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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

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


Title: 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
Author: GBD 2019 Adolescent Mortality Collaborators
Date: 2021-10-30
Language: English
Scope: 26
Department: Department of Psychology
Series: The Lancet; 398(10311)
ISSN: 0140-6736
DOI: https://doi.org/10.1016/S0140-6736(21)01546-4
Subject: Unglingar; Dánarmein; Börn; Kynferði; Sjúkdómar; Dánartíðni; Félagshagfræði; Adolescent; Age distribution; Cause of death; Children; Female; Global disease burden; Male; Human; Mortality; Sex distribution; Socioeconomic factors; Young adult; Medicine (all)
URI: https://hdl.handle.net/20.500.11815/3377

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Citation:

GBD 2019 Adolescent Mortality Collaborators 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 ' , The Lancet , vol. 398 , no. 10311 , pp. 1593-1618 . https://doi.org/10.1016/S0140-6736(21)01546-4

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. Funding: Bill & Melinda Gates Foundation.

Description:

Funding Information: This Article was supported by the Bill & Melinda Gates Foundation and the National Institute on Ageing of the National Institutes of Health (award P30AG047845). J L Ward is funded by the Medical Research Council and G C Patton by an NHMRC Fellowship. P Azzopardi is supported by an NHMRC Fellowship GNT1145228. L Abreu would like to thank Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) - C?digo de Financiamento 001, Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (404710/2018-2 and 310797/2019-5), and Funda??o de Amparo ? Pesquisa de Minas Gerais (FAPEMIG). S Aljunid would like to acknowledge the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. T B?rnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. G Britton is supported by Sistema Nacional de Investigaci?n (SNI) of Secretar?a Nacional de Ciencia, Tecnolog?a e Innovaci?n (SENACYT) of Panam?. F Carvalho and E Fernandes are supported by UID/MULTI/04378/2019 and UID/QUI/50006/2019 with funding from FCT/MCTES through national funds. V Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Funda??o para a Ci?ncia e Tecnologia (FCT), IP, under the Norma Transit?ria DL57/2016/CP1334/CT0006. A Fomenkov and M Titova acknowledge support from the state assignment of Ministry of Science and Higher Education of the Russian Federation (theme 121050500047-5). A Gebreslassie acknowledges the Department of Reproductive Health, College of Health Sciences, School of Public Health at Mekelle University. C Herteliu and M Ausloos are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. P Hoogar acknowledges support from the Centre for Bio Cultural Studies (CBiCS), Directorate of Research, Manipal Academy of Higher Education, Manipal and Centre for Holistic Development and Research (CHDR), Kalaghatagi. S Islam is funded by a fellowship from the National Heart Foundation of Australia and NHMRC. M Jakovljevic acknowledges support through the Grant OI 175 014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. P Jeemon received (2015-2021) Wellcome Trust/DBT India Alliance Clinical and Public Health Intermediate Fellowship (IA/CPHI/14/1/501497). M Khan acknowledges the support of Jatiya Kabi Kazi Nazrul Islam University, Bangladesh. C Kieling is a Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq, Brazil) researcher and an Academy of Medical Sciences (UK) Newton advanced fellow. YJ Kim was supported by the Research Management Centre, Xiamen University Malaysia [XMUMRF/2020-C6/ITCM/0004]. K Krishan is supported by the UGC Centre of Advanced Study (Phase II), awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar acknowledges support from the Fogarty International Center/National Institutes of Health K43 TW010716-04. B Lacey acknowledges support from UK Biobank, University of Oxford. I Landires is member of the Sistema Nacional de Investigaci?n (SNI), supported by the Secretar?a Nacional de Ciencia, Tecnolog?a e Innovaci?n (SENACYT), Panama. S Lorkowski acknowledges institutional support from the Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig (Germany; German Federal Ministry of Education and Research; grant agreement number 01EA1808A). P Mahasha acknowledges support from Grants, Innovation and Product Development (GIPD) Unit, South African Medical Research Council (SAMRC). A Mason-Jones was supported by the University of York. J McGrath is supported by the Danish National Research Foundation (Niels Bohr Professorship). J McGrath is employed by The Queensland Centre for Mental Health Research which receives core funding from the Department of Health, Queensland Government. S Nomura acknowledges support from the Ministry of Education, Culture, Sports, Science and Technology of Japan (MEXT). J Padubidri acknowledges Manipal Academy of Higher Education, Manipal for their constant support to academic research. S Patten holds the Cuthbertson & Fischer Chair at the University of Calgary. G Patton is supported by an NHMRC research fellowship. M Phillips is supported in part by National Natural Science Foundation of China (NSFC 81761128031). A Raggi, D Sattin and S Schiavolin are supported by a grant from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C. Besta, Linea 4 ? Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). A Samy acknowledges the support from the Egyptian Fulbright Mission Program. A Sheikh is supported by HDRUK. B Shetty acknowledges the research support from Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. J Silva acknowledges support shafrom grant number UIDB/04378/2020 from the Applied Molecular Biosciences Unit (UCIBIO), supported through Portuguese national funds via FCT/MCTES. S Tadakamadla acknowledges support from National Health and Medical Research Council Early Career Fellowship, Australia. R Uddin is supported by an Alfred Deakin Postdoctoral Research Fellowship, Deakin University, Australia. B Unnikrishnan acknowledges support from the Manipal Academy of Higher Education, Manipal. S Zaman received a scholarship from the Australian Government research training program (RTP) in support of his academic career. Y Zhang was supported by Science and Technology Research Project of Hubei Provincial Department of Education (Grant Q20201104), Open Fund Project of Hubei Province Key Laboratory of Occupational Hazard Identification and Control (Grant OHIC2020Y01), Outstanding Young and Middle Aged Technology Innovation Team Project of Hubei Provincial Department of