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Mortality Bill Brieger | 30 Mar 2011 06:24 am

Youth vs Children – a mortality trade off

BBC has reported on a new study that shows global mortality trends favoring young children compared to adolescents and youth. “Young men aged 15-24 are now two to three times more likely to die prematurely than young boys aged one to four.” Female youth are no better off that their younger counterparts.

The study, published online in The Lancet, reviewed data from an economic spectrum of 50 countries over 50 years.  The need for available high quality data meant that no Subsaharan African country, where the burden of malaria is highest, was included.

Increased rates of injury and greater urbanization were key factors in mortality among youth. The former is not conducive to malaria, but the latter combined with the tendency toward more risky behaviors, does not exclude other infectious diseases, especially HIV.

under-5-mortality-rate-trends.jpgEven though they could not include African countries, the researchers did study at least 15 low or very low income countries and therefor, encourage continued monitoring in other low income settings. They note that trends such as urbanization and greater prevalence of non-communicable disease and injury are occuring in low income countries, too and “Because some of the greatest improvements in mortality in children younger than 5 years have been made in very low-income countries.”  Unicef’s 2011 State of th World’s Children supports the latter assumption as seen in the attached graph.

Although the authors note a decreasing trend in maternal mortality globally, pregnant teenage women in malaria endemic areas are still at high risk. These are often the group that do not get adequate antenatal care including prevention of malaria in pregnancy.

dscn0540a.jpgAn accompanying editorial in The Lancet calls attention to the general neglect of the health of adolescents and youth and reminds us that this new research shows “that mortality in young people aged 10–24 years has proved less responsive to the international alliances and interventions that have so effectively reduced early childhood mortality worldwide, emphasising the need for a vigorous global focus on the health and mortality of adolescents and young adults.”

Our efforts at malaria elimination and child survival will come to naught, if those children who make it past their fifth birthday never realize their potentials as adult members of the society.

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