Overview
Survival chances for adolescents and young adults vary greatly across the world. In 2021, the probability of dying among those aged 10–24 years was highest in sub-Saharan Africa and lowest in Europe and Northern America. The average global probability of a 10-year-old dying before age 24 was about 6 times higher in sub-Saharan Africa than in North America and Europe.
Within the age group 10–24 years, mortality rates are lowest among adolescents aged 10–14, and highest among young adults aged 20–24 years. Females generally have lower mortality rates for these ages than males.
The patterns of death in those aged 10 to 24 years reflect the underlying risk profiles of the age groups, with those of 10–14-year-olds dominated by infectious diseases. Among older adolescents and young adults, a shift away from infectious diseases of childhood is seen, towards accidents and injuries, self-harm and interpersonal violence. Sex differences in mortality rates also become apparent in adolescence. Rates are higher for males from the conditions mentioned above along with collective violence and legal intervention (war/conflict). Maternal conditions become an increasingly important cause of death for young women in lower-income countries.
Main health issues
Many unintentional injuries such as road traffic and drowning are the leading cause of death and disability among adolescents.
- Road traffic accidents
In 2019, 115 000 adolescents (10–19 years) died as a result of road traffic accidents. Many of those who died were vulnerable road users, including pedestrians, cyclists or users of motorized two-wheelers.
- Drowning
Drowning is also among the top causes of death among adolescents; more than 30 000 adolescents, over three quarters of them boys, are estimated to have drowned in 2019.
- Violence
Interpersonal violence is among the leading causes of death in adolescents and young people globally. Its prominence varies substantially by world region. It causes nearly a third of all adolescent male deaths in low- and middle-income countries in the WHO Region of the Americas.
Violence during adolescence also increases the risks of injury, HIV and other sexually transmitted infections, mental health problems, poor school performance and dropout, early pregnancy, reproductive health problems, and communicable and noncommunicable diseases.
- Alcohol and drug use
Drinking alcohol among adolescents is a major concern in many countries. Worldwide, more than a quarter of all people aged 15–19 years are current drinkers, amounting to 155 million adolescents. Prevalence of heavy episodic drinking among adolescents aged 15–19 years was 13.6% in 2016, with males most at risk.
Cannabis is the most widely used psychoactive drug among young people with about 4.7% of people aged 15–16 years using it at least once in 2018. Alcohol and drug use in children and adolescents is associated with neurocognitive alterations which can lead to behavioural, emotional, social and academic problems in later life.
- Tobacco use
- Mental health
- Communicable diseases
- Early pregnancy and childbirth
- Environmental health
- Overweight
- Nutrition
- Physical activity
The vast majority of people using tobacco today began doing so when they were adolescents. Globally in 2018, at least 1 in 10 adolescents aged 13–15 years uses tobacco, although there are areas where this figure is much higher. E-cigarettes are particularly risky when used by children and adolescents. Nicotine is highly addictive and young people’s brains develop up to their mid-twenties.
E-cigarettes: how risky are they?
Depression and anxiety are among the leading causes of illness and disability among adolescents, and suicide is among the leading causes of death in people aged 15–19 years. Half of all mental health disorders in adulthood start by age 14, but most cases are undetected and untreated.
Many factors have an impact on the well-being and mental health of adolescents. Violence, poverty, stigma, exclusion, and living in humanitarian and fragile settings can increase the risk of developing mental health problems.
Adolescent mental health fact sheet
HIV
An estimated 1.7 million adolescents (age 10–19 years) were living with HIV in 2021 with around 90% in the WHO African Region. While there have been substantial declines in new infections amongst adolescents from a peak in 1994, adolescents still account for about 10% of new HIV infections, with three-quarters amongst adolescent girls. Additionally, while new infections may have fallen in many of the most severely affected countries, recent testing coverage remains low suggesting that many adolescents and young people living with HIV may not know their status.
Tuberculosis
Tuberculosis (TB) is a preventable and curable disease, but it continues to impact the lives and development of millions of children and adolescents. Children and young adolescents aged under 15 years represent about 11% of all people with TB globally. This means 1.1 million children and young adolescents aged under 15 years fall ill with TB every year, and more than 225 000 of them lose their lives.
Adolescents and young adults usually present with bacteriologically infectious TB characterized by cavities seen on chest x-rays. The Global Tuberculosis Report shows that notification rates in adolescents aged 15–19 years are relatively high compared with younger adolescents.
