Why Isn't the Teen Mortality Rate Dropping?

Over the past 50 years, a lot of effort has been put into improving the health and survival of young children around the world, and for the most part it's worked. That's great, but once they make it into their teenage years, they're right back in danger. As if adolescence isn't hard enough on its own, a new report from UNICEF found that each year 1.4 million kids between the ages of 10 and 19 die from preventable things like traffic injuries, violence, childbirth complications, suicide, and AIDS. So what are we doing about? Not enough, apparently.

John Santelli, a specialist in adolescent medicine at Columbia University, says the reason we haven't had the same success at reducing teen mortality as we have child mortality is because, "Young adults and older teens die from very different conditions." He adds, "We haven't done enough thinking about the health behaviors that emerge during adolescence." Well, that and it's a lot easier to make sure a child gets immunized than it is to talk a teen out of texting while they're driving.

The main issue is for teens is death from injuries, according to a synthesis of data from 23 high-income countries that was done for The Lancet. Injuries account for about 40 percent of deaths of people ages 10 to 24 but just 10 percent of deaths in the general population. Homicide is one of the leading causes of death for teen boys in many countries, while suicide is a leading cause of death for adolescents worldwide. This is due, in part, to the fact that it's estimated that 20 percent of teens have mental health problems at some point, most often a bout of major depression or another mood disturbance.

There are also issues that tend to affect girls disproportionately. For instance, there are an estimated 2.2 million adolescents with HIV, and 60 percent of them are girls. What's worse is that most of them don't know they have HIV. Teen births are also a major problem. They account for about 11 percent of births worldwide, and they're especially dangerous because it's the youngest mothers who are most at risk for developing complications and dying of pregnancy-related issues.

And this isn't just a problem of faraway places, the Lancet comparison found that of the 27 high-income countries that were looked at, the U.S. had the highest mortality rate for young people between 10 and 24. That's attributable to the fact that we have the highest rate of violent deaths. God, that's depressing.

So, since so many of these teen deaths are entirely preventable, why haven't we done a very good job at stopping them? Well, Judith Diers, who is the director of UNICEF's Adolescent Development and Participation Unit, says it's because we don't often think of adolescence as a specific population: "In many countries you move very quickly from childhood into adulthood. There isn't even a period that's understood as adolescence." But even in places like the U.S., where adolescence is a clearly defined period, more focused intervention is clearly required.

The UNICEF report found that the 1.2 billion adolescents on the planet make up nearly one-fifth of the world's population. That's a lot of teens running around, and it would behoove us all to keep them out of trouble. What's even scarier is that the older they get, the bigger their risk of death. For instance, between the ages of 10 and 14, there just 95 deaths per 100,000. But by the time young people reach 20-24, it's 224 per 100,000. And it's not just that we need to stop teens from actively dying—though that is certainly a good starting place—Judith Diers explains that adolescence is "a time of transitions when young people without opportunities can drop off the track and never fully recover." Thus, even if something doesn't kill them, it can change the course of their life forever and put them at a lifelong disadvantage.

The much-needed bright spot in all of this is that while there are terrible things happening to teens throughout the world, most of them are conditions that also affect adults and have been well studied. Richard Catalano, lead author of the Lancet article, says, "The good news is that these problems are preventable, and we know a heck a lot about them." Great. Now we just need to pay specific attention to the teen population, and maybe in 50 years we'll be able to say it's no more dangerous to be an awkward adolescent than it is to be a baby or a fully-grown awkward adult.

Young people's health is not keeping pace [USA Today]

Image via Paul Schlemmer/Shutterstock.