Part II. Global health indicators

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1 2015 Part II Global health indicators

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3 2015 General notes The following summary tables represent the best estimates of WHO for a broad range of key public health indicators based on evidence available at the beginning of These best estimates have wherever possible been computed by WHO using standardized categories and methods in order to enhance cross-national comparability. In some cases this approach may result in differences between the estimates presented here and the official national statistics prepared and endorsed by individual WHO s. It is also important to stress that these estimates are subject to considerable uncertainty, particularly for countries with weak statistical and health information systems where the quality of the underlying empirical data is limited. In addition, it should not be assumed that changes in the values shown for indicators reported on in previous editions of the World Health Statistics series accurately reflect underlying trends. This applies to all types of data and estimates (reported and survey-based data, and modelling-based estimates) and to all reporting levels (national, regional and global). For indicators with a reference period expressed as a range in Tables 4, 5, 6 and 9, the figure shown is for the most recent year in the range for which data are available unless otherwise noted. For survey data, the year of the report is used to determine the latest available year to be consistent across indicators. For more information on specific years, indicator definitions and metadata please refer to: The WHO regional, income-group and global estimates for rates and ratios are population-weighted averages when relevant, while for absolute numbers they are the aggregated sums. Figures are calculated only if data are available for at least 50% of the population within an indicated region or group. For indicators with a reference period expressed as a range, the estimate provided covers the reference period shown in the heading unless otherwise noted. Income-group averages and aggregates, unless otherwise noted, are calculated using the World Bank analytical income classification of economies for fiscal year 2015, which is based on the 2013 Atlas gross national income per capita estimates indicates data not available or not applicable. 1. See Annex 1. 41

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5 1. Life expectancy and mortality 2015 Table 1 The indicators of life expectancy and mortality presented in Table 1 are: life expectancy at birth; life expectancy at age 60; healthy life expectancy (HALE) at birth; neonatal mortality rate (the probability of death occurring during the first 28 days of life); infant and under-five mortality rates (the probability of dying between birth and 1 year of age, and before 5 years of age, respectively); and adult mortality rate (the probability of dying between 15 and 60 years of age). The estimates of mortality presented here have been derived wherever possible from death-registration data reported annually to WHO. For countries where such data are not available or are of poor quality, estimates of mortality by age and sex were used to construct life tables from which life expectancy was then calculated. Life expectancy at birth reflects the overall mortality level of a population and summarizes the mortality pattern that prevails across all age groups children and adolescents, adults and the elderly. HALE represents the average number of years that a person in a population can expect to live in full health by taking into account years lived in less than full health due to disease and/or injury. In recent years, WHO has liaised more closely with the United Nations Population Division in producing life tables for countries in order to maximize the consistency of United Nations and WHO life tables, and to minimize differences in the use and interpretation of available data on mortality levels. In the case of child mortality, WHO is part of the Inter-agency Group for Child Mortality Estimation (IGME) which carries out annual updates of estimates for infant and child mortality for UNICEF, WHO and other international agencies. As well as harmonizing the child mortality estimates used by its members, the IGME monitors progress towards the achievement of the relevant MDG target. 1 Child mortality rates measure child survival, and reflect the social, economic and environmental conditions in which children (and others in society) live, including their access to health care. 1. MDG 4; Target 4.A: Reduce by two thirds, between 1990 and 2015, the under-five mortality rate. 43

6 1. Life expectancy and mortality Life expectancy at birth a (years) Life expectancy at age 60 a (years) Both sexes Male Female Both sexes Male Female Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia (Plurinational State of) Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Central African Republic Chad Chile China Colombia Comoros Congo Cook Islands Costa Rica Côte d'ivoire Croatia Cuba Cyprus Czech Republic Democratic People's Republic of Korea Democratic Republic of the Congo Denmark

7 2015 Healthy life expectancy at birth a (years) Neonatal mortality rate (per 1000 live births) b Infant mortality rate (probability of dying by age 1 per 1000 live births) b MDG 4 Under-five mortality rate b (probability of dying by age 5 per 1000 live births) Adult mortality rate a (probability of dying between 15 and 60 years of age per 1000 population) Table 1 Both sexes Both sexes Both sexes Both sexes Male Female Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia (Plurinational State of) Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Central African Republic Chad Chile China Colombia Comoros Congo Cook Islands Costa Rica Côte d'ivoire Croatia Cuba Cyprus Czech Republic Democratic People's Republic of Korea Democratic Republic of the Congo Denmark 45

