Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019

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dc.contributor.authorAbbas, Kaja M.
dc.contributor.authorAbbasifard, Mitra
dc.contributor.authorAbbasi Kangevari, Mohsen
dc.contributor.authorAbbastabar, Hedayat
dc.contributor.authorAbd Allah, Foad
dc.contributor.authorAbdelalim, Ahmed
dc.contributor.authorAbolhassani, Hassan
dc.contributor.authorAbreu, Lucas Guimarães
dc.contributor.authorAbrigo, Michael R. M.
dc.contributor.authorAbushouk, Abdelrahman I.
dc.contributor.authorAdabi, Maryam
dc.contributor.authorAdair, Tim
dc.contributor.authorAdebayo, Oladimeji M.
dc.contributor.authorAdedeji, Isaac Akinkunmi
dc.contributor.authorAdekanmbi, Victor
dc.contributor.authorAdeoye, Abiodun Moshood
dc.contributor.authorAdetokunboh, Olatunji O.
dc.contributor.authorAdvani, Shailesh M.
dc.contributor.authorAfshin, Ashkan
dc.contributor.authorAghaali, Mohammad
dc.contributor.authorAgrawal, Anurag
dc.contributor.authorAhmadi, Keivan
dc.contributor.authorAhmadieh, Hamid
dc.contributor.authorAhmed, Muktar Beshir
dc.contributor.authorAl Aly, Ziyad
dc.contributor.authorAlam, Khurshid
dc.contributor.authorAlam, Tahiya
dc.contributor.authorAlanezi, Fahad Mashhour
dc.contributor.authorAlanzi, Turki M.
dc.contributor.authorAlcalde Rabanal, Jacqueline Elizabeth
dc.contributor.authorAli, Muhammad
dc.contributor.authorAlicandro, Gianfranco
dc.contributor.authorAlijanzadeh, Mehran
dc.contributor.authorAlinia, Cyrus
dc.contributor.authorAlipour, Vahid
dc.contributor.authorAlizade, Hesam
dc.contributor.authorAljunid, Syed Mohamed
dc.contributor.authorAllebeck, Peter
dc.contributor.authorAlmadi, Majid Abdulrahman Hamad
dc.contributor.authorAlmasi Hashiani, Amir
dc.contributor.authorAl Mekhlafi, Hesham M.
dc.contributor.authorAltirkawi, Khalid A.
dc.contributor.authorAlumran, Arwa Khalid
dc.contributor.authorAlvis Guzman, Nelson
dc.contributor.authorAmini Rarani, Mostafa
dc.contributor.authorAminorroaya, Arya
dc.contributor.authorAncuceanu, Robert
dc.contributor.authorAndrei, Catalina Liliana
dc.contributor.authorAndroudi, Sofia
dc.contributor.authorAngus, Colin
dc.contributor.authorAnjomshoa, Mina
dc.contributor.authorAnsari, Fereshteh
dc.contributor.authorAnsari, Iman
dc.contributor.authorAnsari Moghaddam, Alireza
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dc.contributor.authorAntony, Catherine M.
dc.contributor.authorAnvari, Davood
dc.contributor.authorAppiah, Seth Christopher Yaw
dc.contributor.authorArabloo, Jalal
dc.contributor.authorArab Zozani, Morteza
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dc.contributor.authorAremu, Olatunde
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dc.contributor.authorAsadi Pooya, Ali A.
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dc.contributor.authorAsghari Jafarabadi, Mohammad
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dc.contributor.authorAvila Burgos, Leticia
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dc.contributor.authorAyala Quintanilla, Beatriz Paulina
dc.contributor.authorAyano, Getinet
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dc.contributor.authorAzarian, Ghasem
dc.contributor.authorBabaee, Ebrahim
dc.contributor.authorBadiye, Ashish D.
dc.contributor.authorBagli, Eleni
dc.contributor.authorBahrami, Mohammad Amin
dc.contributor.authorBakhtiari, Ahad
dc.contributor.authorBalassyano, Shelly
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dc.contributor.authorBanik, Palash Chandra
dc.contributor.authorBarker Collo, Suzanne Lyn
dc.contributor.authorBärnighausen, Till Winfried
dc.contributor.authorBarzegar, Akbar
dc.contributor.authorBasu, Sanjay
dc.contributor.authorBaune, Bernhard T.
dc.contributor.authorBayati, Mohsen
dc.contributor.authorBazmandegan, Gholamreza
dc.contributor.authorBedi, Neeraj
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dc.contributor.authorBhageerathy, Reshmi
dc.contributor.authorBhala, Neeraj
dc.contributor.authorBhattacharyya, Krittika
dc.contributor.authorBhutta, Zulfiqar A.
