Background: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results: GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions: GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.
Bibliographical noteFunding Information:
388Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran 389Faculty of Life Sciences and Medicine, King’s College London, London, UK 390Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy 391Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa 392Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran 393Kermanshah University of Medical Sciences, Kermanshah, Iran 394Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran 395Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran 396Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran 397International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Queensland, Australia 398Gorgas Memorial Institute for Health Studies, Panama City, Panama 399Department of Psychiatry, Badhir Dar University, Ethiopia 400Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia 401School of Medical Sciences, Science University of Malaysia, Kubang Kerian, Malaysia 402Department of Pediatric Medicine, Nishtar Medical University, Multan, Pakistan 403Department of Pediatrics & Pediatric Pulmonology, Institute of Mother & Child Care, Multan, Pakistan 404Clinical Research Development Center, Kermanshah University of Medical Sciences, Kermanshah, Iran 405Research and Analytics, Initiative for Financing Health and Human Development, Chennai, India 406Research and Analytics, Bioinsilico Technologies, Chennai, India 407Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA 408Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia 409Experimental Surgery and Oncology Laboratory, Kursk State Medical University of the Ministry of Health of the Russian Federation, Kursk, Russia 410Department of Epidemiology & Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran 411Suraj Eye Institute, Nagpur, India 412Hospital of the Federal University of Minas Gerais, Federal University of Minas Gerais, Belo Horizonte, Brazil 413Mental Health Research Center, IUMS, Tehran, Iran 414Preventive Medicine and Public Health Research Center, IUMS, Tehran, Iran 415Department of Forensic Medicine and Toxicology, Manipal Academy of Higher Education, Manipal, India 416Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran 417Iranian Ministry of Health and Medical Education, Tehran, Iran 418Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa 419Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania 420Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania 421Department of Biological Sciences, University of Embu, Embu, Kenya 422Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam 423Project of ADB, National Institute of Nutrition, Hanoi, Vietnam 424Industrial Management Department, Hanoi University of Science and Technology, Hanoi, Vietnam 425Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran 426Heidelberg University Hospital, Heidelberg, Germany 427Public Health Department, Universitas Negeri Semarang, Kota Semarang, Indonesia 428Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan 429School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa 430Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Victoria, Australia 431Independent Consultant, Accra, Ghana 432UCIBIO, University of Porto, Porto, Portugal 433Reproductive Health Sciences, Department Obstetrics and Gynecology, University of Ibadan, Ibadan, Nigeria 434Department of Preventive Medicine, Kyung Hee University, Dongdaemun-gu, South Korea 435Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada 436Department of Psychiatry, University of Lagos, Lagos, Nigeria 437Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada 438Diplomacy and Public Relations Department, University of Human Development, Sulaimaniyah, Iraq 439Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria 440Applied Research Division, Public Health Agency of Canada, Ottawa, Ontario, Canada 441School of Psychology, University of Ottawa, Ottawa, Ontario, Canada 442Department of Global Health Nursing, St. Luke’s International University, Chuo-ku, Japan 443Academic Department, Unium Ltd, Moscow, Russia 444Department of Project Management, National Research University Higher School of Economics, Moscow, Russia 445Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India 446Department of Forensic Medicine, Manipal Academy of Higher Education, Manipal, India 447Department of Medicine, Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, Ontario, Canada 448Parasitology and Mycology Department, Shiraz University of Medical Sciences, Shiraz, Iran 449Augenpraxis Jonas, Heidelberg University, Heidelberg, Germany 450Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea 451Research and Evaluation Department, Population Council, New Delhi, India 452Indian Institute of Health Management Research University, Jaipur, India 453Department of Pediatircs, RD Gardi Medical College, Ujjain, India 454Public Health Sciences, Karolinska Institutet, Stockholm, Sweden 455Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, India 456Department of Midwifery, Wolaita Sodo