Adolescent and young adult mortality by cause: age, gender, and country, 1955 to 1994

The purpose of this study was to compare mortality rates from motor vehicle accidents (MVA), homicide, and suicide across countries, age groups, and time. Methods: The World Health Organization Mortality Database was used to construct age- and gender-specific rates in 26 countries for individuals aged 15 to 34 years during the period 1955 to 1994. The rates were adjusted for differences among countries in the age-and-gender distributions of their populations. Cause-specific rates were compared by country, 4-year age groups, 8-year time blocks, and male/female ratios. Results: The proportion of deaths in 15–34-year-olds owing to MVA, homicide, and suicide increased from 26% to 43% over the 40-year study period. Mortality rates differ by country more than time block, peak at ages 15–29 years, and are higher in males than females. Compared to the United States, 24 countries had lower homicide rates and 23 had lower MVA-death rates. Conclusions: Despite declining rates of death from other causes, the rates of adolescent and young adult death from MVA, homicide, and suicide remain high in countries throughout the world. The proportion of deaths attributable to these causes increased steadily during the latter half of the 20th century. Fatal risk behaviors begin to increase during adolescence but do not peak until age 30 years, suggesting that the target population for prevention extends well beyond the teenage years.