dc.contributor.authorBijani, Ali
dc.contributor.authorBiondi, Antonio
dc.contributor.authorBisanzio, Donal
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dc.contributor.authorBiswas, Raaj Kishore
dc.contributor.authorBjørge, Tone
dc.contributor.authorBohlouli, Somayeh
dc.contributor.authorBohluli, Mehdi
dc.contributor.authorBolla, Srinivasa Rao Rao
dc.contributor.authorBorzì, Antonio Maria
dc.contributor.authorBorzouei, Shiva
dc.contributor.authorBrady, Oliver J.
dc.contributor.authorBraithwaite, Dejana
dc.contributor.authorBrauer, Michael
dc.contributor.authorBriko, Andrey Nikolaevich
dc.contributor.authorBriko, Nikolay Ivanovich
dc.contributor.authorBumgarner, Blair R.
dc.contributor.authorBurugina Nagaraja, Sharath
dc.contributor.authorButt, Zahid A.
dc.contributor.authorCaetano dos Santos, Florentino Luciano
dc.contributor.authorCai, Tianji
dc.contributor.authorCallender, Charlton SKH
dc.contributor.authorCámera, Luis LA Alberto
dc.contributor.authorCampos Nonato, Ismael R.
dc.contributor.authorCárdenas, Rosario
dc.contributor.authorCarreras, Giulia
dc.contributor.authorCarrero, Juan J.
dc.contributor.authorCarvalho, Felix
dc.contributor.authorCastaldelli Maia, Joao Mauricio
dc.contributor.authorCastelpietra, Giulio
dc.contributor.authorCastro, Franz
dc.contributor.authorCatalá López, Ferrán
dc.contributor.authorCederroth, Christopher R.
dc.contributor.authorCerin, Ester
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dc.contributor.authorChin, Ken Lee
dc.contributor.authorChu, Dinh Toi
dc.contributor.authorCiobanu, Liliana G.
dc.contributor.authorCirillo, Massimo
dc.contributor.authorComfort, Haley
dc.contributor.authorCosta, Vera Marisa
dc.contributor.authorCowden, Richard G.
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dc.contributor.authorCroneberger, Andrew J.
dc.contributor.authorCunningham, Matthew
dc.contributor.authorDahlawi, Saad M. A.
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dc.contributor.authorDandona, Lalit
dc.contributor.authorDandona, Rakhi
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dc.contributor.authorDaryani, Ahmad
dc.contributor.authorDas Gupta, Rajat
dc.contributor.authordas Neves, José
dc.contributor.authorDavletov, Kairat
dc.contributor.authorDe Leo, Diego
dc.contributor.authorDenova Gutiérrez, Edgar
dc.contributor.authorDeribe, Kebede
dc.contributor.authorDervenis, Nikolaos
dc.contributor.authorDesai, Rupak
dc.contributor.authorDhungana, Govinda Prasad
dc.contributor.authorDias da Silva, Diana
dc.contributor.authorDiaz, Daniel
dc.contributor.authorDippenaar, Ilse N.
dc.contributor.authorDjalalinia, Shirin
dc.contributor.authorDo, Hoa Thi
dc.contributor.authorDokova, Klara
dc.contributor.authorDoku, David Teye
dc.contributor.authorDorostkar, Fariba
dc.contributor.authorDoshi, Chirag P.
dc.contributor.authorDoshmangir, Leila
dc.contributor.authorDoyle, Kerrie E.
dc.contributor.authorDubljanin, Eleonora
dc.contributor.authorDuraes, Andre Rodrigues
dc.contributor.authorEdvardsson, David
dc.contributor.authorEffiong, Andem
dc.contributor.authorEl Sayed, Iman
dc.contributor.authorEl Tantawi, Maha
dc.contributor.authorElbarazi, Iffat
dc.contributor.authorEl Jaafary, Shaimaa I.
dc.contributor.authorEmamian, Mohammad Hassan
dc.contributor.authorEskandarieh, Sharareh
dc.contributor.authorEsmaeilzadeh, Firooz
dc.contributor.authorEstep, Kara
dc.contributor.authorFarahmand, Mohammad
dc.contributor.authorFaraj, Anwar
dc.contributor.authorFareed, Mohammad
dc.contributor.authorFaridnia, Roghiyeh
dc.contributor.authorFaro, Andre
dc.contributor.authorFarzadfar, Farshad
dc.contributor.authorFattahi, Nazir
dc.contributor.authorFazaeli, Ali Akbar
dc.contributor.authorFazlzadeh, Mehdi
dc.contributor.authorFeigin, Valery L.
