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Mortality rates for adolescents have decreased over the past
3 decades, yet the trends remain troubling. The mortality rate is
18.0 per 100,000 population for early adolescents (10–14
years) and 65.1 per 100,000 population for late adolescents (15–19
years). The more than 300% increase in mortality from early
to late adolescence reflects the violent etiology of most deaths
with increased access to motor vehicles and firearms combined with
use of substances. The trend worsens in young adulthood: Young adults
have 5 times the mortality rate of younger adolescents, with 97.5
deaths per 100,000 population (20–24 years). The majority
of adolescent and young adult deaths are due to preventable causes,
with unintentional injury (mostly due to motor vehicle accidents),
homicide, and suicide accounting for 75% of all deaths.
Adolescent males are more likely than females to die from each leading
cause of death, and this gap increases with age. The most striking
difference between males and females is in homicide rates: Older
adolescent and young adult males are about 6 times as likely as
females to die from homicide. Although homicide rates have decreased
significantly since peak levels in the early 1990s, black, non-Hispanic
male adolescents still have the highest rates of mortality, primarily
due to homicide.1,2
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Unintentional injuries account for the greatest number of adolescent
deaths (about 45%); the majority of these unintentional
deaths involve motor vehicle accidents. Among young people ages
10 to 24 in 2005, 17,443 died from unintentional injuries. Mortality
rates from unintentional injuries increased from 7.2 per 100,000
population among early adolescents to 40.5 among young adults. Male
adolescents and young adults have a higher unintentional injury
mortality rate than females, and this disparity increases with age.1,3 Seven
in 10 unintentional injury deaths involve motor vehicle accidents,
making motor vehicle crashes the leading cause of mortality among
adolescents, accounting for about a third of all deaths among adolescents
and young adults. Among 15 to 24 year olds, the mortality rate is
25.8 per 100,000 population. Non-Hispanic American Indian/Alaska
Native youth have the highest motor vehicle accident mortality rate, followed
by white, non-Hispanic youth.1-4 The peak time
for vehicular accidents among 15 to 19 year olds occurs on weekends
between 11 pm and 5 am. Factors such as inexperience leading to
judgment errors, poor decision making and low control, fatigue,
failure to use seatbelts, alcohol use, high speed, and recklessness
all contribute to motor vehicle accident mortality.1,3 Three
in 10 fatal vehicle crashes involve alcohol. Due to these factors, the
implementation of graduated driver licensing (GDL) has become widely
accepted in the United States over the past decade. Research has
demonstrated that GDL reduces teenage driver crashes and fatalities.
The GDL components of extended learner’s permit holding
periods, nighttime restrictions, and passenger restrictions—have
been found to be particularly effective in reducing accidents.5 While mortality
rates for motor vehicle accidents among male adolescents have decreased
significantly in the past decade, female ...