8 1. Life expectancy and mortality Life expectancy at birth a (years) Life expectancy at age 60 a (years) Both sexes Male Female Both sexes Male Female Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya

9 2015 Healthy life expectancy at birth a (years) Neonatal mortality rate (per 1000 live births) b Infant mortality rate (probability of dying by age 1 per 1000 live births) b MDG 4 Under-five mortality rate b (probability of dying by age 5 per 1000 live births) Adult mortality rate a (probability of dying between 15 and 60 years of age per 1000 population) Table 1 Both sexes Both sexes Both sexes Both sexes Male Female Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya 47

10 1. Life expectancy and mortality Life expectancy at birth a (years) Life expectancy at age 60 a (years) Both sexes Male Female Both sexes Male Female Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia (Federated States of) Monaco Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Niue Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Republic of Korea Republic of Moldova Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa

11 2015 Healthy life expectancy at birth a (years) Neonatal mortality rate (per 1000 live births) b Infant mortality rate (probability of dying by age 1 per 1000 live births) b MDG 4 Under-five mortality rate b (probability of dying by age 5 per 1000 live births) Adult mortality rate a (probability of dying between 15 and 60 years of age per 1000 population) Table 1 Both sexes Both sexes Both sexes Both sexes Male Female Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia (Federated States of) Monaco Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Niue Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Republic of Korea Republic of Moldova Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa 49

12 1. Life expectancy and mortality Life expectancy at birth a (years) Life expectancy at age 60 a (years) Both sexes Male Female Both sexes Male Female San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syrian Arab Republic Tajikistan Thailand The former Yugoslav Republic of Macedonia Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United Republic of Tanzania United States of America Uruguay Uzbekistan Vanuatu Venezuela (Bolivarian Republic of) Viet Nam Yemen Zambia Zimbabwe

13 2015 Healthy life expectancy at birth a (years) Neonatal mortality rate (per 1000 live births) b Infant mortality rate (probability of dying by age 1 per 1000 live births) b MDG 4 Under-five mortality rate b (probability of dying by age 5 per 1000 live births) Adult mortality rate a (probability of dying between 15 and 60 years of age per 1000 population) Table 1 Both sexes Both sexes Both sexes Both sexes Male Female San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syrian Arab Republic Tajikistan Thailand The former Yugoslav Republic of Macedonia Timor-Leste Togo Tonga Trinidad and Tobago Tunisia c Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United Republic of Tanzania United States of America Uruguay Uzbekistan Vanuatu Venezuela (Bolivarian Republic of) Viet Nam Yemen Zambia Zimbabwe 51

14 1. Life expectancy and mortality Life expectancy at birth a (years) Life expectancy at age 60 a (years) Both sexes Male Female Both sexes Male Female Ranges of country values Minimum Median Maximum WHO region African Region Region of the Americas South-East Asia Region European Region Eastern Mediterranean Region Western Pacific Region Income group Low income Lower middle income Upper middle income High income Global a. Mortality and global health estimates [online database]. Geneva: World Health Organization; 2014 ( Income groups were derived using the 2013 World Bank list of economies. South Sudan is included in the WHO Eastern Mediterranean Region for consistency of time series with World Health Statistics 2014 figures. b. Levels & Trends in Child Mortality. Report Estimates Developed by the UN Interagency Group for Child Mortality Estimation. New York: UNICEF; 2014 ( unicef.org/media/files/levels_and_trends_in_child_mortality_2014.pdf, accessed 6 April 2015). c. Turkey has recently improved its vital registration system and reported an infant mortality of 10.8 per 1,000 live births for 2013 ( do?id=16050). An assessment of death registration coverage for years showed 90% completeness for adult deaths. Completeness of child death registration is likely to be somewhat lower. 52

