The recent report from the Lancet commission on adolescent health and wellbeing investigates the detrimental effects decades of neglect and insufficient financial resources have had on adolescents aged 10-24 years. The authors warn that the costs of inaction will be enormous and see their findings as an ultimate warning and call for major new investments in the generation of adolescents. Two-thirds of young people grow up in countries where preventable and treatable health problems such as HIV/AIDS, unsafe sex, early pregnancy, injury and violence remain daily threats to their physical wellbeing and life chances. Today, they also face new challenges including rising obesity with its associated risk factors, mental health disorders, high unemployment as well as the risk of radicalisation.
The cohort of adolescents represents over a quarter of the world’s population (1.89 billion), 89% of whom live in developing countries. While global public health efforts have been successfully improving the health of children below the age of five, no similar trend has emerged in older age groups. Global mortality overall has fallen in the adolescent group since 1990, yet in a much slower pace than in young children according to the Global Burden of Disease analysis, published alongside the commission’s report. Moreover, the analysis reveals that:
- The leading causes of death for young people aged 10-14 were HIV/AIDS, road injuries, and drowning (25.2%), whereas transport injuries were the leading cause of death for ages 15-19 (14.2%)
- Maternal disorders were the highest cause of death for young women aged 20-24 years (15.6%)
- Depression affected more than 10% of the 10-24 year-olds in 2013
The fastest-growing risk factor for ill health in young people aged 10-24 over the past 23 years is unsafe sex, while alcohol remains the world’s leading risk factor for ill health in adolescents aged 20-24 responsible for 7% disease burden
Most of these health problems are preventable and the commission stresses that adolescence is a crucial time of formative growth and brain development. Most health problems as well as lifestyle risk factors for disease in later life emerge during these years including obesity, smoking, unsafe sex, and mental health disorders. Adolescents are commonly thought to be healthy and have therefore attracted little interests and too few resources as well as the poorest health-care coverage of any group.
In our daily work we see the growing burden, especially NCDs have on adolescents in the Asia Pacific region and therefore support the authors’ recommendations to improve prospects for adolescent health and wellbeing, such as: expand access to free secondary education, enforce laws that empower and protect adolescents, and continue gathering better evidence for action particularly around mental health and violence.