Has the Epidemiological Transition Occurred in Children? Fifty Years After Omran’s Theory

<ns3:p>Background The epidemiological transition theory, originally centred on adult mortality, has been insufficiently examined in children and adolescents, who exhibit distinct disease patterns and vulnerabilities. Methods Using data from the Global Burden of Disease Study (1990–2019), we analysed trends in mortality, prevalence, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) among individuals aged 0–19 years. Health outcomes were grouped into communicable, maternal, neonatal, and nutritional conditions (CMNNCs); non-communicable diseases (NCDs); and injuries, and were stratified by age, sex, and Sociodemographic Index (SDI). Results We observed substantial overall improvements in global child and adolescent health, reflected in declining mortality across all age groups, particularly among infants. While CMNNCs markedly decreased, the burden of NCDs persisted or increased in several settings. Injuries also emerged as a rising cause of mortality in specific SDI groups and older children. The trajectory and pace of the epidemiological transition varied markedly by age and level of country development. Conclusion Our findings indicate an incomplete epidemiological transition in children and adolescents, characterised by the continued burden of CMNNCs alongside rising NCDs and injuries, especially in older age groups and lower-SDI countries. These patterns underscore the need for context-specific health policies and interventions to address the evolving landscape of child and adolescent health.</ns3:p>