During the past 15 years, the attention of the international community, as reflected in the Millennium Declaration and its associated Development Goals (UN 2000), has focused on the health of children under age five years and of adults. Adolescents and children older than age five years have been relatively neglected. However, publication of the report of a Lancet Commission on Adolescent Health and Wellbeing (Patton and others 2016), as well as the essays in this volume, suggest the beginning of serious concern for this neglected age group.
Mortality rates provide the most significant single indicator of health, but two publications (UN 2014; Wang and others 2012) have arrived at different estimates of numbers of deaths in the age 5–19 years range. Both the UN and Wang studies use models to generate mortality estimates. This chapter reviews and expands on a third set of estimates of mortality rates and numbers of deaths in those ages 5–19 years in low- and middle-income countries (LMICs) for 1990 and 2010 (Hill, Zimmerman, and Jamison 2015). The purpose of the Hill, Zimmerman, and Jamison (2015) study was to generate empirical estimates of mortality rates to check against the modeled numbers from UN (2014) and Wang and others (2012). It compares and contrasts the empirical estimates with those from the two previous modeling exercises. More specifically, the chapter summarizes the findings in Hill, Zimmerman, and Jamison (2015) on gender-specific mortality risks and numbers of deaths by World Bank geographical region for ages 5–9 years and 10–14 years for 1990 and 2010, and on the rates of change in these risks and numbers during the two decades. It then extends these findings to ages 15–19 years. The chapter concludes by reporting the World Health Organization’s (WHO) estimates of percentage of deaths by broad cause of death category. We do not discuss risk factors or potential interventions. Definitions of age groupings and age-specific terminology used in this volume can be found in chapter 1 (Bundy and others 2017).
The age range of 5–19 years encompasses the inflection point of human mortality risks, with infectious disease mortality declining from the high risks of early childhood before noncommunicable disease risks start their exponential increase in adulthood. Despite being a healthy age range relative to all others, the number of deaths exceeded an estimated 2 million in 2010. This age range is also crucial for human development. In most societies, it covers the large majority of educational attainment; in many societies, it also covers the start of family formation (Sawyer and others 2012; UNICEF 2012). This chapter attempts to ground this volume’s discussion of these larger issues with a reminder that the mortality reduction agenda remains unfinished and substantial.
© 2017 International Bank for Reconstruction and Development / The World Bank.