Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019

GBD 2019 Adolescent Transport and Unintentional Injuries Collaborators

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Abstract

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 100000 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 214337 [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 100000) for unintentional injuries. However, in low-SDI
nations the absolute number of deaths increased (by 80·5% to 42774 for transport injuries and by 39·4% to 31961 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.
Original languageEnglish
Pages (from-to)E657-E669
JournalThe Lancet Public Health
Volume7
Issue number8
DOIs
Publication statusPublished - 1 Aug 2022

Bibliographical note

Funding Bill & Melinda Gates Foundation.

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