15 2015 Healthy life expectancy at birth a (years) Neonatal mortality rate (per 1000 live births) b Infant mortality rate (probability of dying by age 1 per 1000 live births) b MDG 4 Under-five mortality rate b (probability of dying by age 5 per 1000 live births) Adult mortality rate a (probability of dying between 15 and 60 years of age per 1000 population) Table 1 Both sexes Both sexes Both sexes Both sexes Male Female Minimum Median Maximum African Region Region of the Americas South-East Asia Region European Region Eastern Mediterranean Region Western Pacific Region Low income Lower middle income Upper middle income High income Global 53

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17 Cause-specific mortality and morbidity Table 2 Table 2 brings together indicators on the levels and distribution of the broad categories and more-specific causes of deaths. The three broad categories shown are communicable 1 and noncommunicable conditions, and deaths caused by injury. The years of life lost (YLL) is a measure of premature mortality that takes into account the frequency of premature death and the ages at which deaths occur. Estimates are also provided of the number of deaths among children under 5 years old, and the percentage distributions of the major causes of such deaths. These causes include: HIV/AIDS; diarrhoea; other major communicable diseases such as measles, malaria and acute respiratory infections; conditions arising in the perinatal period such as prematurity, intrapartum-related complications, neonatal sepsis and congenital anomalies; injuries; and other causes. Table 2 also includes point estimates for key MDG-related indicators, including maternal mortality, and mortality and morbidity caused by HIV/AIDS, malaria and tuberculosis. The cause-specific indicators presented in Table 2 have been derived from a range of sources of mortality, incidence and prevalence data. These include death-registration records, health-facility reports, household surveys, censuses, and special studies on deaths due to HIV/AIDS and to conflict. Estimating cause-specific mortality is particularly difficult in developing countries where systems for counting deaths and accurately recording their causes are weak or non-existent. Due to resulting limitations in data availability, quality and timeliness, many of the indicators shown are associated with significant uncertainty, the margins of which are available on the Global Health Observatory web site ( 1. Columns labelled Communicable diseases show estimates pertaining to a group of conditions that includes communicable (infectious or contagious) diseases, maternal causes, conditions arising during the perinatal period and nutritional deficiencies. While the latter three conditions are not communicable, the term is used for practical purpose to refer to the entire group of conditions encompassing the primary mortality risks for countries still undergoing epidemiological transition. 55

18 2. Cause-specific mortality and morbidity Age-standardized mortality rates by cause a (per population) Communicable Noncommunicable Injuries All causes Years of life lost a (per population) Communicable Noncommunicable Injuries MDG 4 Number of deaths among children aged < 5 years b (000s) Distribution of causes of death among children aged < 5 years b,c Mortality HIV/AIDS Diarrhoea Measles Malaria Afghanistan <1 < <1 <1 Albania <1 <1 0 0 Algeria <1 < Andorra 0 0 Angola < Antigua and Barbuda <1 <1 Argentina <1 < Armenia <1 <1 3 1 < Australia <1 < <1 Austria <1 <1 0 <1 <1 < Azerbaijan <1 < < Bahamas <1 < Bahrain <1 <1 0 0 <1 < Bangladesh < <1 <1 Barbados <1 < Belarus <1 < Belgium <1 0 1 < Belize <1 <1 2 < Benin Bhutan <1 < <1 <1 Bolivia (Plurinational State of) < <1 0 Bosnia and Herzegovina < < Botswana <1 Brazil <1 < <1 <1 Brunei Darussalam <1 < Bulgaria <1 0 0 Burkina Faso Burundi Cabo Verde <1 < <1 <1 <1 Cambodia < Cameroon < Canada <1 < Central African Republic Chad Chile <1 <1 1 < China <1 < <1 0 0 Colombia <1 < <1 <1 Comoros Congo Cook Islands <1 0 Costa Rica <1 < Côte d'ivoire < Croatia <1 <1 0 0 < Cuba < Cyprus <1 <1 0 0 <1 < Czech Republic <1 <1 0 0 < Democratic People's Republic of Korea <1 < < Democratic Republic of the Congo Denmark <1 <

