in young men & women

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Centre for Adolescent Health


Global patterns of mortality
in young men & women


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

TWO IDEAS

Paradox of Adolescent Health

Health Transition

Scope of Talk


Mortality


Morbidity


A picture of young people’s health

Scope of Talk


Mortality


Morbidity


A picture of young people’s health

World Health Organisation (WHO) Regions

Death Registration of at least 70% (stripes)

WHERE (regions)

WHO (age)

HOW (causes)

All
-
cause Mortality 10
-
24 years

300+
200-300
150-200
100-150
50-100
0-50
All
-
cause Mortality 10
-
24 years

300+
200-300
150-200
100-150
50-100
0-50
All
-
cause Mortality 10
-
24 years

300+
200-300
150-200
100-150
50-100
0-50
All
-
cause Mortality 10
-
24 years

300+
200-300
150-200
100-150
50-100
0-50
All
-
cause Mortality 10
-
24 years

305/100,000 pa

45/100,000 pa

300+
200-300
150-200
100-150
50-100
0-50
% 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…

WHERE (regions)

WHO (age)

HOW (causes)

All
-
cause Mortality 10
-
14 years

300+
200-300
150-200
100-150
50-100
25-50
0-25
All
-
cause Mortality 15
-
19 years

300+
200-300
150-200
100-150
50-100
25-50
0-25
All
-
cause Mortality 20
-
24 years

505/100,000 pa

69/100,000 pa

300+
200-300
150-200
100-150
50-100
25-50
0-25
WHERE (regions)

WHO (age)

HOW (causes)

Mortality Classification

Group Ia
-

Maternal

Group Ib
-

Infectious, Nutritional

Group II
-

Non
-
communicable

Group III



Injuries*


* 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 years

134/100,000 pa

0.5/100,000 pa

>100
50-100
25-50
10~25
5~10
<5
<1
Infectious Disease Deaths 10
-
24 years

149/100,000 pa

1.4/100,000 pa

>100
50-100
25-50
10~25
5~10
<5
<1
Chronic Disease Deaths 10
-
24 years

40/100,000 pa

13/100,000 pa

51/100,000 pa

>100
50-100
25-50
10~25
5~10
<5
<1
Injury Deaths 10
-
24 years

68/100,000 pa

30/100,000 pa

>100
50-100
25-50
10~25
5~10
<5
<1
But things change
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
100
120
140
160
180
200
1955
1962
1969
1976
1983
1990
1997
2004
deaths/100,000
medi cal
transport
other non-i nt
sui ci de
vi ol ence
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
cummulative cause of death
vi ol ence
sui ci de
other non-i nt
transport
medi cal
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
Deaths/100,000
1-4yr
5-9yr
10-14yr
15-19yr
20-24yr
Age at death
Introduction 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 Talk


Mortality



Morbidity


DALYS


A 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 Talk


Mortality



Morbidity


A picture of young people’s
health


Measuring adolescent health


Mortality not enough


Effects of epidemiological transition


Changing relevance of adolescence


Beyond the health sector


Joined
-
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
Macro and structural influences
socio
-
economic
Cultural including status of youth
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
Macro and structural influences
socio
-
economic
Cultural including status of youth
1

2

3