Global, regional, and national mortality among young people aged 10–24 years, 1950–2019: a systematic analysis for the Global Burden of Disease Study 2019

GBD 2019 Adolescent Mortality Collaborators, and Peden, A.E. (2021) Global, regional, and national mortality among young people aged 10–24 years, 1950–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet, 398 (10311). pp. 1593-1618.

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Abstract

Background: Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10–24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.

Methods: We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10–24 years by age group (10–14 years, 15–19 years, and 20–24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10–24 years with that in children aged 0–9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10–24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017).

Findings: In 2019 there were 1·49 million deaths (95% uncertainty interval 1·39–1·59) worldwide in people aged 10–24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or maternal causes; 27·0% were due to non-communicable diseases; and 8·2% were due to self-harm. Since 1950, deaths in this age group decreased by 30·0% in females and 15·3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10–14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15–19 years was 1·3% in males and 1·6% in females, almost half that of males aged 1–4 years (2·4%), and around a third less than in females aged 1–4 years (2·5%). The proportion of global deaths in people aged 0–24 years that occurred in people aged 10–24 years more than doubled between 1950 and 2019, from 9·5% to 21·6%.

Interpretation: Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10–24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group.

Item ID: 73647
Item Type: Article (Research - C1)
ISSN: 1474-547X
Copyright Information: © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Additional Information:

GBD 2019 Adolescent Mortality Collaborators:

