Adolescent health

July 2015

Key facts

  • More than 2.6 million young people aged 10 to 24 die each year in the world, mostly due to preventable causes.
  • About 16 million girls aged 15 to 19 give birth every year.
  • Young people, 15 to 24 years old, account for 40% of all new HIV infections among adults.
  • In any given year, about 20% of adolescents will experience a mental health problem, most commonly depression or anxiety.
  • An estimated 150 million young people use tobacco.
  • Approximately 430 young people aged 10 to 24 die every day through interpersonal violence.
  • Road traffic injuries cause an estimated 330 young people to die every day.

Overview

  • A great number of young people suffer from illnesses which hinder their ability to grow and develop to their full potential.
  • Many still engage in behaviour that jeopardizes not only their current state of health, but often their health for years to come.
  • Nearly two thirds of premature deaths and one third of the total disease burden in adults are associated with conditions or behaviour that began in their youth, including tobacco and substance use, lack of physical activity, unprotected sex and exposure to violence.
  • Promoting healthy practices during adolescence, and taking steps to better protect young people from health risks is critical to the future of countries’ health and social infrastructure and to the prevention of health problems in adulthood.

An important framework for young people's health is the Millennium Development Goals (MDGs). Two of the MDGs are particularly relevant to young people's health.

  • MDG 5 aims to achieve universal access to reproductive health, for which one of the indicators is the pregnancy rate among 15 to 19 year old girls.
  • MDG 6, to halt the spread of HIV/AIDS, has indicators such as a 25% cut of infections among young people, and also measures the proportion of 15 to 24 year olds with comprehensive and correct knowledge of HIV/AIDS.

Health issues affecting young people

Some of the main health issues affecting young people are described below.

Early pregnancy and childbirth

  • About 16 million girls aged 15 to 19 years give birth every year – roughly 11% of all births worldwide. The vast majority of adolescents’ births occur in developing countries.
  • Adolescent fertility rates are very high (94 births per 1000 adolescent women) in the Lao People’s Democratic Republic and high (between 30 and 53 births per 1000 for women aged 15–19 years) in Cambodia and the Philippinesi.
  • In rural areas of the Lao People’s Democratic Republic, 20.5% of women had their first pregnancy between the ages of 15 and 19; the figure was 8.8% in urban areasii.
  • The risk of dying from pregnancy-related causes is much higher for adolescents than for older women. The younger the adolescent, the greater the risk.
  • The formulation and enforcement of laws that specify a minimum age of marriage, community mobilization to support these laws, and better access to reproductive health services can reduce early pregnancies.
  • Adolescents who become pregnant should be provided with quality antenatal care and skilled birth attendance. Where permitted by law, those adolescents who opt to terminate their pregnancies should have access to safe abortion.

HIV

  • Young people aged from 15 to 24 accounted for an estimated 40% of all new HIV infections among adults worldwide in 2011. Every day, 2400 more young people get infected and globally, more than 5 million young people live with HIV/AIDS.
  • The prevalence of HIV is generally low in most countries of the Region but a trend towards feminization of the epidemic is observed in some countries. In 2012, an estimated 690 000 young people were living with HIV (of whom 46% are female) in Asia and the Pacific.iii Globally, young women aged 15–24 have HIV infection rates twice as high as in young men.
  • In Viet Nam, as in many developing countries, HIV/AIDS is particularly prevalent among young people. More than half of all reported HIV cases are among young people aged 20 to 29.iv
  • Young people need to know how to protect themselves and have the means to do so. This includes condoms to prevent sexual transmission of the virus and clean needles and syringes for those who inject drugs.
  • Currently, only 36% of young men and 24% of young women have the comprehensive and correct knowledge they need to protect themselves from acquiring HIV. Better access to testing and counselling will inform young people about their status, help them to get the care they need, and avoid further spread of the virus.
  • Where social, cultural and economic conditions increase the vulnerability of young people to HIV infection, an effective HIV prevention strategy should aim to address these factors as well.

Malnutrition

  • Many boys and girls in developing countries enter adolescence undernourished, making them more vulnerable to disease and early death. Conversely, overweight and obesity are increasing among young people in all types of countries. Overnutrition represents a big issue, especially in the Pacific island countries, where the prevalence of overweight adolescents can be as high as 50%.
  • Adequate nutrition, healthy eating habits and physical exercise at this age are foundations for good health in adulthood. In addition, it is important to prevent nutritional problems by providing advice, food and micronutrient supplementation (e.g. to pregnant or malnourished adolescents), as well as detecting and managing problems (such as anaemia) promptly and effectively when they occur.

