What's killing our youth

A new study in the venerable medical publication The Lancet has for the first time systematically analyzed the principle causes of death among adolescents and young adults around the globe. This may seem like a rather pessimistic topic for discussion, but before investigating solutions that bolster health, we need to understand what threatens health.

This will be the first in a series of entries here at Justmeansand at our companion health blog that will look at global threats to children's health.

The Lancet study analyzed death rates among people aged 10 to 24 years in 78 countries during 2004. Countries were divided into two groups: high-income countries, and low- and middle-income countries. Worldwide, 2.6 million deaths occurred among the 1.8 billion people in this age group, 97% in low and middle income regions, and roughly 60% in sub-Saharan Africa and southeast Asia.

The principle killers? Diseases (primarily HIV/AIDS, tuberculosis, lower respiratory tract infection, cardiovascular disease, cancer, andneuropsychiatric disorders), and injuries (the major ones being traffic accidents, fire, drowning, violence and suicide). Communicable diseases were a leading cause of death among females, responsible for 48% of deaths in this age group (7% were maternity related). Among males, injuries were the leading cause, responsible for 51% of death. Unintentional and intentional injuries accounted for more than 2 in 5 deaths among males and females.

For both sexes, in all regions, death rates increased substantially with age, anywhere from 2 to 4 times.And rates were higher among males than females, especially in high-income nations where male behavior, combined with lower disease-related female death, leads to 2.4 times more death among males than females. As has been shown in other health research, geography plays a heavy hand in health destiny, with the death rate in wealthier nations about one-third (among males) to one-fifth (among females)the rate in the rest of the world.

The generality of the findings may not contribute much to our overall assessment of specific programs that may be needed, but a few conclusions can be reached. While global emphasis has been placed on HIV/AIDS and maternal causes of ill health among the young, these findings make itclear that equal emphasis should be placed on injury prevention. Worldwide, accidents and injuries, whether the intentional acts of violence or war, or the unintentional misjudgments of traffic pile-ups, are claiming over a million young-people every year.