Joseph L Ward, Peter S Azzopardi, Kate Louise Francis, John S Santelli, Vegard Skirbekk, Susan M Sawyer, Nicholas J Kassebaum, Ali H Mokdad, Simon I Hay, Foad Abd-Allah, Amir Abdoli, Mohammad Abdollahi, Aidin Abedi, Hassan Abolhassani, Lucas Guimarães Abreu, Michael R M Abrigo, Eman Abu-Gharbieh, Abdelrahman I Abushouk, Oladimeji M Adebayo, Victor Adekanmbi, Davoud Adham, Shailesh M Advani, Khashayar Afshari, Anurag Agrawal, Tauseef Ahmad, Keivan Ahmadi, Anwar E Ahmed, Budi Aji, Blessing Akombi-Inyang, Fares Alahdab, Ziyad Al-Aly, Khurshid Alam, Fahad Mashhour Alanezi, Turki M Alanzi, Jacqueline Elizabeth Alcalde-Rabanal, Biresaw Wassihun Alemu, Samar Al-Hajj, Robert Kaba Alhassan, Saqib Ali, Gianfranco Alicandro, Mehran Alijanzadeh, Syed Mohamed Aljunid, Amir Almasi-Hashiani, Nihad A Almasri, Hesham M Al-Mekhlafi, Jordi Alonso, Rajaa M Al-Raddadi, Khalid A Altirkawi, Nelson Alvis-Guzman, Azmeraw T Amare, Saeed Amini, Arya Aminorroaya, Arianna Maever L Amit, Dickson A Amugsi, Robert Ancuceanu, Deanna Anderlini, Catalina Liliana Andrei, Sofia Androudi, Fereshteh Ansari, Iman Ansari, Carl Abelardo T Antonio, Davood Anvari, Razique Anwer, Seth Christopher Yaw Appiah, Jalal Arabloo, Morteza Arab-Zozani, Johan Ärnlöv, Malke Asaad, Mehran Asadi-Aliabadi, Ali A Asadi-Pooya, Maha Moh’d Wahbi Atout, Marcel Ausloos, Elvis Korku Avenyo, Leticia Avila-Burgos, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Yared Asmare Aynalem, Samad Azari, Zelalem Nigussie Azene, Mohammad Hossein Bakhshaei, Shankar M Bakkannavar, Maciej Banach, Palash Chandra Banik, Miguel A Barboza, Suzanne Lyn Barker-Collo, Till Winfried Bärnighausen, Sanjay Basu, Bernhard T Baune, Mohsen Bayati, Neeraj Bedi, Ettore Beghi, Tariku Tesfaye Bekuma, Arielle Wilder Bell, Michelle L Bell, Corina Benjet, Isabela M Bensenor, Abadi Kidanemariam Berhe, Kidanemaryam Berhe, Adam E Berman, Akshaya Srikanth Bhagavathula, Nikha Bhardwaj, Pankaj Bhardwaj, Krittika Bhattacharyya, Suraj Bhattarai, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Antonio Biondi, Tesega Tesega Mengistu Birhanu, Raaj Kishore Biswas, Somayeh Bohlouli, Srinivasa Rao Bolla, Archith Boloor, Rohan Borschmann, Soufiane Boufous, Nicola Luigi Bragazzi, Dejana Braithwaite, Nicholas J K Breitborde, Hermann Brenner, Gabrielle B Britton, Richard A Burns, Sharath Burugina Nagaraja, Zahid A Butt, Florentino Luciano Caetano dos Santos, Luis Alberto Cámera, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Rosario Cárdenas, Giulia Carreras, Juan J Carrero, Felix Carvalho, Joao Mauricio Castaldelli-Maia, Carlos A Castañeda-Orjuela, Giulio Castelpietra, Ferrán Catalá-López, Ester Cerin, Joht Singh Chandan, Hsing-Yi Chang, Jung-Chen Chang, Jaykaran Charan, Vijay Kumar Chattu, Sarika Chaturvedi, Jee-Young Jasmine Choi, Mohiuddin Ahsanul Kabir Chowdhury, Devasahayam J Christopher, Dinh-Toi Chu, Michael T Chung, Sheng-Chia Chung, Flavia M Cicuttini, Traian Vasile Constantin, Vera Marisa Costa, Saad M A Dahlawi, Haijiang Dai, Xiaochen Dai, Giovanni Damiani, Lalit Dandona, Rakhi Dandona, Parnaz Daneshpajouhnejad, Aso Mohammad Darwesh, Claudio Alberto Dávila-Cervantes, Kairat Davletov, Fernando Pio De la Hoz, Diego De Leo, Nikolaos Dervenis, Rupak Desai, Assefa Desalew, Keshab Deuba, Samath Dhamminda Dharmaratne, Govinda Prasad Dhungana, Mostafa Dianatinasab, Diana Dias da Silva, Daniel Diaz, Alireza Didarloo, Shirin Djalalinia, Fariba Dorostkar, Chirag P Doshi, Leila Doshmangir, Kerrie E Doyle, Andre Rodrigues Duraes, Mohammad Ebrahimi Kalan, Sanam Ebtehaj, David Edvardsson, Maha El Tantawi, Islam Y Elgendy, Shaimaa I El-Jaafary, Aisha Elsharkawy, Babak Eshrati, Sharareh Eskandarieh, Saman Esmaeilnejad, Firooz Esmaeilzadeh, Sadaf Esteghamati, Andre Faro, Farshad Farzadfar, Nazir Fattahi, Valery L Feigin, Tomas Y Ferede, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Pietro Ferrara, Irina Filip, Florian Fischer, James L Fisher, Nataliya A Foigt, Morenike Oluwatoyin Folayan, Artem Alekseevich Fomenkov, Masoud Foroutan, 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Fatemeh Heydarpour, Hung Chak Ho, Michael K Hole, Ramesh Holla, Praveen Hoogar, Mostafa Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Mowafa Househ, Mohamed Hsairi, Tanvir M Huda, Ayesha Humayun, Rabia Hussain, Bing-Fang Hwang, Ivo Iavicoli, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Leeberk Raja Inbaraj, Nirun Intarut, Usman Iqbal, Seyed Sina Naghibi Irvani, M Mofizul Islam, Sheikh Mohammed Shariful Islam, Hiroyasu Iso, Rebecca Q Ivers, Mohammad Ali Jahani, Mihajlo Jakovljevic, Amir Jalali, Manthan Dilipkumar Janodia, Tahereh Javaheri, Panniyammakal Jeemon, Ensiyeh Jenabi, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Jost