Global Health
Burdens and risk factors for mortality in young people aged 10-24 years in Australia and comparison with OECD countries between 2000-2021: GBD 2021 Study Zahra Ali Padhani* Zahra Ali Padhani Gizachew Jodie Salima Zohra
Background
Adolescents are considered the healthiest population of all age groups, yet they are vulnerable to illnesses and deaths from preventable causes. We aimed to systematically investigate the burden of morbidity, mortality, and risk factors for mortality among adolescents and young adults (10-24 years) in Australia compared to the Organisation for Economic Co-operation and Development (OECD) countries.
Methods
We retrieved the Global Burden of Disease (GBD) 2021 estimates on mortality and disease burden for Australia and compared them with those of 37 other OECD countries for the years 2000 and 2021. Country and age-specific estimates with 95% uncertainty intervals (UI) were obtained from the GBD Compare and Results Tool on all-cause mortality and ‘disability-adjusted life-years (DALYs)’ as an indicator of disability. The top 15 level-three risk factors of death were also investigated for adolescents and young adults. Causes of death by age groups, sex, and year for other diseases were measured using the Cause of Death Ensemble model (CODEm).
Findings
Since 2000, there has been a reduction in the mortality rate in Australia and across OECD regions on average, with substantial reductions in Australia (47.1 deaths/100,000 population; 95% UI: 46.6-47.5 to 27.9 deaths/100,000 population; 95% UI: 27.6-28.3 in 2021). We observed a very minimal decrease in DALYs among adolescents and young adults, with Australia ranked among the top eight countries for DALYs (10,363.9 DALYs/100,000 population) among young people.
Higher mortality rates and DALYs were observed among young adults (aged 20-24 years) compared to other age groups. In 2021, males in Australia (38.3 deaths/100,000 population; 95% UI: 37.8-38.8) and OECD regions (65.6 deaths/100,000 population; 95% UI: 64.3-67.1) had a higher mortality rate. In contrast, Australian females (10,748.3 DALYs/100,000 population; 95% UI: 8,126.1-13,670.2) had a higher rate of DALYs than males (9,999.3 DALYs/100,000 population; 95% UI: 8163.7-12079.4). The 10-14 age group had the lowest rates of both mortality and DALYs.
High alcohol and drug use were identified as the leading risk factors for death among young people, followed by metabolic risk factors. Environmental and occupational risks varied by age and country, and intimate partner violence emerged as a persistent concern, particularly among Australian females.
Interpretation
The mortality rate among adolescents and young adults has substantially reduced in Australia as compared to OECD countries, with only a minimal decrease in disease burden. However, the gap in mortality rates and disease burden continues to grow across countries, age groups, and genders. This widening gap may be largely attributed to the limited focus on males and young adults in health strategies. Therefore, this study calls for comprehensive health strategies that address these disparities and aim to reduce the disease burden in young people, specifically among males.