Leading causes of death rankings among U.S. adolescents by race and ethnicity: A comparison of two classification schemes

The World Health Organization (WHO) classification scheme for leading causes of death (LCODs) provides greater granularity than the National Center for Health Statistics (NCHS) scheme by subdividing broad categories such as cancer, heart disease, and accidents into 17, 8, and 7 specific groups, respectively. This study compared LCOD rankings among U.S. adolescents aged 10-19 years across racial and ethnic groups using CDC WONDER mortality data. Across 48 sex-age-race/ethnicity-period strata, top-ranked causes differed between schemes in 31 strata. For example, policy priorities for non-Hispanic White boys aged 15-19 years would differ by classification: accidents ranked first under the NCHS scheme, whereas suicide or transportation accidents ranked highest under the WHO scheme. Substantial changes in ranks of top five LCODs across years were observed in some racial/ethnic groups. Among boys aged 10-14 years, transportation accidents rose from third in 2018-2019 to first in 2020-2021 and remained first in 2022-2023 among non-Hispanic Asians, while remaining consistently second among non-Hispanic Black and White boys and first among Hispanic boys. The WHO and NCHS schemes offer complementary LCOD profiles that can guide adolescent mortality surveillance and health policy decision-making.