dc.contributor.authorFereshtehnejad, Seyed Mohammad
dc.contributor.authorFernandes, Eduarda
dc.contributor.authorFerreira, Manuela L.
dc.contributor.authorFilip, Irina
dc.contributor.authorFischer, Florian
dc.contributor.authorFlohr, Carsten
dc.contributor.authorFoigt, Nataliya A.
dc.contributor.authorFolayan, Morenike Oluwatoyin
dc.contributor.authorFomenkov, Artem Alekseevich
dc.contributor.authorFreitas, Marisa
dc.contributor.authorFukumoto, Takeshi
dc.contributor.authorFuller, John E.
dc.contributor.authorFurtado, João M.
dc.contributor.authorGad, Mohamed M.
dc.contributor.authorGakidou, Emmanuela
dc.contributor.authorGallus, Silvano
dc.contributor.authorGebrehiwot, Abiyu Mekonnen
dc.contributor.authorGebremedhin, Ketema Bizuwork
dc.contributor.authorGething, Peter W.
dc.contributor.authorGhamari, Farhad
dc.contributor.authorGhashghaee, Ahmad
dc.contributor.authorGholamian, Asadollah
dc.contributor.authorGilani, Syed Amir
dc.contributor.authorGitimoghaddam, Mojgan
dc.contributor.authorGlushkova, Ekaterina Vladimirovna
dc.contributor.authorGnedovskaya, Elena V.
dc.contributor.authorGopalani, Sameer Vali
dc.contributor.authorGoulart, Alessandra C.
dc.contributor.authorGugnani, Harish Chander
dc.contributor.authorGuo, Yuming
dc.contributor.authorGupta, Rajeev
dc.contributor.authorGupta, Subodh Sharan
dc.contributor.authorHaagsma, Juanita A.
dc.contributor.authorHaj Mirzaian, Arvin
dc.contributor.authorHaj Mirzaian, Arya
dc.contributor.authorHalvaei, Iman
dc.contributor.authorHamadeh, Randah R.
dc.contributor.authorHamagharib Abdullah, Kanaan
dc.contributor.authorHan, Chieh
dc.contributor.authorHandiso, Demelash Woldeyohannes
dc.contributor.authorHankey, Graeme J.
dc.contributor.authorHaririan, Hamidreza
dc.contributor.authorHaro, Josep Maria
dc.contributor.authorHasaballah, Ahmed I.
dc.contributor.authorHassanipour, Soheil
dc.contributor.authorHassankhani, Hadi
dc.contributor.authorHay, Simon I.
dc.contributor.authorHeibati, Behzad
dc.contributor.authorHeidari Soureshjani, Reza
dc.contributor.authorHenny, Kiana
dc.contributor.authorHenry, Nathaniel J.
dc.contributor.authorHerteliu, Claudiu
dc.contributor.authorHeydarpour, Fatemeh
dc.contributor.authorHole, Michael K.
dc.contributor.authorHoogar, Praveen
dc.contributor.authorHosgood, H. Dean
dc.contributor.authorHossain, Naznin
dc.contributor.authorHosseinzadeh, Mehdi
dc.contributor.authorHostiuc, Mihaela
dc.contributor.authorHostiuc, Sorin
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dc.contributor.authorHoy, Damian G.
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dc.contributor.authorHuda, Tanvir M.
dc.contributor.authorIbitoye, Segun Emmanuel
dc.contributor.authorIkuta, Kevin S.
dc.contributor.authorIlesanmi, Olayinka Stephen
dc.contributor.authorIlic, Irena M.
dc.contributor.authorIlic, Milena D.
dc.contributor.authorImani Nasab, Mohammad Hasan
dc.contributor.authorIslam, MdMohaimenul
dc.contributor.authorIso, Hiroyasu
dc.contributor.authorIwu, Chinwe Juliana
dc.contributor.authorJaafari, Jalil
dc.contributor.authorJacobsen, Kathryn H.
dc.contributor.authorJahagirdar, Deepa
dc.contributor.authorJahanmehr, Nader
dc.contributor.authorJalali, Amir
dc.contributor.authorJalilian, Farzad
dc.contributor.authorJames, Spencer L.
dc.contributor.authorJanjani, Hosna
dc.contributor.authorJenabi, Ensiyeh
dc.contributor.authorJha, Ravi Prakash
dc.contributor.authorJha, Vivekanand
dc.contributor.authorJi, John S.
dc.contributor.authorJonas, Jost B.
