The pervasiveness of violence in the Region is recognized as one of the most urgent threats to adolescent health and development. The leading cuases of death among people between the ages of 10 and 19 include homicide, suicide, and motor vehicle crashes. In 2000 in the Region of the Americas, the homicide rate among 15 to 29 year-old men and women was 68.6 and 6.4 per 100,000, respectively (compared to high income countries in Europe where the homicide rate only reached 1.7 and .7 per 100,000 men and women, respectively).

Alcohol consumption contributes to a significant portion of physical, social and mental harm. In the Region of the Americas, 4.8% of all deaths and 9.7% of all disability-adjusted years lost in the year 2000 were attributable to alcohol consumption. In 2005 in the Caribbean, 40% of adolescent girls and 50% of adolescent boys 12-18 years old had consumed alcohol and 1 in 10 youth 16-18 years old had consumed four or more alcoholic beverages at once. Approximately 1 in 10 adolescents 13-17 years old had used illegal drugs sometime in their lives.