Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61.7 years (95% uncertainty interval 61.4-61.9) in 1980 to 71.8 years (71.5-72.2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11.3 years (3.7-17.4), to 62.6 years (56.5-70.2). Total deaths increased by 4.1% (2.6-5.6) from 2005 to 2015, rising to 55.8 million (54.9 million to 56.6 million) in 2015, but age-standardised death rates fell by 17.0% (15.8-18.1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14.1% (12.6-16.0) to 39.8 million (39.2 million to 40.5 million) in 2015, whereas age-standardised rates decreased by 13.1% (11.9-14.3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42.1%, 39.1-44.6), malaria (43.1%, 34.7-51.8), neonatal preterm birth complications (29.8%, 24.8-34.9), and maternal disorders (29.1%, 19.3-37.1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Copyright (C) The Author(s). Published by Elsevier Ltd.Peer reviewe

Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.

BACKGROUND: Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate. FINDINGS: Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2·9 years (95% uncertainty interval 2·9-3·0) for men and 3·5 years (3·4-3·7) for women, while HALE at age 65 years improved by 0·85 years (0·78-0·92) and 1·2 years (1·1-1·3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs. INTERPRETATION: Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum. FUNDING: Bill & Melinda Gates Foundation

A Methodology to Assess the Historical Environmental Footprint of In-Situ Recovery (ISR) of Uranium: A Demonstration in the Goliad Sand in the Texas Coastal Plain, USA

In-situ recovery (ISR) has been the only technique used to extract uranium from sandstone-hosted uranium deposits in the Pliocene Goliad Sand in the Texas Coastal Plain. Water plays a crucial role throughout the ISR lifecycle of production and groundwater restoration yet neither the water use nor other environmental footprints have been well documented. The goal of this study is to examine historical records for all six ISR operations completed in the Goliad Sand to identify and quantify parameters that indicate the surface and aquifer disturbances, water use, and radon emissions. Overall, the average mine area was 0.00023 ± 0.00006 acres per pound (ac/lb) U3O8. The average mine pore volume was 48.9 ± 50 gal/lb U3O8 with a minimum affected aquifer volume of 0.51 ± 0.08 cubic feet per pound (cu ft/lb) U3O8. An average of 258 ± 40 gallons (gal) of fluid were disposed per pound (lb) U3O8, with an average of 169 ± 26 gal/lb U3O8 attributed to restoration and 89 ± 36 gal/lb U3O8 attributed to the uranium production phase. The average radon emitted was 1.06 × 10−3 ± 7.4 × 10−4 curies per pound (Ci/lb) U3O8. Goodness-of-fit (R2) values are ≥0.79 for linear regressions of the amount of uranium produced versus mine area, mine pore volumes, mine aquifer volumes, water pumped, and total water disposed. The R2 value for radon emitted was 0.68. However, the water disposed only during the uranium production phase is more strongly correlated to the number of production days (R2 = 0.96) than to uranium production (R2 = 0.84), whereas the volume of water disposed during restoration is more strongly correlated to the “pore volume” (R2 = 0.97) than to uranium production (R2 = 0.90). Pore volume is an industry term used to describe the amount of fluid circulated through the aquifer during the uranium production period and stipulated in bond agreements in order to satisfy groundwater restoration requirements. Models constructed in this study can be used to estimate probable water use and the extent of surface and aquifer disturbances associated with ISR-amenable undiscovered uranium resources in the Goliad Sand. The historical perspective offered by the data compiled and correlations may prove useful to both industry and regulators

A Refined Hydrogeologic Framework Model for Gaines, Terry, and Yoakum Counties, Texas

