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INTRODUCTION

The Centers for Disease Control and Prevention (CDC) and World Health Organization define adolescence as the phase of life between childhood and adulthood, usually between the ages of 10 and 19 years. Adolescence is a period of rapid physical, emotional, cognitive, and social development. There is considerable variability in the pace of adolescent development, and chronological age may be a poor indicator of physical, physiologic, and emotional maturity. Most teenagers complete puberty by age 16–18 years; in Western society, however, for educational and cultural reasons, the adolescent period is prolonged to allow for further psychosocial development before the individual assumes adult status. The transition to adulthood often continues through ages 20–24 years (young adulthood). The developmental passage from childhood to adulthood includes the following steps: (1) completing puberty and somatic growth; (2) developing socially, emotionally, and cognitively, and moving from concrete to abstract thinking; (3) establishing an independent identity and separating from the family; and (4) preparing for a career or vocation.

EPIDEMIOLOGY

Adolescents and young adults make up 13% of the population of the United States. Several important public health and social problems can greatly affect morbidity and mortality during these years. The most common causes of illness, injury, and death in adolescents are preventable. Cultural and environmental factors are critical in challenging or supporting an adolescent’s health. The behavioral patterns established during the developmental periods of adolescence help determine young people’s current health status and their risk for developing chronic diseases in adulthood.

MORTALITY DATA

In 2021, there were 13,407 deaths among adolescents aged 15–19 years, representing a rate of 62.2 per 100,000 and an 8% increase since 2020. The three leading causes of death of adolescents aged 15–19 years in 2021 were unintentional injury (37.9%), homicide (20.6%), and suicide (17.5%). The primary cause of unintentional injury death was motor vehicle crashes (62%), followed by poisoning (20%), which includes prescription drug overdoses. In the United States, the fatal crash rate per mile driven for 16- to 19-year-olds was nearly three times the rate for drivers ages 20 and older, with the highest risk for death at ages 16–17 years. Since 2000, deaths from opioid overdose have increased by over twofold among 15- to 24-year-olds. Homicide deaths were predominantly attributable to firearms (95%), and firearms were also a leading mechanism of suicide death (51%).

The mortality rate of adolescents differs by gender, with the rate significantly higher among males aged 15–19 compared to females (88 vs 35.1 per 100,000, respectively, in 2021). This reflects gender differences in the top three leading causes of death of adolescents. Among adolescent males, homicide was the leading cause of death in 2021 (2383 deaths), followed by motor vehicle crashes (1984 deaths), suicide (1780 deaths), and poisonings/overdoses (1220). Among adolescent females, motor vehicle crashes were the leading cause of death in 2021 (954 deaths), followed by ...

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