Global, regional, and national mortality trends in youth aged 15–24 years between 1990 and 2019: a systematic analysis

Abstract

Summary Background The global health community is devoting considerable attention to adolescents and young people, but risk of death in this population is poorly measured. We aimed to reconstruct global, regional, and national mortality trends for youths aged 15–24 years between 1990 and 2019. Methods In this systematic analysis, we used all publicly available data on mortality in the age group 15–24 years for 195 countries, as compiled by the UN Inter-agency Group for Child Mortality Estimation. We used nationally representative vital registration data, estimated the completeness of death registration, and extracted mortality rates from surveys with sibling histories, household deaths reported in censuses, and sample registration systems. We used a Bayesian B-spline bias-reduction model to generate trends in 10 q 15 , the probability that an adolescent aged 15 years would die before reaching age 25 years. This model treats observations of the 10 q 15 probability as the product of the actual risk of death and an error multiplier that varies depending on the data source. The main outcome that we assessed was the levels of and trends in youth mortality and the global and regional mortality rates from 1990 to 2019. Findings Globally, the probability of an individual dying between age 15 years and 24 years was 11·2 deaths (90% uncertainty interval [UI] 10·7–12·5) per 1000 youths aged 15 in 2019, which is about 2·5 times less than infant mortality (28·2 deaths [27·2–30·0] by age 1 year per 1000 live births) but is higher than the risk of dying from age 1 to 5 (9·7 deaths [9·1–11·1] per 1000 children aged 1 year). The probability of dying between age 15 years and 24 years declined by 1·4% per year (90% UI 1·1–1·8) between 1990 and 2019, from 17·1 deaths (16·5–18·9) per 1000 in 1990; by contrast with this total decrease of 34% (27–41), under-5 mortality declined by 59% (56–61) in this period. The annual number of deaths declined from 1·7 million (90% UI 1·7–1·9) in 1990 to 1·4 million (1·3–1·5) in 2019. In sub-Saharan Africa, the number of deaths increased by 20·8% from 1990 to 2019. Although 18·3% of the population aged 15–24 years were living in sub-Saharan Africa in 2019, the region accounted for 37·9% (90% UI 34·8–41·9) of all worldwide deaths in youth. Interpretation It is urgent to accelerate progress in reducing youth mortality. Efforts are particularly needed in sub-Saharan Africa, where the burden of mortality is increasingly concentrated. In the future, a growing number of countries will see youth mortality exceeding under-5 mortality if current trends continue. Funding UN Children's Fund, Bill & Melinda Gates Foundation, United States Agency for International Development.

Quality of adolescent and youth-friendly health services in Dehana district public health facilities, northeast Ethiopia: Using the Donabedian quality framework

“…The 2016 Ethiopia Demographic and Health Survey (EDHS) estimated that youth mortality rates were 11.61 deaths per 1000 population [ 9 ]. Injuries (including road traffic injuries and drowning), self-harm, violence, and maternal conditions are the top causes of death among adolescents and youths [ 10 , 11 ].…”

Then and Now: Investigating Anthropometrics and Child Mortality among Females in Malawi

“…Moreover, the population is youthful because there is a gradual decline in the number of young people entering adulthood [68,69]. Adolescents and young are vulnerable to community and household influences that increase avoidable mortality risk [70,71]. The increased susceptibility to mortality during adolescence might reduce the number of adolescents and young people entering adulthood.…”

“…Similarly, the intensity of scarce resources may further be influenced by the mother's inactivity, a common practice among obese females [88][89][90]. Where young children or infants have less access to resources, even at the subsistence level, they become malnourished-lacking the right amount of nutrients needed for survival-and susceptible to infectious diseases, the leading causes of death among children in Malawi and SSA [71,91]. Moreover, the persistence of poor health care access for the marginalized groups, including obese females and children in Malawi [92,93], further increases the mortality risk among children born to obese and overweight females.…”

National, regional, and global causes of mortality in 5–19-year-olds from 2000 to 2019: a systematic analysis

“… 15 , 16 To derive regional mortality estimates, we grouped countries in nine regions according to the UN Inter-agency Group for Child Mortality Estimation (IGME; appendix pp 3–6 ). 4 , 17 …”

“…To convert the CSMFs into cause-specific mortality rates and death counts, we used country estimates of all-cause mortality envelopes from UN-IGME ( appendix pp 16–17 ). 4 , 17 …”