World’s adolescents – large unmet needs and growing inequalities

Image of students in class
The global study provides the first comprehensive and integrated snapshot of the health and wellbeing of the 1.8 billion adolescents aged 10-24 who make up a third of the world’s population. Image: Doug Linstedt on Unsplash

Today’s adolescents make up the largest generation in history, but a landmark study reveals these young people are encountering greater health challenges than those faced 25 years ago, and investments in their wellbeing have not kept pace with population growth.

The first detailed global study of adolescent health reveals:

  • Growing inequality with a large disease burden in sub-Saharan Africa, Asia and the Pacific
  • Obesity rates have doubled, with countries in the Pacific region having among the highest prevalence
  • Anaemia remains unchecked, India bearing heavy burden
  • Investments in health, education, legal systems have not kept pace with needs
  • Gender inequity is a powerful driver of poor adolescent health.

The global study provides the first comprehensive and integrated snapshot of the health and wellbeing of the 1.8 billion adolescents aged 10-24 who make up a third of the world’s population.

The research, published in The Lancet, builds on the earlier Lancet Commission of Adolescent Health and wellbeing and was led by the Murdoch Children’s Research Institute, the University of Melbourne and the Burnet Institute.

The study tracked the progress of adolescent health in 195 countries between 1990 and 2016 against 12 indicators including tobacco use, obesity, anaemia, secondary school education, child marriage, nutrition and non-communicable diseases.

Lead author, Burnet Institute Co-Head of Adolescent Health Peter Azzopardi, who also holds positions with the Murdoch Children’s Research Institute and the University of Melbourne, said the study exposes the failure of health, education and legal systems to keep up with shifting adolescent needs and demographic change.

“While there have been great improvements in adolescent health in some countries, the greatest population growth has been in countries where adolescents experience the largest disease burden. There are now an extra 250 million adolescents living in these settings compared to 25 years ago,” Dr Azzopardi said.

“Investments in adolescent health have also not kept pace with needs. For example, compared to 1990, there are now 180 million more adolescents overweight and obese, and 75 million more living with anaemia.

“The absolute number of young people not completing secondary education, 300 million, has changed little since 1990, and there remains substantial gender inequality in post education opportunities, with young women three times more likely to not be in employment or training compared to young men,” he said.

Dr Azzopardi said investing in adolescent health provided a “triple dividend” by ensuring the health of adolescents now, in the future, and for their children.

He said the paper, titled ‘Progress in adolescent health and wellbeing: tracking 12 headline indicators for 195 countries and territories, 1990–2016’, would not only help to inform government policy, but would provide many under-resourced, low and middle-income countries with much needed data to identify priorities for health action.

“Many countries in the Asia Pacific region and Sub-Saharan Africa, where the majority of the world’s adolescents live, don’t have access to data describing adolescent health needs. This report describes how they are progressing, but also how they compare with the rest of the world,” Dr Azzopardi said.

Senior author, University of Melbourne Adolescent Health Professor George Patton of the Murdoch Children’s Research Institute, said adolescent health was underfunded and overlooked by many governments.

“Social and digital media, changing diets, urbanisation, armed conflict and migration are some of the forces now shaping adolescent health growth and development, and the world is not keeping up. With a huge rise in the numbers of adolescents growing up in poor countries, the global challenges in adolescent health are now greater than 25 years ago,” Professor Patton said.

“Yet we still do not invest in adolescent health: in low-income countries young people make up around 30 per cent of the population but receive less than two per cent of the world’s health investments,” Professor Patton said.

Dr Azzopardi and Professor Patton said the research reinforced the case for comprehensive and integrated investments in adolescent health, growth, and development.

The paper was funded by Australian National Health and Medical Research Council, and the Bill & Melinda Gates Foundation.

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