Premature death among young people globally used to be concentrated on 1 to 4 year old children, not any more. Now, in a reversal of patterns, mortality among 15 to 24 years old is higher in all countries, both rich and poor.

Young men aged 15 to 24 are dying prematurely at three times the rate, compared to boys aged 1 to 4. Most young people aged 15 to 24 are dying because of injuries – this age group saw mortality rates improve over the last half-century at half the rate of 1 to 4 year old children.

Russell Viner from the UCL Institute of Child Health, London, UK, and team published their findings in the medical journal The Lancet. They explain that not enough is being done to tackle the health problems young people are faced with. They hope this new study will encourage a new worldwide emphasis on dealing with the causes of death in teenagers and young adults.

Viner said:

“Mortality in young adults aged 10-24 years has proved less responsive to the epidemiological transition [of the past 50 years], and to alliances and interventions, than has early childhood mortality (1-4 years). These trends are likely to continue because mortality in children younger than 5 years is expected to decline further, and injury-related mortality is expected to increase in the next 25 years with the continuation of the epidemiological transition in developing countries.”

The global focus on tackling mortality rates for under fives has paid off. Unfortunately, older groups have slipped, and now require special attention. Over 40% of the population of this planet consists of 5 to 24 year olds.

Viner and team gathered and analysed data from the World Health Organization (WHO) database, with information on mortality rates in 50 countries of varying incomes between 1955 and 2004. They examined patterns of mortality by cause of death, including injury, communicable and non-communicable diseases. They focused on these periods to determine whether there had been any changes in mortality: 1995-1959, 1978-1982, and 2000-2004.

The researchers found that:

  • In the 1950s mortality rates of 1 to 4 year olds were considerably greater everywhere than all other age groups
  • Death rates among 1 to 9 year olds dropped between 80% and 93% between 1954 and 2004. The improvement was mainly due to fewer deaths from infectious diseases.
  • Mortality rates during the same period among 15 to 24 year olds dropped by about half, compared to 1 to 9 year olds. Injuries among young males were a major factor in this discrepancy.
  • Injuries accounted for between 70% and 75% of all premature deaths among males aged 10 to 24 years in every part of the world by the end of the last century
  • Between one quarter and one third of all deaths among 10 to 24 year-old males were caused by violence or suicide

The authors wrote:

“The high injury burden in young people means that they are particularly affected by the persistent low global investment in non-communicable diseases and injury relative to global disease burden.

(Conclusion) Future global health targets should include the causes of death in people aged 10-24 years, and should extend beyond HIV infection and maternal mortality to include injury and mental health.”

Michael Resnick from the University of Minnesota, Minneapolis, wrote:

“The profound health and social changes that have accompanied economic development and urbanisation are particularly toxic for young people in both high-income and low-income settings.

Breakthroughs in medical discovery and service delivery are incomplete responses to the health threats faced by young people, in view of the profound role of socioeconomic conditions, access to education, and opportunity as determinants of life trajectory. . . Adolescence represents the second crucial window for prevention and health promotion. Effectively addressing the social determinants of health in the second decade of life can interrupt the processes by which disadvantage becomes adverse destiny, including premature mortality.”

“50-year mortality trends in children and young people: a study of 50 low-income, middle-income, and high-income countries”
Dr Russell M Viner PhD, Carolyn Coffey GradDipEpi b c, Colin Mathers PhD, Paul Bloem MBA, Prof Anthony Costello FMedSci, Prof John Santelli MD, Prof George C Patton MD
The Lancet, Early Online Publication, 29 March 2011

Written by Christian Nordqvist