University, Wolaita Sodo, Ethiopia 457School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia 458Center for Research and Innovation, Ateneo De Manila University, Pasig City, Philippines 459Department of Orthopedics, Yenepoya Medical College, Mangalore, India 460Department of Psychiatry, Department of Epidemiology, Columbia University, New York, NY, USA 461Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China 462Department of Epidemiology and Evidence-Based Medicine, Sechenon University, Moscow, Russia 463School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada 464Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran 465Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India 466Health Sciences Department, Muhammadiyah University of Surakarta, Sukoharjo, Indonesia 467Department of Chemistry, Sharif University of Technology, Tehran, Iran 468Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran 469College of Medicine, University of Central Florida, Orlando, FL, USA 470College of Graduate Health Sciences, A.T. Still University, Mesa, AZ, USA 471Department of Epidemiology & Biostatistics, Contech School of Public Health, Lahore, Pakistan 472Department of Medicine, University of Alberta, Edmonton, Alberta, Canada 473Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran 474Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran 475Thalassemia and Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 476Metabolomics and Genomics Research Center, Tehran University of Medical Sciences, Tehran, Iran 477Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 478School of Nursing and Healthcare Professions, Federation University Australia, Berwick, Victoria, Australia 479School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia 480Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran 481European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization (WHO), Moscow, Russia 482Department of Oral Pathology, Srinivas Institute of Dental Sciences, Mangalore, India
594Department of Preventive Medicine, Northwestern University, Chicago, IL, USA 595School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada 596Health Services Management Research Center, Kerman University of Medical Sciences, Kerman, Iran 597Department of Health Management, Policy and Economics, Kerman University of Medical Sciences, Kerman, Iran 598Division of Injury Prevention and Mental Health Improvement, National Center for Chronic and Noncommunicable Disease Control, Chinese Center for Disease Control and Prevention, Beijing, China 599Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China 600Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China 601School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia 602Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan 603Department of Sociology, Yonsei University, Seoul, South Korea 604Department of Health Policy & Management, Jackson State University, Jackson, MS, USA 605School of Medicine, Tsinghua University, Beijing, China 606Department of Environmental Health, Mazandaran University of Medical Sciences, Sari, Iran 607Environmental Health, Academy of Medical Science, Sari, Iran 608Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China 609Global Health Institute, Wuhan University, Wuhan, China 610School of Public Health and Management, Hubei University of Medicine, Shiyan, China 611Social Determinants of Health Research Center, Ardabil University of Medical Science, Ardabil, Iran 612Department of Epidemiology, University Hospital of Setif, Setif, Algeria 613Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia 614Student Research Committee, Babol University of Medical Sciences, Babol, Iran 615Department of Community Medicine, Ardabil University of Medical Science, Ardabil, Iran 616Faculty of Medical Sciences, Department of Health Education, Tarbiat Modares University, Tehran, Iran 617Department of Preventive Medicine, Wuhan University, Wuhan, China 618School of Public Health, Wuhan University of Science and Technology, Wuhan, China 619Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China 620Indian Institute of Public Health, Public Health Foundation of India, Gurugram, India 621Public Health Foundation of India, Gurugram, India 622Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka Acknowledgements Seyed Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. Alaa Badawi acknowledges support by the Public Health Agency of Canada. Till Bärnighausen acknowledges support by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. Traolach Brugha received support from NatCen Social Research (http://natcen.ac.uk/) via NHS Digital and Department of Health and Social Care London, for the Adult Psychiatric Morbidity Survey (APMS) programme. Felix Carvalho received support from UID/MULTI/04378/2019 with funding from FCT/MCTES through national funds. Vera M Costa acknowledges support from grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. Kebede Deribe is supported by a grant from the Wellcome Trust [grant number 201900] as part of his International Intermediate Fellowship. Tim Driscoll acknowledges that work on occupational risk factors was partially supported by funds from the