A series published in The Lancet last Wednesday found that adolescents today face greater risks to their physical and mental health than in the past. The success of childhood survival programs and a greater focus on children’s health means that more youths are entering adolescence. Although this is clearly outstanding news, it means that the programmatic and policy focus must broaden to include the specific challenges faced by adolescents. The Lancet series argues “that it is now time to put the young person, not the specific issue, centre stage” and to elevate the “marginalised subspeciality” of adolescent health.
With the advent of globalization, youths are more likely to choose lifestyles that put them at greater risk for non-communicable diseases. Furthermore, risky behaviors, unprotected sex, alcohol and drugs, violence, mental illness, and traffic accidents remain major barriers to adolescent health and well-being. UNICEF released a concurrent report card on adolescents that gives a global breakdown of adolescent health, education, and social norms. As The Lancet pointed out, the “worst adolescent health profiles” come from the sub-Saharan Africa region. In this region, diseases such as HIV and malaria, societal norms such as early marriages and pregnancies, and behaviors that can lead to non-communicable diseases have converged. In fact, despite the hullabaloo in the American press about childhood and teen obesity (which is still a major issue), adolescents from low- and middle-income countries are the most likely to engage in behavior that puts them at risk for non-communicable diseases. However, adolescents everywhere need more support, and more must be done in the global health sector to prevent risky behavior, understand mental health vulnerabilities, and address harmful social norms at such a formative time in the lives of between one and two billion people.
Adolescence is a tumultuous time. Between childhood and adolescence, teens around the world are asked to take on greater responsibilities, often before they’re ready mentally or physically. For example, more than one in 10 girls in developing countries is married before she is 15. Neuropsychiatric disorders (including substance abuse) and unintentional injuries are the leading causes of disability among teenagers. Social pressure from parents and the community and from peers can lead to risky choices. Overall, adolescence tends to set the stage for life: smoking, diet, mental health, education, exercise, pregnancy, STIs, and so on, will all dictate good health and well-being in the future, and furthermore, how a person will be able to engage with and contribute to society. We’ve made great strides to ensure that children are growing up to be teenagers. Although we should not lose our focus on child survival, we must broaden our vision to include adolescents so that we can also ensure that those teenagers grow up to be adults.