Overview
Across all regions, the risk of dying at age 15–24 is lower than for children under 5 years old. The probability of dying among adolescents and youth aged 10–24 years was 14 deaths per 1000 children aged 10 in 2020. Globally, deaths among adolescents aged 10 to 19 years accounted for 43% of all deaths in those aged 5 to 24 years.
Females have lower mortality rates for the ages 15 to 24 years than males. For example, the ratio of male to female mortality rates rises from 1.1 in those aged 5 to 9 years compared to 1.5 for those aged 20 to 24 years, showing a female advantage in mortality increasing with age. The underlying reason for this change is that the cause of death structure shifts from infectious diseases in young children to accidents and injuries primarily among older male adolescents and young adults.
However, survival chances for adolescents and young adults also vary greatly across the world. In sub-Saharan Africa, the probability of dying among those aged 15–24 years in 2019 was 23 deaths per 1,000 adolescents aged 15 years. Most deaths among those aged 15–24 years occurred in sub-Saharan Africa, and Oceania (excluding Australia and New Zealand). The third highest regional rate for older adolescents (15 to 19 years) and young adults (20 to 24 years) is in Latin America and the Caribbean.
At the country level, mortality for those aged 15–24 years ranged from 2 to 41 per 1000 adolescents aged 15. The higher mortality countries are concentrated in sub-Saharan Africa. Countries with the highest number of deaths for this age group include the Democratic Republic of the Congo, Chad, Sierra Leone and Somalia.
Causes of death
The patterns of death in those aged 15 to 24 years reflect the underlying risk profiles of the age groups, with a shift away from infectious diseases of childhood and towards accidents and injuries, self-harm and interpersonal violence. Sex differences in mortality rates 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.
Response
The rise of injury deaths, particularly, road traffic injuries and drowning, demonstrate that the risk exposure is different for those over the age of 15 years. As a result, the nature of interventions needed to prevent poor health outcomes have shifted away from health sector actions to prevent and treat the infectious diseases of early childhood towards other sectors needed to take action to prevent mortality from road traffic injuries, violence and mental health problems.
Actions across a range of government sectors including education, transportation and road infrastructure, water and sanitation and law enforcement are needed to prevent premature mortality in older children, adolescents and young adults. National governments will need to critically assess their countries’ adolescent and young adult health needs, determine the most appropriate evidence-based intervention to address them and then prioritize these within their national health programming. WHO can help by providing guidance on effective interventions, prioritization, programme planning, monitoring and evaluation and research areas to strengthen the response.
COVID-19 disease and adolescent and young adult health
Overall there are proportionally fewer cases of and deaths from COVID-19 disease for children, adolescents and young adults than for older adults (1). To date, older adolescents and young adults (15 to 24 years) represent 14.2% (16 602 124) of global cases and 0.4% (7720) of global deaths (2). Nonetheless, the global COVID-19 pandemic has the potential to undermine the health and well-being of adolescents and young adults. While the pandemic’s long-term impact on youth mental health is not yet understood, evidence from past emergencies suggests potential elevated risks of anxiety and depression, trauma, self-harm, and even suicide among adolescents (3). School closures have also impacted adolescent and young adult well-being through loss of instruction time, social isolation, physical inactivity with compounded risks of food insecurity and domestic violence (4).
WHO response
WHO calls on Member States to address health equity through universal health coverage so that all children are able to access essential health services without undue financial hardship. Moving from business as usual to innovative, multiple and tailored approaches to increase access, coverage and quality of health services for adolescents and young adults will require strategic direction and an optimal mix of community, facility-based care and a multi-sectoral approach to address intentional and unintentional injuries in these age groups. Health sector and multisectoral efforts are also needed to overcome the inequalities and the social determinants of health.
- World Health Organization. (2021). COVID-19 disease in children and adolescents: scientific brief, 29 September 2021. License: CC BY-NC-SA 3.0 IGO.
- WHO Coronavirus (COVID-19) Dashboard | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data; data reported to WHO from 184 countries; last accessed 16 December 2021.
- Marques de Miranda D, da Silva Athanasio B, Sena Oliveira AC, Simoes ESAC. How is COVID-19 pandemic impacting mental health of children and adolescents? Int J Disaster Risk Reduct. 2020;51:101845
- United Nations Children's Fund. COVID-19 and school closures: one year of education disruption. New York: UNICEF; 2021.