Declining groundwater levels in Gaines, Yoakum, and Terry counties in the Southern High Plains have raised concerns about the amount of available groundwater and the potential for water-quality changes resulting from dewatering and increased vertical groundwater movement between adjacent water-bearing hydrogeologic units. More than 11,500 well records containing pertinent data were compiled, including data delineating the vertical extents of wells penetrating one or more of the units. Additional geophysical data were collected to improve the spatial coverage of available data across the study area and to reduce uncertainty regarding hydrogeologic unit extents. Across the study area, the average altitude of the base of the Ogallala Aquifer was approximately 1.7 feet lower compared to previous assessments of the altitude of the base of the aquifer, resulting in an increase in the saturated thickness by the same amount. Some of the largest increases in the altitude of the base of the Ogallala Aquifer were observed in central and east-central Gaines County where the units that compose the Edwards-Trinity Aquifer thin at approximately 136 feet and the largest decreases in altitudes are in Yoakum County at around 185 feet. Both the thickest and thinnest part of the Ogallala Aquifer is in Gaines County at just over 300 feet in west Gaines County and around 20 feet in northeast Gaines County.   Citation: Thomas JV, Teeple AP, Payne JD, Ikard SJ. 2019. A refined hydrogeologic framework model for Gaines, Terry, and Yoakum counties, Texas. Texas Water Journal. 10(1):1-21. Available from: https://doi.org/10.21423/twj.v10i1.7082

Development and Description of a Composite Hydrogeologic Framework for Inclusion in a Geoenvironmental Assessment of Undiscovered Uranium Resources in Pliocene- to Pleistocene-Age Geologic Units of the Texas Coastal Plain

A previously completed mineral resources assessment of the Texas Coastal Plain indicated the potential for the future discovery of uranium resources. Geoenvironmental assessments that include the hydrogeologic framework can be used as a tool to understand the potential effects of mining operations. The hydrogeologic framework for this study focused on the composite hydrogeologic unit of the tract permissive for the occurrence of uranium consisting of the upper part of the Miocene-age Fleming Formation/Lagarto Clay, Pliocene-age Goliad and Pleistocene-age Willis Sands, Pleistocene-age Lissie and Beaumont Formations, and Holocene-age alluvial sediments (fluvial alluvium and eolian sand deposits). This composite hydrogeologic unit, which contains the Chicot and Evangeline aquifers of the Gulf Coast aquifer system, is intended for inclusion in a regional-scale geoenvironmental assessment of as yet undiscovered uranium resources. This article provides (1) a brief literature review describing the geologic and hydrogeologic settings, (2) the methodology used to develop a composite hydrogeologic framework, and (3) descriptions and maps of the land-surface altitude, composite hydrogeologic unit base and midpoint depth, water-level altitude, depth of water, unsaturated and saturated zone thickness, and transmissivity and hydraulic conductivity. A composite hydrogeologic unit, created by combining geologic and hydrogeologic data and maps for individual geologic and hydrogeologic units, is intended for use as a tool in a geoenvironmental assessment to evaluate potential contaminant migration through various avenues. Potential applications include using the hydrogeologic framework as an input into a geoenvironmental assessment to help estimate the potential for (1) runoff of contaminants into surface water, (2) infiltration of contaminants into the groundwater (aquifers), or (3) movement of contaminants from the mining area through wind, groundwater-flow, or streamflow in a given permissive tract. The procedures outlined in this paper also provide a method for developing hydrogeologic frameworks that can be applied in other areas where mining may occur

Data Collection and Compilation for a Geodatabase of Groundwater, Surface-Water, Water-Quality, Geophysical, and Geologic Data, Pecos County Region, Texas, 1930–2011

The U.S. Geological Survey, in cooperation with Middle Pecos Groundwater Conservation District, Pecos County, City of Fort Stockton, Brewster County, and Pecos County Water Control and Improvement District No. 1, compiled groundwater, surface-water, water-quality, geophysical, and geologic data for site locations in the Pecos County region, Texas, and developed a geodatabase to facilitate use of this information. Data were compiled for an approximately 4,700 square mile area of the Pecos County region, Texas. The geodatabase contains data from 8,242 sampling locations; it was designed to organize and store field-collected geochemical and geophysical data, as well as digital database resources from the U.S. Geological Survey, Middle Pecos Groundwater Conservation District, Texas Water Development Board, Texas Commission on Environmental Quality,and numerous other State and local databases. The geodatabase combines these disparate database resources into a simple data model. Site locations are geospatially enabled and stored in a geodatabase feature class for cartographic visualization and spatial analysis within a Geographic Information System. The sampling locations are related to hydrogeologic information through the use of geodatabase relationship classes. The geodatabase relationship classes provide the ability to perform complex spatial and data-driven queries to explore data stored in the geodatabase