Other infectious diseases
Diarrhoea and lower respiratory tract infections (pneumonia) are estimated to be among the top five causes of death for adolescents 10–14 years, with mortality rates being particularly high in African low- and middle-income countries. Thanks to improved childhood vaccination, adolescent deaths and disability from measles have fallen markedly.
Early adolescence (9–14 years) is the optimal time for vaccination against HPV infection and it is estimated that if 90% of girls globally get the HPV vaccine more than 40 million lives could be saved over the next century. However, it is estimated that in 2021 only 12% of girls globally received the vaccine.
Human papillomavirus (HPV) and cervical cancer fact sheet
Overall there are proportionally fewer cases of and deaths from COVID-19 disease for adolescents and young adults than for older adults. However, the pandemic has severe indirect negative effects on young people’s well-being, including on their mental health, loss of education time through school closures, social isolation, physical inactivity, malnutrition and domestic violence.
Approximately 12 million girls aged 15–19 years and at least 777 000 girls under 15 years give birth each year in developing regions. Complications from pregnancy and childbirth are among the leading causes of death for girls aged 15–19 years globally.
The global adolescent birth rate in 2021 was 42 births per 1000 girls this age, and country rates range from 1 to over 200 births per 1000 girls annually. This indicates a marked decrease since 1990. This decrease is reflected in a similar decline in maternal mortality rates among girls aged 15–19 years.
One of the specific targets of the health Sustainable Development Goal (SDG 3) is that by 2030, the world should ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.
Adolescent pregnancy fact sheet
Many of the main causes of mortality in adolescents and young adults have strong links to the environment, including unintentional injuries and infectious diseases. Young people are at increased risk of environmental hazards and pollution due to their developmental physiology and immature systems. Primary environmental hazards and pollution affecting the health of adolescents and young adults include air pollution, chemicals and heavy metals, climate change, UV radiation, urban health and WASH.
WHO's work on children's environmental health
Globally, in 2016, over 1 in 6 adolescents aged 10–19 years was overweight. Prevalence varied across WHO regions, from lower than 10% in the WHO South-East Asia Region to over 30% in the WHO Region of the Americas.
Obesity and overweight fact sheet
Many boys and girls in developing countries enter adolescence undernourished, making them more vulnerable to disease and early death.
Iron deficiency anaemia was the second leading cause of healthy years of life lost due to disability by adolescents aged 10–19 in 2019. Iron and folic acid supplements are a solution that also helps to promote health of adolescents. Regular deworming in areas where intestinal helminths such as hookworm are common is recommended to prevent micronutrient (including iron) deficiencies.
Globally, in 2016, only 1 in 5 adolescents are estimated to meet WHO guidelines on physical activity. Prevalence of inactivity is high across all WHO regions, and higher in female as compared to male adolescents.
Globally, in 2016, only 1 in 5 adolescents are estimated to meet WHO guidelines on physical activity. Prevalence of inactivity is high across all WHO regions, and higher in female as compared to male adolescents.
Rights of adolescents
The rights of children (people under 18 years of age) to survive, grow and develop are enshrined in international legal documents. In 2013, the Committee on the Rights of the Child (CRC), which oversees the child rights convention, published guidelines on the right of children and adolescents to the enjoyment of the highest attainable standard of health, and a General Comment on realizing the rights of children during adolescence was published in 2016. It highlights states’ obligations to recognize the special health and development needs and rights of adolescents and young people.
The Convention on the Elimination of Discrimination Against Women (CEDAW) also sets out the rights of women and girls to health and adequate health care.
WHO response
WHO works with Member States and partners to improve the health of young people by producing evidence-based guidelines, advocating and providing recommendations for adolescent-responsive health systems, and documenting progress in adolescent health and development.
In May 2017, WHO published a major report: Global Accelerated Action for the Health of Adolescents (AA-HA!): Guidance to support country implementation. The AA-HA! Guidance has drawn on inputs received during extensive consultations with Member States, United Nations agencies, adolescents and young people, civil society and other partners. It aims to assist governments in deciding what they plan to do and how they plan to do it as they respond to the health needs of adolescents in their countries.
To improve adolescent health measurement globally, WHO, in collaboration with UNAIDS, UNESCO, UNFAP, UNICEF, UN Women, the World Bank Group, and the World Food Programme (WFP), has established the Global Action for Measurement of Adolescent health (GAMA) Advisory Group. GAMA provides technical guidance to WHO and UN partner agencies to define a core set of adolescent health indicators, for the purpose of harmonizing efforts around adolescent health measurement and reporting.