WHO calls for stronger focus on adolescent health

KARACHI: WHO’s “Health for the world’s adolescents” report reveals that depression is the predominant cause of illness and disability for both boys and girls aged 10 to 19 years. The top 3 causes of adolescent deaths globally are road traffic injuries, HIV/AIDS, and suicide. Worldwide, an estimated 1.3 million adolescents died in 2012.

Drawing on a wealth of published evidence and consultations with 10 to 19-year-olds around the world, the report also brings together, for the first time, all WHO guidance on the full spectrum of health issues affecting adolescents. These include tobacco, alcohol and drug use, HIV, injuries, mental health, nutrition, sexual and reproductive health, and violence. The report recommends key actions to strengthen the ways countries respond to adolescents’ physical and mental health needs.

“The world has not paid enough attention to the health of adolescents,” says Dr Flavia Bustreo, Assistant Director-General for Family, Women and Children’s Health, WHO. “We hope this report will focus high-level attention on the health needs of 10 to 19-year-olds and serve as a springboard for accelerated action on adolescent health.”

Road traffic injuries are the number 1 cause of adolescent deaths globally, and the number 2 cause of illness and disability. Boys are disproportionately affected, with more than three times the rate of deaths than that of girls. Increasing access to reliable and safe public transport can reduce road traffic injuries among adolescents. Road safety regulations (e.g. alcohol and speed limits), establishing safe pedestrian areas around schools, and graduated licensing schemes where drivers privileges are phased in over time, can all reduce risks.

Globally, depression is the number 1 cause of illness and disability in this age group, and suicide ranks number 3 among causes of death. Some studies show that half of all people who develop mental disorders have their first symptoms by the age of 14. If adolescents with mental health problems get the care they need, this can prevent deaths and avoid suffering throughout life.

Deaths due to complications of pregnancy and childbirth among adolescents have dropped significantly since 2000, particularly in regions where maternal mortality rates are highest. WHO’s South-East Asia, Eastern Mediterranean and African Regions have seen estimated declines of 57%, 50% and 37%, respectively. Despite these improvements, maternal mortality still ranks second among causes of death among 15 to 19-year-old girls globally, exceeded only by suicide.

Estimates suggest that the number of HIV-related deaths among adolescents is rising. The increase is predominantly in the African Region, at a time when HIV-related deaths are decreasing in all other population groups. HIV now ranks as the second cause of deaths in adolescents globally.

Thanks to childhood vaccination, adolescent deaths and disability from measles have fallen markedly—by 90% in the African Region between 2000 and 2012. However, common infectious diseases that have been a focus for action in young children are still killing adolescents. For example, diarrhoea and lower respiratory tract infections now rank second and fourth among causes of death in 10 to 14-year-olds. Combined with meningitis, these conditions account for 18% of all deaths in this age group, little changed from 19% in 2000.

New data from countries where surveys have been done show that fewer than 1 in every 4 adolescents does enough exercise (WHO recommends at least one hour of moderate to vigorous exercise per day), and in some countries as many as 1 in 3 is obese.

But some trends in adolescent health-related behaviours are improving. For example, rates of cigarette smoking are decreasing among younger adolescents in most high-income countries and in some middle- and low-income countries as well.

Adolescence is an important time for laying the foundations of good health in adulthood. Many health-related behaviours and conditions that underlie the major noncommunicable diseases start or are reinforced during this period of life.

“If left unchecked, health problems and behaviours that arise during adolescence—such as tobacco and alcohol use, diet and exercise patterns, overweight and obesity—have a serious impact on the health and development of adolescents today, and potentially devastating effects on their health as adults tomorrow,” says Jane Ferguson, Scientist in WHO’s Department of Maternal, Newborn, Child and Adolescent Health and lead author of the report. “At the same time, we must not let up on efforts to promote and safeguard the sexual and reproductive health of adolescents, including HIV.”

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