Adolescents: health risks and solutions
Fact sheet
Updated May 2017
Key facts
- Estimated 1.2 million adolescents died in 2015, over 3000 every day, mostly from preventable or treatable causes.
- Road traffic injuries were the leading cause of death in 2015.
Other major causes of adolescent deaths include lower respiratory
infections, suicide, diarrhoeal diseases, and drowning.
- Globally, there are 44 births per 1000 to girls aged 15 to 19 per year.
- Half of all mental health disorders in adulthood start by age 14, but most cases are undetected and untreated.
Around 1.2 billion people, or 1 in 6 of the world’s population, are adolescents aged 10 to 19.
Most are healthy, but there is still substantial premature
death, illness, and injury among adolescents. Illnesses can hinder their
ability to grow and develop to their full potential. Alcohol or tobacco
use, lack of physical activity, unprotected sex and/or exposure to
violence can jeopardize not only their current health, but also their
health as adults, and even the health of their future children.
Promoting healthy behaviours during adolescence, and taking
steps to better protect young people from health risks are critical for
the prevention of health problems in adulthood, and for countries’
future health and ability to develop and thrive.
Main health issues include:
Early pregnancy and childbirth
The leading cause of death for 15– 19-year-old girls globally is complications from pregnancy and childbirth.
Some 11% of all births worldwide are to girls aged 15–19
years, and the vast majority of these births are in low- and
middle-income countries. The UN Population Division puts the global
adolescent birth rate in 2015 at 44 births per 1000 girls this age –
country rates range from 1 to over 200 births per 1000 girls
(1).
This indicates a marked decrease since 1990. This decrease is reflected
in a similar decline in maternal mortality rates among 15–19 year olds.
One of the specific targets of the health Sustainable
Development Goal (SDG 3) is that by 2030, the world should ensure
universal access to sexual and reproductive health-care services,
including for family planning, information and education, and the
integration of reproductive health into national strategies and
programmes. To support this, a proposed indicator for the
Global strategy for women’s, children’s and adolescents’ health is the adolescent birth rate.
Better access to contraceptive information and services can
reduce the number of girls becoming pregnant and giving birth at too
young an age. Laws that specify a minimum age of marriage at 18 and
which are enforced can help.
Girls who do become pregnant need access to quality antenatal
care. Where permitted by law, adolescents who opt to terminate their
pregnancies should have access to safe abortion.
HIV
More than 2 million adolescents are living with HIV. Although
the overall number of HIV-related deaths is down 30% since the peak in
2006 estimates suggest that HIV deaths among adolescents are rising.
This increase, which has been predominantly in the WHO African Region,
may reflect the fact that although more children with HIV survive into
adolescence, they do not all then get the care and support they need to
remain in good health and prevent transmission. In sub-Saharan Africa
only 10% of young men and 15% of young women aged 15 to 24 are aware of
their HIV status.
One of the specific targets of the health Sustainable
Development Goal (SDG 3) is that by 2030 there should be an end to the
epidemics of AIDS, tuberculosis, malaria and neglected tropical
diseases, hepatitis, water-borne diseases and other communicable
diseases. Given the high prevalence of HIV in many countries, to achieve
this, adolescents will need to be central to control efforts.
Young people need to know how to protect themselves and must
have the means to do so. This includes being able to obtain condoms to
prevent sexual transmission of the virus and clean needles and syringes
for those who inject drugs. Better access to HIV testing and
counselling, and stronger subsequent links to HIV treatment services for
those who test HIV positive, are also needed.
Other infectious diseases
Thanks to improved childhood vaccination, adolescent deaths
and disability from measles have fallen markedly – for example, by 90%
in the African Region between 2000 and 2012. Diarrhoea and lower
respiratory tract infections are estimated to be among the top 5 causes
of death for 10–19 year olds. These two diseases, together with
meningitis, are the top three causes of adolescent death in African low
and middle-income countries (LMICs).
Mental health
Depression is the third leading cause of illness and
disability among adolescents, and suicide is the third leading cause of
death in older adolescents (15–19 years). Violence, poverty, humiliation
and feeling devalued can increase the risk of developing mental health
problems.
Building life skills in children and adolescents and providing
them with psychosocial support in schools and other community settings
can help promote good mental health. Programmes to help strengthen the
ties between adolescents and their families are also important. If
problems arise, they should be detected and managed by competent and
caring health workers.
Violence
Violence is a leading cause of death in older adolescent
males. Interpersonal violence represents 43% of all adolescent male
deaths in LMICs in the WHO Americas Region. Globally, 1 in 10 girls
under the age of 20 years report experiencing sexual violence.
