Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Biomass Production and Carbon Sequestration Potential of Different Agroforestry Systems in India: A Critical Review

Agroforestry systems (AFS) and practices followed in India are highly diverse due to varied climatic conditions ranging from temperate to humid tropics. The estimated area under AFS in India is 13.75 million ha with the highest concentration being in the states of Uttar Pradesh (1.86 million ha), followed by Maharashtra (1.61 million ha), Rajasthan (1.55 million ha) and Andhra Pradesh (1.17 million ha). There are many forms of agroforestry practice in India ranging from intensified simple systems of monoculture, such as block plantations and boundary planting, to far more diverse and complex systems, such as home gardens. As a result, the biomass production and carbon sequestration potential of AFS are highly variable across different agro-climatic zones of India. Studies pertaining to the assessment of biomass and carbon storage in different agroforestry systems in the Indian sub-continent are scanty and most of these studies have reported region and system specific carbon stocks. However, while biomass and carbon stock data from different AFS at national scale has been scanty hitherto, such information is essential for national accounting, reporting of C sinks and sources, as well as for realizing the benefits of carbon credit to farmers engaged in tree-based production activities. Therefore, the objective of this study was to collate and synthesize the existing information on biomass carbon and SOC stocks associated with agroforestry practices across agro-climatic zones of India. The results revealed considerable variation in biomass and carbon stocks among AFS, as well as between different agro-climatic zones. Higher total biomass (>200 Mg ha−1) was observed in the humid tropics of India which are prevalent in southern and northeastern regions, while lower total biomass (−1) was reported from Indo-Gangetic, western and central India. Total biomass carbon varied in the range of 1.84 to 131 Mg ha−1 in the agrihorticulture systems of western and central India and the coffee agroforests of southern peninsular India. Similarly, soil organic carbon (SOC) ranged between 12.26–170.43 Mg ha−1, with the highest SOC in the coffee agroforests of southern India and the lowest in the agrisilviculture systems of western India. The AFS which recorded relatively higher SOC included plantation crop-based practices of southern, eastern and northeastern India, followed by the agrihorticulture and agrisilviculture systems of the northern Himalayas. The meta-analysis indicated that the growth and nature of different agroforestry tree species is the key factor affecting the carbon storage capacity of an agroforestry system. The baseline data obtained across various regions could be useful for devising policies on carbon trading or financing for agroforestry

Biomass Production and Carbon Sequestration Potential of Different Agroforestry Systems in India: A Critical Review

Agroforestry systems (AFS) and practices followed in India are highly diverse due to varied climatic conditions ranging from temperate to humid tropics. The estimated area under AFS in India is 13.75 million ha with the highest concentration being in the states of Uttar Pradesh (1.86 million ha), followed by Maharashtra (1.61 million ha), Rajasthan (1.55 million ha) and Andhra Pradesh (1.17 million ha). There are many forms of agroforestry practice in India ranging from intensified simple systems of monoculture, such as block plantations and boundary planting, to far more diverse and complex systems, such as home gardens. As a result, the biomass production and carbon sequestration potential of AFS are highly variable across different agro-climatic zones of India. Studies pertaining to the assessment of biomass and carbon storage in different agroforestry systems in the Indian sub-continent are scanty and most of these studies have reported region and system specific carbon stocks. However, while biomass and carbon stock data from different AFS at national scale has been scanty hitherto, such information is essential for national accounting, reporting of C sinks and sources, as well as for realizing the benefits of carbon credit to farmers engaged in tree-based production activities. Therefore, the objective of this study was to collate and synthesize the existing information on biomass carbon and SOC stocks associated with agroforestry practices across agro-climatic zones of India. The results revealed considerable variation in biomass and carbon stocks among AFS, as well as between different agro-climatic zones. Higher total biomass (>200 Mg ha−1) was observed in the humid tropics of India which are prevalent in southern and northeastern regions, while lower total biomass (<50 Mg ha−1) was reported from Indo-Gangetic, western and central India. Total biomass carbon varied in the range of 1.84 to 131 Mg ha−1 in the agrihorticulture systems of western and central India and the coffee agroforests of southern peninsular India. Similarly, soil organic carbon (SOC) ranged between 12.26–170.43 Mg ha−1, with the highest SOC in the coffee agroforests of southern India and the lowest in the agrisilviculture systems of western India. The AFS which recorded relatively higher SOC included plantation crop-based practices of southern, eastern and northeastern India, followed by the agrihorticulture and agrisilviculture systems of the northern Himalayas. The meta-analysis indicated that the growth and nature of different agroforestry tree species is the key factor affecting the carbon storage capacity of an agroforestry system. The baseline data obtained across various regions could be useful for devising policies on carbon trading or financing for agroforestry

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

BackgroundEstimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period.Methods22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution.FindingsGlobal all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations.InterpretationGlobal adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic