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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
Authors: Ward, Joseph L.
Azzopardi, Peter S.
Francis, Kate L.
Santelli, John S.
Skirbekk, Vegard
Sawyer, Susan M.
Kassebaum, Nicholas J.
Mokdad, Ali H.
Hay, Simon I.
Abd-Allah, Foad
Abdoli, Amir
Mohammad Abdollahi
Abedi, Aidin
Abolhassani, Hassan
Abreu, Lucas Guimaraes
Abrigo, Michael R. M.
Abu-Gharbieh, Eman
Abushouk, Abdelrahman I.
Adebayo, Oladimeji M.
Adekanmbi, Victor
Adham, Davoud
Advani, Shailesh M.
Afshari, Khashayar
Agrawal, Anurag
Ahmad, Tauseef
Ahmadi, Keivan
Ahmed, Anwar E.
Aji, Budi
Akombi-Inyang, Blessing
Alahdab, Fares
Al-Aly, Ziyad
Alam, Khurshid
Alanezi, Fahad Mashhour
Alanzi, Turki M.
Alcalde-Rabanal, Jacqueline Elizabeth
Alemu, Biresaw Wassihun
Al-Hajj, Samar
Alhassan, Robert Kaba
Ali, Saqib
Alicandro, Gianfranco
Alijanzadeh, Mehran
Aljunid, Syed Mohamed
Almasi-Hashiani, Amir
Almasri, Nihad A.
Al-Mekhlafi, Hesham M.
Alonso, Jordi
Al-Raddadi, Rajaa M.
Altirkawi, Khalid A.
Alvis-Guzman, Nelson
Amare, Azmeraw T.
Amini, Saeed
Aminorroaya, Arya
Amit, Arianna Maever L.
Amugsi, Dickson A.
Ancuceanu, Robert
Anderlini, Deanna
Andrei, Catalina Liliana
Androudi, Sofia
Ansari, Fereshteh
Ansari, Iman
Antonio, Carl Abelardo T.
Anvari, Davood
Anwer, Razique
Appiah, Seth Christopher Yaw
Arabloo, Jalal
Arab-Zozani, Morteza
Ärnlöv, Johan
Asaad, Malke
Asadi-Aliabadi, Mehran
Asadi-Pooya, Ali A.
Atout, Maha Moh'd Wahbi
Ausloos, Marcel
Avenyo, Elvis Korku
Avila-Burgos, Leticia
Quintanilla, Beatriz Paulina Ayala
Ayano, Getinet
Aynalem, Yared Asmare
Azari, Samad
Azene, Zelalem Nigussie
Bakhshaei, Mohammad Hossein
Bakkannavar, Shankar M.
Banach, Maciej
Banik, Palash Chandra
Barboza, Miguel A.
Barker-Collo, Suzanne Lyn
Bärnighausen, Till Winfried
Basu, Sanjay
Baune, Bernhard T.
Bayati, Mohsen
Bedi, Neeraj
Beghi, Ettore
Bekuma, Tariku Tesfaye
Bell, Arielle Wilder
Bell, Michelle L.
Benjet, Corina
Bensenor, Isabela M.
Berhe, Abadi Kidanemariam
Berhe, Kidanemaryam
Berman, Adam E.
Bhagavathula, Akshaya Srikanth
Car, Lorainne Tudor
Keywords: Science::Medicine
Issue Date: 2021
Source: Ward, J. L., Azzopardi, P. S., Francis, K. L., Santelli, J. S., Skirbekk, V., Sawyer, S. M., Kassebaum, N. J., Mokdad, A. H., Hay, S. I., Abd-Allah, F., Abdoli, A., Mohammad Abdollahi, Abedi, A., Abolhassani, H., Abreu, L. G., Abrigo, M. R. M., Abu-Gharbieh, E., Abushouk, A. I., Adebayo, O. M., ...Car, L. T. (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, 398(10311), 1593-1618.
Journal: The Lancet 
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.
ISSN: 0140-6736
DOI: 10.1016/S0140-6736(21)01546-4
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Rights: © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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