Education (Grant T2020003), and the Key Research Center for Humanities and Social Sciences in Hubei Province (Hubei University of Medicine) (Grant 2020ZD001). C Zhu is funded by UTHealth Innovation for Cancer Prevention Research Training Program Pre-doctoral Fellowship (Cancer Prevention and Research Institute of Texas Grant RP160015) which does not necessary endorse this study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Cancer Prevention and Research Institute of Texas. All other authors received no specific funding for this work. Funding Information: This Article was supported by the Bill & Melinda Gates Foundation and the National Institute on Ageing of the National Institutes of Health (award P30AG047845). J L Ward is funded by the Medical Research Council and G C Patton by an NHMRC Fellowship. P Azzopardi is supported by an NHMRC Fellowship GNT1145228. L Abreu would like to thank Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) - Código de Financiamento 001, Conselho Nacional de Desenvolvimento Científico e Tecnológico (404710/2018-2 and 310797/2019-5), and Fundação de Amparo à Pesquisa de Minas Gerais (FAPEMIG). S Aljunid would like to acknowledge the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. T Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. G Britton is supported by Sistema Nacional de Investigación (SNI) of Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT) of Panamá. F Carvalho and E Fernandes are supported by UID/MULTI/04378/2019 and UID/QUI/50006/2019 with funding from FCT/MCTES through national funds. V Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. A Fomenkov and M Titova acknowledge support from the state assignment of Ministry of Science and Higher Education of the Russian Federation (theme 121050500047-5). A Gebreslassie acknowledges the Department of Reproductive Health, College of Health Sciences, School of Public Health at Mekelle University. C Herteliu and M Ausloos are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. P Hoogar acknowledges support from the Centre for Bio Cultural Studies (CBiCS), Directorate of Research, Manipal Academy of Higher Education, Manipal and Centre for Holistic Development and Research (CHDR), Kalaghatagi. S Islam is funded by a fellowship from the National Heart Foundation of Australia and NHMRC. M Jakovljevic acknowledges support through the Grant OI 175 014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. P Jeemon received (2015-2021) Wellcome Trust/DBT India Alliance Clinical and Public Health Intermediate Fellowship (IA/CPHI/14/1/501497). M Khan acknowledges the support of Jatiya Kabi Kazi Nazrul Islam University, Bangladesh. C Kieling is a Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, Brazil) researcher and an Academy of Medical Sciences (UK) Newton advanced fellow. YJ Kim was supported by the Research Management Centre, Xiamen University Malaysia [XMUMRF/2020-C6/ITCM/0004]. K Krishan is supported by the UGC Centre of Advanced Study (Phase II), awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M Kumar acknowledges support from the Fogarty International Center/National Institutes of Health K43 TW010716-04. B Lacey acknowledges support from UK Biobank, University of Oxford. I Landires is member of the Sistema Nacional de Investigación (SNI), supported by the Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT), Panama. S Lorkowski acknowledges institutional support from the Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig (Germany; German Federal Ministry of Education and Research; grant agreement number 01EA1808A). P Mahasha acknowledges support from Grants, Innovation and Product Development (GIPD) Unit, South African Medical Research Council (SAMRC). A Mason-Jones was supported by the University of York. J McGrath is supported by the Danish National Research Foundation (Niels Bohr Professorship). J McGrath is employed by The Queensland Centre for Mental Health Research which receives core funding from the Department of Health, Queensland Government. S Nomura acknowledges support from the Ministry of Education, Culture, Sports, Science and Technology of Japan (MEXT). J Padubidri acknowledges Manipal Academy of Higher Education, Manipal for their constant support to academic research. S Patten holds the Cuthbertson & Fischer Chair at the University of Calgary. G Patton is supported by an NHMRC research fellowship. M Phillips is supported in part by National Natural Science Foundation of China (NSFC 81761128031). A Raggi, D Sattin and S Schiavolin are supported by a grant from the Italian Ministry of Health (Ricerca Corrente, Fondazione Istituto Neurologico C. Besta, Linea 4 – Outcome Research: dagli Indicatori alle Raccomandazioni Cliniche). A Samy acknowledges the support from the Egyptian Fulbright Mission Program. A Sheikh is supported by HDRUK. B Shetty acknowledges the research support from Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal. J Silva acknowledges support shafrom grant number UIDB/04378/2020 from the Applied Molecular Biosciences Unit (UCIBIO), supported through Portuguese national funds via FCT/MCTES. S Tadakamadla acknowledges support from National Health and Medical Research Council Early Career Fellowship, Australia. R Uddin is supported by an Alfred Deakin Postdoctoral Research Fellowship, Deakin University, Australia. B Unnikrishnan acknowledges support from the Manipal Academy of Higher Education, Manipal. S Zaman received a scholarship from the Australian Government research training program (RTP) in support of his academic career. Y Zhang was supported by Science and Technology Research Project of Hubei Provincial Department of Education (Grant Q20201104), Open Fund Project of Hubei Province Key Laboratory of Occupational Hazard Identification and Control (Grant OHIC2020Y01), Outstanding Young and Middle Aged Technology Innovation Team Project of Hubei Provincial Department of Education (Grant T2020003), and the Key Research Center for Humanities and Social Sciences in Hubei Province (Hubei University of Medicine) (Grant 2020ZD001). C Zhu is funded by UTHealth Innovation for Cancer Prevention Research Training Program Pre-doctoral Fellowship (Cancer Prevention and Research Institute of Texas Grant RP160015) which does not necessary endorse this study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Cancer Prevention and Research Institute of Texas. All other authors received no specific funding for this work. Publisher Copyright: © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

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