Young adult mortality increased in recent years following 15-year fall, study finds

ANAHEIM, Calif. — The all-cause mortality rate in young adults and adolescents increased from 2015 to 2020 after a 15-year period of decline, according to study findings.

Nabil Abou Baker, MD, assistant professor of medicine at UChicago Medicine, presented findings from the study at the AAP National Conference & Exhibition. Baker told Healio the project came from a desire to “[improve] the health care transitions of adolescents and young adults” from a pediatrics to adult model of care.

“The growth into a young adult can be a challenging moment in one’s life,” Baker said. “This is made more difficult in patients with a chronic medical or special health care needs.”

In the last year, researchers have reported gaps in transitions from pediatric to adult health care, particularly in chronic conditions such as diabetes. Baker also cited a 2002 joint statement from the AAP, American College of Physicians and American Academy of Family Physicians on the importance of proper health care transitions.

“This study is a look back to see if the mortality of this age group has improved with national and varied statewide efforts,” Baker said.

Through data obtained from the CDC’s mortality database, the researchers found that the mortality rate for those aged between 15 and 19 years declined from 69 deaths per 100,000 people in 1999 to 46 deaths per 100,000 in 2014, followed by an increase from 2015 to 2020, when it was 59 deaths per 100,000. The trajectory was similar for those aged 20 to 24 years, with the mortality rate dropping from 91 deaths per 100,000 in 1999 to 84 deaths per 100,000 in 2015, then increasing to 109 deaths per 100,000 by 2020.

The rate among people aged 25 to 29 years did not reach a nadir similar to the other age groups at around the same time, Baker said. Their mortality rate was 100 deaths per 100,000 people in 2014, and peaked at 141 deaths per 100,000 in 2020.

Mortality between ages 15 and 29 years was twice as high for males compared with females, and was highest for Black or African American patients.

In addition to this finding, the researchers reported that even adolescents and young adults who do not have chronic medical conditions “continue to demonstrate rapid increases in mortality rate slopes.”

The study did not identify causes for the increase or interventions to address it — targets for future research, the authors noted.

“There is an important need to focus studies improving outcomes such as mortality in [adolescents and young adults], especially those populations that are disproportionately affected,” Baker said.