centre for adolescent health global patterns of mortality in young men & women professor george...
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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
ral i
ncl
ud
ing
sta
tus
of y
ou
th
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