19 2015 Distribution of causes of death among children aged < 5 years b,c Acute respiratory infections Prematurity Intrapartumrelated complications Neonatal sepsis Congenital anomalies Other diseases Injuries Table Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia (Plurinational State of) Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Central African Republic Chad Chile China Colombia Comoros Congo Cook Islands Costa Rica Côte d'ivoire Croatia Cuba Cyprus Czech Republic Democratic People's Republic of Korea Democratic Republic of the Congo Denmark 57

20 2. Cause-specific mortality and morbidity (contd.) Mortality MDG 5 MDG 6 Maternal mortality ratio d (per live births) Cause-specific mortality rate (per population) HIV/AIDS e Malaria f Tuberculosis g (among HIV-negative people) Afghanistan <1 < Albania <0.5 < Algeria < Andorra Angola Antigua and Barbuda Argentina Armenia <2 < Australia <2 < Austria Azerbaijan <1 < Bahamas <157 < Bahrain Bangladesh <0.5 < Barbados <36 < Belarus <3 < Belgium Belize <34 < Benin Bhutan <2 < Bolivia (Plurinational State of) < Bosnia and Herzegovina Botswana Brazil < Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde <17 < Cambodia Cameroon Canada 6 i 7 i 11 i <2 < Central African Republic Chad Chile < China < Colombia Comoros Congo Cook Islands Costa Rica <4 < Côte d'ivoire Croatia Cuba <1 < Cyprus <2 < Czech Republic <0.5 < Democratic People's Republic of Korea Democratic Republic of the Congo Denmark <0.5 <

21 Morbidity 2015 Incidence rate (per population per year) MDG 6 Prevalence (per population) HIV/AIDS e Malaria f Tuberculosis h HIV/AIDS d Tuberculosis h < Afghanistan < <3 < Albania Algeria Andorra Angola Antigua and Barbuda < Argentina <10 < Armenia Australia Austria <8 12 < Azerbaijan < Bahamas Bahrain Bangladesh <44 < Barbados Belarus Belgium <125 < Belize Benin < <28 < Bhutan 22 < Bolivia (Plurinational State of) Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi < Cabo Verde Cambodia Cameroon Canada Central African Republic Chad Chile China Colombia Comoros Congo Cook Islands < Costa Rica Côte d'ivoire Croatia Cuba < <22 < Cyprus < < Czech Republic Democratic People's Republic of Korea Democratic Republic of the Congo < Denmark Table 2 59

22 2. Cause-specific mortality and morbidity Age-standardized mortality rates by cause a (per population) Communicable Noncommunicable Injuries All causes Years of life lost a (per population) Communicable Noncommunicable Injuries MDG 4 Number of deaths among children aged < 5 years b (000s) Distribution of causes of death among children aged < 5 years b,c Mortality HIV/AIDS Diarrhoea Measles Malaria Djibouti Dominica <1 <1 Dominican Republic <1 <1 Ecuador < <1 0 Egypt <1 < <1 0 0 El Salvador Equatorial Guinea Eritrea <1 <1 Estonia <1 < Ethiopia Fiji <1 <1 <1 < Finland <1 < France <1 < <1 0 Gabon < Gambia < Georgia <1 <1 3 1 < Germany <1 <1 <1 <1 < Ghana Greece < Grenada <1 <1 Guatemala <1 0 Guinea Guinea-Bissau < Guyana Haiti Honduras <1 <1 Hungary <1 < Iceland <1 < India <1 < <1 1 Indonesia < <1 2 Iran (Islamic Republic of) <1 <1 8 3 <1 <1 0 0 Iraq <1 0 0 Ireland <1 < < Israel < Italy <1 <1 <1 < Jamaica Japan <1 1 2 < Jordan <1 <1 0 0 Kazakhstan <1 < Kenya <1 5 4 Kiribati <1 <1 Kuwait <1 < Kyrgyzstan <1 < Lao People's Democratic Republic <1 < Latvia <1 < < Lebanon < < Lesotho <1 0 0 Liberia Libya

23 2015 Distribution of causes of death among children aged < 5 years b,c Acute respiratory infections Prematurity Intrapartumrelated complications Neonatal sepsis Congenital anomalies Other diseases Injuries Table Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras < Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya 61

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