Background
Globally, transport and unintentional injuries persist as leading preventable causes
of mortality and morbidity for adolescents. We sought to report comprehensive trends
in injury-related mortality and morbidity for adolescents aged 10–24 years during
the past three decades.
Methods
Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed
mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional
injuries for adolescents in 204 countries. Burden is reported in absolute numbers
and age-standardised rates per 100 000 population by sex, age group (10–14, 15–19,
and 20–24 years), and sociodemographic index (SDI) with 95% uncertainty intervals
(UIs). We report percentage changes in deaths and DALYs between 1990 and 2019.
Findings
In 2019, 369 061 deaths (of which 214 337 [58%] were transport related) and 31·1 million
DALYs (of which 16·2 million [52%] were transport related) among adolescents aged
10–24 years were caused by transport and unintentional injuries combined. If compared
with other causes, transport and unintentional injuries combined accounted for 25%
of deaths and 14% of DALYs in 2019, and showed little improvement from 1990 when such
injuries accounted for 26% of adolescent deaths and 17% of adolescent DALYs. Throughout
adolescence, transport and unintentional injury fatality rates increased by age group.
The unintentional injury burden was higher among males than females for all injury
types, except for injuries related to fire, heat, and hot substances, or to adverse
effects of medical treatment. From 1990 to 2019, global mortality rates declined by
34·4% (from 17·5 to 11·5 per 100 000) for transport injuries, and by 47·7% (from 15·9
to 8·3 per 100 000) for unintentional injuries. However, in low-SDI nations the absolute
number of deaths increased (by 80·5% to 42 774 for transport injuries and by 39·4%
to 31 961 for unintentional injuries). In the high-SDI quintile in 2010–19, the rate
per 100 000 of transport injury DALYs was reduced by 16·7%, from 838 in 2010 to 699
in 2019. This was a substantially slower pace of reduction compared with the 48·5%
reduction between 1990 and 2010, from 1626 per 100 000 in 1990 to 838 per 100 000
in 2010. Between 2010 and 2019, the rate of unintentional injury DALYs per 100 000
also remained largely unchanged in high-SDI countries (555 in 2010 vs 554 in 2019;
0·2% reduction). The number and rate of adolescent deaths and DALYs owing to environmental
heat and cold exposure increased for the high-SDI quintile during 2010–19.
Interpretation
As other causes of mortality are addressed, inadequate progress in reducing transport
and unintentional injury mortality as a proportion of adolescent deaths becomes apparent.
The relative shift in the burden of injury from high-SDI countries to low and low–middle-SDI
countries necessitates focused action, including global donor, government, and industry
investment in injury prevention. The persisting burden of DALYs related to transport
and unintentional injuries indicates a need to prioritise innovative measures for
the primary prevention of adolescent injury.
Funding
Bill & Melinda Gates Foundation.