Mental health

  • In any given year, about 20% of adolescents will experience a mental health problem, most commonly depression or anxiety. According to a study in the Philippines, over 42% of students showed signs of depression (feeling hopeless almost every day for two weeks in the past 12 months) while the Malaysian National Mental Health Survey in 2000 found that 49% of Malaysian youth have emotional problems.
  • The risk of depression is heightened by experiences of violence, humiliation, devaluation and poverty. Suicide is one of the leading causes of death in young people.
  • Building life skills in children and adolescents and providing them with psychosocial support in schools and other community settings can help promote mental health.

Tobacco use

  • The vast majority of tobacco users worldwide began when they were adolescents. Today an estimated 150 million young people use tobacco. This number is increasing globally, particularly among young women. Half of those users will die prematurely as a result of tobacco use;.
  • In the Western Pacific Region, Global Youth Tobacco Surveys (1999–2005) found that 15% of boys were current users of tobacco in any form compared with 7.8% of girls.
  • Banning tobacco advertising, raising the price of tobacco products, and laws prohibiting smoking in public places reduce the number of people who start using tobacco products. They also lower the amount of tobacco consumed by smokers and increase the numbers of young people who quit smoking.

Harmful use of alcohol

  • Harmful drinking among young people is an increasing concern in many countries. Alcohol use starts at a young age: 14% of adolescent girls and 18% of boys aged 13–15 years in low- and middle-income countries are reported to use alcohol; in Cambodia, for example, more than 50% of girls aged 10–19 and more than 80% of boys aged 10–19 had ever consumed alcohol.
  • Alcohol abuse reduces self-control and increases risky behaviour. It is a primary cause of injuries (including those due to road traffic accidents), violence (especially domestic violence) and premature deaths.
  • Banning alcohol advertising and regulating access to it are effective strategies to reduce alcohol use by young people. Brief interventions of advice and counselling when alcohol use is detected can contribute to reducing harmful use.

Violence

  • Violence is one of the leading causes of death among young people, particularly males. An estimated 430 young people in the world aged 10 to 24 die every day through interpersonal violence. For each death, an estimated 20 to 40 youths require hospital treatment for a violence-related injury. In the Region, 53 young people aged 15 to 29 die every day from interpersonal violence.
  • Promoting nurturing relationships between parents and children early in life, providing training in life skills, and reducing access to alcohol and lethal means such as firearms help prevent violence.
  • Effective and empathetic care for adolescent victims of violence and ongoing support can help deal with both the physical and the psychological consequences of violence.

Injuries

  • Unintentional injuries are a leading cause of death and disability among young people. Road traffic injuries take the lives of a staggering 700 young people in the world every day. In the Region almost 34 000 young people aged 10–19 die every year from road traffic injuries, or 93 young people every day.
  • Educating young people on driver safety, strictly enforcing laws that prohibit driving under the influence of alcohol and drugs and improving access to reliable and safe public transportation can reduce road traffic accidents among young people. When road traffic crashes occur, prompt access to effective trauma care can be lifesaving.

WHO's response

In May 2014, WHO published a major report, “Health for the world’s adolescents”. It analyses what is known about adolescent health, highlights gaps in policies and services and draws together guidance and recommendations from across WHO.

WHO carries out a range of functions to improve the health of young people:

  • Identifying the most effective ways of promoting good health among young people, preventing health problems and responding to them when they occur.
  • Producing the methods and tools by which evidence can be applied in countries.
  • Ensuring that there are individuals and institutions that can apply these tools in countries.
  • Raising attention to issues among the public at large and among special groups.
  • Building a shared understanding among partners and a shared sense of purpose on what needs to be done.
  • Supporting countries with the formulation of policies and programmes, their implementation, and monitoring and evaluation.

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i World Health Statistics 2015. World Health Organization, 2015.
ii Health of Adolescents in Lao People’s Democratic Republic. World Health Organization Western Pacific Region, 2011.
iiiJoint United Nations Programme on HIV/AIDS. HIV in Asia and the Pacific: UNAIDS report 2013. Bangkok; 2013)
iv HIV/AIDS in Vietnam. Population Reference Bureau, 2007.

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