Mortality Trends and Leading Causes of Death Among Adolescents and Young Adults -- United States, 1979-1988

Approximately three fourths of the more than 40,000 deaths each year among persons aged 10-24 years in the United States are related to preventable causes such as motor-vehicle crashes (37%), homicide (14%), suicide (12%), and other injuries (e.g., drowning, poisoning, and burns) (12%). To characterize changes in leading causes of death among adolescents and young adults during 1979- 1988, data were analyzed from the vital statistics mortality reporting system maintained by CDC's National Center for Health Statistics. This report summarizes the results of the analysis.

Data were obtained from the Compressed Mortality File (CMF), which contains information from death certificates filed in the 50 states and the District of Columbia that have been prepared in accordance with external cause codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). CDC's Wide-Ranging ONline Data for Epidemiologic Research (WONDER) computerized information system was used to access CMF data (1,2). Death rates are presented as crude rates * based on a decedent's state of residence and exclude deaths of nonresidents of the United States. Death rates are analyzed by various demographic characteristics, including age group (10-14, 15-19, 20-24, and 10-24 years), for overall mortality and for the four leading causes of death.

From 1979 through 1988, overall death rates for all persons aged 10-24 years decreased 11.7% (Table 1). The greatest decline in death rates for all persons was associated with the "other injury" category (35.7%). Death rates also declined for motor-vehicle crashes (15.5%), but increased for suicide and homicide (7.9% and 6.7%, respectively).

Overall death rates and death rates from motor-vehicle crashes and from other injuries decreased for all three age groups (Table 1). Suicide rates increased for persons aged 10-14 years (75.0%) and 15-19 years (34.5%) but decreased for those aged 20-24 years (8.5%). Homicide rates increased for all three age groups, with the sharpest increase among persons aged 10-14 years (41.7%).

In 1987 and 1988, overall death rates for persons aged 10-24 years were highest in the District of Columbia (135.2 per 100,000 population), Alaska (106.7), New Mexico (105.3), Idaho (95.2), Florida (94.3), Arkansas (93.7), Arizona (92.5), Georgia (91.8), Mississippi (91.7), and South Carolina (91.7). Overall death rates were lowest in Rhode Island (56.4), Hawaii (57.0), Massachusetts (58.5), Minnesota (60.0), Utah (64.6), Iowa (64.9), New Hampshire (66.0), Wisconsin (66.0), Colorado (66.3), and Connecticut (66.3). Reported by: Div of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion; National Center for Injury Prevention and Control, CDC.

Editorial Note

Editorial Note: The findings in this report indicate that, during 1979-1988, death rates among adolescents and young adults varied among states. These variations may reflect state-specific differences in several factors, including personal risk behaviors (e.g., drinking and driving and carrying a weapon); legislation and enforcement practices (e.g., mandatory safety-belt laws and speed limits); safety standards (e.g., passive restraint systems in automobiles and improved building codes); and environmental factors (e.g., terrain).

Cause-specific death rates for adolescents and young adults can be used by policy planners, decision makers, and education and health officials to initiate or improve public health policies, comprehensive school health programs, and other interventions designed to reduce death rates and related risk behaviors. For example, in Colorado, the Advisory Council on Adolescent Health has proposed model programs to address the leading causes of death among adolescents and has established health objectives for the year 2000 that target specific reductions in motor-vehicle crash deaths, homicides, suicides, and deaths from other injuries among adolescents (3).

CDC has established a monograph series (4) to help monitor adolescent morbidity and mortality and to provide national, state, and local education and health agencies with information about a broad range of priority health outcomes. States and communities can use information in the first monograph to monitor progress in attaining numerous national health objectives for the year 2000 (5). ** Single copies of the first monograph, Adolescent Health: State of the Nation -- Mortality Trends, Causes of Death, and Related Risk Behaviors Among U.S. Adolescents (4), are available from CDC's Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, Mailstop K-33, 4770 Buford Highway, NE, Atlanta, GA 30341-3724.

References

1. CDC. Wide-Ranging ONline Data for Epidemiologic Research (WONDER): compressed mortality file, 1979-1988. Atlanta: US Department of Health and Human Services, Public Health Service, 1990.

2. Friede A, Reid JA, Ory HW. CDC WONDER: the Centers for Disease Control and Prevention's online public health information system. Am J Public Health 1993 (in press).

3. Colorado Department of Health. Adolescent health in Colorado: status, implications and strategies for action -- report and recommendations of the Advisory Council on Adolescent Health. Denver: Colorado Department of Health, 1992.

4. CDC. Adolescent health: state of the nation -- mortality trends, causes of death, and related risk behaviors among U.S. adolescents. Atlanta: US Department of Health and Human Services, Public Health Service, 1993; DHHS publication no. (CDC)099-4112 (Monograph no. 1).

5. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives -- full report, with commentary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50212.

• Age group distributions (10 14, 15 19, and 20 24 years) were not significantly different across states or across years; therefore, no age adjustments were used. ** Objectives 4.1b, 6.1a, 6.1b, 7.1c, 7.1e, 7.2a, 7.2b, 7.3, 9.1, 9.3a, 9.3b, and two age-related objectives that aim to reduce the death rate by 15% to no more than 28 per 100,000 children aged 1 14 years and to no more than 85 per 100,000 population aged 15 24 years.

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