While global adult mortality rates drop, gaps between countries grow, Lancet study finds

May 3 2010

"The global mortality rate for adults [ages 15-59] has fallen by about 1 percent a year for the past 40 years, with women making greater gains than men and huge differences opening up between countries and regions over that period, according to a new study" published online Friday in the journal Lancet, the Washington Post reports, noting the study offers "the most detailed nation-by-nation trends in adult mortality" to date.

For the study, researchers analyzed close to 4,000 measurements for adult mortality for 187 countries from 1970 to 2010, using vital registration data and census and survey data on deaths. "Adult mortality, measured as the probability of dying after the 15th birthday but before the 60th, dropped 19 percent for men and 34 percent for women over the past 40 years" (Brown, 4/30).

Reuters reports that the risk of early death in women in south Asia fell 56 percent over the past 40 years. "'In 1970, [south Asia] was the region with the highest risk of female mortality…,'" according to the study (Fox, 4/29).

Agence France-Presse: "a 15-year old girl in the country with the worst female death rate today, Zambia, is 16 times more likely to die before reaching the sixth decade of life than her counterpart in Cyprus, the nation on top of the ranking. … More broadly, the rates of mortality across all of southern Africa are, in 2010, higher than they were in Sweden in 1751, nearly two centuries before the widespread production of life-saving antibiotics, the study showed" (4/30).

"Death rates were highest for men in Swaziland and for women in Zambia," the Associated Press reports. "Researchers also found death rates jumped in eastern Europe, perhaps because health systems fell apart after the collapse of the Soviet Union and widespread smoking. In sub-Saharan Africa, deaths have fallen, possibly due to the rollout of lifesaving AIDS drugs."

Overall, "[t]he findings are in contrast to the trends in child and maternal mortality, where rates are mostly dropping worldwide. Health officials have long thought if child deaths were decreasing and health systems were improving, adult deaths would similarly decline. But that's not what researchers found" (Cheng, 4/30).

U.K. Press Association: "The researchers, led by Christopher Murray at the University of Washington in Seattle, said three times as many adults aged 15 to 60 died each year as did children under five. They concluded: 'The prevention of premature adult death is just as important for global health policy as is the improvement of child survival. The global health community needs to broaden its focus and to learn from measures applied in countries such as Australia and South Korea to ensure that those who survive to adulthood will also survive until old age'" (4/29).

"Despite the growing interest in the health of adults over the past two decades … a rigorous assessment of the levels and trends of adult mortality has been neglected, partly due to the huge measurement challenge (ie, adult deaths are rare events compared with deaths in children) and the preference of donors to focus on disease-specific adult mortality estimates which cannot be consistent without all-cause adult mortality," write the authors of an accompanying Lancet comment. "With only 5 years left to achieve the Millennium Development Goals (MDGs), which include a subset of adult mortality, the global health community is in dire need of data to monitor progress in health-related MDGs and evaluate the impact of global health initiatives" (Koyanagi/Kenji Shibuya, 4/30).

Reuters features a fact box of additional highlights from the Lancet study (4/29).