Teenagers facing ‘emerging crisis’ of high death rates, global study warns

The world faces an “emerging crisis” of high death rates among the youth despite significant improvements in global health over the past few decades, a new study warns.

The Global Burden of Disease study, published in The Lancet, tracked 375 diseases and injuries and 88 risk factors by age and sex, both regionally and nationally, for as many as 204 nations and territories from 1990 to 2023, making it the most comprehensive research of its kind.

It found the global average life expectancy in 2023 was more than 20 years higher than in 1950, with all 204 countries and territories reporting declines in mortality rates. The global life expectancy rates returned to pre-pandemic levels of around 76 years for women and 71 years for men, which was almost 20 years higher compared to 1950.

The research, however, warned of an “emerging crisis” of high death rates among adolescents and young adults in the Americas due to suicide and drug and alcohol consumption and in sub-Saharan Africa due to infectious diseases and unintentional injuries.

From 2011 to 2023, high-income North America saw the highest increase in deaths among people aged 20 to 39, mainly due to suicide, drug overdose, and high alcohol consumption, the study noted.

The continent also witnessed a rise in deaths in the 5-19 age group during the same period, as did Eastern Europe and the Caribbean.

Infant deaths declined more than for any other age group, with East Asia recording the steepest decrease of 68 per cent in the mortality rate for the under-five age group due to better nutrition, vaccines, and stronger health systems, the study noted.

Mortality among children aged 5-14 in sub-Saharan Africa was higher than previously estimated for the period from 1950 to 2021.

The increase was likely driven by high rates of respiratory infections and tuberculosis, other infectious diseases and unintentional injuries.

“Decades of work to close the gap in low-income regions with persistent health inequities are in danger of unravelling due to the recent cuts to international aid,” Emmanuela Gakidou, an author of the study from the Institute for Health Metrics and Evaluation, said. “These countries rely on global health funding for life-saving primary care, medicine, and vaccines. Without it, the gap is sure to widen.”

Non-communicable diseases such as heart ailments, stroke and diabetes now account for nearly two-thirds of the world’s total mortality and morbidity.

After becoming the leading cause of death in 2021, Covid dropped down to 20th place in 2023, putting ischemic heart disease and stroke back at the top of the list.

Nearly half of all the cases of death and disability could be prevented by modifying some of the key risk factors such as reducing high blood sugar levels and high body mass index, the study said.

“Rapid growth in the world’s aging population and evolving risk factors have ushered in a new era of global health challenges,” noted Christopher Murray, another study author from IHME.

The evidence presented in the study was a wake-up call, he said, urging governments and health care leaders to “respond swiftly and strategically to the disturbing trends that are reshaping public health needs”.

The research found that almost half of the global death and disease burden in 2023 was attributable to 88 preventable risk factors.

These factors mainly include high blood pressure, air pollution, smoking, high blood glucose levels, low birthweight, high BMI, high LDL cholesterol, kidney dysfunction, child growth failure, and lead exposure.

Mental health disorders also have risen steeply, with anxiety disorders increasing by 63 per cent and depressive disorders by 26 per cent over the study period, the study noted.

Overall, the researchers say, their findings highlight the urgent need for policymakers to expand health priorities beyond reducing child mortality to include adolescents and young adults.

Mark L Wahlqvist, head of medicine at Monash University, called the study “monumental” and “encyclopaedic”.

“Paradoxically, it comes at a time when the agencies which have enabled this informational repository to be published are being assaulted and desecrated politically,” Dr Wahlqvist, who was not involved in the research, said.

“Moreover, the time frame for corrective action is itself existential given climate change, conflict, and institutional vulnerabilities.”

If you are experiencing feelings of distress, or are struggling to cope, you can speak to the Samaritans, in confidence, on 116 123 in UK and ROI, email jo@samaritans.org or visit the Samaritans website to find details of your nearest branch.

If you are based in the USA, and you or someone you know needs mental health assistance right now, call or text 988, or visit 988lifeline.org to access online chat from the 988 Suicide and Crisis Lifeline. This is a free, confidential crisis hotline that is available to everyone 24 hours a day, seven days a week.

If you are in another country, you can go to www.befrienders.org to find a helpline near you