Young People’s Health: Filling in the Blanks

November 3, 2009

This is a joint post with Miriam Temin.

When the Lancet published “Global patterns of mortality in young people: a systematic analysis of population health data” by George Patton et al., it brought into the public domain new data to tell an important story: adolescent boys and girls are at risk during this transitional life phase, and those risks have major implications for the health and well-being of this and the next generation.

The article highlights just how much boys’ and girls’ lives diverge with adolescence and how gender fundamentally affects health. Traffic accidents cause 14 percent of deaths among males 10-24 years old deaths but only 5 percent of female deaths; violence causes 12 percent of male deaths but doesn’t even feature in the “top ten” for females. For girls and young women, the major causes of death are maternal factors, at 15 percent.

The study improves upon earlier research that did not break down data by age and sex, but we’re still a long way from having a full picture of the health of teens. Because the focus is on causes of death – a relatively rare event in adolescent populations – it offers only incomplete and indirect evidence about the full burden of disease, which includes sickness and disability as well as fatalities. For adolescents, perhaps even more than for the infants and children, what matters most is found in the day-to-day assaults on wellbeing, rather than deaths.

We’re talking about the non-fatal diseases that affect adolescents, often with serious current and long term consequences. For girls, anemia, human papilloma virus, and other untreated sexually transmitted infections precede a cascade of health problems at older ages and among their future children. Girls and women pass health problems on to their children, an unfortunate legacy exacerbated when girls become mothers before age 18 – a common situation in many developing countries. Unhealthy girls make for continuing cycles of ill health and gender inequality.

We’re also talking about the life-long health behaviors established in the teenage years (and even earlier). Patterns of eating, physical activity, sexual behavior, tobacco and drug use among today’s adolescents underlie a large part of WHO’s prediction that non-communicable health problems will cause more than three-quarters of all deaths in 2030.

It’s an adolescent world out there and without more focused attention on young people, spirals of ill health, poverty, and gender discrimination will persist. As noted in the Lancet, many of the health problems of adolescent girls, and indeed boys, are preventable; proven solutions are available. The opportunity to do something grand with a new agenda for global health is at our fingertips: start with a girl and the rest will follow.

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3 Responses to “Young People’s Health: Filling in the Blanks”

L A W Says:
November 4th, 2009 at 1:14 am

Great points, Ruth. Whether one points to the lucrative youth market for tobacco or the rising rates of STIs among teenagers, the data is increasingly clear that adolescents throughout the world are adopting all sorts of unhealthy behaviors.

The real driver of this problem that policymakers and parents continue to ignore is obvious: adolescent behavior is largely shaped by information– or a woeful lack thereof! The title of your post rings true for those who work with adolescents in developing countries– there are a lot of blanks in teenagers’ understanding of the world that desperately need filling in by reliable medical sources.

Predictably, unsafe sex and substance abuse among young people are in part due to increased freedom from parental surveillance, which widens the array of choices available to them regarding leisure and consumption. But more importantly, most young people have a very minimal understanding of the health consequences of these increasingly typical behaviors.

Many young women, especially, are shockingly unaware of how their reproductive systems work, often relying on male partners to make the decisions about “safe” sex practices. At the Indonesian Planned Parenthood Association, where I am currently based, I regularly meet with sexually active teenagers who have no knowledge of STIs and rely on coitus interruptus as their default form of birth control. It’s no wonder, then, that unsafe abortion remains a major determinant of mortality among women of reproductive age, nor that nearly half of HIV/AIDS cases in this country are reported among young people ages 15-29.

I have great faith in adolescents’ abilities to make healthy choices for themselves, but they must first have the information necessary to inform their decisions. Cigarettes and chlamydia are not the greatest threats to a young person’s health– ignorance is.

It’s time donors and governments started investing in substantive, practical health education that will provide real answers to our questions about young people’s futures.
Kun Says:
November 4th, 2009 at 2:10 pm

I think one of the fundamental tasks for development project is to keep people healthy in developing countries. It is disheartening to know that some diseases that should be preventable but take many teenagers’ lives in Africa. What’s worse, as the article said, unhealthy women are likely to pass their problems on to their children. I once watched a documentary about water at class. It showed that many regions in poor countries are unable to clean water. It’s doubtless that contaminated water should be blamed for the poor health condition. Concert efforts including infrastructure building and health education should reach poor regions as many as possible, not only to save the teenagers, but all in need! Without health, it’s meaningless to mention development.
GCAntunes Says:
November 8th, 2009 at 9:24 pm

I think we are all familiar with one impact of globalization on women: the feminization of labor. The 12, 14, or 16 hour days, 24/7, no benefits, no bathroom breaks, sexual harassment and abuse, tolerated by women, young women, and girls working in factories, flower farmers, etc. The ramifications on a women’s health, as we can imagine, are at worst, deadly and at best, outlined in this blog. If the global community is committed to global health, women and poverty reduction, then ameliorating/changing/investing not only in women’s working conditions but, the very locations they are employed and education for women should be at the top of the list. If the global community actively chooses to perpetuate the current trends, then can we identify globalization in light of global health as a success story?