Latest Publications
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NCD Countdown 2030 Collaborators 2025, ISBN: 0140-6736. ()
@article{Bennett2025,
title = {Benchmarking progress in non-communicable diseases: a global analysis of cause-specific mortality from 2001 to 2019}, author = {NCD Countdown 2030 Collaborators}, doi = {10.1016/S0140-6736(25)01388-1}, isbn = {0140-6736}, year = {2025}, date = {2025-09-10}, abstract = {Summary Background Non-communicable diseases (NCDs) have received substantial policy attention globally and in most countries. Our aim was to quantify how much NCD mortality changed from 2010 to 2019 in different countries, especially compared with the preceding decade and with the best-performing country in each region, and the specific NCD causes of death that contributed to change. Methods We used data on NCD mortality by sex, age group, and underlying cause of death for 185 countries and territories from the 2021 WHO Global Health Estimates. Our primary outcome was the probability of dying from an NCD between birth and age 80 years in the absence of competing causes of death, and was calculated using age-specific death rates from NCDs and lifetable methods. We calculated change in the probability of death as the difference between values in the final and first year of each period (2001\textendash10 and 2010\textendash19). For 51 countries with high-quality mortality data and 12 countries with large populations within their region, we used the Horiuchi method of decomposition to calculate how much specific causes of death and 5-year age groups contributed towards: (1) increases or decreases in NCD mortality from 2010 to 2019; (2) improvements or deteriorations compared with the preceding decade (2001\textendash10); and (3) differences from the country that had the largest reduction in each region. Findings From 2010 to 2019, the probability of dying from an NCD between birth and age 80 years decreased in 152 (82%) of 185 countries for females and in 147 (79%) countries for males; it increased in the remaining 33 (18%) countries for females and 38 (21%) countries for males. The countries where NCD mortality declined for females accounted for 72% of the world female population in 2019, and those where NCD mortality declined for males accounted for 73% of the world male population. NCD mortality declined in all high-income western countries, with Denmark experiencing the largest decline for both sexes and the USA experiencing the smallest decline. Among the largest countries in other regions, NCD mortality declined for both sexes in China, Egypt, Nigeria, Russia, and Brazil, and increased for both sexes in India and Papua New Guinea. On average, females in countries in the central Asia, Middle East and north Africa region had the greatest reduction in NCD mortality followed by those in central and eastern Europe. For males, the largest reduction was among countries in central and eastern Europe, followed by those in central Asia, Middle East and north Africa. The smallest declines were those in the Pacific Island nations. Circulatory diseases were the greatest contributors to declines in NCD mortality from 2010 to 2019 in most countries, with some cancers (eg, stomach and colorectal cancers for both sexes, cervical and breast cancers for females, and lung and prostate cancers for males) also contributing towards lower NCD mortality in 2019 than in 2010 in many countries. Neuropsychiatric conditions and pancreatic and liver cancers contributed towards higher NCD mortality from 2010 to 2019 in most countries. In some countries, NCD mortality in working and older (≥65 years) ages changed in the same direction leading to large overall declines or increases; in others, it changed in opposite directions, diminishing the magnitude of the overall change. In 75 (41%) of 185 countries for females and in 73 (39%) countries for males, the change in NCD mortality from 2010 to 2019 was an improvement (ie, larger decline, smaller increase, or reversal of an increase) compared with the change from 2001 to 2010. These countries accounted for 29% and 63% of the world female and male population, respectively, and included both sexes in Russia and Egypt, and males in China, India, and Brazil. Decadal changes saw a deterioration (ie, smaller decline, larger increase, or reversal of a decline) in the remaining 110 (59%) countries for females and 112 (61%) countries for males, including in both sexes in the USA, Nigeria, and Papua New Guinea, and females in China, India, and Brazil. Change from 2010 to 2019 saw deterioration in direction or size compared with the preceding decade for both sexes in most high-income western countries, most countries in Latin America and the Caribbean, and in east and southeast Asia, and for females in south Asia. There was a decadal improvement in the direction or size of change for many countries in central and eastern Europe (eg, Russia) and central Asia, and in parts of the Middle East and north Africa. Improvements or deteriorations in the direction or size of change in NCD mortality between the two decades resulted from multiple NCD causes of death. Among causes of death, the decline in mortality from circulatory diseases was smaller from 2010 to 2019 than from 2001 to 2010 in most countries, except in countries in central and eastern Europe and some countries in central Asia, where these declines were larger from 2010 to 2019 than from 2001 to 2010. Change in lung cancer saw a decadal improvement in many countries, especially for males, and many other cancers saw a mix of improvement and deterioration. Interpretation From 2010 to 2019, NCD mortality declined in four of every five countries in the world. These improvements were not as large as the preceding decade for most countries, driven by smaller declines in mortality from multiple NCDs. Funding UK Medical Research Council, UK National Institute for Health and Care Research, and NCD Alliance.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Summary