dc.contributor.authorJoukar, Farahnaz
dc.contributor.authorJozwiak, Jacek Jerzy
dc.contributor.authorJürisson, Mikk
dc.contributor.authorKabir, Zubair
dc.contributor.authorKalani, Hamed
dc.contributor.authorKalankesh, Leila R.
dc.contributor.authorKamiab, Zahra
dc.contributor.authorKanchan, Tanuj
dc.contributor.authorKapoor, Neeti
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dc.contributor.authorKarimi, Seyed Asaad
dc.contributor.authorKassebaum, Nicholas J.
dc.contributor.authorKatikireddi, Srinivasa Vittal
dc.contributor.authorKawakami, Norito
dc.contributor.authorKayode, Gbenga A.
dc.contributor.authorKeiyoro, Peter Njenga
dc.contributor.authorKeller, Cathleen
dc.contributor.authorKhader, Yousef Saleh
dc.contributor.authorKhalid, Nauman
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dc.contributor.authorKhater, Amir M.
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dc.contributor.authorKim, Cho il
dc.contributor.authorKim, Young Eun
dc.contributor.authorKim, Yun Jin
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dc.contributor.authorKissimova Skarbek, Katarzyna
dc.contributor.authorKivimäki, Mika
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dc.contributor.authorLa Vecchia, Carlo
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dc.contributor.authorLal, Dharmesh Kumar
dc.contributor.authorLalloo, Ratilal
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dc.contributor.authorLansky, Sonia
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dc.contributor.authorLasrado, Savita
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dc.contributor.authorLazarus, Jeffrey V.
dc.contributor.authorLee, Paul H.
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dc.contributor.authorLeonardi, Matilde
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dc.contributor.authorMeitei, Wahengbam Bigyananda
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dc.contributor.authorMohammad, Yousef
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dc.contributor.authorMohammadian Hafshejani, Abdollah
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dc.contributor.authorNegoi, Ruxandra Irina
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dc.contributor.authorNguyen, Huong Lan Thi
dc.contributor.authorNguyen, Trang Huyen
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dc.contributor.authorYeheyis, Tomas Y.
dc.contributor.authorYilgwan, Christopher Sabo
dc.contributor.authorYip, Paul
dc.contributor.authorYonemoto, Naohiro
dc.contributor.authorYoon, Seok Jun
dc.contributor.authorYoosefi Lebni, Javad
dc.contributor.authorYork, Hunter W.
dc.contributor.authorYounis, Mustafa Z.
dc.contributor.authorYounker, Theodore Patrick
dc.contributor.authorYousefi, Zabihollah
dc.contributor.authorYousefinezhadi, Taraneh
dc.contributor.authorYousuf, Abdilahi Yousuf
dc.contributor.authorYusefzadeh, Hasan
dc.contributor.authorZahirian Moghadam, Telma
dc.contributor.authorZakzuk, Josefina
dc.contributor.authorZaman, Sojib Bin
dc.contributor.authorZamani, Mohammad
dc.contributor.authorZamanian, Maryam
dc.contributor.authorZandian, Hamed
dc.contributor.authorZhang, Zhi Jiang
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dc.date.accessioned2021-03-01T15:11:07Z
dc.date.available2021-03-01T15:11:07Z
dc.date.issued2021
dc.description.abstractenglishBackground Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Interpretation Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1016/s0140-6736(20)30977-6
dc.identifier.instnameinstname:Universidad El Bosquespa
dc.identifier.issn1474-547X
dc.identifier.reponamereponame:Repositorio Institucional Universidad El Bosquespa
dc.identifier.repourlrepourl:https://repositorio.unbosque.edu.co
dc.identifier.urihttps://hdl.handle.net/20.500.12495/5477
dc.language.isoeng
dc.publisherElsevier Ltd.spa
dc.publisher.journalThe Lancetspa
dc.relation.ispartofseriesThe Lancet, 1474-547X, Vol. 396, Nro. 10258, p. 1160–1203spa
dc.relation.urihttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30977-6/fulltext
dc.rightsAttribution 4.0 International*
dc.rights.accessrightshttps://purl.org/coar/access_right/c_abf2
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.accessrightsAcceso abierto
dc.rights.creativecommons2020
dc.rights.localAcceso abiertospa
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subject.keywordsPopulationspa
dc.subject.keywordsGeographyspa
dc.subject.keywordsMortality ratespa
dc.titleGlobal age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019spa
dc.title.translatedGlobal age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019spa
dc.type.coarhttps://purl.org/coar/resource_type/c_6501
dc.type.driverinfo:eu-repo/semantics/article
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localArtículo de revista

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