Data Collection and Compilation for a Geodatabase of Groundwater, Surface-Water, Water-Quality, Geophysical, and Geologic Data, Pecos County Region, Texas, 1930–2011

The U.S. Geological Survey, in cooperation with Middle Pecos Groundwater Conservation District, Pecos County, City of Fort Stockton, Brewster County, and Pecos County Water Control and Improvement District No. 1, compiled groundwater, surface-water, water-quality, geophysical, and geologic data for site locations in the Pecos County region, Texas, and developed a geodatabase to facilitate use of this information. Data were compiled for an approximately 4,700 square mile area of the Pecos County region, Texas. The geodatabase contains data from 8,242 sampling locations; it was designed to organize and store field-collected geochemical and geophysical data, as well as digital database resources from the U.S. Geological Survey, Middle Pecos Groundwater Conservation District, Texas Water Development Board, Texas Commission on Environmental Quality,and numerous other State and local databases. The geodatabase combines these disparate database resources into a simple data model. Site locations are geospatially enabled and stored in a geodatabase feature class for cartographic visualization and spatial analysis within a Geographic Information System. The sampling locations are related to hydrogeologic information through the use of geodatabase relationship classes. The geodatabase relationship classes provide the ability to perform complex spatial and data-driven queries to explore data stored in the geodatabase

Geoelectric Monitoring of the Electric Potential Field of the Lower Rio Grande before, during, and after Intermittent Streamflow, May–October, 2022

Understanding the intermittent hydraulic connectivity between ephemeral streams and alluvial aquifers is a key challenge for managing water resources in arid environments. The lower Rio Grande flows for short, discontinuous periods during the irrigation season through the Mesilla Basin in southeastern New Mexico and southwestern Texas. Hydraulic connections between the Rio Grande and the Rio Grande alluvial aquifer in the Mesilla Basin vary spatially and temporally and are not well understood. Self-potential (SP) monitoring and time-lapse electric resistivity tomography (ERT) were therefore performed along linear cross-sections spanning the riverbed and flood plain for more than 4 months to monitor the transient hydraulic connection between the river and the alluvial aquifer by measuring time-lapse changes in the electric potential field in the riverbed and flood plain. The monitoring period began on 21 May 2022, when the riverbed was completely dry, continued through the irrigation season while streamflow was provided by reservoir releases from upstream dams, and ended on 4 October 2022, when the riverbed was again dry. SP monitoring data show (1) a background condition in the dry riverbed consisting of (a) a positive electric potential anomaly with a maximum amplitude of about +100 mV attributed predominantly to a subsurface vertical salt concentration gradient and (b) diurnal electric potential fluctuations with amplitudes of 40,000–90,000 mV attributed to near-surface heat conduction driven by weather variability, in addition to (2) a streaming potential anomaly during the irrigation season with a maximum amplitude of about −3500 mV whose transient behavior clearly exhibited a change from the background anomaly to depict exclusively losing streamflow conditions that persisted through the irrigation season. Time-lapse ERT monitoring results depict rapid infiltration of streamflow into the subsurface and imply the river and Rio Grande alluvial aquifer established a full hydraulic connection within a few hours after streamflow arrival at the monitoring site. SP monitoring data show an apparent transition from hydraulic connection to disconnection at the end of the irrigation season and indicate that the transitional phase between connection and disconnection may last substantially longer than the transition from disconnection to connection. The combination of SP and ERT monitoring demonstrated herein shows the potential for broader applications of time-lapse monitoring of hydraulic intermittency and near-surface heat fluxes in different rivers

Mesilla/Conejos-Médanos Basin: U.S.-Mexico Transboundary Water Resources

Synthesizing binational data to characterize shared water resources is critical to informing binational management. This work uses binational hydrogeology and water resource data in the Mesilla/Conejos-Médanos Basin (Basin) to describe the hydrologic conceptual model and identify potential research that could help inform sustainable management. The Basin aquifer is primarily composed of continuous basin-fill Santa Fe Group sediments, allowing for transboundary through flow. Groundwater flow, however, may be partially or fully restricted by intrabasin uplifts and limited recharg