The data-poor lives of ado­les­cents

Financial Mirror (Cyprus) - - FRONT PAGE -

Data can save lives. With­out it, we wouldn’t know that smok­ing causes lung can­cer and coronary dis­ease, that hel­mets re­duce death rates for mo­tor­cy­cle ac­ci­dents, and that bet­ter ed­u­ca­tion for women im­proves child sur­vival – and much else. Given the im­por­tance of re­li­able data, col­lect­ing it must be a high pri­or­ity.

One area where data col­lec­tion is par­tic­u­larly in­ad­e­quate is ado­les­cent health. Peo­ple aged ten to 24 re­ceive far less at­ten­tion than other age groups. More broadly, as the new Lancet Com­mis­sion on Ado­les­cent Health and Well­be­ing high­lights, global health and so­cial pol­icy largely tends to ig­nore ado­les­cent health.

In many ways, our fu­ture depends on the health of our ado­les­cents. In low- and mid­dle-in­come coun­tries, there are more ado­les­cents than ever be­fore. And their health to­day will af­fect their fu­ture well­be­ing, shap­ing their abil­ity to earn a liv­ing, pro­duce and raise healthy chil­dren, care for aging par­ents, and lead their societies to­ward peace and pros­per­ity.

By en­abling gov­ern­ments and oth­ers to de­sign ef­fec­tive and tar­geted health pro­grammes for ado­les­cents, data on ado­les­cent health can play a crit­i­cal role in se­cur­ing a bet­ter fu­ture. The first step is to find out where, why, and how many ado­les­cents are dy­ing.

Myr­iad sur­veys con­ducted in re­cent decades have aimed specif­i­cally to de­ter­mine death rates among adults and chil­dren un­der the age of five. Yet those in be­tween are not specif­i­cally ad­dressed, mak­ing it very dif­fi­cult to track ado­les­cent deaths in coun­tries that lack ad­e­quate sys­tems for civil reg­is­tra­tion and record­ing of vi­tal statis­tics.

To ad­dress this short­com­ing, donors and gov­ern­ments should fund the devel­op­ment of sur­vey meth­ods to mea­sure ado­les­cent death rates. Ques­tions de­signed to elicit the needed in­for­ma­tion could be in­cor­po­rated into sur­veys al­ready be­ing con­ducted reg­u­larly in low- and mid­dle-in­come coun­tries, such as the De­mo­graphic and Health Sur­veys and Mul­ti­ple In­di­ca­tor Clus­ter Sur­veys.

Of course, we also need data about ado­les­cents dur­ing their lives – ideally, data that come from the ado­les­cents di­rectly. As it stands, in­di­vid­u­als un­der the age of 15 are gen­er­ally ex­cluded from house­hold sur­veys. And while school sur­veys are con­ducted in some coun­tries, fund­ing con­straints of­ten mean that they are car­ried out in­fre­quently. More prob­lem­atic, school-based sur­veys in low- and mid­dlein­come coun­tries typ­i­cally ex­clude those who are not in school, whether be­cause they dropped out or never en­rolled at all.

Gov­ern­ments and donors must there­fore also work to de­velop and carry out tar­geted sur­veys of ado­les­cents. Among other things, such sur­veys should aim to cre­ate a clear pic­ture of ado­les­cents’ ex­po­sure to avoid­able risk fac­tors, such as al­co­hol and il­licit drug use, un­safe sex­ual be­hav­iours, vi­o­lence, obe­sity, phys­i­cal in­ac­tiv­ity, and un­healthy diet.

To com­ple­ment this ef­fort, we must also im­prov­ing our un­der­stand­ing of how th­ese risk in­vest in fac­tors – most of­ten stud­ied in con­nec­tion with early child­hood and adult­hood – af­fect ado­les­cents’ health. Ac­cord­ing to the Global Bur­den of Dis­ease Study, health risk fac­tors ex­plain at least 50% of the early death and dis­abil­ity of adults aged 50 and over; for young peo­ple, the fig­ure drops to 26%. More stud­ies are needed to in­form health pol­icy and plan­ning ad­e­quately.

The data-col­lec­tion ef­fort should also in­clude a fo­cus on men­tal health. The Global Bur­den of Dis­ease Study has es­ti­mated that, in 2013, de­pres­sion was one of the top three causes of ado­les­cent fe­males’ loss of healthy years, and one of the top seven causes of lost healthy years in ado­les­cent males.

Yet the data on men­tal health for in­di­vid­u­als un­der the age of 18 are poor, par­tic­u­larly in low-in­come coun­tries, and what is avail­able is not com­pa­ra­ble across coun­tries. It is thus im­per­a­tive that gov­ern­ments and donors in­vest in build­ing an ex­pert con­sen­sus on how best to mea­sure men­tal health and im­ple­ment those meth­ods glob­ally, in­clud­ing in low-resource set­tings.

Be­fore long, to­day’s ado­les­cents will be run­ning the world. If they are to lead it well, they need to be healthy. And we need to in­vest in col­lect­ing the data that are so essential to en­sur­ing that they are.

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