Study: Teens, young adults face high risk of death from injury, violence, suicide

As the world has urbanized, public health needs have changed. For most of the 20th century, epidemiologists worried about communicable diseases killing very young children. Now, a new paper in the journal the Lancet suggests, the bigger concern in many countries is mortality among young adults ages 15 to 24 -- especially young men. Modernization and urbanization may have pushed back disease. But they have made accidents, suicide and violence more common causes of death during the second decade of life.

To investigate the mortality trends, researchers led by Dr. Russell Viner of the University College London Institute of Child Health looked at the World Health Organization’s mortality database from 1955 to 2004, breaking out data by age group and sex in 50 countries with good mortality data. These included nations with low-, middle- and high-income levels.

Over the study period, mortality from all causes was reduced by as much as 93% in children 1 to 4 years old, the study reported. But young men ages 15 to 24 experienced a decline in mortality of just 41% to 48%. In the period 2000-2004, mortality among young men was two to three times higher than that among young boys, the researchers said. By the late 1970s, injury was the dominant cause of death in young men. Violence and suicide accounted for one-quarter to one-third of mortality in young men between 2000 and 2004.

So what does it all mean? The researchers suggest that children ages 1 to 4, and girls and women benefited most from the epidemiological trends of the second half of the 20th century -- notably, the shift from communicable disease to noncommunicable disease and injury as leading causes of death. Young men benefited, at least in part, the authors wrote, because of the effects of development and urbanization. Usually, these are considered positive forces for public health. But here, as young men enter the workforce, they may be introduced to new risks. They’re exposed more often to injury on the job or as they travel, as well as suicide and violence in the midst of economic downturn. In failing countries, the authors wrote, violence arising from “conflict and black economies” is also a factor.

The paper calls on global health advocates to look at the problems facing young men in the same aggressive way they’ve tackled infant mortality and maternal mortality. A related comment by Dr. Michael D. Resnick, of the University of Minnesota Medical School in Minneapolis, mentions recent UNICEF recommendation that suggest such action might be under way: “The State of the World’s Children 2001--Adolescence: An Age of Opportunity.”