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Mortality

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INTRODUCTION

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Mortality rates for adolescents and young adults have decreased over the past decades globally and in the United States; however, adolescence and young adulthood remain risky periods of life. In the United States, after ages 5 to 9, the years with the lowest risk of death, the mortality rate increases. In 2014, the mortality rate was 14.0 per 100,000 population for early adolescents (10–14 years) and 45.5 per 100,000 population for late adolescents (15–19 years). The more than 200% increase in mortality across these intervals reflects the violent etiology of most deaths; increased access to motor vehicles and firearms, combined with use of substances, likely drives this increase. The trend continues to worsen in young adulthood: Young adults have 6 times the mortality rate of younger adolescents, with 83.8 deaths per 100,000 population (20–24 years).

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The majority of adolescent and young adult deaths are due to preventable causes, with the top 3 causes of death in the United States—unintentional injury, suicide, and homicide—accounting for 70.6% of all deaths. Unintentional injuries account for the greatest number of adolescent deaths (39.7%); 12,586 young people died from unintentional injuries in 2014. Suicide, recently surpassing homicide, has become the second leading cause of death, accounting for 17.4% of adolescent and young adult deaths. Suicide has risen moderately for most groups, but tripled among girls ages 10 to 14 between 1999 and 2014, going from 0.5 per 100,000 to 1.5 per 100,000. Homicide, the third leading cause of death, accounts for 14.2% of all deaths among adolescents and young adults. Other frequent causes of mortality among adolescents and young adults ages 10 to 24 are malignant neoplasms (5.9% of deaths) and heart disease (3.2% of deaths).

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Motor vehicle accidents are the leading cause of unintentional injury in the United States, accounting for 54.9% of fatal accidents (and 21.8% of all deaths) among adolescents and young adults. Inexperience, fatigue, failure to use seatbelts, alcohol use, high speed, and recklessness all contribute to motor vehicle accident mortality among adolescents. In order to mitigate these factors and the risk associated with 15- to 19-year-olds driving late at night, graduated driver licensing components, such as extended learners’ permit holding periods, nighttime restrictions, and passenger restrictions that have been shown to be effective in reducing traffic mortality, have become widely accepted in the United States. Mortality rates for motor vehicle accidents among adolescents have decreased significantly in the past decade.

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Firearms account for about 20% of deaths among US youth 10 to 24 years old. Gun death rates among 10- to 24-year-olds, currently 10.0 per 100,000 (about a third of the 1994 gun death rate), are at historic lows, mirroring the overall decline in gun crime in the general population. Still, firearms remain an important factor in adolescent mortality; they are the instrument of death in 88% of teen homicides and 41% of teen suicides, and almost 1 ...

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