Depression Top Cause of Illness, Disability Among Teens: WHO
Megan Brooks
May 14, 2014

Depression is the main cause of illness and disability in adolescents worldwide, and road traffic injuries are the top cause of death, according to a new report from the World Health Organization (WHO).

"The world has not paid enough attention to the health of adolescents," Flavia Bustreo, MD, WHO assistant director-general for family, women's, and children's health, said in a news release announcing publication of the WHO's "Health for the World's Adolescents" report. "We hope this report will focus high-level attention on the health needs of 10 to 19-year-olds and serve as a springboard for accelerated action on adolescent health," Dr. Bustreo added.

The report notes that mortality rates are low in adolescents compared with other age groups and that rates have declined in the last decade, although the decline has been slight, especially among 10- to 14-year-olds. "Despite the rates being relatively low, there is still significant mortality during the adolescent years. In 2012 an estimated 1.3 million adolescents died, down from 1.5 million in 2000," the report states.

Accidents, Mental Health Problems

Road traffic injuries are the leading cause of adolescent deaths globally and the number 2 cause of illness and disability (behind depression), the report notes. Boys are disproportionately affected, with more than 3 times the rate of deaths than that of girls.

"Increasing access to reliable and safe public transport can reduce road traffic injuries among adolescents. Road safety regulations (e.g. alcohol and speed limits), establishing safe pedestrian areas around schools, and graduated licensing schemes where drivers' privileges are phased in over time, can all reduce risks," the WHO says in the release.

Table 1. Top 10 Causes of Death in Adolescents
Rank Event
1. Road traffic injuries
2. HIV/AIDS
3. Suicide
4. Lower respiratory infections
5. Violence
6. Diarrhea
7. Drowning
8. Meningitis
9. Epilepsy
10. Endocrine, blood, immune disorders

According to the WHO, depression is the number 1 cause of illness and disability in 10- to 19-year-olds worldwide, and suicide ranks number 3 among causes of death. "Some studies show that half of all people who develop mental disorders have their first symptoms by the age of 14. If adolescents with mental health problems get the care they need, this can prevent deaths and avoid suffering throughout life," the WHO says in the release.

Table 2. Top 10 Causes of Illness/Disability
Rank Event
1. Depression
2. Road traffic injuries
3. Anemia
4. HIV/AIDS
5. Self-harm
6. Back and neck pain
7. Diarrhea
8. Anxiety disorders
9. Asthma
10. Lower respiratory infections

The report also points to significant progress since 2000 in reducing deaths resulting from complications of pregnancy and childbirth among adolescents, particularly in regions where maternal mortality rates are highest. "WHO's South-East Asia, Eastern Mediterranean and African Regions have seen estimated declines of 57%, 50% and 37%, respectively. Despite these improvements, maternal mortality still ranks second among causes of death among 15 to 19-year-old girls globally, exceeded only by suicide," the WHO says.

Yet progress on HIV seems to have stalled, and new estimates suggest that the number of HIV-related deaths among adolescents is rising. "The increase is predominantly in the African Region, at a time when HIV-related deaths are decreasing in all other population groups. HIV now ranks as the second cause of deaths in adolescents globally," the WHO points out.

Some other infectious diseases also remain a concern. Diarrhea and lower respiratory tract infections now rank second and fourth among causes of death in 10- to 14-year-olds, and when combined with meningitis, they account for 18% of all deaths in this age group, a figure little changed from 19% in 2000, the WHO says.

A Critical Time to Prevent Chronic Disease

Data from countries that survey the exercise habits of young people suggest that fewer than 1 in 4 adolescents gets enough daily exercise. The WHO recommends at least 1 hour of moderate to vigorous exercise per day. In some countries, as many as 1 in 3 teenagers is obese.

"[S]ome trends in adolescent health-related behaviors are improving," the WHO states. "For example, rates of cigarette smoking are decreasing among younger adolescents in most high-income countries and in some middle- and low-income countries as well."

The WHO also notes that adolescence is a critical time for laying the foundations of good health in adulthood. Many health-related behaviors and conditions behind major chronic diseases start, or are reinforced, during this period of life.

"If left unchecked, health problems and behaviors that arise during adolescence — such as tobacco and alcohol use, diet and exercise patterns, overweight and obesity — have a serious impact on the health and development of adolescents today, and potentially devastating effects on their health as adults tomorrow," Jane Ferguson, scientist in WHO's Department of Maternal, Newborn, Child and Adolescent Health and lead author of the report, said in the release. "At the same time, we must not let up on efforts to promote and safeguard the sexual and reproductive health of adolescents, including HIV."

For the report, the authors reviewed health policies from 109 countries and report that 84% give some attention to adolescents. In three quarters of the policies, the focus is on sexual and reproductive health (including HIV/AIDS), approximately one third address tobacco and alcohol use among adolescents, and one quarter address mental health, the report says.

"The report highlights the need for more countries to follow the example of countries like India whose new adolescent health strategy addresses a broader spectrum of health issues affecting adolescents, including mental health, nutrition, substance use, violence, and noncommunicable diseases, in addition to sexual and reproductive health," the WHO says.

The agency is seeking comments on the report and proposed areas for action on their Web site.

"Health for the World's Adolescents." WHO. Published online May 14, 2014. Full text