Patton George C, Coffey Carolyn, Sawyer Susan M, Viner Russell M, Haller Dagmar M, Bose Krishna, Vos Theo, Ferguson Jane, Mathers Colin D
Centre for Adolescent Health and Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Lancet. 2009 Sep 12;374(9693):881-92. doi: 10.1016/S0140-6736(09)60741-8.
Pronounced changes in patterns of health take place in adolescence and young adulthood, but the effects on mortality patterns worldwide have not been reported. We analysed worldwide rates and patterns of mortality between early adolescence and young adulthood.
We obtained data from the 2004 Global Burden of Disease Study, and used all-cause mortality estimates developed for the 2006 World Health Report, with adjustments for revisions in death from HIV/AIDS and from war and natural disasters. Data for cause of death were derived from national vital registration when available; for other countries we used sample registration data, verbal autopsy, and disease surveillance data to model causes of death. Worldwide rates and patterns of mortality were investigated by WHO region, income status, and cause in age-groups of 10-14 years, 15-19 years, and 20-24 years.
2.6 million deaths occurred in people aged 10-24 years in 2004. 2.56 million (97%) of these deaths were in low-income and middle-income countries, and almost two thirds (1.67 million) were in sub-Saharan Africa and southeast Asia. Pronounced rises in mortality rates were recorded from early adolescence (10-14 years) to young adulthood (20-24 years), but reasons varied by region and sex. Maternal conditions were a leading cause of female deaths at 15%. HIV/AIDS and tuberculosis contributed to 11% of deaths. Traffic accidents were the largest cause and accounted for 14% of male and 5% of female deaths. Other prominent causes included violence (12% of male deaths) and suicide (6% of all deaths).
Present global priorities for adolescent health policy, which focus on HIV/AIDS and maternal mortality, are an important but insufficient response to prevent mortality in an age-group in which more than two in five deaths are due to intentional and unintentional injuries.
WHO and National Health and Medical Research Council.
健康模式在青春期和青年期会发生显著变化，但尚未有关于这些变化对全球死亡率模式影响的报告。我们分析了全球青春期早期至青年期的死亡率及模式。
我们从2004年全球疾病负担研究中获取数据，并使用了为《2006年世界卫生报告》编制的全因死亡率估计数，同时对因艾滋病毒/艾滋病以及战争和自然灾害导致的死亡数据修订进行了调整。死亡原因数据在可获取时源自各国的人口动态登记；对于其他国家，我们使用抽样登记数据、口头尸检和疾病监测数据来模拟死亡原因。按世界卫生组织区域、收入状况以及10 - 14岁、15 - 19岁和20 - 24岁年龄组的死因，对全球死亡率及模式进行了调查。
2004年，10 - 24岁人群中有260万人死亡。其中256万（97%）例死亡发生在低收入和中等收入国家，近三分之二（167万）例在撒哈拉以南非洲和东南亚。从青春期早期（10 - 14岁）到青年期（20 - 24岁），死亡率显著上升，但原因因地区和性别而异。孕产妇疾病是导致女性死亡的主要原因，占15%。艾滋病毒/艾滋病和结核病导致的死亡占11%。交通事故是最大死因，占男性死亡的14%和女性死亡的5%。其他突出原因包括暴力（占男性死亡的12%）和自杀（占所有死亡的6%）。
当前全球青少年健康政策的重点是艾滋病毒/艾滋病和孕产妇死亡率，这对于预防该年龄组的死亡而言是重要但不足的应对措施，因为该年龄组超过五分之二的死亡是由有意和无意伤害导致的。
世界卫生组织和国家卫生与医学研究委员会。
