Centre for Adolescent Health
Global patterns of mortality
in young men & women
Professor George Patton. Expert Group
Meeting on Adolescents, Youth & Development,
United Nations, New York July 2011.
TWO IDEAS
Paradox of Adolescent Health
Health Transition
Scope of Talk
 Mortality
 Morbidity
 A picture of young people’s health
Scope of Talk
 Mortality
 Morbidity
 A picture of young people’s health
World Health Organisation (WHO) Regions
Death Registration of at least 70% (stripes)
WHERE (regions)
WHO (age)
HOW (causes)
All-cause Mortality 10-24 years
300+
200-300
150-200
100-150
50-100
0-50
All-cause Mortality 10-24 years
300+
200-300
150-200
100-150
50-100
0-50
All-cause Mortality 10-24 years
300+
200-300
150-200
100-150
50-100
0-50
All-cause Mortality 10-24 years
300+
200-300
150-200
100-150
50-100
0-50
All-cause Mortality 10-24 years
45/100,000 pa
300+
200-300
150-200
100-150
50-100
0-50
305/100,000 pa
2.6 million deaths each year…
% of Youth Population & Deaths
40
35
30
25
Pop'n
20
Deaths
15
10
5
0
Hi Inc
AFR
AMR
EMR
EUR
SEAR
WPR
WHERE (regions)
WHO (age)
HOW (causes)
All-cause Mortality 10-14 years
300+
200-300
150-200
100-150
50-100
25-50
0-25
All-cause Mortality 15-19 years
300+
200-300
150-200
100-150
50-100
25-50
0-25
All-cause Mortality 20-24 years
69/100,000 pa
300+
200-300
150-200
100-150
50-100
25-50
0-25
505/100,000 pa
WHERE (regions)
WHO (age)
HOW (causes)
Mortality Classification
Group Ia - Maternal
Group Ib - Infectious, Nutritional
Group II - Non-communicable
Group III – Injuries*
* Traffic, Suicide, Violence & War, Drowning & Burns
Male deaths by Group
Female deaths by Group
15%
27%
30%
52%
Injury
33%
21%
Chronic
22%
Infectious
Maternal
Maternal Deaths 15-24 years
0.5/100,000 pa
>100
50-100
25-50
10~25
5~10
<5
<1
134/100,000 pa
Infectious Disease Deaths 10-24 years
1.4/100,000 pa
>100
50-100
25-50
10~25
5~10
<5
<1
149/100,000 pa
Chronic Disease Deaths 10-24 years
13/100,000 pa
>100
50-100
25-50
10~25
5~10
<5
<1
40/100,000 pa
51/100,000 pa
Injury Deaths 10-24 years
30/100,000 pa
>100
50-100
25-50
10~25
5~10
<5
<1
68/100,000 pa
But things change
quickly!
Gun Deaths in Latin
America
200
AMR
180
160
140
Violence
120
Suicide
100
Drowning
80
Fires
60
Traffic Inj
40
20
0
10-14 15-19 20-24 10-14 15-19 20-24
M
F
50-year Lating America: Cause-specific death rates
in 15-24yo males
200
180
deaths/100,000
160
140
medical
120
100
trans port
80
60
40
20
0
1955 1962 1969 1976 1983 1990 1997 2004
other non-int
s uicide
violence
50-year Sth America: Cause specific proportions
of 15-24yo male deaths
cummulative cause of death
100%
80%
violence
60%
40%
20%
0%
1955 1962 1969 1976 1983 1990 1997 2004
s uicide
other non-int
trans port
medical
50 year trends in mortality of 1 to 24
year old males in 49 countries
400
Introduction of EEC data
Age at death
350
1-4yr
Deaths/100,000
300
5-9yr
10-14yr
250
15-19yr
200
20-24yr
150
100
50
0
1955
1962
1969
1976
1983
1990
1997
2004
Changing Priorities in Youth Health
Proportion of deaths in 10-24 yo in WPR
Maternal
HIV
Infect_oth
Chronic
Injury
Changing Priorities in Youth Health
Proportion of WPR spending by Group
Proportion of deaths in 10-24 yo in WPR
Maternal
HIV
Grp I
Infect_oth
Grp II
Chronic
Grp III
Injury
Scope of Talk
 Mortality
 Morbidity – DALYS
 A picture of young peoples health
Mortality and Morbidity components of
global DALYS in 10-24 year olds
DALYs per 1000 in 15 to 19-year-olds
Scope of Talk
 Mortality
 Morbidity
 A picture of young people’s
health
Measuring adolescent health
 Mortality not enough
–Effects of epidemiological transition
–Changing relevance of adolescence
 Beyond the health sector
–Joined-up approaches
Macro and structural influences
socio-economic
Cultural including status of youth
A framework for measuring youth health
Role transitions
- First sex
- School leaving
- Marriage
- Employment
- Parenthood
Risk & Protective Factors
- Family
- School
- Peer
- Neighbourhood
- Individual
Health Risks
- Obesity/Nutrition/Activity
- Substance use
- Sexual health
- Mental Health
Inputs
- Prevention
- Health service delivery
Health Outcomes
- Death
- Mental disorder
- Chronic illness
- Injury
1
Macro and structural influences
socio-economic
Cultural including status of youth
A framework for measuring youth health
Role transitions
- First sex
- School leaving
- Marriage
- Employment
- Parenthood
Risk & Protective Factors
- Family
- School
- Peer
- Neighbourhood
- Individual
Health Risks
- Obesity/Nutrition/Activity
- Substance use
- Sexual health
- Mental Health
Health Outcomes
- Death
- Mental disorder
- Chronic illness
- Injury
2
3
Inputs
- Prevention
- Health service delivery
1