Background Non-communicable diseases (NCDs) have received substantial policy attention globally and in most countries. Our aim was to quantify how much NCD mortality changed from 2010 to 2019 in different countries, especially compared with the preceding decade and with the best-performing country in each region, and the specific NCD causes of death that contributed to change. Methods We used data on NCD mortality by sex, age group, and underlying cause of death for 185 countries and territories from the 2021 WHO Global Health Estimates. Our primary outcome was the probability of dying from an NCD between birth and age 80 years in the absence of competing causes of death, and was calculated using age-specific death rates from NCDs and lifetable methods. We calculated change in the probability of death as the difference between values in the final and first year of each period (2001–10 and 2010–19). For 51 countries with high-quality mortality data and 12 countries with large populations within their region, we used the Horiuchi method of decomposition to calculate how much specific causes of death and 5-year age groups contributed towards: (1) increases or decreases in NCD mortality from 2010 to 2019; (2) improvements or deteriorations compared with the preceding decade (2001–10); and (3) differences from the country that had the largest reduction in each region. Findings From 2010 to 2019, the probability of dying from an NCD between birth and age 80 years decreased in 152 (82%) of 185 countries for females and in 147 (79%) countries for males; it increased in the remaining 33 (18%) countries for females and 38 (21%) countries for males. The countries where NCD mortality declined for females accounted for 72% of the world female population in 2019, and those where NCD mortality declined for males accounted for 73% of the world male population. NCD mortality declined in all high-income western countries, with Denmark experiencing the largest decline for both sexes and the USA experiencing the smallest decline. Among the largest countries in other regions, NCD mortality declined for both sexes in China, Egypt, Nigeria, Russia, and Brazil, and increased for both sexes in India and Papua New Guinea. On average, females in countries in the central Asia, Middle East and north Africa region had the greatest reduction in NCD mortality followed by those in central and eastern Europe. For males, the largest reduction was among countries in central and eastern Europe, followed by those in central Asia, Middle East and north Africa. The smallest declines were those in the Pacific Island nations. Circulatory diseases were the greatest contributors to declines in NCD mortality from 2010 to 2019 in most countries, with some cancers (eg, stomach and colorectal cancers for both sexes, cervical and breast cancers for females, and lung and prostate cancers for males) also contributing towards lower NCD mortality in 2019 than in 2010 in many countries. Neuropsychiatric conditions and pancreatic and liver cancers contributed towards higher NCD mortality from 2010 to 2019 in most countries. In some countries, NCD mortality in working and older (≥65 years) ages changed in the same direction leading to large overall declines or increases; in others, it changed in opposite directions, diminishing the magnitude of the overall change. In 75 (41%) of 185 countries for females and in 73 (39%) countries for males, the change in NCD mortality from 2010 to 2019 was an improvement (ie, larger decline, smaller increase, or reversal of an increase) compared with the change from 2001 to 2010. These countries accounted for 29% and 63% of the world female and male population, respectively, and included both sexes in Russia and Egypt, and males in China, India, and Brazil. Decadal changes saw a deterioration (ie, smaller decline, larger increase, or reversal of a decline) in the remaining 110 (59%) countries for females and 112 (61%) countries for males, including in both sexes in the USA, Nigeria, and Papua New Guinea, and females in China, India, and Brazil. Change from 2010 to 2019 saw deterioration in direction or size compared with the preceding decade for both sexes in most high-income western countries, most countries in Latin America and the Caribbean, and in east and southeast Asia, and for females in south Asia. There was a decadal improvement in the direction or size of change for many countries in central and eastern Europe (eg, Russia) and central Asia, and in parts of the Middle East and north Africa. Improvements or deteriorations in the direction or size of change in NCD mortality between the two decades resulted from multiple NCD causes of death. Among causes of death, the decline in mortality from circulatory diseases was smaller from 2010 to 2019 than from 2001 to 2010 in most countries, except in countries in central and eastern Europe and some countries in central Asia, where these declines were larger from 2010 to 2019 than from 2001 to 2010. Change in lung cancer saw a decadal improvement in many countries, especially for males, and many other cancers saw a mix of improvement and deterioration. Interpretation From 2010 to 2019, NCD mortality declined in four of every five countries in the world. These improvements were not as large as the preceding decade for most countries, driven by smaller declines in mortality from multiple NCDs. Funding UK Medical Research Council, UK National Institute for Health and Care Research, and NCD Alliance. |
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Metzler AB, Nathvani R, Sharmanska V, Bai W, Moulds S, Owoo NS, Fynn IEM, Muller E, Dufitimana E, Akara GK, Owusu G, Agyei-Mensah S, Ezzati M. Science of The Total Environment, 988 (179739), 2025. ()
@article{AB2025,
