Cafferky Virginia, Sun Shufang, Saadeh Frances B, Loucks Eric B
Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island; Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts.
Department of Behavioral Sciences, Brown University School of Public Health, Providence, Rhode Island; Mindfulness Center, Brown University, Providence, Rhode Island.
J Adolesc Health. 2025 Apr;76(4):571-583. doi: 10.1016/j.jadohealth.2024.11.247. Epub 2025 Feb 20.
To evaluate temporal trends and drivers of mortality among younger adults (aged 18-39), from 1999 to 2021.
Observational study using nationally representative United States mortality data from 1999 to 2021, acquired via the US Centers for Disease Control Wide-ranging Online Data for Epidemiologic Research database. Exposure of interest was cause of death. Primary outcomes were population-level mortality rates and percent increase from 1999 to 2021. Secondary outcomes were cause-specific and subgroup-specific (sex, race, ethnicity) mortality rates and percent increases.
From 1999 to 2021, US younger adults aged 18-39 experienced a 54.1% increase in annual mortality (from 113.4 deaths per 100,000 in 1999 to 174.7 deaths per 100,000 in 2021; Cochran-Armitage p < .0001). Before COVID, from 1999 to 2019, younger adults experienced a 10.8% increase in mortality, compared to a 1.5% increase among the broader US population. The top driver of increased younger adult mortality, from 1999 through 2021, was accidental poisoning and exposure to noxious substances. Mortality trends varied by demographic variables with notable increases among American Indian/Alaskan Native Americans.
US younger adults are suffering from rising premature mortality. Resources should be calibrated to better support this generation.
评估1999年至2021年美国18至39岁年轻成年人的死亡率时间趋势及驱动因素。
采用观察性研究，使用通过美国疾病控制中心的广泛在线流行病学研究数据库获取的1999年至2021年具有全国代表性的美国死亡率数据。感兴趣的暴露因素为死亡原因。主要结局为人群水平的死亡率以及1999年至2021年的增长百分比。次要结局为特定原因和亚组（性别、种族、族裔）的死亡率及增长百分比。
1999年至2021年，美国18至39岁的年轻成年人年死亡率上升了54.1%（从1999年的每10万人113.4例死亡增至2021年的每10万人174.7例死亡； Cochr an - Armitage检验p <.0001）。在新冠疫情之前，即1999年至2019年，年轻成年人的死亡率上升了10.8%，而美国总体人群的死亡率仅上升了1.5%。1999年至2021年，年轻成年人死亡率上升的首要驱动因素是意外中毒和接触有害物质。死亡率趋势因人口统计学变量而异，美国印第安/阿拉斯加原住民的死亡率显著上升。
美国年轻成年人正面临过早死亡率上升的问题。应调整资源配置以更好地支持这一代人。