B Jonas, Kelly M Jones, Farahnaz Joukar, Jacek Jerzy Jozwiak, Petur B Juliusson, Mikk Jürisson, Ali Kabir, Zubair Kabir, Leila R Kalankesh, Rohollah Kalhor, Naser Kamyari, Tanuj Kanchan, André Karch, Salah Eddin Karimi, Supreet Kaur, Gbenga A Kayode, Peter Njenga Keiyoro, Nauman Khalid, Mohammad Khammarnia, Maseer 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Mansournia, Gabriel Martinez, Jose Martinez-Raga, Francisco Rogerlândio Martins-Melo, Amanda J Mason-Jones, Seyedeh Zahra Masoumi, Manu Raj Mathur, Pallab K Maulik, John J McGrath, Man Mohan Mehndiratta, Fereshteh Mehri, Peter T N Memiah, Walter Mendoza, Ritesh G Menezes, Endalkachew Worku Mengesha, Atte Meretoja, Tuomo J Meretoja, Tomislav Mestrovic, Bartosz Miazgowski, Tomasz Miazgowski, Irmina Maria Michalek, Ted R Miller, GK Mini, Andreea Mirica, Erkin M Mirrakhimov, Hamed Mirzaei, Maryam Mirzaei, Babak Moazen, Dara K Mohammad, Shadieh Mohammadi, Abdollah Mohammadian-Hafshejani, Noushin Mohammadifard, Reza Mohammadpourhodki, Shafiu Mohammed, Lorenzo Monasta, Ghobad Moradi, Maziar Moradi-Lakeh, Rahmatollah Moradzadeh, Paula Moraga, Shane Douglas Morrison, Abbas Mosapour, Amin Mousavi Khaneghah, Ulrich Otto Mueller, Moses K Muriithi, Christopher J L Murray, Saravanan Muthupandian, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Mukhammad David Naimzada, Vinay Nangia, Vinod C Nayak, Javad Nazari, Rawlance Ndejjo, Ionut Negoi, Ruxandra Irina Negoi, Henok Biresaw Netsere, Georges Nguefack-Tsague, Diep Ngoc Nguyen, Huong Lan Thi Nguyen, Jing Nie, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Shuhei Nomura, Jean Jacques Noubiap, Christoph Nowak, Virginia Nuñez-Samudio, Felix Akpojene Ogbo, Onome Bright Oghenetega, In-Hwan Oh, Morteza Oladnabi, Andrew T Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Ahmed Omar Bali, Muktar Omer Omer, Obinna E Onwujekwe, Alberto Ortiz, Adrian Otoiu, Nikita Otstavnov, Stanislav S Otstavnov, Simon Øverland, Mayowa O Owolabi, Mahesh P A, Jagadish Rao Padubidri, Keyvan Pakshir, Raffaele Palladino, Adrian Pana, Songhomitra Panda-Jonas, Anamika Pandey, Carlo Irwin Able Panelo, Eun-Kee Park, Scott B Patten, Amy E Peden, Veincent Christian Filipino Pepito, Emmanuel K Peprah, Jeevan Pereira, Konrad Pesudovs, Hai Quang Pham, Michael R Phillips, Michael A Piradov, Meghdad Pirsaheb, Maarten J Postma, Faheem Hyder Pottoo, Hadi Pourjafar, Akram Pourshams, Sergio I Prada, Elisabetta Pupillo, Zahiruddin Quazi Syed, Mohammad Hasan Rabiee, Navid Rabiee, Amir Radfar, Ata Rafiee, Alberto Raggi, Fakher Rahim, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, Kiana Ramezanzadeh, Chhabi Lal Ranabhat, Sowmya J Rao, Vahid Rashedi, Prateek Rastogi, Priya Rathi, David Laith Rawaf, Salman Rawaf, Lal Rawal, Reza Rawassizadeh, Andre M N Renzaho, Negar Rezaei, Nima Rezaei, Mohammad Sadegh Rezai, Seyed Mohammad Riahi, Jennifer Rickard, Leonardo Roever, Luca Ronfani, Gregory A Roth, Enrico Rubagotti, Susan Fred Rumisha, Godfrey M Rwegerera, Siamak Sabour, Perminder S Sachdev, Basema Saddik, Ehsan Sadeghi, Sahar Saeedi Moghaddam, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, S Mohammad Sajadi, Marwa Rashad Salem, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Milena M Santric-Milicevic, Sivan Yegnanarayana Iyer Saraswathy, Nizal Sarrafzadegan, Arash Sarveazad, Thirunavukkarasu 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Tareque, Kavumpurathu Raman Thankappan, Rekha Thapar, Nihal Thomas, Mariya Vladimirovna Titova, Marcello Tonelli, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Ravensara S Travillian, Alexander C Tsai, Aristidis Tsatsakis, Lorainne Tudor Car, Riaz Uddin, Brigid Unim, Bhaskaran Unnikrishnan, Era Upadhyay, Marco Vacante, Sahel Valadan Tahbaz, Pascual R Valdez, Santosh Varughese, Tommi Juhani Vasankari, Narayanaswamy Venketasubramanian, Paul J Villeneuve, Francesco S Violante, Vasily Vlassov, Theo Vos, Giang Thu Vu, Yasir Waheed, Richard G Wamai, Yafeng Wang, Yanzhong Wang, Yuan-Pang Wang, Ronny Westerman, Nuwan Darshana Wickramasinghe, Ai-Min Wu, Chenkai Wu, Seyed Hossein Yahyazadeh Jabbari, Kazumasa Yamagishi, Yuichiro Yano, Sanni Yaya, Vahid Yazdi-Feyzabadi, Yordanos Gizachew Yeshitila, Paul Yip, Naohiro Yonemoto, Seok-Jun Yoon, Mustafa Z Younis, Taraneh Yousefinezhadi, Chuanhua Yu, Yong Yu, Deniz Yuce, Syed Saoud Zaidi, Sojib Bin Zaman, Mohammad Zamani, Maryam Zamanian, Hadi Zarafshan, Ahmad Zarei, Mikhail Sergeevich Zastrozhin, Yunquan Zhang, Zhi-Jiang Zhang, Xiu-Ju George Zhao, Cong Zhu, George C Patton*, Russell M Viner* *Joint senior authors.

Funders: Bill & Melinda Gates Foundation
Date Deposited: 27 Apr 2022 22:55
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