Centre for Adolescent Health

Global patterns of mortality in young men & women

Professor George Patton. Expert Group Professor George Patton. Expert Group Meeting on Meeting on Adolescents, Youth & DevelopmentAdolescents, Youth & Development, , United Nations, New York July 2011. United Nations, New York July 2011.

TWO IDEASTWO IDEAS

Paradox of Adolescent HealthParadox of Adolescent Health

Health TransitionHealth Transition

Scope of TalkScope of Talk

Mortality Mortality MorbidityMorbidity A picture of young people’s healthA picture of young people’s health

Scope of TalkScope of Talk

Mortality Mortality MorbidityMorbidity A picture of young people’s healthA picture of young people’s health

World Health Organisation (WHO) Regions World Health Organisation (WHO) Regions

Death Registration of at least 70% (stripes)

WHERE (regions)WHERE (regions)

WHO (age)WHO (age)

HOW (causes)HOW (causes)

All-cause Mortality 10-24 yearsAll-cause Mortality 10-24 years

300+200-300150-200100-15050-1000-50

All-cause Mortality 10-24 yearsAll-cause Mortality 10-24 years

300+200-300150-200100-15050-1000-50

All-cause Mortality 10-24 yearsAll-cause Mortality 10-24 years

300+200-300150-200100-15050-1000-50

All-cause Mortality 10-24 yearsAll-cause Mortality 10-24 years

300+200-300150-200100-15050-1000-50

All-cause Mortality 10-24 yearsAll-cause Mortality 10-24 years

305/100,000 305/100,000 papa

45/100,000 pa45/100,000 pa

300+200-300150-200100-15050-1000-50

% of Youth Population & Deaths

0

5

10

15

20

25

30

35

40

Hi Inc AFR AMR EMR EUR SEAR WPR

Pop'n

Deaths

2.6 million deaths each year…2.6 million deaths each year…

WHERE (regions)WHERE (regions)

WHO (age)WHO (age)HOW (causes)HOW (causes)

All-cause Mortality 10-14 yearsAll-cause Mortality 10-14 years

300+200-300150-200100-15050-10025-500-25

All-cause Mortality 15-19 yearsAll-cause Mortality 15-19 years

300+200-300150-200100-15050-10025-500-25

All-cause Mortality 20-24 yearsAll-cause Mortality 20-24 years

505/100,000 505/100,000 papa

69/100,000 pa69/100,000 pa

300+200-300150-200100-15050-10025-500-25

WHERE (regions)WHERE (regions)

WHO (age)WHO (age)

HOW (causes)HOW (causes)

Mortality ClassificationMortality Classification

Group Ia - MaternalGroup Ia - MaternalGroup Ib - Group Ib - Infectious, Nutritional Infectious, Nutritional

Group II - Group II - Non-communicable Non-communicable

Group IIIGroup III – Injuries* – Injuries*

* Traffic, Suicide, Violence & War, Drowning & Burns* Traffic, Suicide, Violence & War, Drowning & Burns

Female deaths by Group

30%15%

33%

22%

Injury

Chronic

Infectious

Maternal

Male deaths by Group

21%

27%

52%

Maternal Deaths 15-24 yearsMaternal Deaths 15-24 years

134/100,000 134/100,000 papa

0.5/100,000 0.5/100,000 papa

>10050-10025-5010~255~10<5<1

Infectious Disease Deaths 10-24 Infectious Disease Deaths 10-24 yearsyears

149/100,000 149/100,000 papa

1.4/100,000 1.4/100,000 papa

>10050-10025-5010~255~10<5<1

Chronic Disease Deaths 10-24 Chronic Disease Deaths 10-24 yearsyears

40/100,000 pa40/100,000 pa

13/100,000 pa13/100,000 pa

51/100,000 pa51/100,000 pa

>10050-10025-5010~255~10<5<1

Injury Deaths 10-24 yearsInjury Deaths 10-24 years

68/100,000 pa68/100,000 pa

30/100,000 pa30/100,000 pa

>10050-10025-5010~255~10<5<1

But things change But things change quickly!quickly!

Gun Deaths in Latin America

AMR

0

20

40

60

80

100

120

140

160

180

200

10-14 15-19 20-24 10-14 15-19 20-24

M F

Fires

Traffic Inj

Drowning

Suicide

Violence

0

20

40

60

80

100120

140

160

180

200

1955 1962 1969 1976 1983 1990 1997 2004

deat

hs/1

00,0

00 medica l

transport

other non-int

suicide

violence

50-year Lating America: Cause-specific death rates in 15-24yo males

0%

20%

40%

60%

80%

100%

1955 1962 1969 1976 1983 1990 1997 2004

cum

mul

ative

caus

e of

dea

th

violence

suicide

other non-int

transport

medica l

50-year Sth America: Cause specific proportions of 15-24yo male deaths

0

50

100

150

200

250

300

350

400

1955 1962 1969 1976 1983 1990 1997 2004

Dea

ths/

100,

000

1-4yr

5-9yr

10-14yr

15-19yr

20-24yr

Age at deathIntroduction of EEC data

50 year trends in mortality of 1 to 24 year old males in 49 countries

Proportion of deaths in 10-24 yo in WPR

Maternal

HIV

Infect_oth

Chronic

Injury

Changing Priorities in Youth Health

Proportion of deaths in 10-24 yo in WPR

Maternal

HIV

Infect_oth

Chronic

Injury

Proportion of WPR spending by Group

Grp I

Grp II

Grp III

Changing Priorities in Youth Health

Scope of TalkScope of Talk

MortalityMortality

Morbidity – DALYSMorbidity – DALYS A picture of young peoples healthA 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 TalkScope of Talk

MortalityMortality MorbidityMorbidity

A picture of young people’s A picture of young people’s health health

Measuring adolescent healthMeasuring adolescent health

Mortality not enoughMortality not enough–Effects of epidemiological transitionEffects of epidemiological transition

–Changing relevance of adolescenceChanging relevance of adolescence

Beyond the health sectorBeyond the health sector–Joined-up approachesJoined-up approaches

A framework for measuring youth health

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

Role transitions- First sex - School leaving- Marriage - Employment- Parenthood

Inputs - Prevention - Health service delivery

Ma

cro

an

d s

tru

ctu

ral

infl

ue

nc

es

so

cio

-eco

no

mic

C

ultu

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sta

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of y

ou

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1

A framework for measuring youth health

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

Role transitions- First sex - School leaving- Marriage - Employment- Parenthood

Inputs - Prevention - Health service delivery

Ma

cro

an

d s

tru

ctu

ral

infl

ue

nc

es

so

cio

-eco

no

mic

C

ultu

ral i

ncl

ud

ing

sta

tus

of y

ou

th

1

2

3