - Rai, Rajesh Kumar

AU - Rajsic, Sasa

AU - Ram, Usha

AU - Rawaf, Salman

AU - Rehm, Colin D.

AU - Rehm, Jürgen

AU - Reiner, Robert C.

AU - Reitsma, Marissa B.

AU - Remuzzi, Giuseppe

AU - Renzaho, Andre M.N.

AU - Resnikoff, Serge

AU - Reynales-Shigematsu, Luz Myriam

AU - Rezaei, Satar

AU - Ribeiro, Antonio L

AU - Rivera, Juan A.

AU - Roba, Kedir Teji

AU - Rojas-Rueda, David

AU - Roman, Yesenia

AU - Room, Robin

AU - Roshandel, Gholamreza

AU - Roth, Gregory A.

AU - Rothenbacher, Dietrich

AU - Rubagotti, Enrico

AU - Rushton, Lesley

AU - Sadat, Nafis

AU - Safdarian, Mahdi

AU - Safi, Sare

AU - Safiri, Saeid

AU - Sahathevan, Ramesh

AU - Salama, Joseph

AU - Salomon, Joshua A

AU - Samy, Abdallah M.

AU - Sanabria, Juan Ramon

AU - Sanchez-Niño, Maria Dolores

AU - Sánchez-Pimienta, Tania G

AU - Santomauro, Damian

AU - Santos, Itamar S

AU - Santric Milicevic, Milena M.

AU - Sartorius, Benn

AU - Satpathy, Maheswar

AU - Sawhney, Monika

AU - Saxena, Sonia

AU - Schmidt, Maria Inês

AU - Schneider, Ione J C

AU - Schutte, Aletta E.

AU - Schwebel, David C

AU - Schwendicke, Falk

AU - Seedat, Soraya

AU - Sepanlou, Sadaf G

AU - Serdar, Berrin

AU - Servan-Mori, Edson E

AU - Shaddick, Gavin

AU - Shaheen, Amira

AU - Shahraz, Saeid

AU - Shaikh, Masood Ali

AU - Shamsipour, Mansour

AU - Shamsizadeh, Morteza

AU - Shariful Islam, Sheikh Mohammed

AU - Sharma, Jayendra

AU - Sharma, Rajesh

AU - She, Jun

AU - Shen, Jiabin

AU - Shi, Peilin

AU - Shibuya, Kenji

AU - Shields, Chloe

AU - Shiferaw, Mekonnen Sisay

AU - Shigematsu, Mika

AU - Shin, Min Jeong

AU - Shiri, Rahman

AU - Shirkoohi, Reza

AU - Shishani, ka*wkab

AU - Shoman, Haitham

AU - Shrime, Mark G.

AU - Sigfusdottir, Inga Dora

AU - Silva, Diego Augusto Santos

AU - Silva, João Pedro

AU - Silveira, Dayane Gabriele Alves

AU - Singh, Jasvinder A

AU - Singh, Virendra

AU - Sinha, Dhirendra Narain

AU - Skiadaresi, Eirini

AU - Slepak, Erica Leigh

AU - Smith, David L.

AU - Smith, Mari

AU - Sobaih, Badr H.A.

AU - Sobngwi, Eugene

AU - Soneji, Samir

AU - Sorensen, Reed J.D.

AU - Sposato, Luciano A

AU - Sreeramareddy, Chandrashekhar T

AU - Srinivasan, Vinay

AU - Steel, Nicholas

AU - Stein, Dan J.

AU - Steiner, Caitlyn

AU - Steinke, Sabine

AU - Stokes, Mark Andrew

AU - Strub, Bryan

AU - Subart, Michelle

AU - Sufiyan, Muawiyyah Babale

AU - Suliankatchi, Rizwan Abdulkader

AU - Sur, Patrick J.

AU - Swaminathan, Soumya

AU - Sykes, Bryan L

AU - Szoeke, Cassandra E.I.

AU - Tabarés-Seisdedos, Rafael

AU - Tadakamadla, Santosh Kumar

AU - Takahashi, Ken

AU - Takala, Jukka S.

AU - Tandon, Nikhil

AU - Tanner, Marcel

AU - Tarekegn, Yihunie L.

AU - Tavakkoli, Mohammad

AU - Tegegne, Teketo Kassaw

AU - Tehrani-Banihashemi, Arash

AU - Terkawi, Abdullah Sulieman

AU - Tesssema, Belay

AU - Thakur, J. S.

