A new Lancet Commission suggests that adolescent health and wellbeing has been neglected and underinvested with the poorest healthcare coverage of any age group. While global efforts to improve the health of children under 5 have led to major improvements in younger ages, the leading causes of death for young people aged 10-24 years have changed remarkably little from 1990 to 2013.
Maternal disorders were the leading cause of death in young women in 2013, responsible for 17% of deaths in women aged 20-24 and 11.5% in girls aged 15-19. In addition, obesity, mental health conditions and sexual and reproductive health problems, including unsafe sex and early pregnancy, contribute to some of the most dominant health problems in young people
Dr David Richmond, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said:
“The findings of this major study are a stark wake-up call around the importance of protecting the health and wellbeing of young people globally. Behaviours that start in childhood and adolescence can determine health and wellbeing for a lifetime. We must therefore focus on a life-course approach to healthcare, using every interaction a person has with a health service, irrespective of age, to promote health and lifestyle rather than a constant firefight against disease and ill health.
"The study highlights that unsafe sex is the fastest growing risk-factor for ill health among 10-24 year olds and early pregnancy remains a significant threat to a young woman’s health, wellbeing and life chances. We know that approximately 225 million women in the world have no access to family planning and therefore little control over whether and when they become pregnant. Providing these women with the choice to use effective contraception and to space their babies by 24 months or more, would prevent 54 million unintended pregnancies, 79,000 maternal deaths and 1.1 million infant deaths. Our Leading Safe Choices programme is committed to improving women’s health by expanding contraceptive choice, particularly long-acting reversible methods.
“Another challenge that adolescents face today, which can have a significant impact on a woman’s long-term health, is the rising levels of obesity. Obesity during pregnancy has been linked to an increased risk of miscarriage, stillbirth and neonatal death as well as pregnancy complications such as gestational diabetes, blood clots, pre-eclampsia, a more complicated labour, and severe bleeding after the birth. Obesity also impacts on gynaecological health and some cancers are associated with obesity including breast and endometrial cancers. As healthcare professionals, we have a key role in encouraging women to adopt healthy lifestyles through regular moderate physical activity and eating well.
“One in four people will experience a mental health problem at some point in their lifetime. This study highlights more than 10% of 10-24 year olds experience depression and self-harm contributed to 9.3% of deaths in 20-24 year olds. Maternal mental health problems are also a growing epidemic. No woman or girl should suffer in silence and the RCOG is committed to improving care, but also ending the taboo which continues to surround maternal mental health.
“Over the past few decades, global efforts have been made to improve the health of children under 5, however, this study underlines the urgent need to focus on improving the health and reducing the burden of disease among the 1.8 billion adolescents worldwide. A key aspect of this will include education, awareness raising and empowering them to take responsibility for their health.”
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