Global mortality continues to fall. Life expectancy has improved to unprecedented levels and deaths in young children have plummeted. Yet for adolescents and young adults, especially those aged 15 to 24, little progress has been made according to data from the latest Global Burden of Disease study. In parts of North America and eastern Europe, mortality in those aged 15-24 has actually risen in the past decade.
This latest study also showed the main causes of death among young people aren’t disease or poor health. The main causes were shown to be injury, violence, suicide, road traffic accidents and substance abuse.
This shows us that health systems worldwide are still ill-equipped to prevent or intervene effectively in social and structural causes of youth mortality.
The Global Burden of Disease study is one of the largest studies on the picture of health, disease and mortality worldwide. The study analysed more than 310,000 data sources collected between 1950 and 2023 from 204 countries. Using death registries, censuses and household surveys, the research team estimated age-specific mortality trends across the lifespan.
The overall picture is one of uneven progress.
For children, especially in low and middle-income countries, vaccines, improved sanitation and better nutrition have saved millions of lives. In east Asia, for instance, mortality in under-fives fell by 68% between 2011 and 2023.
For older adults, the global mortality rate declined by 67% between 1950 and 2023, thanks to better screening, medication and chronic disease management.
Deaths from cardiovascular disease (the leading cause of death globally) have also improved substantially. But cardiovascular disease and other non-communicable diseases (such as cancer and diabetes) still account for nearly two-thirds of all deaths ariund the world.
For young people aged 15-24, the risk profile was different. For them, the main causes of death were primarily preventable ones.
In North America, deaths among people aged 20 to 39 rose by as much as 50% in the past decade – largely due to suicide, drug overdose and alcohol-related harms. The picture was also similar in some parts of Latin America.
But in other parts of the world, such as sub-Saharan Africa, infectious diseases (such as as tuberculosis) and unintentional injuries were the main drivers of youth mortality.
The study also highlighted stark inequalities in mortality risk for youth from marginalised, low-income or Indigenous groups. For instance, the study found that mortality in young women aged 15-29 living in sub-Saharan Africa was 61% higher than previously estimated, mostly due to maternal mortality, road injuries and meningitis.
However, these groups remain systematically underrepresented in global health datasets. The study found that more than 80% of countries lacked nationally representative data across key health domains, including mental health and child health. This meant most of the data was drawn from high-income regions.
Latin Americans, for example, make up over 8% of the global population but represent less than 1% of some global reference datasets. Such a systemic lack of representation from these groups renders their health needs invisible – including the health needs of those affecting the young.
Emerging trends
Today’s young people face unprecedented economic insecurity, social volatility, violence and pressures from social media – all of which can have an extraordinary toll on both mental health and wellbeing.
Mental health challenges underlie many of the leading causes of adolescent death reported in the study. It’s clear from this and other studies that youth mental health urgently needs to be addressed.
For instance, research from Spain which looked at over 2 million adolescent hospitalisations between 2000 and 2021, found admissions for mental health conditions more than doubled – surging especially after the COVID-19 pandemic.
For teenage boys, substance use, ADHD and psychosis were the most common causes of hospitalisation. For girls, eating disorders, anxiety and depression were more prevalent.
A related study found admissions for adolescent anorexia nervosa rose by almost 90% after 2020 – with cases overwhelmingly concentrated in girls aged 13-17.
Health survey data from 2023 also showed that half of US young adults aged 18-24 reported experiencing symptoms of anxiety or depression. Additionally, a separate US survey also found that more than one-third of 18-24-year-olds reported they’d recently thought about self-harm or suicide.
Other factors which may also have contributed to high youth mortality rates may include a historical lack of preparedness by health systems in focusing on adolescent health issues, as well as a lack of interventions aimed at reducing the actual leading causes of youth death (such as road safety, violence prevention and meaningful mental health care).
The response to youth mortality cannot be medical alone as the leading causes of death in this age group require interventions that sit outside healthcare and require coordination across sectors.
Data systems must also change. Youth from low-income countries, Indigenous people and marginalised groups are underrepresented in research. This means we don’t fully understand the needs of these groups and the problems they face – making it difficult to plan and implement effective interventions.
Youth health must be re-framed as an equity issue, as well. The current model treats young people as responsible for their own poor outcomes, when research shows that, overwhelmingly, these issues can be caused by conditions that young people do not control: poverty, exposure to violence, unsafe road environments, inadequate mental health services and lack of economic opportunity.
These deaths are preventable. We cannot celebrate global health gains when youth mortality is stagnant – and even worsening in many parts of the world. Preventing adolescent and young adult deaths is the next frontier for a fairer, healthier future.
Manuel Corpas does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
This article was originally published on The Conversation. Read the original article.
