Global decline in deaths among children, adolescents but progress uneven

Deaths among children and adolescents decreased worldwide from nearly 14.2 million deaths in 1990 to just over 7.2 million deaths in 2015 but this global progress has been uneven, according to a new article published online by JAMA Pediatrics.

The article by corresponding author Nicholas J. Kassebaum, M.D., of the University of Washington, Seattle, and his Global Burden of Disease Child and Adolescent Health Collaboration colleagues describes mortality and nonfatal health outcomes among children and adolescents (19 years old and younger) in 195 countries and territories from 1990 to 2015. A composite indicator of income, education and fertility - called a Sociodemographic Index (SDI) - was developed for each geographic unit.

Included among the most common causes of death globally were neonatal preterm birth complications, lower respiratory tract infections, diarrheal deaths, congenital anomalies, malaria, neonatal sepsis, meningitis and HIV and AIDS, according to the report.

Countries with lower SDIs had a greater share of the burden of death in 2015 compared with 1990, while the most deaths among children and adolescents occurred in South Asia and sub-Saharan Africa.

The report speculates one reason for growing inequality of disease among children and adolescents may be that geographical areas with the lowest SDIs have historically not received significant development assistance for health.

Limitations of the study include variations in the availability and quality of data.

"Timely, robust and comprehensive assessment of disease burden among children and adolescents provides information that is essential to health policy decision making in countries at all points along the spectrum of economic development," the article concludes.