title = {Unsupervised deep clustering of high-resolution satellite imagery reveals phenotypes of urban development in Sub-Saharan Africa}, author = {Metzler AB, Nathvani R, Sharmanska V, Bai W, Moulds S, Owoo NS, Fynn IEM, Muller E, Dufitimana E, Akara GK, Owusu G, Agyei-Mensah S, Ezzati M.}, doi = {10.1016/j.scitotenv.2025.179739}, year = {2025}, date = {2025-08-01}, journal = {Science of The Total Environment}, volume = {988}, number = {179739}, abstract = {Sub-Saharan Africa and other developing regions have urbanized extensively, leading to complex urban features with varying presence and types of roads, buildings and vegetation. We use a novel hierarchical deep learning framework and high-resolution satellite images to characterize multidimensional urban environments in multiple cities. Application of the model to images from Accra, Dakar, and Dar es Salaam identified areas with analogous patterns of building density, roads and vegetation. These included dense settlements within the metropolitan boundary (20\textendash54% of urban area), peri-urban intermix of natural and built environment (21\textendash44%), natural vegetation (9\textendash13%) and agricultural land (8\textendash15%). Kigali, with its mountainous geography and post-colonial expansion, exhibited unique urban characteristics including a sparser urban core (23%) and significant wildland-urban intermix (19% of vegetation). Other notable clusters were water (2% of area of Accra) and empty land (8\textendash10% of Accra and Dakar). Our results demonstrate that unlabeled satellite images with unsupervised deep learning can be used for consistent and coherent near-real-time urban monitoring, particularly in regions where traditional data are scarce.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Sub-Saharan Africa and other developing regions have urbanized extensively, leading to complex urban features with varying presence and types of roads, buildings and vegetation. We use a novel hierarchical deep learning framework and high-resolution satellite images to characterize multidimensional urban environments in multiple cities. Application of the model to images from Accra, Dakar, and Dar es Salaam identified areas with analogous patterns of building density, roads and vegetation. These included dense settlements within the metropolitan boundary (20–54% of urban area), peri-urban intermix of natural and built environment (21–44%), natural vegetation (9–13%) and agricultural land (8–15%). Kigali, with its mountainous geography and post-colonial expansion, exhibited unique urban characteristics including a sparser urban core (23%) and significant wildland-urban intermix (19% of vegetation). Other notable clusters were water (2% of area of Accra) and empty land (8–10% of Accra and Dakar). Our results demonstrate that unlabeled satellite images with unsupervised deep learning can be used for consistent and coherent near-real-time urban monitoring, particularly in regions where traditional data are scarce.
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Clark SN, Arku RE, Ezzati M, Bennett J, Nathvani R, Alli AS, Nimo J, Moses JB, Baah S, Hughes A, Agyei-Mensah S, Owusu G, Toledano M, Brauer M. Scientific Reports, (15), pp. 21403, 2025. ()
@article{SN2025,
title = {Moving beyond the noise: geospatial modelling of urban sound environments in a sub-Saharan African city}, author = {Clark SN, Arku RE, Ezzati M, Bennett J, Nathvani R, Alli AS, Nimo J, Moses JB, Baah S, Hughes A, Agyei-Mensah S, Owusu G, Toledano M, Brauer M. }, doi = {10.1038/s41598-025-06537-1}, year = {2025}, date = {2025-07-01}, journal = {Scientific Reports}, number = {15}, pages = {21403}, abstract = {Cities encompass a mixture of artificial, human, animal, and nature-based sounds, which through long and short-term exposures, can impact on physical and mental health. Yet, most epidemiological research has focused on only transportation noise, leaving a significant gap in understanding the health impacts of other urban sound types, especially in sub-Saharan Africa (SSA). We conducted a large-scale measurement campaign in Accra, Ghana, collecting audio recordings and sound levels from 129 locations between April 2019-June 2020. We classified sound types with a neural network model and then used Random Forest land use regression to predict prevalences of different sound types citywide. We then developed a composite metric integrating sound levels with the prevalence of sound types. Road traffic sounds dominated the urban core, while human and animal sounds were prominent in high-density and peri-urban areas, respectively. Our high-resolution approach provides a comprehensive characterization of the complexity of urban sounds in a major SSA city, paving the way for new epidemiological studies on the health impacts of exposure to diverse sound sources in the future.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Cities encompass a mixture of artificial, human, animal, and nature-based sounds, which through long and short-term exposures, can impact on physical and mental health. Yet, most epidemiological research has focused on only transportation noise, leaving a significant gap in understanding the health impacts of other urban sound types, especially in sub-Saharan Africa (SSA). We conducted a large-scale measurement campaign in Accra, Ghana, collecting audio recordings and sound levels from 129 locations between April 2019-June 2020. We classified sound types with a neural network model and then used Random Forest land use regression to predict prevalences of different sound types citywide. We then developed a composite metric integrating sound levels with the prevalence of sound types. Road traffic sounds dominated the urban core, while human and animal sounds were prominent in high-density and peri-urban areas, respectively. Our high-resolution approach provides a comprehensive characterization of the complexity of urban sounds in a major SSA city, paving the way for new epidemiological studies on the health impacts of exposure to diverse sound sources in the future.
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