World Health Organization. Eduarda Fernandes acknowledges support from UID/QUI/50006/2019 with funding from FCT/ MCTES through national funds. Yuming Guo acknowledges support from Career Development Fellowships of the Australian National Health and Medical Research Council (numbers APP1107107 and APP1163693). Sheikh Mohammed Shariful Islam is funded by a Fellowship from National Heart Foundation of Australia and Institute for Physical Activity and Nutrition, Deakin University. Mihajlo Jakovljevic acknowledges support by the Ministry of Education Science and Technological Development of the Republic of Serbia through the Grant number OI175014; publication of results was not contingent upon Ministry’s censorship or approval. Sudha Jayaraman acknowledges support from: NIH R21: 1R21TW010439-01A1 (PI); Rotary Foundation Global Grant #GG1749568 (PI); NIH P20: 1P20CA210284-01A1 (Co-PI) and DOD grant W81XWH-16-2-0040 (Co-I), during the period of this study. Yun Jin Kim acknowledges support from a grant from the Research Management Centre, Xiamen University Malaysia [grant number: XMUMRF/2018-C2/ITCM/0001]. Kewal Krishan is supported by UGC Centre of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India. Mansai Kumar acknowledges support from FIC/ NIH K43 1K43MH114320-01. Amanda Mason-Jones acknowledges support by the University of York. Mariam Molokhia is supported by the National Institute for Health Research Biomedical Research Center at Guy’s and St Thomas’s National Health Service Foundation Trust and King’s College London. Ilais Moreno Velasquez is supported by the Sistema Nacional de Investigación (SNI, Senacyt, Panama). Mukhammad David Naimzada acknowledges support from Government of the Russian Federation (Agreement No – 075-02-2019-967). Duduzile Ndwandwe acknowledges support from Cochrane South Africa, South African Medical Research Council. Stanislav S. Otstavnov acknowledges the support from the Government of the Russian Federation (Agreement No – 075-02-2019-967). Ashish Pathak acknowledges support from Indian Council of Medical Research (ICMR), New Delhi, India (Grant number 2013-1253). Michael R Phillips acknowledges support in part by a grant from the National Natural Science Foundation of China (No.81761128031). Abdallah M. Samy received a fellowship from the Egyptian Fulbright Mission Program. Milena Santric Milicevic acknowledges the support from the Ministry of Education, Science and Technological Development, Republic of Serbia (Contract No. 175087). Seyedmojtaba Seyedmousavi was supported by the Intramural Research Program of the National Institutes of Health, Clinical Center, Department of Laboratory Medicine, Bethesda, MD, USA. Rafael Tabarés-Seisdedos was supported in part by the national grant PI17/00719 from ISCIII-FEDER. Sojib Bin Zaman acknowledges support from an "Australian Government Research Training Program (RTP) Scholarship.” Funding This study was funded by The Bill and Melinda Gates Foundation. SLJ conducts research for a grant on influenza and RSV which is funded in part by Sanofi Pasteur.
Competing interests Dr. James reports grants from Sanofi Pasteur, outside the submitted work. Dr. Driscoll reports grants from World Health Organisation, during the conduct of the study. Dr Shariful Islam is funded by a Fellowship from National Heart Foundation of Australia and Institute for Physical Activity and Nutrition, Deakin University. Dr. Ivers reports grants from National Health and Medical Research Council of Australia, during the conduct of the study. Dr. Jozwiak reports personal fees from TEVA, personal fees from ALAB, personal fees from BOEHRINGER INGELHEIM, personal fees from SYNEXUS, non-financial support from SERVIER, non-financial support from MICROLIFE, non-financial support from MEDICOVER, outside the submitted work. Walter Mendoza is currently Program Analyst Population and Development at the Peru Country Office of the United Nations Population Fund-UNFPA, which does not necessarily endorses this study. Dr. Rakovac reports grants from World Health Organization, during the conduct of the study. Dr. Sheikh reports grants from Health Data Research UK, outside the submitted work. Dr. Singh reports personal fees from Crealta/Horizon, Medisys, Fidia, UBM LLC, Trio health, Medscape, WebMD, Clinical Care options, Clearview healthcare partners, Putnam associates, Spherix, Practice Point communications, the National Institutes of Health and the American College of Rheumatology, personal fees from Speaker’s bureau of Simply Speaking. Dr. Singh owns stock options in Amarin pharmaceuticals and Viking pharmaceuticals. Dr. Singh serves on the steering committee of OMERACT, an international organization that develops measures for clinical trials and receives arms-length funding from 12 pharmaceutical companies. Dr. Singh serves on the FDA Arthritis Advisory Committee. Dr. Singh is a member of the Veterans Affairs Rheumatology Field Advisory Committee. Dr. Singh is the editor and the Director of the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis, outside the submitted work. Dr. Stein reports personal fees from Lundbeck and Sun, outside the submitted work.
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