AU - Thamsuwan, Ornwipa

AU - Thankappan, Kavumpurathu Raman

AU - Theis, Andrew M.

AU - Thomas, Matthew Lloyd

AU - Thomson, Alan J.

AU - Thrift, Amanda G

AU - Tillmann, Taavi

AU - Tobe-Gai, Ruoyan

AU - Tobollik, Myriam

AU - Tollanes, Mette C.

AU - Tonelli, Marcello

AU - Topor-Madry, Roman

AU - Torre, Anna

AU - Tortajada, Miguel

AU - Touvier, Mathilde

AU - Tran, Bach Xuan

AU - Truelsen, Thomas

AU - Tuem, Kald Beshir

AU - Tuzcu, Emin Murat

AU - Tyrovolas, Stefanos

AU - Ukwaja, Kingsley Nnanna

AU - Uneke, Chigozie Jesse

AU - Updike, Rachel

AU - Uthman, Olalekan A.

AU - van Boven, Job F.M.

AU - Varughese, Santosh

AU - Vasankari, Tommi J

AU - Veerman, Lennert J

AU - Venkateswaran, Vidhya

AU - Venketasubramanian, Narayanaswamy

AU - Violante, Francesco S

AU - Vladimirov, Sergey K.

AU - Vlassov, Vasiliy Victorovich

AU - Vollset, Stein Emil

AU - Vos, Theo

AU - Wadilo, Fiseha

AU - Wakayo, Tolassa

AU - Wallin, Mitchell T

AU - Wang, Yuan Pang

AU - Weichenthal, Scott

AU - Weiderpass, Elisabete

AU - Weintraub, Robert G

AU - Weiss, Daniel J.

AU - Werdecker, Andrea

AU - Westerman, Ronny

AU - Whiteford, Harvey A

AU - Wiysonge, Charles Shey

AU - Woldeyes, Belete Getahun

AU - Wolfe, Charles D A

AU - Woodbrook, Rachel

AU - Workicho, Abdulhalik

AU - Xavier, Denis

AU - Xu, Gelin

AU - Yadgir, Simon

AU - Yakob, Bereket

AU - Yan, Lijing L

AU - Yaseri, Mehdi

AU - Yimam, Hassen Hamid

AU - Yip, Paul

AU - Yonemoto, Naohiro

AU - Yoon, Seok-Jun

AU - Yotebieng, Marcel

AU - Younis, Mustafa Z

AU - Zaidi, Zoubida

AU - Zaki, Maysaa El Sayed

AU - Zavala-Arciniega, Luis

AU - Zhang, Xueying

AU - Zimsen, Stephanie Raman M.

AU - Zipkin, Ben

AU - Zodpey, Sanjay

PY - 2017/9/16

Y1 - 2017/9/16

N2 - Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. Findings Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9·3% (6·9–11·6) decline in deaths and a 10·8% (8·3–13·1) decrease in DALYs at the global level, while population ageing accounts for 14·9% (12·7–17·5) of deaths and 6·2% (3·9–8·7) of DALYs, and population growth for 12·4% (10·1–14·9) of deaths and 12·4% (10·1–14·9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27·3% (24·9–29·7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. Interpretation Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade. Funding The Bill & Melinda Gates Foundation, Bloomberg Philanthropies.

AB - Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. Findings Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9·3% (6·9–11·6) decline in deaths and a 10·8% (8·3–13·1) decrease in DALYs at the global level, while population ageing accounts for 14·9% (12·7–17·5) of deaths and 6·2% (3·9–8·7) of DALYs, and population growth for 12·4% (10·1–14·9) of deaths and 12·4% (10·1–14·9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27·3% (24·9–29·7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. Interpretation Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade. Funding The Bill & Melinda Gates Foundation, Bloomberg Philanthropies.

U2 - 10.1016/S0140-6736(17)32366-8

DO - 10.1016/S0140-6736(17)32366-8

M3 - Article

C2 - 28919119

SN - 2214-109X

VL - 390

SP - 1345

EP - 1422

JO - The Lancet Global Health

JF - The Lancet Global Health

IS - 10100

ER -

Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abdulle AM et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Global Health. 2017 Sept 16;390(10100):1345-1422. doi: 10.1016/S0140-6736(17)32366-8

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 (2024)

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