Promoting nurturing relationships between parents and children
early in life, providing training in life skills, and reducing access
to alcohol and firearms can help to prevent injuries and deaths due to
violence. Effective and empathetic care for adolescent survivors of
violence and ongoing support can help deal with the physical and
psychological consequences.
Alcohol and drugs
Harmful drinking among adolescents is a major concern in many
countries. It reduces self-control and increases risky behaviours, such
as unsafe sex or dangerous driving. It is a primary cause of injuries
(including those due to road traffic accidents), violence (especially by
a partner) and premature deaths. It can also lead to health problems in
later life and affect life expectancy. Setting a minimum age for buying
and consuming alcohol and regulating how alcoholic drinks are targeted
at the younger market are among the strategies for reducing harmful
drinking.
Drug use among 15–19 year olds is also an important global
concern. Drug control may focus on reducing drug demand, drug supply, or
both, and successful programmes usually include structural, community,
and individual-level interventions.
Injuries
Unintentional injuries are the leading cause of death and
disability among adolescents. In 2015, over 115 000 adolescents died as a
result of road traffic accidents. Young drivers need advice on driving
safely, while laws that prohibit driving under the influence of alcohol
and drugs need to be strictly enforced. Blood alcohol levels need to be
set lower for teenage drivers. Graduated licences for novice drivers
with zero-tolerance for drink-driving are recommended.
Drowning is also a major cause of death among adolescents – 57
000 adolescents, two-thirds of them boys, are estimated to have drowned
in 2015, and teaching children and adolescents to swim is an essential
intervention to prevent these deaths.
Malnutrition and obesity
Many boys and girls in developing countries enter adolescence
undernourished, making them more vulnerable to disease and early death.
At the other end of the spectrum, the number of adolescents who are
overweight or obese is increasing in low, middle and high-income
countries.
Exercise and nutrition
Iron deficiency anaemia is the leading cause of years lost to
death and disability in 2015. Iron and folic acid supplements are a
solution that also helps to promote health before adolescents become
parents. Regular deworming in areas where intestinal helminths such as
hookworm are common is recommended to prevent micronutrient (including
iron) deficiencies.
Developing healthy eating and exercise habits in adolescence
are foundations for good health in adulthood. Reducing the marketing of
foods high in saturated fats, trans-fatty acids, free sugars, or salt
and providing access to healthy foods and opportunities to engage in
physical activity are important for all but especially children and
adolescents. Yet available survey data indicate that fewer than 1 in
every 4 adolescents meets the recommended guidelines for physical
activity: 60 minutes of moderate to vigorous physical activity daily.
Tobacco use
The vast majority of people using tobacco today began doing so
when they were adolescents. Prohibiting the sale of tobacco products to
minors and increasing the price of tobacco products through higher
taxes, banning tobacco advertising and ensuring smoke-free environments
are crucial. Globally, at least 1 in 10 adolescents aged 13 to 15 years
uses tobacco, although there are areas where this figure is much higher.
Cigarette smoking seems to be decreasing among younger adolescents in
some high-income countries.
Rights of adolescents
The rights of children (people under 18 years of age) to
survive, grow and develop are enshrined in international legal
documents. In 2013, the Committee on the Rights of the Child (CRC),
which oversees the child rights convention, published guidelines on the
right of children and adolescents to the enjoyment of the highest
attainable standard of health, and a General Comment on realizing the
rights of children during adolescence was published in 2016. It
highlights states’ obligations to recognise the special health and
development needs and rights of adolescents and young people.
The Convention on the Elimination of Discrimination Against
Women (CEDAW) also sets out the rights of women and girls to health and
adequate health care.
WHO response
In May 2017, WHO published a major report:
Global Accelerated Action for the Health of Adolescents (AA-HA!): Guidance to support country implementation.
The AA-HA! Guidance has drawn on inputs received during extensive
consultations with Member States, United Nations agencies, adolescents
and young people, civil society and other partners. It aims to assist
governments in deciding what they plan to do and how they plan to do it
as they respond to the health needs of adolescents in their countries.
This reference document targets national-level policy-makers and
programme managers to assist them in planning, implementing , monitoring
and evaluation of adolescent health programmes.
Overall, WHO carries out a range of functions to improve the health of young people, including:
- production of evidence-based guidelines to support health services and other sectors;
- making recommendations to governments on adolescent health and
the provision of high quality, age-appropriate health services for
adolescents;
- documenting progress in adolescent health and development; and
- raising awareness of health issues for young people among the general public and other interested stakeholders.
References
