Ward JL, Azzopardi PS, Francis KL, et al. - Widening of variation in adolescent mortality between countries as well as by gender has been observed which is driven by poor progress in decreasing deaths in males and older adolescents. The changing worldwide burden of adolescent mortality deserves urgent attention and addressing inequities is also important where they occur. In addition, the availability and quality of primary mortality data in this age group is required to be improved.

• Estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used to study data on the number of deaths, years of life lost, and death rates by gender and age group in individuals aged 10–24 years in 204 countries and territories from 1950 to 2019.

• Globally, 1·49 million deaths were reported, in 2019, among people aged 10–24 years, of which 61% happened in males.

• Since 1950, reduction in deaths was evident in this age group, which was by 30·0% in females and 15·3% in males, and widening of gender-based disparities in mortality rate has been observed in most regions of the world.

• Increase in geographical variation has also been noted, especially in individuals aged 10–14 years.

• Since 1990, annual percentage reduction in all-cause death rate among adolescents aged 15–19 years was estimated to be 1·3% in males and 1·6% in females, nearly half that of males aged 1–4 years (2·4%), and around a third less than in females aged 1–4 years (2·5%).

• The proportion of worldwide deaths in individuals aged 0–24 years that happened in those aged 10–24 years more than doubled, from 9·5% to 21·6%, between 1950 and 2019.

• COVID-19 pandemic, through its indirect effects, is likely to jeopardise efforts to enhance health outcomes including mortality in young persons aged 10–24 years.